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目的探讨CT/WAVE/ADC融合图像在局部晚期宫颈癌放疗前和放疗中期勾画靶区(GTV)的变化意义。方法 12例晚期宫颈癌患者分别在放疗前和放疗中期(约15d)行CT、MRI异机非同步扫描。CT和MRI图像手工配准后传送至飞利浦公司PINNACLE V8.0放射治疗计划系统,并分别进行图像融合。由有经验的放疗计划物理师对患者放疗前和中期融合图像的肿瘤靶区(GTV)按最大径、ADC值低密区和ADC值高密区进行勾画及评价分析。结果放疗中期与前期相比,GTVFUSION-b产生明显缩小的0例;有所缩小的0例;无明显变化的12例。GTVHIGHT-b明显增大的4例;相对增大的7例;变化不大的1例(P<0.01)。结论融合了ADC图的CT/MRI图像融合技术对肿瘤生物靶区的勾画成为可能,有利于晚期宫颈癌放疗靶区的确定,提高了临床对晚期宫颈癌靶区(GTV)勾画的准确性和放疗剂量的有效分布,值得进一步研究。
Objective To investigate the significance of CT / WAVE / ADC fusion imaging in the pre-radiotherapy and metaphase radiotherapy of locally advanced cervical cancer. Methods Twelve patients with advanced cervical cancer underwent CT and MRI scanning before radiotherapy and in the middle of radiotherapy (about 15 days) respectively. CT and MRI images were manually registered and sent to Philips PINNACLE V8.0 radiotherapy planning system and image fusion respectively. The tumor target area (GTV) of patients with radiosurgery before and after radiotherapy was sketched and evaluated according to maximum diameter, low-density ADC value and high-density ADC area by experienced physicians. Results Compared with the early stage of radiotherapy, GTVFUSION-b produced significantly reduced in 0 cases; decreased in 0 cases; no significant change in 12 cases. GTVHIGHT-b significantly increased in 4 cases; 7 cases of relatively increased; little change in 1 case (P <0.01). Conclusion CT / MRI image fusion based on ADC maps is possible for the mapping of tumor biological targets, which is helpful for the determination of target radiation in advanced cervical cancer and improves the accuracy of clinical mapping of advanced cervical carcinoma (GTV) The effective distribution of radiation dose is worth further study.