从仰卧到直立的患者位置的相对胸部变化:一个质子协作小组研究研究
Joseph Marano1, Michael W Kissick2, Tracy S A Underwood3
1Department of Medical Physics, Northwestern Medicine Proton Center, Warrenville, Illinois, USA.
Journal of applied clinical medical physics
|August 26, 2023
概括
胸部器官的位置在直立和仰卧姿势之间发生变化. 这项研究量化了心脏和肺部位置的变化,这对于放射治疗计划至关重要,揭示了需要考虑治疗策略的重大转变.
科学领域:
- 医疗成像医学成像
- 辐射瘤学 辐射瘤学
- 人体解剖学 解剖学 解剖学
背景情况:
- 在放射治疗中,患者的定位至关重要,以确保准确的剂量输送.
- 了解不同患者定向 (垂直 vs 仰卧) 之间的器官运动对于治疗规划至关重要.
研究的目的:
- 量化和分析关键胸部器官在患者直立和仰卧方向之间的位置变化.
- 评估这些位置变化对放射治疗的临床相关性.
主要方法:
- 使用商业治疗计划系统 (TPS) 来测量解剖距离.
- 分析了四维计算机断层扫描 (4D CT) 数据集,用于直立和仰卧的位置.
- 计算了95%的置信区间 (CI),以确定观察到的变化的统计学意义.
主要成果:
- 从心脏底部到胸骨顶部的距离变化为 +2.6% (+4毫米) (95% CI [+0.30%+4.9%]).
- 从C3脊椎中心到靠背的距离变化为+29% (95%CI [+22%+36%]).
- 轮肺体积增加:左肺增加了+17% (95% CI [+12%+21%]) 和右肺增加了+9.9% (95% CI [+4.1%+16%]).
- 由于高度的不确定性,胸骨到肝脏距离的变化是不确定的.
结论:
- 在垂直和仰卧的方向之间观察到肺体积和心脏位置的显著位置变化,可靠性为95%.
- 这些发现表明,患者的定位可以影响内部器官的位置,可能会影响放射治疗的准确性.
- 需要进一步的研究,才能充分理解直立放射治疗对直立放射治疗的影响.
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