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首页> 外文期刊>Physics in medicine and biology. >Spatial correspondence of 4D CT ventilation and SPECT pulmonary perfusion defects in patients with malignant airway stenosis
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Spatial correspondence of 4D CT ventilation and SPECT pulmonary perfusion defects in patients with malignant airway stenosis

机译：恶性气道狭窄患者的4D CT通气与SPECT肺灌注缺陷的空间对应

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To determine the spatial overlap agreement between four-dimensional computed tomography (4D CT) ventilation and single photon emission computed tomography (SPECT) perfusion hypo-functioning pulmonary defect regions in a patient population with malignant airway stenosis. Treatment planning 4D CT images were obtained retrospectively for ten lung cancer patients with radiographically demonstrated airway obstruction due to gross tumor volume. Each patient also received a SPECT perfusion study within one week of the planning 4D CT, and prior to the initiation of treatment. Deformable image registration was used to map corresponding lung tissue elements between the extreme component phase images, from which quantitative three-dimensional (3D) images representing the local pulmonary specific ventilation were constructed. Semi-automated segmentation of the percentile perfusion distribution was performed to identify regional defects distal to the known obstructing lesion. Semi-automated segmentation was similarly performed by multiple observers to delineate corresponding defect regions depicted on 4D CT ventilation. Normalized Dice similarity coefficient (NDSC) indices were determined for each observer between SPECT perfusion and 4D CT ventilation defect regions to assess spatial overlap agreement. Tidal volumes determined from 4D CT ventilation were evaluated versus measurements obtained from lung parenchyma segmentation. Linear regression resulted in a linear fit with slope = 1.01 (R 2= 0.99). Respective values for the average DSC, NDSC 1 mmand NDSC 2 mmfor all cases and multiple observers were 0.78, 0.88 and 0.99, indicating that, on average, spatial overlap agreement between ventilation and perfusion defect regions was comparable to the threshold for agreement within 12 mm uncertainty. Corresponding coefficients of variation for all metrics were similarly in the range: 0.10%19%. This study is the first to quantitatively assess 3D spatial overlap agreement between clinically acquired SPECT perfusion and specific ventilation from 4D CT. Results suggest high correlation between methods within the sub-population of lung cancer patients with malignant airway stenosis.
机译：为了确定患有恶性气道狭窄的患者人群中的二维计算机断层扫描（4D CT）通气和单光子发射计算机断层摄影（SPECT）灌注功能低下的肺缺损区域之间的空间重叠一致性。回顾性地获得了10例肺癌患者的治疗计划4D CT图像，这些患者通过影像学证实由于总肿瘤体积而导致气道阻塞。在计划4D CT的一周内以及开始治疗之前，每位患者还接受了SPECT灌注研究。可变形图像配准用于在极端成分相图像之间映射相应的肺组织元素，从中构建表示局部肺特异性通气的定量三维（3D）图像。进行百分比灌注分布的半自动分割，以识别已知阻塞性病变远端的区域性缺陷。半自动分割由多个观察员类似地执行，以描绘4D CT通气中描绘的相应缺陷区域。为每个观察者确定SPECT灌注和4D CT通气缺陷区域之间的归一化骰子相似系数（NDSC）指标，以评估空间重叠一致性。与通过肺实质分割获得的测量值相比，评估了通过4D CT通气确定的潮气量。线性回归导致线性拟合的斜率= 1.01（R 2 = 0.99）。所有病例和多名观察者的平均DSC，NDSC 1 mm和NDSC 2 mm的分别值为0.78、0.88和0.99，这表明通气和灌注缺损区域之间的空间重叠一致性平均水平与12 mm以内的一致性阈值相当不确定。所有指标的相应变异系数相似地在范围内：0.10％19％。这项研究是第一个定量评估临床获得的SPECT灌注与4D CT特定通气之间的3D空间重叠协议的方法。结果表明，在患有恶性气道狭窄的肺癌患者亚人群中，方法之间存在高度相关性。

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