基于四维计算机断层扫描的内部目标体积与肺立体定向体放射治疗中体积调制电弧治疗和三维适形放射治疗期间呼吸运动变化的剂量比较。

IF 1.7 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Radiological Physics and Technology Pub Date : 2024-03-01 Epub Date: 2023-11-06 DOI:10.1007/s12194-023-00757-8
Daimu Fujimoto, Jun Takatsu, Naoya Hara, Masaki Oshima, Jun Tomihara, Eisuke Segawa, Tatsuya Inoue, Naoto Shikama
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引用次数: 0

摘要

本研究的重点是肺立体定向放射治疗(SBRT)过程中呼吸运动变化的剂量影响。使用基于四维计算机断层扫描(4DCT)的内靶体积(ITV)对体积调制电弧治疗(VMAT)和三维适形放射治疗(3DCRT)进行剂量比较。我们为10名癌症患者制定了回顾性计划,这些患者使用3DCRT和VMAT技术进行了SBRT。Delta4幻影 + (ScandiDos,瑞典乌普萨拉)用于评估基于4DCT的ITV对治疗期间呼吸运动变化的剂量稳健性。我们分析了治疗期间的呼吸运动。对在自由呼吸下获得的CT图像上绘制的计划目标体积(PTV)的95%剂量(D95%)的剂量-体积直方图参数进行评估。还评估了患者呼吸参数与剂量测量误差之间的相关性。在体模研究中,所有组分的平均PTV D95%剂量差异为 - 2.9 ± 4.4%(- 16 - 1.2%)和 - 2 ± 2.8%(- 11.2 - 0.7%)。平均剂量差为 95% > 10%。剂量测量误差与呼吸幅度和速度相关,4DCT和治疗天数之间的呼吸幅度差异是导致剂量测量误差的主要因素。PTV D95%的总体平均剂量误差较小;然而,3DCRT和VMAT病例都观察到超过10%的误差。振幅变化或基线漂移出现较大误差,表明基于4DCT的ITV的稳健性有限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dosimetric comparison of four-dimensional computed tomography based internal target volume against variations in respiratory motion during treatment between volumetric modulated arc therapy and three-dimensional conformal radiotherapy in lung stereotactic body radiotherapy.

This study focused on the dosimetric impact of variations in respiratory motion during lung stereotactic body radiotherapy (SBRT). Dosimetric comparisons between volumetric modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3DCRT) were performed using four-dimensional computed tomography (4DCT)-based internal target volumes (ITV). We created retrospective plans for ten patients with lung cancer who underwent SBRT using 3DCRT and VMAT techniques. A Delta4 Phantom + (ScandiDos, Uppsala, Sweden) was used to evaluate the dosimetric robustness of 4DCT-based ITV against variations in respiratory motion during treatment. We analyzed respiratory motion during treatment. Dose-volume histogram parameters were evaluated for the 95% dose (D95%) to the planning target volume (PTV) contoured on CT images obtained under free breathing. The correlations between patient respiratory parameters and dosimetric errors were also evaluated. In the phantom study, the average PTV D95% dose differences for all fractions were - 2.9 ± 4.4% (- 16.0 - 1.2%) and - 2.0 ± 2.8% (- 11.2 - 0.7%) for 3DCRT and VMAT, respectively. The average dose difference was < 3% for both 3DCRT and VMAT; however, in 5 out of 42 fractions in 3DCRT, the difference in PTV D95% was > 10%. Dosimetric errors were correlated with respiratory amplitude and velocity, and differences in respiratory amplitude between 4DCT and treatment days were the main factors causing dosimetric errors. The overall average dose error of the PTV D95% was small; however, both 3DCRT and VMAT cases exceeding 10% error were observed. Larger errors occurred with amplitude variation or baseline drift, indicating limited robustness of 4DCT-based ITV.

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来源期刊
Radiological Physics and Technology
Radiological Physics and Technology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
3.00
自引率
12.50%
发文量
40
期刊介绍: The purpose of the journal Radiological Physics and Technology is to provide a forum for sharing new knowledge related to research and development in radiological science and technology, including medical physics and radiological technology in diagnostic radiology, nuclear medicine, and radiation therapy among many other radiological disciplines, as well as to contribute to progress and improvement in medical practice and patient health care.
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