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| The Study of Cone Beam CT Image Registration Based on Different Anatomical Markers in Lung Cancer Radiotherapy |
| YUAN Yajie, et al |
| Chengde Medical University, Hebei Chengde 067000, China |
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Abstract Objective: To explore the effect of image registration with different anatomical structures on the results of lung cancer patients in radiotherapy, and to provide a basis for the optimal selection of anatomical structures in image registration of image guided radiotherapy for lung cancer. Methods: From June 2021 to August 2022, 43 lung cancer patients who received chest radiation therapy in Chengde Central Hospital were selected. All patients received image guided intensity-modulated radiation therapy. In 29 patients with central lung cancer, the thoracic vertebrae, sternum, trachea, tracheal ramus, and tumor were used as the anatomical structures, and in the other 14 patients with peripheral lung cancer, the thoracic vertebrae, tumor, affected ribs, and ribs near the tumor union were used as the anatomical structures. (The error values in X (left and right), Y (head and foot) and Z (front and back) directions were recorded, and the error values obtained from the registration of the tumor group as the control group were compared with those of the other groups to analyze the causes of the errors. Results:In the central type of lung cancer, the error value of each anatomical structure is the smallest in the tumor group, followed by the trachea carina group, thoracic vertebrae group, trachea group, and the sternum group, and the sternum group had the largest error values. The results of one-way ANOVA showed that the differences were mainly reflected on the Y and Z axes (F=3.329, P=0.012; F=0.033, P=0.022). Further statistical analysis showed that the difference between Y axis and Z axis was mainly between sternum group and tumor group. In peripheral lung cancer, the error values in ascending order are: the rib near the tumor joint, the rib at the affected side, the thoracic spine, and the tumor. The error value is statistically significant on the X and Z axes (F=3.63, P=0.019; F=2.889, P=0.044). In addition, the error values of the affected rib group and the rib group near the tumor union were statistically significant compared with the error values of the tumor group. Conclusion:Anatomical structure selection during image registration of lung cancer image-guided radiotherapy: tumor combined with adjacent ribs as the registration structure of peripheral lung cancer is preferred; trachea carina, thoracic vertebra and trachea can be used as the registration structure of central lung cancer; trachea carina and thoracic vertebra are preferred.
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2023, Vol. 29 
