[Treatment Planning and Dose Verification for Combined Internal and External Radiotherapy (CIERT)].

IF 1 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Nuklearmedizin-nuclear Medicine Pub Date : 2022-02-01 Epub Date: 2021-11-29 DOI:10.1055/a-1650-9428

Robert Freudenberg, Holger Hartmann, Michael Andreeff, Liane Oehme, Thomas Leichtner, Alexander Fischer, Timo Paulus, Mechthild Krause, Jörg Kotzerke

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引用次数: 1

Abstract

Aim: The combined internal and external radiotherapy (CIERT) take advantage of the benefits from radionuclide therapy and external beam irradiation. These include steep dose gradients and a low toxicity to normal tissue due to the use of unsealed radioisotopes as well as homogeneous dose distribution within the tumor due to external beam irradiation. For a combined irradiation planning, an infrastructure has to be developed that takes into account the dose contributions from both modalities. A physical verification of the absorbed dose distribution should follow by measurements using OSL detectors.

Method: Internal irradiation was performed using Re-188 in a cylindrical phantom with three inserts. SPECT images were acquired to calculate the internal dose using the software STRATOS. The dose distribution was exported as DICOM-RT data and imported in the software Pinnacle. Based on the internal dose distribution the external irradiation using 6 MV photons was planned. The dose contributions of both modalities separately as well as for combined irradiation was measured using OSL detectors made out of Beryllium oxide.

Results: The planed doses of combined irradiation (1 Gy, 2 Gy, 4 Gy) could be verified within the uncertainty of the detectors. The mean energy response to Re-188 was (88.6 ± 2.4) % with respect to the calibration with 200 kV X-ray irradiation. The energy response to 6 MV photons was (146.0 ± 4.9) %.

Conclusion: A workflow for the treatment planning of combined internal and external radiotherapy has been developed and tested. Measurements verified the calculated doses. Therefore, the physical and technical basis for the dosimetry of combined irradiation were worked out.

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[内外联合放疗(CIERT)的治疗计划和剂量验证]。

目的:内外联合放疗(CIERT)综合了放射性核素治疗和外照射的优点。这包括陡峭的剂量梯度和由于使用非密封放射性同位素对正常组织的低毒性，以及由于外部束照射在肿瘤内的均匀剂量分布。对于联合辐照规划，必须发展一种基础设施，考虑到两种方式的剂量贡献。在对吸收剂量分布进行物理验证之后，应使用OSL探测器进行测量。方法:采用Re-188对带3个植入物的圆柱形假体进行内照射。利用STRATOS软件获取SPECT图像计算内剂量。剂量分布导出为DICOM-RT数据，并在Pinnacle软件中导入。根据内部剂量分布，计划了6 MV光子的外照射。用氧化铍制成的OSL探测器分别测量了两种方式以及联合照射的剂量贡献。结果:计划辐照剂量(1 Gy、2 Gy、4 Gy)可在探测器的不确定度范围内进行验证。相对于200 kV x射线辐照校准，Re-188的平均能量响应为(88.6±2.4)%。对6 MV光子的能量响应为(146.0±4.9)%。结论:建立并测试了一套内外联合放疗的治疗计划工作流程。测量结果证实了所计算的剂量。从而为联合辐照的剂量学研究奠定了物理和技术基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nuklearmedizin-nuclear Medicine 医学-核医学

CiteScore

1.70

自引率

13.30%

发文量

267

审稿时长

>12 weeks

期刊介绍： Als Standes- und Fachorgan (Organ von Deutscher Gesellschaft für Nuklearmedizin (DGN), Österreichischer Gesellschaft für Nuklearmedizin und Molekulare Bildgebung (ÖGN), Schweizerischer Gesellschaft für Nuklearmedizin (SGNM, SSNM)) von hohem wissenschaftlichen Anspruch befasst sich die CME-zertifizierte Nuklearmedizin/ NuclearMedicine mit Diagnostik und Therapie in der Nuklearmedizin und dem Strahlenschutz: Originalien, Übersichtsarbeiten, Referate und Kongressberichte stellen aktuelle Themen der Diagnose und Therapie dar. Ausführliche Berichte aus den DGN-Arbeitskreisen, Nachrichten aus Forschung und Industrie sowie Beschreibungen innovativer technischer Geräte, Einrichtungen und Systeme runden das Konzept ab. Die Abstracts der Jahrestagungen dreier europäischer Fachgesellschaften sind Bestandteil der Kongressausgaben. Nuklearmedizin erscheint regelmäßig mit sechs Ausgaben pro Jahr und richtet sich vor allem an Nuklearmediziner, Radiologen, Strahlentherapeuten, Medizinphysiker und Radiopharmazeuten.