MRI与4DCT联合指导勾画原发性肝癌患者放疗靶区初步研究*

doi:10.3969/j.issn.1672-5069.2022.04.028

Abstract

Abstract: Objective The purpose of this study was o evaluate magnetic resonance imaging (MRI)and 4-d computed tomography (4DCT) images in the delineation of target area in patients with primary liver cancer (PLC) undergoingfirst radiotherapy. Methods 56 patients with PLC were admitted to our hospital between May 2019 and May 2021, and all patients tended to receive radiotherapy. Before treatment, the patients underwent MRI and 4DCT examinations respectively, and the images were up-loaded to the workstation. After the automatic registration,the Reg Reveal and Reg Refine were applied for further preciseregistration, the image quality was assessed and local regionof interest (ROI) was locked. The tumor target volume and large body target volume in differentstage of 4DCT images were compared before and after registration. The registration accuracy of T2 weighted image (MR-T2) and 4DCT image was observed. Results After 4DCT registration, the tumor target volume atCT₀₀, CT₁₀, CT₂₀, CT₃₀, CT₄₀, CT₅₀, CT₆₀, CT₇₀, CT₈₀ and CT₉₀ were (389.8±52.5)cm³,(393.4±59.7)cm³,(390.7±50.3)cm³,(388.5±47.8)cm³,(380.4±40.5)cm³,(379.2±40.6)cm³,(383.7±43.3)cm³,(380.2±41.7)cm³,(371.0±38.9)cm³ and (381.7±36.6)cm³, all significantly larger than [(365.7±29.0)cm³,(360.5±29.2)cm³,(347.4±24.9)cm³,(350.2±27.2)cm³,(351.4±28.5)cm³,(358.4±29.3)cm³,(361.5±34.7)cm³,(357.5±28.8)cm³,(350.3±36.6)cm³ and (355.0±34.9)cm³, P＜0.05] before registration; after registration, the large body target volume in the 56 patients with PLC was (468.7±226.2)cm³, significantly larger than [(410.5±192.5)cm³, P＜0.05] before registration; after Reg Refine registration by portal vain or byceliac trunk, the shift at X, Y, Z axis were (0.3±0.1)mm, (0.6±0.2)mm and (0.5±0.2)mm, or (0.7±0.2)mm, (0.7±0.3)mm and (0.6±0.2)mm, all significantly smaller than [(3.3±0.4)mm, (4.9±0.5)mm and (4.2±0.4)mm or (3.4±0.3)mm, (3.7±0.4)mm and (3.2±0.4)mm, respectively, P＜0.05] by automatic registration; the liver volume in MR-T2 image was (2002.4±843.7) cm³, the liver volume in 4DCT image was (2048.7±937.2) cm³, and the overlap of liver volume was (110.2±22.7)%. Conclusion Thecombination of MT-T2 and 4DCT for precise delineation of tumor target in patients withPLC before first radiotherapy could help get accurate tumor targets, which might improve the therapy efficacy.

Key words: Hepatoma, Magnetic resonance imaging, Four-dimensional computed tomography, Radiotherapy, Target delineation, Deformation registration

Wang Yuanping, Zheng Lulu, Zhang Guangliang. A pilot study of MR and 4DCT images in the delineation of target area in patients with primary liver cancer undergoing first radiotherapy[J]. Journal of Practical Hepatology, 2022, 25(4): 567-570.

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A pilot study of MR and 4DCT images in the delineation of target area in patients with primary liver cancer undergoing first radiotherapy

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