呼吸运动对Sliding Window调强射野剂量学的影响
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摘要
目的:研究呼吸运动对Sliding Window(SW)调强射野剂量学的影响。方法:使用胶片分别测量多叶光栅在不同的叶片移动速度(叶片速度)和不同射野宽度条件下,窄束野在呼吸运动平台驱动下胶片上的剂量分布。对运动模式、叶片速度、射野宽度等多个因素分组进行比对分析。结果:不同的运动模式对剂量分布影响差异显著不同;随着叶片速度的增大,射野内剂量波动幅度随之显著增大;随着射野宽度的增大,射野内剂量波动幅度随之减小;射野宽度小叶片速度高,对剂量分布的影响最为显著。结论:有呼吸运动影响时,应通过提高射野宽度和(或)减小叶片速度等方法来减小呼吸运动对SW调强射野剂量分布的影响。
Objective To study the dosimetric effects of respiratory motion in Sliding Window intensity-modulated radiotherapy.Methods The dose distributions with different motion modes, field widths and velocities of multileaf collimators were obtained and compared using EBT2 films driven by respiratory phantom(Quasar). The effects of motion modes, field widths and velocities of multileaf collimators on the dose distribution were analyzed. Results The effects of different motion modes on the dose distribution was significantly different. With the increase of leaf velocity, the dose fluctuation amplitude was obviously increased,and with the increase of the field width, the dose fluctuation amplitude was decreased. The large field width with high leaf velocity had the most significant effects on the dose distribution. Conclusion With the influence of respiratory motion, the effects of respiratory motion on the dose distribution can be reduced by increasing the field width and(or) decreasing the leaf velocity.
Objective To study the dosimetric effects of respiratory motion in Sliding Window intensity-modulated radiotherapy.Methods The dose distributions with different motion modes, field widths and velocities of multileaf collimators were obtained and compared using EBT2 films driven by respiratory phantom(Quasar). The effects of motion modes, field widths and velocities of multileaf collimators on the dose distribution were analyzed. Results The effects of different motion modes on the dose distribution was significantly different. With the increase of leaf velocity, the dose fluctuation amplitude was obviously increased,and with the increase of the field width, the dose fluctuation amplitude was decreased. The large field width with high leaf velocity had the most significant effects on the dose distribution. Conclusion With the influence of respiratory motion, the effects of respiratory motion on the dose distribution can be reduced by increasing the field width and(or) decreasing the leaf velocity.
引文
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[20]ISHIHARA Y,NAKAMURA M,MIYABE Y,et al.Development of a four-dimensional Monte Carlo dose calculation system for real-time tumor-tracking irradiation with a gimbaled X-ray head[J].Phys Med,2017,35:59-65.
[21]MATSUO Y,UEKI N,TAKAYAMA K,et al.Evaluation of dynamic tumour tracking radiotherapy with real-time monitoring for lung tumours using a gimbal mounted linac[J].Radiother Oncol,2014,112(3):360-364.
[2]VORWERK H,WAGNER D,HESS C F.Impact of different leaf velocities and dose rates on the number of monitor units and the dosevolume-histograms using intensity modulated radiotherapy with sliding-window technique[J].Radiat Oncol,2008,3:31.
[3]LAFOND C,JOUYAUX F,BELLEC J,et al.Which IMRT?From"step and shoot"to VMAT:physicist point of view[J].Cancer Radiother,2010,14(6-7):539-549.
[4]田源,马攀,门阔,等.基于VMAT的乳腺癌保乳术后全乳混合调强技术的建立与评价[J].中华放射肿瘤学杂志,2016,25(7):728-732.TIAN Y,MA P,MEN K,et al.Development and evaluation of whole breast irradiation with volumetric modulated arc therapy-based hybrid intensity-modulated radiotherapy after breast conserving surgery for breast cancer[J].Chinese Journal of Radiation Oncology,2016,25(7):728-732.
[5]RIOU O,REGNAULT D,AZRIA D,et al.Volumetric modulated arctherapy(VMAT)compared with sliding window intensitymodulated radiotherapy(IMRT)for whole pelvis irradiation(WPI)of locally advanced prostate cancer(LAPC)[J].J Clin Oncol,2012,30(5):171.
[6]GHOLAMPOURKASHI S,VUJICIC M,BELEC J,et al.Experimental verification of 4D Monte Carlo simulations of dose delivery to a moving anatomy[J].Med Phys,2017,44(1):299-310.
[7]DUNN L,KRON T,JOHNSTON P N,et al.A programmable motion phantom for quality assurance of motion management in radiotherapy[J].Australas Phys Eng Sci Med,2012,35(1):93-100.
[8]ROBATJAZI M,MAHDAVI S R,TAKAVR A,et al.Application of Gafchromic EBT2 film for intraoperative radiation therapy quality assurance[J].Phys Med,2015,31(3):314-319.
[9]张月美,李光俊,白龙,等.辐射显色胶片剂量仪在放射治疗中的应用进展[J].中国医学物理学杂志,2018,35(6):638-642.ZHANG Y M,LI G J,BAI L,et al.Implementation and development of radiochromic film dosimeter in radiotherapy[J].Chinese Journal of Medical Physics,2018,35(6):638-642.
[10]Elekta.RTPConnect Interface Specification[Z].2014.
[11]GHOLAMPOURKASHI S,VUJICIC M,BELEC J,et al.Experimental verification of 4D Monte Carlo simulations of dose delivery to a moving anatomy[J].Med Phys,2017,44(1):299-310.
[12]葛宁,韩栋梁,辜石勇.辐射自显影胶片EBT2在单次曝光与多次曝光条件下的剂量学研究[J].中国医学物理学杂志,2015,32(4):595-598.GE N,HAN D L,GU S Y.Dosimetric study on autoradiography films EBT2 under single-exposure and multi-exposure[J].Chinese Journal of Medical Physics,2015,32(4):595-598.
[13]GANAPATHY K,KURUP P G,MURALI V,et al.A study on comparison of Gafchromic EBT2 film response under single and cumulative exposure conditions[J].J Med Phys,2013,38(4):173-177.
[14]CARRASCO M A,PERUCHA M,LUIS F J,et al.A comparison between radiochromic EBT2 film model and its predecessor EBT film model[J].Phys Med,2013,29(4):412-422.
[15]胡逸民.肿瘤放射物理学[M].北京:原子能出版社,1999:659.HU Y M.Radiation oncology physics[M].Beijing:Atomic Energy Press,1999:659.
[16]习勉,刘孟忠,李巧巧,等.基于4DCT的腹部器官呼吸运动分析[J].癌症,2009,28(9):989-993.XI M,LIU M Z,LI Q Q,et al.Analysis of abdominal organ motion using four-dimensional CT[J].Chinese Journal of Cancer,2009,28(9):989-993.
[17]BRANDNER E D,WU A,CHEN H,et al.Abdominal organ motion measured using 4DCT[J].Int J Radiat Oncol Biol Phys,2006,65(2):554-560.
[18]HIRATA K,YOSHIMURA M,MUKUMOTO N,et al.Threedimensional intrafractional internal target motions in accelerated partial breast irradiation using three-dimensional conformal external beam radiotherapy[J].Radiother Oncol,2017,124(1):118-123.
[19]SANTORO J P,YORKE E,GOODMAN K A,et al.From phase-based to displacement-based gating:a software tool to facilitate respirationgated radiation treatment[J].J Appl Clin Med Phys,2009,10(4):2982.
[20]ISHIHARA Y,NAKAMURA M,MIYABE Y,et al.Development of a four-dimensional Monte Carlo dose calculation system for real-time tumor-tracking irradiation with a gimbaled X-ray head[J].Phys Med,2017,35:59-65.
[21]MATSUO Y,UEKI N,TAKAYAMA K,et al.Evaluation of dynamic tumour tracking radiotherapy with real-time monitoring for lung tumours using a gimbal mounted linac[J].Radiother Oncol,2014,112(3):360-364.