MosaiQ系统验证摆位误差和治疗精度的临床应用
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摘要
目的探讨MosaiQ系统在图像引导放疗(IGRT)中验证摆位误差和治疗精度的效果和临床应用价值。方法收集2014年1月8日至2017年5月30日行IGRT的510例恶性肿瘤患者。通过初审和终审的摆位误差,以及IGRT前MosaiQ系统记录的加速器治疗床值和校位完成后记录的治疗床值,统计分析各个部位肿瘤摆位误差的大小和治疗精度。结果头脚(Y)、左右(X)和前后(Z)3个方向上,头脚方向摆位误差最大(P<0.05);头部、头颈部、胸部、腹部、盆腔5个部位中,腹部肿瘤摆位误差最大(P<0.05);初审与终审间摆位误差的差异较小(P>0.05),3个方向摆位误差的均值都小于2 mm。5个部位治疗精准率的差异无统计学意义(P>0.05),且均超过了80.0%;头脚(Y)方向的精确率为84.7%,低于左右(X)和前后(Z)方向(P<0.05)。结论应用MosaiQ系统记录摆位误差和治疗精度可以对放疗技师在治疗摆位中起到规范作用,实现IGRT的全方位监控,为科室的放疗质量控制和质量保证提供理论及数据支持。
Objective To investigate the efficacy and the application value of MosaiQ system in image-guided radiotherapy(IGRT).Methods From 8 Jan 2014 to 30 May 2017,510 patients with malignancies receiving IGRT were enrolled.The setup errors required from the first trial and the final trial,and the accelerator treatment bed values before IGRT and after the calibration position were recorded.The tumor setup errors and the treatment accuracy of radiotherapy were analyzed statistically.Results The setup errors of Y direction were the largest compared with X and Z directions(P< 0.05).Abdominal tumor setup errors were the largest compared with head,head and neck,chest,abdomen and pelvis(P<0.05).The difference between the first trial and the final decision had no statistical significance(P>0.05),and the mean value of setup errors was less than 2 mm.The treatment accuracy for all parts had no differences(P>0.05),and the accuracy was more than 80.0%.The accuracy of Y direction was 84.7%,lower than X and Z directions(P<0.05).Conclusion MosaiQ system can achieve all-round monitoring of IGRT,improve the accuracy of treatment,and provide theoretical and data support for quality control and assurance in the department of radiotherapy.
Objective To investigate the efficacy and the application value of MosaiQ system in image-guided radiotherapy(IGRT).Methods From 8 Jan 2014 to 30 May 2017,510 patients with malignancies receiving IGRT were enrolled.The setup errors required from the first trial and the final trial,and the accelerator treatment bed values before IGRT and after the calibration position were recorded.The tumor setup errors and the treatment accuracy of radiotherapy were analyzed statistically.Results The setup errors of Y direction were the largest compared with X and Z directions(P< 0.05).Abdominal tumor setup errors were the largest compared with head,head and neck,chest,abdomen and pelvis(P<0.05).The difference between the first trial and the final decision had no statistical significance(P>0.05),and the mean value of setup errors was less than 2 mm.The treatment accuracy for all parts had no differences(P>0.05),and the accuracy was more than 80.0%.The accuracy of Y direction was 84.7%,lower than X and Z directions(P<0.05).Conclusion MosaiQ system can achieve all-round monitoring of IGRT,improve the accuracy of treatment,and provide theoretical and data support for quality control and assurance in the department of radiotherapy.
引文
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[13]许峰,王瑾,柏森,等.应用锥形束CT分析肿瘤放疗中分次间及分次内摆位误差[J].癌症,2008,27(10):1111-1116.
[14]黄大钡,郭纪慈,李珍,等.颈段、胸上段食管癌容积弧形调强放疗与固定野调强放疗分次内误差的比较[J].临床肿瘤学杂志,2017,22(1):58-61.
[2]吴钦宏,李高峰,王婵,等.基于锥形束CT体部肿瘤图像引导放疗的摆位误差分析[J].中华放射肿瘤学杂志,2012,21(1):68-71.
[3]童芳,黄玉荣,鞠忠建,等.标准化放射治疗预约管理模式在消化系统肿瘤患者放射治疗中的应用[J].中国医学装备,2015,12(8):10-13.
[4]Bacchus I,Gopalakrishnan M,Kang Z.SU-E-T-594:Software application for comparison and verification of radiotherapy treatment plans[J].Med Phys,2013,40(6):342.
[5]张书旭.多模医学图像引导的非小细胞肺癌放疗研究新进展[J].癌症进展,2013,11(6):520-524.
[6]Haciislamoglu E,Colak F,Canyilmaz E,et al.Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT,forward-planned IMRT,inverse-planned IMRT,helical tomotherapy,and volumetric arc therapy[J].Phys Med,2015,31(4):360-367.
[7]王鑫,胡超苏,应红梅,等.摆位系统误差对鼻咽癌放疗剂量分布的影响[J].中国癌症杂志,2008,18(8):620-625.
[8]姜斐,于浪,孙显松,等.图像引导放射治疗在653例宫颈癌摆位误差的分析[J].中国医学装备,2017,14(1):21-23,24.
[9]江萍,周舜,王俊杰,等.影像引导下放射治疗脊柱肿瘤六自由度摆位误差分析[J].北京大学学报(医学版),2015,47(6):952-956.
[10]李丹明,朱锡旭,武新虎,等.头颈部肿瘤射野摆位误差的差异性研究[J].中国医学物理学杂志,2008,25(5):785-789,800.
[11]Amoush A,Abdel-Wahab M,Abazeed M,et al.Potential systematic uncertainties in IGRT when FBCT reference images are used for pancreatic tumors[J].J Appl Clin Med Phys,2015,16(3):5257.
[12]Stoiber EM,Schwarz M,Debus J,et al.An optimised IGRT correction vector determined from a displacement vector field:a proof of principle of a decision-making aid for re-planning[J].Acta Oncol,2014,53(1):33-39.
[13]许峰,王瑾,柏森,等.应用锥形束CT分析肿瘤放疗中分次间及分次内摆位误差[J].癌症,2008,27(10):1111-1116.
[14]黄大钡,郭纪慈,李珍,等.颈段、胸上段食管癌容积弧形调强放疗与固定野调强放疗分次内误差的比较[J].临床肿瘤学杂志,2017,22(1):58-61.