作　　者： (张俊）; (周丁屹）; (谢丛华）; (刘晖）; (周福祥）; (钟亚华）; (戴静）; (周云峰）;

机构地区： 武汉大学中南医院放疗科,430071

出　　处： 《中华放射肿瘤学杂志》 2017年第9期1067-1071,共5页

摘　　要： 目的 探讨CT值变化对剂量计算影响,初步寻找一种解决MRI电子密度信息缺失方法。方法 选取头颈、胸部、盆腔部位肿瘤患者各10例CT图像,对各部位主要组织器官CT值随机采样,统计其平均值进行CT值区间划分。在瓦里安Eclipse TPS中构建虚拟模体,给予处方剂量1 Gy记录不同CT值下机器输出剂量,并分析不同CT值区间对剂量计算结果影响。选取5例宫颈癌患者IMRT计划,对靶区、OAR进行CT值分配形成新CT图像,在新CT图像上进行计划移植并与患者原CT图像结果进行剂量学参数比较。结果 通过区间法对CT值进行划分,并在剂量计算中验证,计算出人体不同组织对应的CT值区间为-100~100 HU,CT值变化对剂量计算的影响在3%以内。相同计划下新合成CT图像与原CT图像剂量学参数差异较小,PTV的Dmax、Dmean、D98%、D95%、D5%、D2%均〈3%,膀胱、直肠、小肠、股骨头、骨髓的Dmax、Dmean均〈2%。结论 CT值划分法对盆腔肿瘤治疗计划剂量计算结果影响在可接受范围内,对解决MRI电子密度信息缺失具有一定可行性。 Objective To divide computed tomography （CT） values into different ranges and investigate the influence of CT value division on dose calculation, and to propose a method to combine magnetic resonance imaging （MRI） with assigned CT values. Methods Ten CT images each were collected from patients with head and neck, chest, and pelvic tumors. Random sampling was performed for the CT values of main tissues or organs at the three parts, and then the mean CT value of each tissue or organ was calculated to divide the CT values into different ranges. A virtual phantom was built in the Varian Eclipse treatment planning system, and for the prescribed dose of 100 cGy, the machine output was recorded at different CT values. The influence of different CT value ranges on dose calculation was analyzed. The treatment plans of intensity-modulated radiotherapy were selected from 5 cervical cancer patients, and new CT values were assigned to the planning target volume （PTV） and organs at risk to obtain new CT images. The plans were transferred to the new CT images and compared with the results on the original CT images in terms of dosimetric parameters. Results After dividing the CT values into different ranges and verifying the results in dose calculation, the CT values corresponding to different human tissues or organs were -100 to 100 HU. The influence of CT value variation on dose calculation was within 3%. In the same treatment plan, there were small differences in dosimetric parameters between new CT images and original CT images. Dmax, Dmean, D98%, D95%, D5%, and D2% of PTV were all below 3%, and Dmax and Dmean of the bladder, rectum, small intestine, femoral head, and bone marrow were below 2%. Conclusions The influence of CT value division on dose calculation in the treatment planning for pelvic tumors is acceptable, so it can be used in combination with MRI.

关 键 词： 体层摄影术 线计算机 剂量计算 治疗计划系统 磁共振成像