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适应性4DCBCT扫描协议的临床比较,用于肺瘤运动评估

Sadia Sana¹, Owen Dillon², Ricky T O'Brien¹

¹School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.

Journal of applied clinical medical physics

|July 14, 2025

概括

适应四维形束计算断层扫描 (4DCBCT) 可以准确地图像肺瘤运动,缩短扫描时间. 虽然存在轻微的偏差,但对于大多数肺癌患者来说,更快的60秒适应性4DCBCT扫描是可行的.

科学领域:

医疗成像医学成像
辐射瘤学辐射瘤学
计算成像技术的成像

背景情况:

适应四维形束计算断层扫描 (4DCBCT) 提供了减少辐射剂量和扫描时间的潜力.
这种先进的成像技术结合了自适应成像与运动补偿重建.
适应性4DCBCT对于精确的肺瘤运动描绘缺乏临床验证.

研究的目的:

在肺癌患者中使用适应性4DCBCT评估肺瘤运动精度.
为了比较适应性4DCBCT中的瘤运动与传统的4DCBCT扫描.
评估适应性4DCBCT用于放射治疗的临床可行性.

主要方法:

传统4DCBCT和自适应4DCBCT (200和600个预测) 之间的瘤运动比较.
使用运动补偿重建用于快速自适应扫描 (ADAPT_200) 和FDK用于其他.
通过计算呼吸阶段的质量中心 (COM) 轨迹来量化瘤运动.

主要成果:

快速自适应扫描 (ADAPT_200) 在80.4%的分数中显示了<1毫米的运动差异,与传统的4DCBCT相比.
高质量的自适应扫描 (ADAPT_600) 在76.9%的分数中显示了<1毫米的运动差异.
在两个自适应扫描类型的分数子集中观察到轻微偏差 (1-2mm或>2mm).

结论:

适应性4DCBCT,即使只有200个投影,也可以有效地描绘肺瘤轨迹.
在运动描绘中发现了轻微的偏差,其中13.3%的病例显示1-2毫米的差异,6.7%超过2毫米.
适应性4DCBCT的更快获得 (60s) 对大多数肺癌患者来说在临床上是可行的,支持其在放射治疗中的使用.

关键词:

可适应的4DCBCT.图像指导放射疗法图像指导放射疗法肺瘤的运动肺瘤的运动运动补偿重建呼吸运动跟踪呼吸运动跟踪

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