CN113262390A - Tumor radiotherapy effect evaluation method based on radioactive particle implantation - Google Patents
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Abstract
The application discloses a tumor radiotherapy effect evaluation method based on radioactive particle implantation, which comprises guide wire marking, CT scanning and obtained tomography image layer set Pic1And a tomographic image layer set Pic2Carrying out three-dimensional model reconstruction to obtain a model P1And model P2(ii) a Model P1And model P2Fusion to obtain model P3(ii) a Model P3Gridding, extracting evaluation indexes and outputting evaluation results. The spatial displacement change of the radioactive particles in the tumor body along with the change of time can be counted in detail; meanwhile, the radiotherapy effect brought by tumor bodies is evaluated; by including radioactive particles in the index eta of the gathering degree1Degree of tumor atrophy η2Effective radiotherapy coverage degree index eta3And the accurate radiotherapeutic degree index eta4Making statistics to objectively reflect the current reflective particle tumor to the current tumorAccurate radiotherapy technical effect of body tissue.
Description
Technical Field
The invention relates to the technical field of precise postoperative evaluation of radiotherapy, in particular to an evaluation method for tumor radiotherapy effect by radioactive particle implantation, and specifically relates to an evaluation method for tumor radiotherapy effect based on radioactive particle implantation.
Background
Tumor is a major problem in medical technology worldwide today, and there are nearly 2000 million new cancer patients worldwide each year released by the international agency for research on cancer (IARC), because tumor causes nearly 1000 million people to die. Although there are many effective treatment methods for tumors in the existing medical technology, the early detection and early treatment are difficult because tumors usually have no symptoms due to early onset, so that the method for achieving the recovery by surgical resection is not suitable for most tumor patients; the remaining therapeutic approaches are generally chemoradiotherapy and targeted therapy, wherein targeted therapy is the most effective one of all tumor therapies, but is not or cannot be used by most patients due to the strict requirements on the tumor condition and the high cost of targeted drugs. Thereby making the radiotherapy and chemotherapy the most common and effective treatment means in the tumor treatment means. Although the radiotherapy and chemotherapy have obvious inhibiting and even killing effects on cancer cells, the radiotherapy and chemotherapy also have fatal damage on healthy cells, so that the radiotherapy and chemotherapy inevitably brings great side effects to patients due to the radiotherapy and chemotherapy. With the continuous improvement of scientific technology, the current clinical practice has been widely applied with an accurate radiation means, which utilizes tiny radioactive particles to perform targeted radiation on a possessed area, so as to achieve the technical effects of killing cancer cells in tumors and simultaneously realizing that healthy organ cells are not subjected to radiographic images.
Nevertheless, as one of the best means of the current precise radiotherapy, since the effect of the particles on different tumor tissues is different, after the radioactive particles are implanted into the tumor body, the DNA of the tumor cells is damaged by the radiation and cannot be rapidly copied, and the tumor body gradually shrinks and collapses, thereby achieving the technical effect of treatment.
Then, the existing postoperative evaluation is usually to scan by CT and compare the volume of the tumor body before and after the operation, so as to judge the damage degree of the tumor after being radiated and the hyperplasia degree; however, the accuracy of radiotherapy inside the tumor body, the degree of effective treatment, and the degree of radioactive particle deviation cannot be objectively evaluated, and the action relationship between the type of radioactive particles and the type of tumor tissue and the treatment effect cannot be accurately fed back.
Disclosure of Invention
In order to solve the technical problem that the existing technology for accurately performing radiotherapy on tumors by radioactive particles lacks accurate evaluation, which results in incapability of or effect between different types of radioactive particles and different tumor tissues, the application provides a method for evaluating the tumor radiotherapy effect based on radioactive particle implantation, which can evaluate the treatment effect of the radioactive particles after radiotherapy on specific tumor tissues in detail, objectively and accurately, thereby finally knowing the effect between different radioactive particles and different tumor tissues, so as to facilitate the research on the radioactive particles in the technical field of subsequent accurate radiotherapy, and the type selection of the radioactive particles provides scientific basis.
In order to achieve the purpose, the technical scheme adopted by the application is as follows:
a tumor radiotherapy effect evaluation method based on radioactive particle implantation comprises the following steps:
STP100 guidewire labeling: two guide wires L arranged in a cross shape1And L2Is adhered to the body surface corresponding to the tumor part of the patient, wherein the direction of one guide wire is consistent with the head and foot sides of the patient;
STP200 CT scan: scanning at different angles for two times aiming at tumor parts to respectively obtain a tomography image layer set Pic1And a tomographic image layer set Pic2；
STP300 passes the tomographic image layer set Pic obtained in step STP2001And a tomographic image layer set Pic2Carrying out three-dimensional model reconstruction to obtain a model P1And model P2；
STP400 models P1And model P2Fusing: obtaining a guide wire L1And L2In model P1Imaging of L'1And L'2In the model P2L ″' of1And L ″)2L 'are aligned separately'1And L ″)1，L′2And L ″)2Fusion model P1And model P2Obtaining a model P3；
STP500 model P3Gridding: model P3Placing in a grid composed of grid cells with side length of k, respectively assigning grid cells and model P in RGB mode3A different color value than the radioactive particles;
extracting evaluation indexes of STP 600: separately extracting the number S of radioactive particles by color value threshold1The number of meshes S occupied by the number of radioactive particles2Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4；
Outputting an STP700 evaluation result:
output radioactive particle convergence degree index eta1＝(1-S1/S0)*100％，η1A larger value indicates a higher degree of radioactive particle bunching;
output tumor atrophy degree indicator eta2＝(1-S2/S0)*100％，η2A larger value indicates a higher degree of tumor atrophy;
outputting an effective radiotherapy coverage degree index eta3＝(1-S3/S0)*100％，η3A larger value indicates a higher degree of coverage of the effective radiotherapy for the tumor;
outputting accurate radiotheraphy degree index eta4＝S4/S1If η4When the ratio is 1, the precision radiotherapy degree is 100%; if eta4Not equal to 1, the smaller the value is, the lower the precision radiotherapy degree is; wherein S is0The number of radioactive particles placed.
As a preferable configuration of the present invention, it is preferable that the guide wire L in step STP100 described above1And L2The shortest length of any one of the two imaging layers is not less than 4 layers under the maximum CT inclination angle state. The CT scanning mode comprises any two modes of flat scanning, oblique overhead scanning and oblique overhead scanning.
For a preferred embodiment of the present invention, the radioactive particle number S in the step STP600 is preferably as large as1The statistical method comprises the following steps:
STP610 extracts the color value assignment of the radioactive particles in STP500, and the color value extraction error is +/-5;
STP620 obtains a set of radioactive particle models consisting of a plurality of discrete bodies;
STP630 counts the number of discrete bodies and records as the number of radioactive particles S1。
For a preferable configuration of the present invention, it is preferable that the number of radioactive particles in step STP600 is a grid number S2Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4The method is carried out in a discrete sampling mode, and specifically comprises the following steps:
STP640 takes a grid unit central point O as a reference sampling point, and performs symmetrical sampling on X, Y, Z axes in positive and negative directions of a space coordinate system respectively, wherein the number of sampling nodes is 0.2k, and the number of sampling in a single direction is 4;
STP650 takes the central point O of the grid cell as a reference sampling point, and respectively carries out bilateral symmetry sampling along the diagonal line of the grid cell, and the sampling node is
The number of unidirectional samples is 3;
STP660 step STP610 and STP620 totals 49 sampling points, and if the color value of any one sampling point belongs to the corresponding threshold range, the current grid cell is marked as the selected target grid cell inclusion statistic.
Has the advantages that:
according to the method, through color value sampling, the spatial displacement change of radioactive particles in a tumor body along with the change of time can be counted in detail; meanwhile, the radiotherapy effect brought by tumor bodies is evaluated; by including radioactive particles in the index eta of the gathering degree1Degree of tumor atrophy η2Effective radiotherapy coverage degree index eta3And the accurate radiotherapeutic degree index eta4And (4) counting is carried out, and the accurate radiotherapy technical effect of the current reflective particle tumor on the current tumor body tissue is objectively reflected.
Meanwhile, the effect and the effect period of different reflective particles on different tumor tissues can be obtained through the change of the tumor state, and scientific reference basis can be provided for the improvement of subsequent accurate radiotherapy of the radioactive particles.
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In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below, it is obvious that the drawings in the following description are only some embodiments of the present application, and for those skilled in the art, other drawings can be obtained according to the drawings without inventive exercise.
FIG. 1 is a flow chart of the present invention;
FIG. 2 is a schematic representation of tumor mass modeling;
FIG. 3 is a cross-sectional view taken along A-A in FIG. 2;
FIG. 4 is a schematic diagram of the number of grid cells occupied by the model obtained after color value extraction in FIG. 3;
FIG. 5 is a CT image of pre-implantation lung cancer of the particles of example 1;
FIG. 6 is a CT image of the site of FIG. 5 on the day after implantation of the particles;
fig. 7 is a CT image of the region of fig. 5 one month after particle implantation.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present application clearer, the technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are some embodiments of the present application, but not all embodiments. The components of the embodiments of the present application, generally described and illustrated in the figures herein, can be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present application, presented in the accompanying drawings, is not intended to limit the scope of the claimed application, but is merely representative of selected embodiments of the application. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.
In order to more intuitively and specifically explain the evaluation method of the present invention, the following description will be given with reference to specific examples.
Example 1:
the present embodiment describes a method for evaluating tumor radiotherapy effect based on radioactive particle implantation, taking a lung cancer patient as an example, and includes the following steps:
STP100 guidewire labeling: two guide wires L arranged in a cross shape1And L2Is adhered to the body surface corresponding to the tumor part of the patient, wherein the direction of one guide wire is consistent with the head and foot sides of the patient; the guide wire L in the above step1And L2Has a minimum length of 40mm, and is performed in a manner of oblique downward scanning and oblique upward scanning at a maximum inclination angle of CTThe thickness was 3 mm. It should be noted that the thickness of the scanned layer should be selected according to the arrangement distance of the particles in the particle implantation plan, and the thickness of the layer should be equal to or less than the arrangement distance of the particles, so that the modeling blind area of the particles after model reconstruction is reduced, and the modeling accuracy is improved.
STP200 CT scan: scanning at different angles for two times aiming at tumor parts to respectively obtain a tomography image layer set Pic1And a tomographic image layer set Pic2；
STP300 passes the tomographic image layer set Pic obtained in step STP2001And a tomographic image layer set Pic2Carrying out three-dimensional model reconstruction to obtain a model P1And model P2；
STP400 models P1And model P2Fusing: obtaining a guide wire L1And L2In model P1Imaging of L'1And L'2In the model P2L ″' of1And L ″)2L 'are aligned separately'1And L ″)1，L′2And L ″)2Fusion model P1And model P2Obtaining a model P3；
STP500 model P3Gridding: model P3Placing in a grid composed of grid cells with side length of k, respectively assigning grid cells and model P in RGB mode3A different color value than the radioactive particles; as shown in fig. 2.
Extracting evaluation indexes of STP 600: separately extracting the number S of radioactive particles by color value threshold1The number of meshes S occupied by the number of radioactive particles2Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4(ii) a As shown in fig. 3 and 4; in a preferred embodiment of the present invention, the number of radioactive particles S in the step STP600 is1The statistical method comprises the following steps:
STP610 extracts the color value assignment of the radioactive particles in STP500, and the color value extraction error is +/-5;
STP620 obtains a set of radioactive particle models consisting of a plurality of discrete bodies;
STP630 counts the number of discrete bodies and records as the number of radioactive particles S1。
For a preferable configuration of the present invention, it is preferable that the number of radioactive particles in step STP600 is a grid number S2Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4The method is carried out in a discrete sampling mode, and specifically comprises the following steps:
STP640 takes a grid unit central point O as a reference sampling point, and performs symmetrical sampling on X, Y, Z axes in positive and negative directions of a space coordinate system respectively, wherein the number of sampling nodes is 0.2k, and the number of sampling in a single direction is 4;
STP650 takes the central point O of the grid cell as a reference sampling point, and respectively carries out bilateral symmetry sampling along the diagonal line of the grid cell, and the sampling node is
The number of unidirectional samples is 3;
STP660 step STP610 and STP620 totals 49 sampling points, and if the color value of any one sampling point belongs to the corresponding threshold range, the current grid cell is marked as the selected target grid cell inclusion statistic.
Outputting an STP700 evaluation result:
output radioactive particle convergence degree index eta1＝(1-S1/S0)*100％，η1A larger value indicates a higher degree of radioactive particle bunching;
output tumor atrophy degree indicator eta2＝(1-S2/S0)*100％，η2A larger value indicates a higher degree of tumor atrophy;
outputting an effective radiotherapy coverage degree index eta3＝(1-S3/S0)*100％，η3A larger value indicates a higher degree of coverage of the effective radiotherapy for the tumor;
outputting accurate radiotheraphy degree index eta4＝S4/S1If η4When the ratio is 1, the precision radiotherapy degree is 100%; if eta4Not equal to 1, the smaller the value is, the lower the precision radiotherapy degree is; wherein S is0The number of radioactive seeds implanted.
According to the above steps, a patient with lung cancer is respectively treated with the radioactive particles I125CT scanning is carried out before implantation, on the day of implantation and one month after implantation to obtain images shown in figures 5-7; the figure shows a diagrammatic representation of the same section of a tumor. It should be noted that, although there may be a deviation of 1 to 3mm between one month scanning and positioning error, the particle implantation plan is an equal implantation, and therefore, even if there is a deviation of the tomographic scanning, the judgment of the index tendency is not affected. As can be seen from FIG. 6, the distribution of the radioactive particles is relatively uniform, the particles are implanted uniformly according to the operation plan, and the stability between the particles and the tumor body is good, and the phenomenon of slippage in the needle channel does not occur; the radioactive particles shown in fig. 7 are in the form of clusters, and a plurality of particles are clustered, so that the dispersion uniformity is reduced, and the imaging area of a single ion cluster is increased, which indicates that the tissue of the tumor body is shrunk and the inside of the tumor body is locally collapsed under the action of the radioactive particles.
In this example, the radioactive particles I125Number of implantations S068 grains in number; number of radioactive particles S in reconstructed model142, here said S1The number of the radioactive particles in a discrete state after three-dimensional reconstruction is imaged, that is, a plurality of radioactive particles in contact with each other form an integrated model after three-dimensional reconstruction, then the radioactive particle model forming the irregularity is marked as one, that is, S11/42 of (1). Number of meshes S occupied by number of radioactive particles2Is 33, model P3Number of occupied grid cells S318, radioactive particles and a model P3Number of shared grid cells S4The number is 42. Namely:
index η of radioactive particle gathering degree1＝(1-S1/S0)*100％＝42/68＝38.2％；
Degree of tumor atrophy indicator eta2＝(1-S2/S0)*100％＝51.4％；
Coverage index eta for effective radiotherapy3＝(1-S3/S0)*100％＝73.5％；
Accurate radiotherapeutic degree index eta4＝S4/S142, by upper η1-η4Shows that 68 radioactive particles I exist in the tumor body125Under the action of one month, the tumor body per se shrinks by about half, the distribution gathering degree of the radioactive particles reaches 38.2 percent, namely, along with the shrinking of the tumor body, the positions of the radioactive particles are changed, the distance between two adjacent radioactive particles is reduced, and meanwhile, the radioactive particles are released to different degrees due to the looseness in the tumor body. However, the effective radiotherapy coverage index is 73.5%, which indicates that cancer cell DNA is damaged in different degrees after tumor tissues are subjected to radioactivity, but as the tumor is atrophied, the radioactive particles are continuously moved, so that the tissues close to the edge of the tumor lose the effective radiotherapy effect, and the tumor close to healthy tissues cannot realize effective radiotherapy coverage in the later stage. After one month of accurate radiotherapy, no radioactive particles are found outside the tumor body, the radioactive particles are all wrapped in the tumor body, and other healthy organs are not subjected to I125The radiation of (2) has no side effect and high precision.
The evaluation shows that the scheme of uniformly distributing the particles has two disadvantages:
firstly, the tumor body tissue is continuously shrunk along with the progress of radiotherapy on the part of the tumor body close to the healthy tissue, so that radioactive particles continuously move centripetally, and the tissue close to the outer side of the tumor body can not obtain sufficient and effective radiotherapy effect.
Secondly, the centripetal motion of radioactive particles is increased continuously with the progress of radiotherapy, so that the radiation dose at the center of a tumor body is higher than the prescribed dose, and the coverage index of effective radiotherapy cannot reach more than 85% of the ideal.
Therefore, the invention can not only objectively evaluate the completed accurate radiotherapy particle implantation operation to obtain the actual action effect of the radioactive particles on the tumor tissue in different stages, but also master the displacement rules of the radioactive particles in different stages, and effectively provide objective scientific basis for the relationship between the layout of the radioactive particles and the accurate radiotherapy.
It is worth emphasizing that the invention aims to evaluate the radiotherapy effect of the radioactive particle implantation operation which is finished with treatment, and simultaneously obtains the rule that the radioactive particles move, act on tumor body tissue cells and change on the tumor body tissue in the whole radiotherapy process and the evaluation of the effect after the operation. It does not relate to the treatment or diagnosis of tumours per se.
The above description is only a preferred embodiment of the present application and is not intended to limit the present application, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, improvement and the like made within the spirit and principle of the present application shall be included in the protection scope of the present application.
Claims (5)
1. A tumor radiotherapy effect evaluation method based on radioactive particle implantation is characterized in that: the method comprises the following steps:
STP100 guidewire labeling: two guide wires L arranged in a cross shape1And L2Is adhered to the body surface corresponding to the tumor part of the patient, wherein the direction of one guide wire is consistent with the head and foot sides of the patient;
STP200 CT scan: scanning at different angles for two times aiming at tumor parts to respectively obtain a tomography image layer set Pic1And a tomographic image layer set Pic2；
STP300 passes the tomographic image layer set Pic obtained in step STP2001And a tomographic image layer set Pic2Carrying out three-dimensional model reconstruction to obtain a model P1And model P2；
STP400 models P1And model P2Fusing: obtaining a guide wire L1And L2In model P1Imaging of L'1And L'2In the model P2L ″' of1And L ″)2L 'are aligned separately'1And L ″)1，L′2And L ″)2Fusion model P1And model P2Obtaining a model P3；
STP500 model P3Gridding: model P3Placing in a grid composed of grid cells with side length of k, respectively assigning grid cells and model P in RGB mode3A different color value than the radioactive particles;
extracting evaluation indexes of STP 600: separately extracting the number S of radioactive particles by color value threshold1The number of meshes S occupied by the number of radioactive particles2Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4；
Outputting an STP700 evaluation result:
output radioactive particle convergence degree index eta1＝(1-S1/S0)*100％，η1A larger value indicates a higher degree of radioactive particle bunching;
output tumor atrophy degree indicator eta2＝(1-S2/S0)*100％，η2A larger value indicates a higher degree of tumor atrophy;
outputting an effective radiotherapy coverage degree index eta3＝(1-S3/S0)*100％，η3A larger value indicates a higher degree of coverage of the effective radiotherapy for the tumor;
outputting accurate radiotheraphy degree index eta4＝S4/S1If η4When the ratio is 1, the precision radiotherapy degree is 100%; if eta4Not equal to 1, the smaller the value is, the lower the precision radiotherapy degree is; wherein S is0The number of radioactive particles placed.
2. The method for evaluating the effect of radiotherapy on tumor based on radioactive particle implantation of claim 1, wherein: the guide wire L in step STP1001And L2The shortest length of any one of the two imaging layers is not less than 4 layers under the maximum CT inclination angle state.
3. The method for evaluating the effect of radiotherapy on tumor based on radioactive particle implantation of claim 2, wherein: the CT scanning mode comprises any two modes of flat scanning, oblique overhead scanning and oblique overhead scanning.
4. The method for evaluating the effect of radiotherapy on tumor based on radioactive particle implantation of claim 2, wherein: the number of radioactive particles S in step STP6001The statistical method comprises the following steps:
STP610 extracts the color value assignment of the radioactive particles in STP500, and the color value extraction error is +/-5;
STP620 obtains a set of radioactive particle models consisting of a plurality of discrete bodies;
STP630 counts the number of discrete bodies and records as the number of radioactive particles S1。
5. The method for evaluating the effect of radiotherapy on tumor based on radioactive particle implantation of claim 4, wherein: the number of meshes S occupied by the number of radioactive particles in step STP6002Model P3Number of occupied grid cells S3Radioactive particles and model P3Number of shared grid cells S4The method is carried out in a discrete sampling mode, and specifically comprises the following steps:
STP640 takes a grid unit central point O as a reference sampling point, and performs symmetrical sampling on X, Y, Z axes in positive and negative directions of a space coordinate system respectively, wherein the number of sampling nodes is 0.2k, and the number of sampling in a single direction is 4;
STP650 takes the central point O of the grid cell as a reference sampling point, and respectively carries out bilateral symmetry sampling along the diagonal line of the grid cell, and the sampling node is
The number of unidirectional samples is 3;
STP660 step STP610 and STP620 totals 49 sampling points, and if the color value of any one sampling point belongs to the corresponding threshold range, the current grid cell is marked as the selected target grid cell inclusion statistic.
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