摘要目的 定量评估宫颈癌放疗计划剂量准确性.方法 提出基于图像变换的CT图像校正算法,参考CBCT图像对宫颈癌临床计划CT图像进行校正,获取更能反映实际治疗体位的校正图像;将临床计划移植至校正图像重算剂量生成测试计划,并与临床计划进行剂量学参数比较分析,评估剂量准确性.结果 对比计划靶区覆盖均能满足临床要求(＞98%),均匀性指数HI无较大差别(P＝0. 150);测试计划剂量分布适形性较临床计划差且具有显著性差异(P＜0. 05).测试计划各危及器官的Dmax较临床计划高约30 cGy并具有显著性差异(P＜0. 05),V50较临床计划略高,而Dmean无较大差异.结论 基于图像变换的CT图像校正算法可用于对宫颈癌放疗剂量准确性进行定量评估,为临床解决类似问题提供参考.

abstractsObjective To quantitatively evaluate dose accuracy of radiotherapy for cervical cancer. Methods A CT image correction algorithm based on image transformation was proposed. Referring to CBCT images, CT images of radiotherapy plan for cervical cancer were corrected to obtain the corrected images which could reflect the actual body position of treatment. The clinical plan was transplanted to the corrected images for dose recalculation as a test plan, and the dosimetry parameters were statistically compared to evaluate the dose accuracy. Results Both of the target coverage of contrast plans could meet the clinical requirements (＞98%) , and there was no significant difference in the homogeneity index ( P＝0. 150) . The conformability of the test plan was significantly worse than that of the clinical plan ( P＜0. 05) . The maximum dose of each organ at risk in the test plan was approximately 30 cGy higher than that of the clinical plan ( P＜0. 05) , V50 was slightly higher than that of the clinical plan, whereas the average dose ( Dmean) did not significantly differ. Conclusion The CT image correction algorithm based on image transformation can quantitatively evaluate the dose accuracy of radiotherapy for cervical cancer, which provides reference for resolving similar problems in clinical practice.