现代仪器与医疗

图像引导下膀胱容量仪监测精确放疗技术在局部晚期宫颈癌的应用研究

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石宏 , 吴岳熹 , 王津津 , 武霞 ^*

现代仪器与医疗 | 临床研究 2025,31(3): 61-66

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现代仪器与医疗 |临床研究 2025 , 31 (3) : 61 -66

图像引导下膀胱容量仪监测精确放疗技术在局部晚期宫颈癌的应用研究

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石宏, 吴岳熹, 王津津, 武霞^*

作者信息

山东省立第三医院肿瘤中心，济南　250031

通讯作者:

武霞，女，在读博士研究生，副主任医师，研究方向：肿瘤放射治疗

作者简介:

石宏，男，在读硕士研究生，主管技师，研究方向：肿瘤放射物理

Application of image-guided bladder volume monitoring in precision radiotherapy for locally advanced cervical cancer: a clinical study

Hong Shi, Yuexi Wu, Jinjin Wang, Xia Wu^*

Affiliations

Department of Radiation Oncology, Shangdong Provicial Third Hospital, Jinan 250031, China

出版时间: 2025-06-10 doi: 10.11876/mimt202503011

文章导航

摘要

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目的

针对局部晚期宫颈癌患者，联合使用图像引导放疗技术和膀胱容量测定仪监测膀胱容积，分析使用膀胱容量测定仪对图像引导放疗摆位纠正误差的影响，为临床精确放疗的实施提供参考。

方法

选取40例局部晚期宫颈癌患者，随机分为研究组和对照组，研究组使用膀胱容量测定仪测定膀胱容量，对照组自主憋尿，两组患者均在放疗前行CT定位获得计划计算机断层扫描（planning computed tomography，pCT）影像，在每次治疗前行锥形束计算机断层扫描（cone beam computed tomography，CBCT）验证，在所有pCT和CBCT上勾画膀胱轮廓，获得容积值。对比分析研究组膀胱容量测定仪测定值与pCT和CBCT勾画的膀胱容积值的差异，验证膀胱容量测定仪的准确性；比较每次治疗的CBCT与定位pCT的膀胱容积值及摆位纠正误差，分析使用膀胱容量测定仪对膀胱充盈一致性和摆位纠正误差的影响；比较两组患者靶区及其危及器官受照体积。

结果

使用膀胱容量测定仪测得的膀胱容量与pCT和CBCT勾画的膀胱容积值比较，差异均无统计学意义（P=0.539，P=0.343）。研究组pCT的膀胱容积值与CBCT的膀胱容积值比较，两者差异无统计学意义（P=0.097），对照组pCT与CBCT膀胱容积值的差异有统计学意义（P<0.05）。研究组在X轴、Y轴、Z轴方向上的摆位纠正误差值均小于对照组，差异均有统计学意义（P<0.05）。在靶区及其危及器官受照体积对比中，发现研究组和对照组仅有膀胱和小肠受照体积差异有统计学意义（P<0.05），而临床靶区（clinical target volume，CTV）、计划靶区（planing target volume，PTV）、直肠、股骨头受照体积差异无统计学意义（P>0.05）。

结论

使用膀胱容量测定仪可以准确控制患者放疗分次间膀胱充盈的一致性，有效降低了摆位误差值，保证了靶区的受照射体积及照射剂量，同时降低了小肠等危及器官的受照射风险。

关键词

宫颈癌 / 调强放疗 / 锥形束计算机断层扫描 / 膀胱容量测定仪

Abstract

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Objective

To investigate the impact of combining image-guided radiotherapy (IGRT) with a bladder volume measurement device on reducing positional errors in patients with locally advanced cervical cancer, and to provide references for precise clinical radiotherapy implementation.

Methods

Forty patients with locally advanced cervical cancer were randomly divided into a study group (using a bladder volume measurement device) and a control group (self-regulated bladder filling). Both groups underwent pre-treatment CT simulation (pCT) and daily cone-beam CT (CBCT) scans. Bladder contours were delineated on all pCT and CBCT images to obtain volumetric data. The accuracy of the bladder volume measurement device was assessed by comparing its readings with bladder volumes derived from pCT and CBCT. Inter-fraction bladder filling consistency and positional correction errors were analyzed by comparing CBCT-derived bladder volumes with pCT baselines. Irradiated volumes of the eighth region and the vital organs were compared between the two groups.

Results

No significant differences were observed between bladder volumes measured by the device and those from pCT or CBCT (P = 0.539, P = 0.343, respectively). In the study group, no significant difference existed between pCT and CBCT bladder volumes (P=0.097), whereas the control group showed significant discrepancies (P<0.05). Positional correction errors in the X, Y, and Z axes were significantly smaller in the study group compared to the control group (P<0.05). Significant differences in irradiated volumes of the bladder and small bowel were observed between groups (P<0.05), but not for the CTV, PTV, rectum, or femoral heads (P>0.05).

Conclusion

The bladder volume measurement device effectively ensures consistent bladder filling during radiotherapy, reduces positional errors, stabilizes target dose coverage, and lowers radiation risks to organs at risk (e.g., small bowel). This approach enhances precision in hypofractionated radiotherapy for cervical cancer.

Key words

Cervical cancer / Intensity modulated radiotherapy / Cone beam computed tomography / Bladder capacity measurement instrument

引用本文

石宏, 吴岳熹, 王津津, 武霞. 图像引导下膀胱容量仪监测精确放疗技术在局部晚期宫颈癌的应用研究. 现代仪器与医疗, 2025 , 31 (3) : 61 -66 . DOI: 10.11876/mimt202503011

Hong Shi, Yuexi Wu, Jinjin Wang, Xia Wu. Application of image-guided bladder volume monitoring in precision radiotherapy for locally advanced cervical cancer: a clinical study[J]. Modern Instruments & Medical Treatment, 2025 , 31 (3) : 61 -66 . DOI: 10.11876/mimt202503011

基金

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山东省医学会临床科研项目(YXH2022ZX02201)

参考文献

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2025年第31卷第3期

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文章信息

doi: 10.11876/mimt202503011

首发时间：2026-10-23
出版时间：2025-06-10

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基金

山东省医学会临床科研项目(YXH2022ZX02201)

作者信息

山东省立第三医院肿瘤中心，济南　250031

通讯作者:

武霞，女，在读博士研究生，副主任医师，研究方向：肿瘤放射治疗

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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