在常规呼吸过程中进行相位选区放射治疗时,计划选区窗口与实际照射选区窗口之间的意外差异

IF 1.7 4区 综合性期刊 Q2 MULTIDISCIPLINARY SCIENCES
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引用次数: 0

摘要

我们在不对称呼吸模式中观察到了意想不到的门控窗口差异。因此,本研究旨在验证不对称呼吸导致这种差异的假设。我们使用 QUASAR 软件生成了六种规则的呼吸模式。使用 QUASAR 呼吸运动模型对每种呼吸模式进行四维计算机断层扫描(4DCT),模型中的 1.2 厘米球形丙烯酸球嵌入杉木插入物中。实时位置管理系统用于采集 4DCT 期间的呼吸信号。每个治疗方案都使用 30% 至 70% 的门控窗口创建。TrueBeam STx 用于门控射束传输,并在照射后对存储的波形数据文件和门控 kV 图像进行分析。分析波形数据文件时使用了两种不同的相位概念。在治疗过程中,TrueBeam 选通系统前瞻性地定义的呼吸相位称为 "相位",治疗后通过波形数据分析回顾性地定义的相位称为 "相位"。在所有呼吸模式中,相位值都接近计划的门控窗口(30% 或 70%)。然而,在不对称模式中,相位值与计划选通窗口不同。根据不对称的方向,选通窗口要么被拉前,要么被推后。此外,这种差异随着呼吸模式不对称程度的增加而增大。在一些不对称呼吸模型中,选通 kV 图像上的肿瘤位置位于内部靶体积轮廓线之外。这项研究证实,4DCT 和 TrueBeam 门控系统之间的门控窗口差异发生在呼吸模式不对称的情况下,即使是有规律的呼吸也是如此。因此,如果患者的呼吸不完全对称,则应采取适当的措施防止这种意外的系统误差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unexpected discrepancy between the planned gating window and the actual irradiated gating window in phase-based gating radiotherapy during regular respiration

Introduction

We observed unexpected gating window discrepancies in asymmetric respiratory patterns. Therefore, the present study was conducted to test the hypothesis that asymmetric breathing causes this discrepancy.

Materials and methods

Six regular respiratory patterns were generated using the QUASAR software. 4-dimensional computed tomography (4DCT) was acquired with each breathing pattern using a QUASAR respiratory motion phantom with a 1.2 cm spherical acrylic ball embedded in a cedar insert. A Real-time Position Management system was used for respiratory signal acquisition during the 4DCT. Each treatment plan was created using gating windows ranging from 30% to 70%. TrueBeam STx was used for gated beam delivery, and the stored waveform data files and gated kV images were analyzed after irradiation. Two different concepts of phase were used to analyze the waveform data files. The respiratory phase defined prospectively by the TrueBeam gating system during treatment was called “phasepro”, and the phase defined retrospectively by waveform data analysis after treatment was called “phaseretro".

Results

The phasepro values were close to the planned gating window (30% or 70%) for in all breathing patterns. However, the phaseretro values differed from the planned gating window in the asymmetric patterns. The gating window was either pulled forward or pushed back from the treatment plan depending on the direction of the asymmetry. Furthermore, this discrepancy increased as the asymmetry of the respiratory pattern increased. In some asymmetric breathing models, the tumor location on the gated kV image was outside the internal target volume contour.

Conclusion

This study confirmed that the gating window discrepancy between 4DCT and the TrueBeam gating system occurs with asymmetric respiration pattern, even with regular breathing. Therefore, if a patient's breathing is not exactly symmetrical, appropriate measures should be taken against this unexpected systematic error.

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来源期刊
自引率
5.90%
发文量
130
审稿时长
16 weeks
期刊介绍: Journal of Radiation Research and Applied Sciences provides a high quality medium for the publication of substantial, original and scientific and technological papers on the development and applications of nuclear, radiation and isotopes in biology, medicine, drugs, biochemistry, microbiology, agriculture, entomology, food technology, chemistry, physics, solid states, engineering, environmental and applied sciences.
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