臺灣博碩士論文加值系統

電腦斷層造影 (Computed tomography, CT) 會因呼吸運動而在影像中產生運動假影 (Motion artifact)，當正子斷層造影 (Positron emission tomography, PET) 依據含有運動假影影像衰減校正後，會使得PET影像中腫瘤邊界產生模糊，另外，若將CT與PET影像融合，亦會發生腫瘤位置無法正確疊合之錯位現象，此現象將導致臨床放射腫瘤科醫師於擬定放射治療計畫時，劃定病患腫瘤體積之不準確度增加。本研究為減少運動假影的影響，利用平均內插電腦斷層影像 (Interpolated average CT, IACT) 進行PET影像之衰減校正 (Attenuation correction, AC)，減少因呼吸運動所產生之問題並進行統計分析與應用，實驗共搜集13位肺癌患者進行分析，利用每位病人最大吸氣及最大呼氣相位內插IACT影像，作為PET影像衰減校正之資訊，並定量分析腫瘤體積及標準攝取值 (Standardized uptake value, SUV)，與一般臨床PET/CT比較結果顯示，融合影像之錯位問題可有效解決，進而減少腫瘤體積高估問題，此技術若運用於臨床制定放射治療計劃，勢必能夠大幅降低定義病患腫瘤體積之誤差。

Respiratory motion causes uncertainties in tumor edges on either computed tomography (CT) or positron emission tomography (PET) images and causes misalignment when registering PET and CT images. This phenomenon may cause radiation oncologists to delineate tumor volume inaccurately in radiotherapy treatment planning. The purpose of this study was to analyze radiology applications using interpolated average CT (IACT) as attenuation correction (AC) to diminish the occurrence of this scenario. Thirteen non-small cell lung cancer patients were recruited for the present comparison study. Each patient had full-inspiration, full-expiration CT images and free breathing PET images by an integrated PET/CT scan. IACT for AC in PETIACT was used to reduce the PET/CT misalignment. The standardized uptake value (SUV) correction with a low radiation dose was applied, and its tumor volume delineation was compared to those from HCT/PETHCT (Helical computed tomography, HCT). The misalignment between the PETIACT and IACT was reduced when compared to the difference between PETHCT and HCT. For HCT and PETHCT, correction was from 72 % to 91 %, while for IACT and PETIACT, correction was from 73 % to 93 % (*p < 0.0001). The maximum and minimum differences in SUVMAX were 0.18 % and 27.27 % for PETHCT and PETIACT, respectively. Internal tumor volume defined by functional information using IACT/PETIACT fusion images for lung cancer would reduce the inaccuracy of tumor delineation in radiation therapy planning.

誌謝 I
摘要 II
Abstract III
目錄 IV
圖目錄 VI
表目錄 VIII
第一章 前言 1
1.1 研究背景 1
1.1.1 文獻回顧與探討 1
1.1.2 研究動機 17
1.2 研究目的 19
第二章 研究方法 22
2.1理論基礎 22
2.2 實驗架構與流程 23
2.3 臨床資料收集 25
2.3.1 影像取得 25
2.3.2 定義腫瘤體積 29
2.4 影像處理 31
2.4.1 光流法 31
2.4.2 Interpolated average CT 34
2.5腫瘤體積分析 36
第三章 研究結果 37
3.1 影像評估 37
3.2 統計分析結果 40
第四章 討論 46
4.1 結果討論 46
4.2研究限制 49
第五章 結論與建議 50
參考文獻 51

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