Optical Surface Monitoring系统跟踪运动靶区的位置精度和剂量精度验证
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摘要
目的:评估Optical Surface Monitoring System(OSMS)测量靶区运动的几何精度和使用OSMS跟踪运动靶区放疗时的剂量精度。方法:①分别使用OSMS与锥形束CT监测腹部模体的位置,通过移动治疗床使模体产生位移和旋转,对比二者对模体位置的测量结果;②用呼吸运动平台搭载MatriXX二维电离室阵列,测量不同跟踪阈值时模体内相对剂量,分别与计划剂量分布对比,分析不同跟踪阈值时计划验证的gamma通过率。结果:OSMS和锥形束CT系统对模体平移和旋转预设偏移的测量结果差异很小,使用OSMS门控技术时OSMS的阈值越小gamma通过率越高,相对剂量分布与计划剂量的一致性也越好。结论:OSMS系统对模体表面位置监测精度高,可以应用到实际放射治疗的辅助摆位。使用OSMS门控技术跟踪运动靶区可以提高靶区的剂量精度,而且对患者不附加任何电离辐射,适合应用于分次间的辅助摆位和分次内的靶区跟踪。
Objective To evaluate the geometric accuracy of target motion measurement and dose accuracy in radiotherapy with optical surface monitoring system(OSMS) to track moving targets. Methods The positions of abdominal phantom were monitored with OSMS and cone beam computed tomography(CBCT), separately. The displacement and rotation of the phantom were achieved by moving treatment couch. Finally, the measurements of phantom position between two methods were compared.Matri XX two-dimensional ionization chamber array mounted on a respiratory motion platform was used to measure the relative dose in phantom under different tracking thresholds. The obtained doses were compared with planned doses, thereby analyzing the gamma passing rates of verification plans with different tracking thresholds. Results The difference between OSMS and CBCT system in measuring the preset displacements of phantom translation and rotation was trivial. When using OSMS gating technology, the smaller the threshold of OSMS was, the higher the gamma pass rate was, and the consistency between relative dose distribution and planned dose was better. Conclusion OSMS which has a high accuracy in monitoring the phantom surface position can be applied to the assistant positioning in radiotherapy. Using OSMS gating technology to track moving targets can improve the dose accuracy of target areas, without adding ionizing radiation to patients. OSMS is suitable for inter-fractional assistant positioning and inter-fractional target tracking.
Objective To evaluate the geometric accuracy of target motion measurement and dose accuracy in radiotherapy with optical surface monitoring system(OSMS) to track moving targets. Methods The positions of abdominal phantom were monitored with OSMS and cone beam computed tomography(CBCT), separately. The displacement and rotation of the phantom were achieved by moving treatment couch. Finally, the measurements of phantom position between two methods were compared.Matri XX two-dimensional ionization chamber array mounted on a respiratory motion platform was used to measure the relative dose in phantom under different tracking thresholds. The obtained doses were compared with planned doses, thereby analyzing the gamma passing rates of verification plans with different tracking thresholds. Results The difference between OSMS and CBCT system in measuring the preset displacements of phantom translation and rotation was trivial. When using OSMS gating technology, the smaller the threshold of OSMS was, the higher the gamma pass rate was, and the consistency between relative dose distribution and planned dose was better. Conclusion OSMS which has a high accuracy in monitoring the phantom surface position can be applied to the assistant positioning in radiotherapy. Using OSMS gating technology to track moving targets can improve the dose accuracy of target areas, without adding ionizing radiation to patients. OSMS is suitable for inter-fractional assistant positioning and inter-fractional target tracking.
引文
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[16]张书旭,周凌宏,陈光杰,等.基于Matri XX系统研究呼吸运动对靶区受照剂量分布影响[J].中华放射肿瘤学杂志,2009,18(2):138-141.ZHANG S X,ZHOU L H,CHEN G J,et al.MatriXX system in the study of the influence of respiratory motion on target dose distribution[J].Chinese Journal of Radiation Oncology,2009,18(2):138-141.
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[18]杨露,张英杰,李光俊,等.主动呼吸控制和四维CT技术在肺部肿瘤立体定向放射治疗中的应用[J].中华放射医学与防护杂志,2016,36(9):667-671.YANG L,ZHANG Y J,LI G J,et al.Application of active breathing control(ABC)and four dimensional CT technology in stereotactic radiotherapy of lung tumor[J].Chinese Journal of Radiological Medicine and Protection,2016,36(9):667-671.
[19]HOU J D,GUERRERO M,CHEN W J,et al.Deformable planning CT to cone-beam CT image registration in head-and-neck cancer[J].Med Phys,2011,38(4):2088-2094.
[20]PAN H,CERVI?O L,PAWLICKI T,et al.Frameless,real-time,surface imaging-guided radiosurgery:clinical outcomes for brain metastases[J].Neurosurgery,2012,71(4):844-851.
[2]林高娟.宫颈癌的放射治疗进展[J].现代肿瘤医学,2011,19(1):183-185.LIN G J.Advances in radiotherapy for cervical cancer[J].Journal of Modern Oncology,2011,19(1):183-185.
[3]STAMBAUGH C,EZZELL G.A clinically relevant IMRT QA IMRTQA workflow:design and validation[J].Med Phys,2018,45(4):1391-1399.
[4]LAMBRECHT M,CLEMENTEL E,SONKE J J,et al.Radiotherapy quality assurance of SBRT for patients with centrally located lung tumours within the multicentre phase II EORTC lungtech trial:benchmark case results[J].Radiother Oncol,2019,132:63-69.
[5]ABOUDARAM A,KHALIFA J,MASSABEAU C,et al.Image-guided radiotherapy in lung cancer[J].Cancer Radiother,2018,22(6-7):602-607.
[6]HARVEY S.CBCT scans:teleradiology services[J].Br Den J,2018,225(8):684-685.
[7]WEN N,LI H,SONG K,et al.Characteristics of a novel treatment system for linear accelerator-based stereotactic radiosurgery[J].J Appl Clin Med Phys,2015,16(4):125-148.
[8]ZHAO L R,ZHOU Y B,LI G H,et al.The clinical feasibility and performance of an orthogonal X-ray imaging system for image-guided radiotherapy in nasopharyngeal cancer patients:comparison with conebeam CT[J].Phys Med,2016,32(1):266-271.
[9]LI G,BALLANGRUD A,CHAN M,et al.Clinical experience with two frameless stereotactic radiosurgery(f SRS)systems using optical surface imaging for motion monitoring[J].J Appl Clin Med Phys,2015,16(4):149-162.
[10]LI G,BALLANGRUD A,KUO L C,et al.Motion monitoring for cranial frameless stereotactic radiosurgery using video-based threedimensional optical surface imagingr[J].Med Phys,2011,38(7):3981-3994.
[11]NOUFAL M P,KALLIKUZHIYIL K A,NIYAS P,et al.Study of impacts of different evaluation criteria on gamma pass rates in VMATQA using Matri XX and EPID[J].Polish Journal of Medical Physics and Engineering,2017,23(4):99-107.
[12]SCHMIDHALTER D,FIX M K,WYSS M,et al.Evaluation of a new six degrees of freedom couch for radiation therapy[J].Med Phys,2013,40(11):111710.
[13]VARASTEH ANVAR M,ATTILI A,CIOCCA M,et al.Quality assurance of carbon ion and proton beams:a feasibility study for using the 2D MatriXX detector[J].Phys Med,2016,32(6):831-837.
[14]MANCOSU P,FOGLIATA A,STRAVATO A,et al.Accuracy evaluation of the optical surface monitoring system on EDGE linear accelerator in a phantom study[J].Med Dosim,2016,42(2):173-179.
[15]WEN N,SNYDER K C,SCHEIB S G,et al.Technical Note:evaluation of the systematic accuracy of a frameless,multiple image modality guided,linear accelerator based stereotactic radiosurgery system[J].Med Phys,2016,43(5):2527-2537.
[16]张书旭,周凌宏,陈光杰,等.基于Matri XX系统研究呼吸运动对靶区受照剂量分布影响[J].中华放射肿瘤学杂志,2009,18(2):138-141.ZHANG S X,ZHOU L H,CHEN G J,et al.MatriXX system in the study of the influence of respiratory motion on target dose distribution[J].Chinese Journal of Radiation Oncology,2009,18(2):138-141.
[17]LOW D A,HARMS W B,MUTIC S,et al.A technique for the quantitative evaluation of dose distributions[J].Med Phys,1998,25(5):656-661.
[18]杨露,张英杰,李光俊,等.主动呼吸控制和四维CT技术在肺部肿瘤立体定向放射治疗中的应用[J].中华放射医学与防护杂志,2016,36(9):667-671.YANG L,ZHANG Y J,LI G J,et al.Application of active breathing control(ABC)and four dimensional CT technology in stereotactic radiotherapy of lung tumor[J].Chinese Journal of Radiological Medicine and Protection,2016,36(9):667-671.
[19]HOU J D,GUERRERO M,CHEN W J,et al.Deformable planning CT to cone-beam CT image registration in head-and-neck cancer[J].Med Phys,2011,38(4):2088-2094.
[20]PAN H,CERVI?O L,PAWLICKI T,et al.Frameless,real-time,surface imaging-guided radiosurgery:clinical outcomes for brain metastases[J].Neurosurgery,2012,71(4):844-851.