论文部分内容阅读
[目的]验证在最大密度投影(MIP)软件自动生成融合图像上勾画大体肿瘤体积(GTV)的可靠性。[方法]20例经病理确证为肺癌的患者,根据病灶邻近组织特点,分为A组(病灶周围环绕正常低密度肺泡组织)和B组(病灶周围与等密度或高密度组织紧邻)。同一个医师分别在四维CT(4D-CT)的10个时相、3个时相、2个时相、MIP融合图像上勾画GTV(GTV10、GTV3、GTV2、GTVMIP)。观察GTV体积变化和中心位移情况,比较四种方法之间的差异。[结果]A组GTV10与GTV3、GTV2和GTVMIP的比值分别为1.07±0.03、1.10±0.03和1.08±0.07;四者中心点在X、Y、Z轴上的差异小于1mm且无统计学意义(P>0.05)。B组GTV10与GTV3、GTV2、GTVMIP的比值分别为1.10±0.07、1.16±0.09、1.27±0.26;四者中心点在X、Y、Z轴上的差异小于1mm且无统计学意义(P>0.05)。[结论]对于周围环绕正常肺泡组织的肺内病灶,在四维CT中MIP图像上勾画GTV是可靠的,但病灶紧邻等密度或高密度组织时不够精确,建议代之以3个时相的融合图像,个别特殊情况代之以10个时相的融合图像。
[Objective] To verify the reliability of gross tumor volume (GTV) in automatically generated fused images of maximum density projection (MIP) software. [Methods] Twenty cases of pathologically confirmed lung cancer were divided into group A (surrounding normal lesion alveolar tissue) and group B (lesion adjacent to isodensity or high density tissue) according to the characteristics of the adjacent tissue. The same physician sketched GTV (GTV10, GTV3, GTV2, GTVMIP) on the MIP fusion images in 10 phases, 3 phases, 2 phases and 4 phases of 4D CT. Observe the volume change and center displacement of GTV and compare the differences among the four methods. [Results] The ratios of GTV10 to GTV3, GTV2 and GTVMIP in group A were 1.07 ± 0.03, 1.10 ± 0.03 and 1.08 ± 0.07, respectively. There was no significant difference in the X, Y and Z axes between the four centers P> 0.05). The ratios of GTV10 to GTV3, GTV2 and GTVMIP in group B were 1.10 ± 0.07, 1.16 ± 0.09 and 1.27 ± 0.26, respectively. There was no significant difference in the X, Y and Z axes between the four centers (P> 0.05 ). [Conclusion] GTV mapping on MIP images in four-dimensional CT is reliable for intrapulmonary lesions surrounding normal alveolar tissue, but the lesion is not precise enough when it is close to isodense or high-density tissue. It is suggested that the fusion of three phases Image, the individual special circumstances instead of fusion of 10 phases of the image.