영상변조 프로그램을 이용한 호흡 위상 간 종양의 움직임 특성 분석
Analysis of Intrafractional Mass Variabilities Using Deformable Image Registration Program
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초록
본 연구의 목적은 호흡 위상을 고려한 4DCT 자료를 토대로 자동영상변조등록 프로그램인 MIMVista에서 계산한 최대강도투영 영상에서 폐종양의 발생위치와 유착여부에 따른 종양의 움직임 특성을 분석하고 3DCT 결과 값과 비교하였으며 호흡 위상 간 종양의 도심변화 등 기하학적 변형 특성를 분석했다. 분석결과 폐하부에 위치한 종양에서 Y축으로의 평균 도심 변화가 7.32±6.88mm로 가장 크게 나타났으며 HU값의 차이를 분석한 결과에서도 평균 7.7±4.97%로 가장 큰 차이를 보였다. 유착성 종양보다는 비유착성 종양에서 호흡 간 변화가 크게 나타났다. 3DCT 영상과 MIP 영상간에 종양 용적의 연관성을 분석한 결과 상관계수가 0.998로 매우 높게 나타났다. 종양의 기하학적 변화에 영향을 미치는 요인분석결과 종양의 위치와 유착여부가 큰 영향을 미치는 것으로 분석되었으나 횡격막의 움직임 정도에 따른 차이는 없었으며 환자 간 호흡 위상에 따른 편차가 매우 크기 때문에 종양의 움직임과 관련한 특정 경향성을 파악할 수는 없었다.
Abstract
The aim of this study is to compare the geometric characteristics of the lung tumor, such as tumor centroid, HU change relative to breath phase, depending on tumor location and adhesion using 4DCT and deformable image registration program (MIMVista). The Y axis change was most significant and the mean Y axis centroid fluctuation was 7.32±6.88mm in lower lung tumor. The mean HU variation in lower lung mass has changed more than other locations, and its mean HU variation was 7.7±4.97% and non-adhered mass was more changed. Correlation for the mass volume between 3DCT and MIP was very high and its coefficient was 0.998. The effect of tumor location, adhesion and diaphragm excursion to geometric uncertainties was analyzed by linear regression model, it was influenced to mass deformation and geometrical variation so much except diaphragm excursion. but intra-fractional and inter-patient's uncertainties were great, so it couldn't find any exact deformation trend.
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