МІНІМАЛЬНЕ ДИХАЛЬНЕ ЗМІЩЕННЯ ГРУДЕЙ ЗА ВІЛЬНОГО ДИХАННЯ: ОПИСОВИЙ ОГЛЯД ВІДЕОМАТЕРІАЛІВ ІЗ 4D КТ СКАНАМИ
DOI:
https://doi.org/10.15407/exp-oncology.2026.02.108Ключові слова:
контроль дихання, рак грудної залози, дихальний цикл, чотиривимірна комп’ютерна томографія, контроль за дихальними рухами, променева терапія з поверхневим наведеннямАнотація
Зміщення пухлини під час дихання слід враховувати при променевій терапії пухлин різної локалізації, включаючи рак грудної залози. Зазвичай при плануванні променевої терапії розширюють межі навколо цільового об’єму, щоб урахувати це зміщення. Однак лише в небагатьох дослідженнях обраховують фактичну величину зміщення за вільного дихання. В огляді проаналізовано загальнодоступні відеоматеріали з 4D КТ-сканами з метою оцінювання превалювання дихального зміщення грудей. Скани розділено на категорії в залежності від візуалізованої величини зміщення, а саме: мінімальне (до 3 мм), помірне (до 5 мм) або суттєве (понад 10 мм). Мінімальне зміщення відзначено у 22 із 38 випадків (57,9%), помірне — у 12 випадках (31,6%), суттєве — у 4 випадках (10,5%). Проаналізовані дані свідчать про те, що превалює мінімальне зміщення за рахунок дихальних рухів грудей та грудної клітки, у зв’язку з чим постає питання про доцільність збільшення відступу від меж цільового об’єму у всіх хворих.
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