非小细胞肺癌放疗前应用CT与MRI勾画靶区的临床价值分析
|
摘要
目的探究体层摄影(CT)与磁共振成像(MRI)应用于非小细胞肺癌(NSCLC)患者放疗前靶区勾画的临床价值。方法回顾性分析146例NSCLC放疗患者临床资料,根据靶区勾画借助影像学方法不同分为CT组(n=74)与MRI组(n=72)。以分析两组勾画体积[大体肿瘤体积(GTV)、临床靶区体积(CTV)、计划靶区体积(PTV)]及肺辐照剂量[剂量≥5Gy体积分数(V5)、V20、平均肺受量(MLD)]差异。结果 CT组GTV、CTV、PTV、V5、V20水平均明显高于MRI组(P<0.05),而两组MLD水平比较则无统计学意义(P>0.05)。结论 NSCLC患者放疗前应用MRI相对于CT勾画出靶区体积更小,指导辐照方案更为精准,可降低正常肺组织辐射损伤风险,对提高其放疗效率与安全性有利。
Objective To study the clinical value of computed tomography(CT) and magnetic resonance imaging(MRI) in the delineation of target area of patients with nonsmall cell lung cancer(NSCLC) before radiotherapy. Methods The clinical data of 146 patients with NSCLC radiotherapy were retrospectively analyzed. They were divided into CT group(n=74) and MRI group(n=72) according to different imaging methods for target area delineation. The delineation volume [gross tumor volume(GTV), clinical target volume(CTV), planned target volume(PTV)] and lung irradiation dose [dose≥5 Gy volume fraction(V5), V20, mean lung DOSE(MLD)] were analyzed in the two groups.Results The levels of GTV, CTV, PTV, V5 and V20 in CT group were significantly higher than those in MRI group(P<0.05), but there was no significant difference in the MLD level between the two groups(P>0.05). Conclusion In patients with NSCLCbefore radiotherapy, MRI has smaller delineated target area than CT, and has more accurate guiding irradiation regimen, and it can reduce the risk of radiation damage in normal lung tissues, and it is beneficial to improve the efficacy and safety of radiotherapy.
Objective To study the clinical value of computed tomography(CT) and magnetic resonance imaging(MRI) in the delineation of target area of patients with nonsmall cell lung cancer(NSCLC) before radiotherapy. Methods The clinical data of 146 patients with NSCLC radiotherapy were retrospectively analyzed. They were divided into CT group(n=74) and MRI group(n=72) according to different imaging methods for target area delineation. The delineation volume [gross tumor volume(GTV), clinical target volume(CTV), planned target volume(PTV)] and lung irradiation dose [dose≥5 Gy volume fraction(V5), V20, mean lung DOSE(MLD)] were analyzed in the two groups.Results The levels of GTV, CTV, PTV, V5 and V20 in CT group were significantly higher than those in MRI group(P<0.05), but there was no significant difference in the MLD level between the two groups(P>0.05). Conclusion In patients with NSCLCbefore radiotherapy, MRI has smaller delineated target area than CT, and has more accurate guiding irradiation regimen, and it can reduce the risk of radiation damage in normal lung tissues, and it is beneficial to improve the efficacy and safety of radiotherapy.
引文
[1]王书航,王洁.2018年V3版NCCN非小细胞肺癌指南更新要点解读[J].华西医学,2018,33(4):388-392.
[2]周玉凤,夏淦林.18F-FDGPET-CT显像对非小细胞肺癌术前区域淋巴结诊断及分期的临床价值[J].中国CT和MRI杂志,2014,12(3):70-74.
[3] YanX,LiuH,ChenJ,etal.Comparisons between the National Comprehensive Cancer Network(NCCN)non-small-celllung cancer(NSCLC)Clinical PracticeGuidelines(Chinese version),theNCCNoriginal edition,andtheEuropean SocietyforMedicalOncology NSCLCGuidelinesin2009[J].ThoracicCancer,2010,1(2):83-86.
[4]李奉祥,李建彬,邵倩,等.基于三种CT图像勾画的非小细胞肺癌靶体积比较研究[J].中华放射肿瘤学杂志,2013,22(4):286-290.
[5]王振军,曲金荣,黎海亮,等.MR压脂T2WI/DWI及增强CT对肺癌与肺不张组织的显像效果[J].山东医药,2015,55(15):73-74.
[6]王澜,刘丽虹,韩春,等.依据CT及MRI确定区域淋巴结转移的病理对照研究[J].中华放射肿瘤学杂志,2015,24(5):493-496.
[7]库雷志,马明平,俞顺,等.扩散加权成像表观扩散系数值在不同类型肺癌鉴别中的价值[J].中国医学影像学杂志,2016,24(6):459-463.
[8]蒋洁智,丁莹莹.DWI在肺癌诊疗过程中的应用研究进展[J].放射学实践,2013,28(1):105-107.
[9]张安度,田华,韩春,等.磁共振弥散加权成像在肺癌精确放疗靶区勾画中应用价值分析[J].中华肿瘤防治杂志,2013,20(16):1249-1252,1256.
[10]刘瑞宝,李洪福,王旬果.影像技术在肺癌适形放疗靶区勾画中应用进展[J].海南医学,2015,26(17):2569-2571.
[2]周玉凤,夏淦林.18F-FDGPET-CT显像对非小细胞肺癌术前区域淋巴结诊断及分期的临床价值[J].中国CT和MRI杂志,2014,12(3):70-74.
[3] YanX,LiuH,ChenJ,etal.Comparisons between the National Comprehensive Cancer Network(NCCN)non-small-celllung cancer(NSCLC)Clinical PracticeGuidelines(Chinese version),theNCCNoriginal edition,andtheEuropean SocietyforMedicalOncology NSCLCGuidelinesin2009[J].ThoracicCancer,2010,1(2):83-86.
[4]李奉祥,李建彬,邵倩,等.基于三种CT图像勾画的非小细胞肺癌靶体积比较研究[J].中华放射肿瘤学杂志,2013,22(4):286-290.
[5]王振军,曲金荣,黎海亮,等.MR压脂T2WI/DWI及增强CT对肺癌与肺不张组织的显像效果[J].山东医药,2015,55(15):73-74.
[6]王澜,刘丽虹,韩春,等.依据CT及MRI确定区域淋巴结转移的病理对照研究[J].中华放射肿瘤学杂志,2015,24(5):493-496.
[7]库雷志,马明平,俞顺,等.扩散加权成像表观扩散系数值在不同类型肺癌鉴别中的价值[J].中国医学影像学杂志,2016,24(6):459-463.
[8]蒋洁智,丁莹莹.DWI在肺癌诊疗过程中的应用研究进展[J].放射学实践,2013,28(1):105-107.
[9]张安度,田华,韩春,等.磁共振弥散加权成像在肺癌精确放疗靶区勾画中应用价值分析[J].中华肿瘤防治杂志,2013,20(16):1249-1252,1256.
[10]刘瑞宝,李洪福,王旬果.影像技术在肺癌适形放疗靶区勾画中应用进展[J].海南医学,2015,26(17):2569-2571.