【摘要】 目的验证恶性肿瘤患者放疗定位时同时采用的PET-CT与CT在头颈部、胸部、盆腔异机和同机融合的精度,为PET-CT在临床放疗中的应用提供依据。方法综合采用定位标志和解剖结构对患者的PET-CT和定位CT进行自动融合和人工融合,分别比较头颈部、胸部、盆腔同机以及异机融合的精度,并分析三维方向的融合误差。结果在不同的解剖部位,同机融合均明显优于异机融合;在头颈部和盆腔,在X、Y方向摆位重合度高,和同机融合差异不大,Z方向异机融合精度差于同机融合。在胸部和上腹部不论PET-CT同机融合还是PET与CT异机融合,误差均较大,差异有统计学意义,达不到精确放疗靶区勾画的要求。结论在头颈部和盆腔,PET和CT不管是同机还是异机融合,均能达到精确放疗的要求,而在胸部和上腹部PET能够指导靶区勾画,但呼吸动度等原因影响融合精度,图像融合适应精确放疗还需要更多的验证工作和方法。更多还原

【Abstract】 Objective To evaluate the accuracy of PET and CT using different image registration methods in head and neck,thorax,and cavitas pelvis to provide clinical evidence of the usage of PET-CT for radiotherapy.Methods Registering imagines of the PET and CT artificial and using position signs and anatomic structures automatically in head and neck,thorax,and the cavitas pelvis,and analyzed the fusion error in three diamentions directions respectively.Results Co-registration was significant better than other-registration in various anatomic sites.but in the head and neck and the cavitas pelvis,the latter did not have significant difference from the former because of the high degree positioning coincidence in X and Y directions and even poorer in the Z direction.In thorax and upper abdomen,the fused images could not be used for pinpoint radiotherapy because the fusion error was significant,no matter in co-registration and other-registration.Conclusion The combined PET-CT could reach the requirement of pinpoint radiotherapy in the head and neck and the cavitas pelvis,no matter through any different registrations.While in the thorax,more studies of image fusion might be needed because of the effect from respiration.更多还原