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目的头颈部调强放疗技术高速发展,摆位精度要求越来越高。本研究通过定位发泡垫在头颈部调强放疗摆位中的应用,探讨其在定位中的价值。方法选取上海交通大学附属第九人民医院2014-02-01-2014-05-30收治的20例舌癌患者为研究对象,分为发泡垫组和头枕组,两组患者放疗前后体质量变化<5kg。每例患者在放疗前与放疗20次后,各完成1次定位CT扫描;将定位图像输入MIM软件,建立坐标系,分别勾画颈椎,利用DICE流程计算出的Dice系数、Jaccard系数、Hausdorff距离作为评价指标,分组研究颈椎位置变化。结果定位发泡垫组的Dice系数为0.79±0.07,Jaccard系数为0.65±0.10;头枕组的Dice系数为0.70±0.08,Jaccard系数为0.53±0.10,P<0.000 1。定位发泡垫组的Hausdorff距离为0.65±0.12,头枕组的Hausdorff距离=0.84±0.15,统计值P<0.05。定位发泡垫组颈椎中心间距为0.21±0.08,头枕组为0.30±0.10。定位发泡垫组的Dice系数、Jaccard系数、Hausdorff距离颈椎和颈椎中心间距均优于头枕组。结论相对于传统的头枕,定位发泡垫减少患者横向纵向、以及旋转的误差,更适合临床应用。
The purpose of head and neck IMRT technology is rapid development, higher accuracy requirements. In this study, the application of foam pad in the setting of head-and-neck IMRT and its value in positioning were discussed. Methods Twenty patients with tongue cancer admitted to the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University 2014-02-01-2014-05-30 Subjects were divided into foam pad group and headrest group. Before and after radiotherapy, the body mass Change <5kg. Each patient completed radiotherapy and CT scan 20 times before and after radiotherapy. The positioning images were input into the MIM software to establish the coordinate system, and the cervical vertebrae were drawn respectively. The Dice coefficient, Jaccard coefficient and Hausdorff distance calculated by the DICE procedure were taken as Evaluation index, group study cervical position change. Results The Dice coefficient was 0.79 ± 0.07 and the Jaccard coefficient was 0.65 ± 0.10. The Dice coefficient of the head pillow group was 0.70 ± 0.08, and the Jaccard coefficient was 0.53 ± 0.10, P <0.0001. The Hausdorff distance of the foam pad positioning group was 0.65 ± 0.12, and the Hausdorff distance of the headrest group was 0.84 ± 0.15 (P <0.05). The distance between the centers of the cervical vertebrae and the head pillow group was 0.21 ± 0.08 and 0.30 ± 0.10, respectively. The Dice coefficient, Jaccard coefficient and Hausdorff distance of the foam pad set were better than that of the head restraint group. Conclusion Compared with the traditional head restraints, positioning foam pad to reduce the patient’s horizontal and vertical, as well as the rotation error, more suitable for clinical applications.