跨学科三维标本测绘优化头颈癌放射治疗

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-09-01 DOI:10.1016/S0167-8140(25)04734-6

Jamie J.Y. Kwon , Sarah Hamilton , Matthew Chan , Brad Gill , Samantha Lloyd , Joel Howlett , Cornelius Kürten , Tony Ng , Carl Ren , Eitan Prisman

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引用次数: 0

摘要

目的：头颈癌（HNC）的放射治疗（RT）计划依赖于手术边缘的准确描绘，然而传统的病理报告和成像方法往往无法捕捉肿瘤切除的空间复杂性。本研究评估了将三维标本图（3DSM）整合到RT计划中的可行性和影响，以增强边缘可视化和改善目标描绘。材料与方法：10例局部晚期HNC切除标本行三维扫描。生成3DSM并对正切缘和闭合切缘进行注释，然后将其记录到术前和放疗前CT扫描中，以评估与现有RT计划的临床靶体积（CTV）和计划靶体积（PTV）的体积重叠程度，以及靶体积内的正切缘覆盖率。一项对机构HNC放射肿瘤学家（ROs）的调查将3DSM的临床应用与传统的书面报告和口头交流进行了比较。结果：回顾性分析显示，3DSM与CTV的平均容积重叠率为70.6±21.8%，3DSM与PTV的平均容积重叠率为86.9±14.7%。在33%的病例中，正缘或近缘不包括在CTV内。在所有调查类别中，ROs一致认为3DSM比传统方法更具信息量（p<0.01），特别是在边缘位置的沟通和术后变化的解释方面。结论：这项概念验证研究证明了3D标本图在改善头颈癌放疗计划方面的潜力，特别是在增强边缘可视化和局部复发高风险区域的靶向性方面。调查反馈和体积重叠数据表明，3D模型可以通过提高解剖清晰度和支持高精度RT传递来提供重要的临床价值。虽然未来的研究需要在更大的人群中证实这些发现，但早期的结果有望纳入标准实践。

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INTERDISCIPLINARY 3D SPECIMEN MAPPING TO OPTIMIZE RADIATION THERAPY FOR HEAD AND NECK CANCER

Purpose:

Radiation therapy (RT) planning for head and neck cancer (HNC) relies on accurate delineation of surgical margins, yet traditional pathology reports and imaging methods often fail to capture the spatial complexity of tumour resection. This study evaluates the feasibility and impact of integrating three-dimensional specimen maps (3DSM) into RT planning to enhance margin visualization and improve target delineation.

Materials and Methods:

Ten resected specimens from locally advanced HNC cases underwent 3D scanning. 3DSM were generated and annotated for positive and close margins, then registered to preoperative and pre-radiation CT scans to assess volume overlap with the clinical target volume (CTV) and planning target volume (PTV) from existing RT plans, and positive margin coverage within target volumes. A survey of institutional HNC radiation oncologists (ROs) compared the clinical utility of 3DSM to traditional written reports and verbal communication.

Results:

Retrospective analysis showed a mean volume overlap of 70.6±21.8% between 3DSM and CTV, and 86.9±14.7% between 3DSM and PTV. In 33% of cases, positive or close margins were not encompassed within the CTV. ROs consistently rated 3DSM as more informative than traditional methods in all survey categories (p<0.01), particularly in communication of margin location and interpretation of postoperative changes.

Conclusions:

This proof-of-concept study demonstrates the potential of 3D specimen maps to improve RT planning for head and neck cancer, particularly in enhancing margin visualization and targeting of areas at high risk of local recurrence. Survey feedback and volume overlap data indicate that 3D models may offer significant clinical value by improving anatomical clarity and supporting high-precision RT delivery. While future studies will be needed to confirm these findings in larger cohorts, early results are promising for integration into standard practice.

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.