基于CBCT的体表标记点辅助配准方法在体部肿瘤放疗摆位中的应用研究

目的:应用基于CBCT(cone beam computed tomography)的体表标记点辅助图像配准方法，提高肿瘤放射治疗摆位验证的工作效率。方法:选取胸部、腹部、盆腔共30例肿瘤放疗患者,定位及治疗摆位时体表粘贴标记点。CBCT扫描验证时，医师、主管技师、技师先进行常规图像配准，后采用体表标记点辅助图像配准，以医师常规图像配准为基础分别进行比较。结果:常规图像配准时，主管技师对比医师在胸部、腹部及盆腔部位的X、Y、Z轴上的差异均无统计学意义；技师对比医师在腹部的X、Y、Z轴上及胸部、盆腔部位的X、Y轴上的差异无统计学意义，在胸部及盆腔部位的Z轴上P值分别为0.006，0.014，有显著意义。标记点辅助图像配准时，医师、主管技师及技师对比医师常规图像配准在胸部、腹部及盆腔部位的X、Y、Z轴上的差异均无统计学意义。图像配准的误差发生率腹部大于胸部及盆腔。医师、主管技师、技师分别与自己对比在胸部、腹部及盆腔部位的图像配准完成时间上P值近似于0，有显著意义。结论:以体表标记点辅助图像配准优于常规图像配准，效率高。

Application study of body surface marker assisted registration method based on CBCT in body tumor radiotherapy positioning

Objective:To investigate the efficiency improvement of tumor radiotherapy positioning by useing the method of body surface marker assisted image registration based on CBCT was used.Methods:30 patients with chest,abdomen or pelvic tumors were treated with radiotherapy,and the marked points were pasted on their body surface during radiotherapy positioning and treatment setting.Based the CBCT positioning verification,physician,competent technicians and technicians first carried out routine image registration,then used the body surface markers to assist image registration,the results are compared with the routine image registration results of physician individually.Results:There was no significant positional difference in X,Y,Z axis of chest,abdomen and pelvis between competent technician and physician in routine image registration.There was no significant difference in X,Y,Z axis of abdomen and the X,Y axis of chest and pelvic between technicians and physicians in routine image registration,but the P-values on the Z axis of chest and pelvic were 0.006 and 0.014 respectively,which was significant.At the X,Y,Z axis of the chest,abdomen and pelvis,there were no statistically significant differences in physicians,competent technicians,and technicians compared to physicians' routine image registration by using marker-point-assisted image registration.The error proportion of image registration in abdomen was higher than that in the chest and pelvic.Compared physician,competent technician and technicians with themselves,the P-value of the image registration completion time of chest,abdomen and pelvic parts was all close to 0,which was statistically significant.Conclusion:Surface marker assisted image registration is not only better than routine image registration,but also more efficient.