文章：

利用四维计算机断层扫描优化肺病灶表面引导立体定向放射治疗中皮肤替代物的选择

Optimizing Choice of Skin Surrogates for Surface-Guided Stereotactic Body Radiotherapy of Lung Lesions Using Four-Dimensional Computed Tomography

原文发布日期：27 June 2024

DOI: 10.3390/cancers16132358

类型: Article

开放获取: 是

英文摘要：

Image-guided radiotherapy supported by surface guidance can help to track lower lung lesions’ respiratory motion while reducing a patient’s exposure to ionizing radiation. However, it is not always clear how the skin’s respiratory motion magnitude and its correlation with the lung lesion’s respiratory motion vary between different skin regions of interest (ROI). Four-dimensional computed tomography (4DCT) images provide information on both the skin and lung respiratory motion and are routinely acquired for the purpose of treatment planning in our institution. An analysis of 4DCT images for 57 patients treated in our institution has been conducted to provide information on the respiratory motion magnitudes of nine skin ROIs of the torso, a tracking structure (TS) representing a lower lung lobe lesion, as well as the respiratory motion correlations between the nine ROIs and the TS. The effects of gender and the adipose tissue volume and distribution on these correlations and magnitudes have been analyzed. Significant differences between the ROIs in both the respiratory motion magnitudes and their correlations with the TS have been detected. An overall negative correlation between the ROI respiratory magnitudes and the adipose tissue has been detected for ROIs with rib cage support. A weak to moderate negative correlation between the adipose tissue volume and ROI-to-TS respiratory correlations has been detected for upper thorax ROIs. The respiratory magnitudes in regions without rib support tend to be larger for men than for women, but no differences in the ROI-to-TS correlation between sexes have been detected. The described findings should be considered when choosing skin surrogates for lower lung lesion motion management.

摘要翻译： 

表面引导支持的图像引导放疗有助于追踪下肺病灶的呼吸运动，同时减少患者对电离辐射的暴露。然而，皮肤呼吸运动幅度及其与肺部病灶呼吸运动的相关性在不同皮肤感兴趣区域（ROI）之间的变化并不总是明确的。四维计算机断层扫描（4DCT）图像提供了皮肤和肺部呼吸运动的信息，并且在我们机构中常规获取用于治疗计划。我们对57名在我们机构接受治疗的患者的4DCT图像进行了分析，以提供躯干九个皮肤ROI的呼吸运动幅度、代表下肺叶病灶的追踪结构（TS），以及这九个ROI与TS之间的呼吸运动相关性。分析了性别以及脂肪组织体积和分布对这些相关性和幅度的影响。检测到不同ROI在呼吸运动幅度及其与TS的相关性方面存在显著差异。对于有肋骨支撑的ROI，检测到ROI呼吸幅度与脂肪组织之间存在总体负相关。对于上胸部ROI，检测到脂肪组织体积与ROI至TS呼吸相关性之间存在弱至中度的负相关。在没有肋骨支撑的区域，男性的呼吸幅度往往大于女性，但未检测到性别间ROI至TS相关性的差异。在选择用于下肺病灶运动管理的皮肤替代物时，应考虑上述发现。

原文链接：

Optimizing Choice of Skin Surrogates for Surface-Guided Stereotactic Body Radiotherapy of Lung Lesions Using Four-Dimensional Computed Tomography