Journal of radiological science and technology (대한방사선기술학회지:방사선기술과학)

Korean Society of Radiological Science (대한방사선과학회)
권호 표지

The Evaluation of Composite Dose using Deformable Image Registration in Adaptive Radiotherapy for Head and Neck Cancer

두경부 종양의 적응방사선치료시 변형영상정합을 이용한 합성선량 평가

  • Hwang, Chul-Hwan (Dept. of Radiation Oncology, Pusan National University Hospital) ;
  • Ko, Seong-Jin (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Chang-Soo (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Jung-Hoon (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Dong-Hyun (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Choi, Seok-Yoon (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Ye, Soo-Young (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kang, Se-Sik (Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan)
  • 황철환 (부산대학교병원 방사선종양학과) ;
  • 고성진 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김창수 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김정훈 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 김동현 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 최석윤 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 예수영 (부산가톨릭대학교 보건과학대학 방사선학과) ;
  • 강세식 (부산가톨릭대학교 보건과학대학 방사선학과)
  • Received : 2013.05.10
  • Accepted : 2013.08.30
  • Published : 2013.09.30
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Abstract

In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), oral cavity($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), parotid gland($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy) and temporomandibular joint($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.

적응방사선치료(adaptive radiotherapy, ART)시 획득된 다단계 CT영상으로부터 변형영상정합을 이용하여 전체 처방선량에 대한 주변 정상조직의 합성선량을 획득하고, 각각의 단일 치료계획으로부터 합산되어진 선량을 비교분석하여 임상적 의의를 얻고자 한다. 2011년 5월 1부터 2012년 7월 31일까지 두경부 종양으로 3차원 입체조형치료, 세기변조방사선치료를 시행한 환자 중에서 치료기간 중 종양크기의 변화, 체중의 급격한 감소 등으로 인해 적응방사선치료를 시행한 환자를 대상으로 하였다. 변형영상정합을 이용하여 전체 처방선량에 대한 주변 정상조직의 합성선량을 획득할 수 있었으며, 단일 치료계획으로부터 합산되어진 선량과의 비교에서 하악골($48.95{\pm}3.89$ vs $49.10{\pm}3.55$ Gy), 구강($36.93{\pm}4.03$ vs $38.97{\pm}5.08$ Gy), 이하선($35.71{\pm}6.22$ vs $36.12{\pm}6.70$ Gy), 턱관절($18.41{\pm}9.60$ vs $20.13{\pm}10.42$ Gy)에서 차이의 결과를 보였다. 적응방사선치료시 변형영상정합에 의한 합성선량과 단일 치료계획으로부터 합산되어진 선량과의 유의한 차이를 확인할 수 있었으며, 다단계 CT영상을 사용하는 경우 변형영상정합에 의한 합성선량획득은 주변 정상조직에 대해 보다 정확한 평가가 가능할 것으로 사료된다.

Keywords

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