Analysis of Setup Errors in Thoracic Tumors Radiotherapy under Different Registration Methods Guided by X-ray Volume Imaging
Objective:To investigate the impact of different registration methods of the X-ray volume imaging(XVI)system on setup errors of thoracic tumors.Method:Fifteen patients with lung cancer,15 patients with esophageal cancer and 15 patients with breast cancer who received radiotherapy in Ji'an Central People's Hospital from February 2022 to May 2023 were randomly selected.A total of 135 pre-treatment cone beam CT(CBCT)scan images were obtained and compared with the planning CT image.Four types of image registration were performed,gray value automatic registration(GAR),gray value automatic&manual registration(GA&MR),bone automatic registration(BAR)and bone automatic&manual registration(BA&MR).The left-right(X),superior-inferior(Y),and anterior-posterior(Z)setup errors were obtained and statistically analyzed.Result:There was a statistically significant difference in the Y direction between the BAR and BA&MR methods for lung cancer patients(P=0.019).The differences between GAR and GA&MR,BAR and GA&MR in the Y direction of breast cancer patients were statistically significant(P=0.022,0.015);the differences in the Z direction between the GAR and GA&MR,GAR and BAR,GAR and BA&MR methods for breast cancer patients were statistically significant(P=0.023,0.027,0.017).The GA&MR method for lung cancer and breast cancer patients had better error values in the X,Y,and Z directions compared to other registration methods,with an absolute value of≤2 mm.The frequency data in the error interval were better,which can greatly improve the accuracy of radiotherapy.The error range of lung cancer CTV external expansion PTV were referenced as X directions 2.0 mm,Y directions 4.4 mm,Z directions 3.3 mm,and breast cancer CTV external expansion PTV were referenced as X directions 4.1 mm,Y directions 4.7 mm,Z directions 5.4 mm.The positioning error results calculated by the four registration methods for esophageal cancer patients showed no statistically significant difference in the X,Y,and Z directions(P＞0.05).GA&MR and BA&MR had better error values in the absolute values of≤2 mm,＞2 mm and≤4 mm in the X,Y,and Z directions.The frequency data of the error area were better in the absolute values of≤2 mm,＞2 mm and≤4 mm.The reference range of errors for esophageal cancer CTV extravasation PTV was X directions 2.4 mm,Y directions 5.6 mm,and Z directions 3.0 mm.Conclusion:Automatic gray value of patients with lung cancer and breast cancer plus manual micro-adjustment(GA&MR),automatic gray value value value of esophageal cancer plus manual micro-adjustment(GA&MR)or osteo automatic allocation plus manual micro-adjustment(BA&MR),which can be more efficient and standardized.Improve the accuracy of treatment.
万方数据
维普
