磁共振兼容头部固定装置的开发和磁共振引导的中枢神经系统肿瘤放射治疗的初步经验。

IF 3.4 3区 医学 Q2 ONCOLOGY
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引用次数: 0

摘要

目的:我们的目的是开发一种固定装置(Unity Brain Tumor Immobilization Device,UBID),并研究其在使用 1.5 特斯拉(T)磁共振直线加速器(LINAC)进行磁共振引导放疗(RT)的脑肿瘤患者中的位置重现性,以评估其在临床实践中的可行性,并报告中枢神经系统(CNS)肿瘤患者的代表性病例:通过比较仅将核磁共振模型放在沙发上和将 UBID 放在核磁共振模型旁边所获得的图像,进行定量分析。回顾性分析了 2022 年 6 月至 2022 年 10 月期间使用 1.5T MR-LINAC 接受中枢神经系统肿瘤 RT 治疗的 20 名患者。其中,5 例未使用 UBID,15 例使用了 UBID。使用前10个分段的分段间和分段内误差中位数评估了UBID的位置可重复性:结果:使用 UBID 的磁共振模型的每个磁共振质量因子都符合 Elekta 提出的标准。点间误差在内侧、前胸和颅尾轴的中位偏移值分别为2.98毫米、2.35毫米和1.40毫米。分内误差的中值分别为0.05毫米、0.03毫米和0.06毫米。点间旋转和点内旋转的俯仰、滚动和偏航中位值均为 0.00°。一名被诊断为视神经鞘脑膜瘤的患者在接受 RT 照射时接受了运动监测。两名患者分别在第一次治疗当天和第21次分次治疗前使用1.5T MR-LINAC获得的磁共振图像中观察到肿瘤腔和残留病灶的变化,因此进行了离线/在线适应:结论:在使用 1.5T MR-LINAC 接受 RT 治疗的中枢神经系统肿瘤患者中,可重复和不可移动的 UBID 在临床上是可行的。根据我们的初步经验,我们开发了一套 1.5T MR-LINAC 治疗中枢神经系统肿瘤的工作流程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development of Magnetic Resonance-Compatible Head Immobilization Device and Initial Experience of Magnetic Resonance-Guided Radiation Therapy for Central Nervous System Tumors

Purpose

We aimed to develop and investigate positional reproducibility using a fixation device (Unity Brain tumor Immobilization Device [UBID]) in patients with brain tumor undergoing magnetic resonance (MR)-guided radiation therapy (RT) with a 1.5 Tesla (T) MR-linear accelerator (MR-LINAC) to evaluate its feasibility in clinical practice and report representative cases of patients with central nervous system (CNS) tumor.

Materials and Methods

Quantitative analysis was performed by comparing images obtained by placing only the MR phantom on the couch with those obtained by placing UBID next to the MR phantom. Twenty patients who underwent RT for CNS tumors using 1.5T MR-LINAC between June and October 2022 were retrospectively analyzed. Among them, 5 did not use UBID, whereas 15 used UBID. The positional reproducibility of UBID was evaluated using the median interfractional and intrafractional errors in the first 10 fractions.

Results

Each MR quality factor of the MR phantom with UBID satisfied the criteria presented by Elekta. Median values of median shifts in the mediolateral, anteroposterior, and craniocaudal axes for interfractional errors were 2.98, 2.35, and 1.40 mm, respectively. For intrafractional errors, the median values were 0.05, 0.03, and 0.06 mm, respectively. The median values of the median rotations in pitch, roll, and yaw for both interfractional and intrafractional rotations were 0.00°. One patient diagnosed with an optic nerve sheath meningioma received RT with motion monitoring during irradiation. In 2 patients, changes in the tumor cavity and residual lesions were observed in the MRI obtained using 1.5T MR-LINAC on the day of the first treatment and immediately before the 21st fraction, respectively; therefore, offline/online adaptation was performed.

Conclusions

The reproducible and immobile UBID is clinically feasible in patients with CNS tumors receiving RT with 1.5T MR-LINAC. Based on our initial experience, we developed a workflow for 1.5T MR-LINAC treatment of CNS tumors.

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来源期刊
Practical Radiation Oncology
Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
6.10%
发文量
177
审稿时长
34 days
期刊介绍: The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.
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