摘要
目的探讨SPECT/CT应用于颈部淋巴结转移癌^(125)I粒子植入术后剂量验证可行性。方法搜集行^(125)I粒子植入治疗的颈部淋巴结转移癌患者13例(共15处病灶),处方剂量120 Gy,活度0.4~0.8 mCi。所有患者均在术后24 h内行SPECT/CT显像,并进行同机融合。将其中CT图像导入治疗计划系统(TPS)进行术后剂量验证,得到等剂量曲线分布图,记录该组病例的D_(90)、V_(90)及V_(150),并与术前计划对应参数进行统计学分析。然后在融合图像上调整ROI分别与术后验证计划中D_(90)、150%D_(90)等剂量线范围一致,记录对应计数值,重复3遍上述操作并取平均值,然后将所得到的2组计数值用(x±s)表示。结果13例患者中,5处病灶应用3D模板引导粒子植入,10处病灶在CT引导下徒手植入,TPS术前、术后D_(90)、V_(90)及V_(150)差异均无统计学意义,所有患者均达到术前计划剂量要求;SPECT/CT融合图像中计数值达到200.9±2.7、303.5±4.1可完全包绕术后计划D_(90)、150%D_(90)等剂量曲线范围。结论SPECT/CT可以探测到颈部转移淋巴结内^(125)I粒子的剂量分布并可对TPS剂量参数量化,有望成为评价粒子植入术后剂量分布的新方法。
Objective To explore the feasibility of applying SPECT/CT to verify the dose of^(125)I seed implantation in cervical lymph node metastasis.Methods Collected 13 patients(15 lesions in total)who underwent^(125)I seed implantation in the treatment of cervical lymph node metastasis.The prescription dose is 120 Gy,and the activity is 0.3~0.8 mCi.SPECT/CT was performed within 24 hours after^(125)I seed implantation,then to get the fused images.The CT images were imported into TPS,the postoperative dose verification was performed and the isodose curve distribution map was obtained,and record the D_(90),V_(90)and V_(150)of the group of cases,and statistical analysis of the parameters corresponding to the preoperative plan was performed.Then adjust the ROI on the fusion image to be consistent with the D_(90)and 150%D_(90)in the postoperative verification plan,and record the corresponding count values.Repeat the above operation 3 times and take the average.The two groups of radioactive concentration count values obtained are expressed as mean±standard deviation.Results Of the 13 patients,5 tagets received the operation guided by CT scans combined with 3D-printed individual template and 10tagets were implanted by hand under CT guidance.There was no statistically significant difference in D_(90),V_(90)and V_(150)before and after TPS.All patients met the planned dose requirements before surgery;the count values in the SPECT/CT fusion images reached 200.9±2.7 and 303.5±4.1 respectively,which can completely cover the range of the postoperative planned D_(90)and 150%D_(90)isodose curve.Conclusion SPECT/CT can detect the dose distribution of^(125)I seeds in cervical metastatic lymph nodes and quantify the TPS dose parameters.It is expected to be a new method to evaluate the dose distribution after seed implantation.
作者
闵学雅
于慧敏
张宏涛
刘泽洲
乔诗淇
梁岩松
王娟
MIN Xueya;YU Huimin;ZHANG Hongtao(Graduate School of Hebei Medical University,Shjjazhuang,Hebei Province 050017,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第11期2110-2114,共5页
Journal of Clinical Radiology
