应用一维、二维、三维探测器阵列进行螺旋断层调强放疗计划剂量验证
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摘要
目的:比较Tomotherapy标配Cheese模体联合EBT3免冲洗胶片(一维探测器阵列)、Octavius八角模体配合PTW Seven29二维探测器阵列(二维探测器阵列)、Delta4三维探测器阵列用于螺旋断层放疗系统(Tomo Therapy,TOMO)的调强计划实施剂量验证的差异。方法:分别采用一维、二维、三维探测器对10例患者TOMO的调强计划实施验证。通过TOMO系统MVCT成像和配准消除床面沉降的影响,确保实现体模和探测器阵列的精确摆位。实施治疗质量保证(Delivery Quality Assurance,DQA)计划照射后将测量获得的平面剂量分布与TOMO计划系统模体计划计算获得的平面剂量分布进行比较。采用Gamma分析方法,选择多个不同的剂量标准分析评估验证情况。结果:采用3%/2mm、3%/3 mm、3%/4 mm、3%/5 mm四种不同剂量偏差/吻合距离剂量标准,γ≤1的平均通过率均超过95.2%,测量所得剂量分布与计算结果在相应平面的几何分布均呈现出良好的一致性。结论:胶片空间分辨率高于二维、三维探测器阵列,是调强计划验证的"金标准"。而二维和三维探测器阵列凭借其操作简便、数据处理快捷的特点可作为一维验证方法的有效补充。
Objective:To compare the difference of dose verification of intensity modulated planning of tomo Therapy(TOMO) using the EBT3 no rinse film combining cheese phantom, PTW Seven29 2D-ARRAY inserted in a dedicated octagonal phantom, called Octavius and Delta4 three dimensional detector array. Methods:The EBT3 no rinse film, PTW Seven292D-ARRAY combining Octavius phantom and Delta4 detector array was used to verify the TOMO treatment plan dose distribution of 10 patients. The precise setup of detector array was guided and registered by MVCT imaging. After the implementation of delivery quality assurance(DQA) plan, the measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system(TPS). Based on several different Gamma criteria, the Gamma analysis method was utilized to evaluate the dose verification. Results:According to the different acceptance criteria combination of dose difference(DD) / distance to agreement(DTA) at different threshold level including 3%/2 mm, 3%/3 mm, 3%/4 mm, 3%/5 mm, the mean passing rates with γparameter ≤ 1 were all above 95.2%. the dose distribution measured by the EBT3 no rinse film, 2D-ARRAY combining Octavius phantom and Delta4 detector array was well consistent with that calculated by the TPS. Conclusions:Film detector has the highest spatial resolution and is the golden standard in radiation therapy delivery verification including TOMO. Two dimensional and three dimensional detector arrays are the complementary tools to film withtheir simple operation and easy data processing.in clinical quality assurance(QA) work.
Objective:To compare the difference of dose verification of intensity modulated planning of tomo Therapy(TOMO) using the EBT3 no rinse film combining cheese phantom, PTW Seven29 2D-ARRAY inserted in a dedicated octagonal phantom, called Octavius and Delta4 three dimensional detector array. Methods:The EBT3 no rinse film, PTW Seven292D-ARRAY combining Octavius phantom and Delta4 detector array was used to verify the TOMO treatment plan dose distribution of 10 patients. The precise setup of detector array was guided and registered by MVCT imaging. After the implementation of delivery quality assurance(DQA) plan, the measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system(TPS). Based on several different Gamma criteria, the Gamma analysis method was utilized to evaluate the dose verification. Results:According to the different acceptance criteria combination of dose difference(DD) / distance to agreement(DTA) at different threshold level including 3%/2 mm, 3%/3 mm, 3%/4 mm, 3%/5 mm, the mean passing rates with γparameter ≤ 1 were all above 95.2%. the dose distribution measured by the EBT3 no rinse film, 2D-ARRAY combining Octavius phantom and Delta4 detector array was well consistent with that calculated by the TPS. Conclusions:Film detector has the highest spatial resolution and is the golden standard in radiation therapy delivery verification including TOMO. Two dimensional and three dimensional detector arrays are the complementary tools to film withtheir simple operation and easy data processing.in clinical quality assurance(QA) work.
引文
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[7]Chandraraj V,Stathakis S,Manickam R,et al.Comparison of four commercial devices for Rapid Arc and sliding window IMRT QA[J].J Appl Clin Med Phys,2011,12:338-349.坎德拉拉,斯托瑟肯斯,麦尼肯,等.Rapid Arc和滑窗调强放疗QA四种商用装置的比较[J].临床应用医学物理学杂志,2011,12:338-349.
[8]Feygelman V,Opp D,Javedan K,et al.Evaluation of a 3D diode array dosimeter for helical tomotherapy delivery QA[J].Medical Dosimetry,2010,35:324-329.费舍曼,奥普,扎福达,等.Tomotherapy QA三维探测器阵列的评估[J].医学计量学,2010,35:324-329.
[9]Van Esch A,Clermont C,Devillers M,et al.On-line quality assurance of rotational radiotherapy treatment delivery by means of a 2D ion chamber array and the octavius phantom[J].Med Phys,2007,34:3825-3837.范艾克,克莱门特,戴维勒,等.应用二维电离室阵列和Octavius体模进行旋转放疗的在线QA[J].医学物理学,2007,34:3825-3837.
[10]Syam Kumar SA,Sukumar P,Sriram P,et al.A patient-specific quality assurance study on absolute dose verification using ionization chambers of different volumes in Rapid Arc treatments[J].Medical Dosimetry,2012,37:436-441.萨姆库玛,素库玛,斯雷拉姆,等.应用不同体积电离室进行特定患者的Rapid Arc放疗绝对剂量验证的QA研究[J].医学计量学,2012,37:436-441.
[11]Myers P,Stathakis S,Gutiérr ez AN,et al.Evaluation of PTW Seven29 for tomotherapy patient-specific quality assurance and comparison with Scandi Dos Delta4[J].Journal of Medical Physics,2012,37:72-80.梅斯,斯托瑟肯斯,谷铁雷斯,等.应用PTW 729阵列进行特定患者tomotherapy放疗QA的评估及与Delta4的比较[J].医学物理学杂志,2012,37:72-80.
[12]Whitmore N,Nalichowski A,Burmeister J,et al.Effects of dose scaling on delivery quality assurance in tomotherapy[J].J Appl Clin Med Phys,2012,13:84-92.维特莫尔,纳利库斯基,博梅斯特,等.剂量刻度对Tomotherapy放疗QA的影响[J].临床应用医学物理学杂志,2012,13:84-92.
[13]徐寿平,邓小武,戴相昆,等.螺旋断层放疗系统调强放疗验证[J].中华放射肿瘤学杂志,2008,17:395-397.Xu SP,Deng XW,Dai XK,et al.Treatment verification of helical tomotherapy intensity modulated radiation therapy[J].Chin J Radiat Onc,2008,17:395-397.
[14]徐寿平,解传滨,鞠忠建,等.用二维电离室阵列对螺旋断层治疗的调强计划进行剂量验证[J].中华放射肿瘤学杂志,2009,18:233-236.Xu SP,Xie CB,Ju ZJ,et al.Two-dimensional ion chamber array in dose verification for intensity modulated planning of helical tomotherapy[J].Chin J Radiat Onc,2009,18:233-236.
[15]张富利,王雅棣,刘清智,等.应用Delta4三维探测器阵列进行螺旋断层治疗计划剂量验证[J].中华放射肿瘤学杂志,2013,22:309-311.Zhang FL,Wang YD,Liu QZ,et al.Delta three-dimensional semiconductor array verification for intensity modulated planning of helical tomotherapy[J].Chin J Radiat Onc,2013,22:309-311.
[16]张富利,张勇乾,王雅棣.螺旋断层加速器与常规加速器在肺癌调强放疗中的剂量学评估初探[J].中国医学物理学杂志,2012,29:3596-3598.Zhang FL,Zhang YQ,Wang YD.Dosimetric comparison xlated radiotherapy for lung cancer[J].CHINESE JOURNAL OF MEDICAL PHYSICS,2012,29:3596-3598.
[17]徐寿平,解传滨,戴相昆,等.二维半导体阵列实施旋转调强治疗计划验证的剂量学评估[J].中国医学物理学杂志,2009,26:1477-1480.Xu SP,Xie CB,Dai XK,et al.Dose analysis of a diode array for dose verification of rotational intensity modulated radiation therapy planning[J].CHINESE JOURNAL OF MEDICAL PHYSICS,2009,26:1477-1480.
[18]Chandraraj V,Stathakis S,Manickam R,et al.Consistency and reproducibility of the VMAT plan delivery using three independent validation methods[J].J Appl Clin Med Phys,2010,12:129-140.坎德拉拉,斯托瑟肯斯,麦尼肯,等.应用三种不同方法验证容积旋转调强放疗计划实施的一致性和重复性[J].临床应用医学物理学杂志,2010,12:129-140.
[19]Journal of the ICRU Report 83:Prescribing,Recording,and Reporting Photon-Beam Intensity-Modulated Radiation Therapy(IMRT).2010,Oxford University Press.国际放射单位委员会第83号报告:光子束调强放疗的处方,记录和报告.2010,牛津大学出版社.
[20]Low DA,Dempsey JF.Evaluation of the gamma dose distribution comparison method[J].Med Phys,2003,30:2455-2464.罗,戴姆斯.Gamma剂量分布比较方法的评估[J].医学物理学,2003,30:2455-2464.
[21]Geurts M,Gonzalez J,Serrano-Ojeda P.Longitudinal study using a diode phantom for helical tomotherapy IMRT QA.Med Phys,2009,36:4977-4983.古尔特斯,冈萨雷斯,赛拉诺-欧吉达.应用二极管模体进行tomotherapy调强放疗QA的纵向研究[J].医学物理学,2009,36:4977-4983.
[2]Mackie TR,Balog J,Ruchala K,et al.Tomotherapy[J].Semin Radiat Oncol,1999,9:108-117.麦基,伯劳哥,鲁切拉,等.Tomotherapy[J].放射肿瘤研讨,1999,9:108-117.
[3]Yang JN,Mackie TR,Reckwerdt P,et al.An investigation of tomotherapy beam delivery[J].Med Phys,1997,24:425-436.杨,麦基,热科沃德,等.Tomotherapy射束照射实施[J].医学物理学,1997,24:425-436.
[4]Saminathan S,Manickan R,Chandraraj V,et al.Dosimetric study of2D ion chamber array matrix for the modern radiotherapy treatment verification[J].J Appl Clin Med Phys,2010,11:116-127.萨米那兹,麦尼肯,坎德拉拉,等.应用二维电离室阵列矩阵进行现代放疗验证的剂量学研究[J].临床应用医学物理学杂志,2010,11:116-127.
[5]Herzen J,Todorovic M,Cremers F,et al.Dosimetric evaluation of a2D pixel ionization chamber for implementation in clinical routine[J].Phys Med Biol,2007,52:1197-1208.贺尊,特德洛维奇,克莱默,等.临床应用二维像素电离室的剂量学研究[J].医学生物物理学,2007,52:1197-1208.
[6]Woo M,Nico A.Using a matrix detector for rotational delivery QA[J].Med Phys,2007,34:2502.吴,尼克.应用矩阵探测器进行旋转照射QA[J].医学物理学,2007,34:2502.
[7]Chandraraj V,Stathakis S,Manickam R,et al.Comparison of four commercial devices for Rapid Arc and sliding window IMRT QA[J].J Appl Clin Med Phys,2011,12:338-349.坎德拉拉,斯托瑟肯斯,麦尼肯,等.Rapid Arc和滑窗调强放疗QA四种商用装置的比较[J].临床应用医学物理学杂志,2011,12:338-349.
[8]Feygelman V,Opp D,Javedan K,et al.Evaluation of a 3D diode array dosimeter for helical tomotherapy delivery QA[J].Medical Dosimetry,2010,35:324-329.费舍曼,奥普,扎福达,等.Tomotherapy QA三维探测器阵列的评估[J].医学计量学,2010,35:324-329.
[9]Van Esch A,Clermont C,Devillers M,et al.On-line quality assurance of rotational radiotherapy treatment delivery by means of a 2D ion chamber array and the octavius phantom[J].Med Phys,2007,34:3825-3837.范艾克,克莱门特,戴维勒,等.应用二维电离室阵列和Octavius体模进行旋转放疗的在线QA[J].医学物理学,2007,34:3825-3837.
[10]Syam Kumar SA,Sukumar P,Sriram P,et al.A patient-specific quality assurance study on absolute dose verification using ionization chambers of different volumes in Rapid Arc treatments[J].Medical Dosimetry,2012,37:436-441.萨姆库玛,素库玛,斯雷拉姆,等.应用不同体积电离室进行特定患者的Rapid Arc放疗绝对剂量验证的QA研究[J].医学计量学,2012,37:436-441.
[11]Myers P,Stathakis S,Gutiérr ez AN,et al.Evaluation of PTW Seven29 for tomotherapy patient-specific quality assurance and comparison with Scandi Dos Delta4[J].Journal of Medical Physics,2012,37:72-80.梅斯,斯托瑟肯斯,谷铁雷斯,等.应用PTW 729阵列进行特定患者tomotherapy放疗QA的评估及与Delta4的比较[J].医学物理学杂志,2012,37:72-80.
[12]Whitmore N,Nalichowski A,Burmeister J,et al.Effects of dose scaling on delivery quality assurance in tomotherapy[J].J Appl Clin Med Phys,2012,13:84-92.维特莫尔,纳利库斯基,博梅斯特,等.剂量刻度对Tomotherapy放疗QA的影响[J].临床应用医学物理学杂志,2012,13:84-92.
[13]徐寿平,邓小武,戴相昆,等.螺旋断层放疗系统调强放疗验证[J].中华放射肿瘤学杂志,2008,17:395-397.Xu SP,Deng XW,Dai XK,et al.Treatment verification of helical tomotherapy intensity modulated radiation therapy[J].Chin J Radiat Onc,2008,17:395-397.
[14]徐寿平,解传滨,鞠忠建,等.用二维电离室阵列对螺旋断层治疗的调强计划进行剂量验证[J].中华放射肿瘤学杂志,2009,18:233-236.Xu SP,Xie CB,Ju ZJ,et al.Two-dimensional ion chamber array in dose verification for intensity modulated planning of helical tomotherapy[J].Chin J Radiat Onc,2009,18:233-236.
[15]张富利,王雅棣,刘清智,等.应用Delta4三维探测器阵列进行螺旋断层治疗计划剂量验证[J].中华放射肿瘤学杂志,2013,22:309-311.Zhang FL,Wang YD,Liu QZ,et al.Delta three-dimensional semiconductor array verification for intensity modulated planning of helical tomotherapy[J].Chin J Radiat Onc,2013,22:309-311.
[16]张富利,张勇乾,王雅棣.螺旋断层加速器与常规加速器在肺癌调强放疗中的剂量学评估初探[J].中国医学物理学杂志,2012,29:3596-3598.Zhang FL,Zhang YQ,Wang YD.Dosimetric comparison xlated radiotherapy for lung cancer[J].CHINESE JOURNAL OF MEDICAL PHYSICS,2012,29:3596-3598.
[17]徐寿平,解传滨,戴相昆,等.二维半导体阵列实施旋转调强治疗计划验证的剂量学评估[J].中国医学物理学杂志,2009,26:1477-1480.Xu SP,Xie CB,Dai XK,et al.Dose analysis of a diode array for dose verification of rotational intensity modulated radiation therapy planning[J].CHINESE JOURNAL OF MEDICAL PHYSICS,2009,26:1477-1480.
[18]Chandraraj V,Stathakis S,Manickam R,et al.Consistency and reproducibility of the VMAT plan delivery using three independent validation methods[J].J Appl Clin Med Phys,2010,12:129-140.坎德拉拉,斯托瑟肯斯,麦尼肯,等.应用三种不同方法验证容积旋转调强放疗计划实施的一致性和重复性[J].临床应用医学物理学杂志,2010,12:129-140.
[19]Journal of the ICRU Report 83:Prescribing,Recording,and Reporting Photon-Beam Intensity-Modulated Radiation Therapy(IMRT).2010,Oxford University Press.国际放射单位委员会第83号报告:光子束调强放疗的处方,记录和报告.2010,牛津大学出版社.
[20]Low DA,Dempsey JF.Evaluation of the gamma dose distribution comparison method[J].Med Phys,2003,30:2455-2464.罗,戴姆斯.Gamma剂量分布比较方法的评估[J].医学物理学,2003,30:2455-2464.
[21]Geurts M,Gonzalez J,Serrano-Ojeda P.Longitudinal study using a diode phantom for helical tomotherapy IMRT QA.Med Phys,2009,36:4977-4983.古尔特斯,冈萨雷斯,赛拉诺-欧吉达.应用二极管模体进行tomotherapy调强放疗QA的纵向研究[J].医学物理学,2009,36:4977-4983.