电子射野影像系统在调强剂量验证中的应用
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摘要
目的:使用电子射野影像系统(EPID)结合Rapidose剂量分析软件在医科达(Elekta)Synergy机器上对IMRT和VMAT计划进行剂量验证。方法:随机选取11例IMRT计划和6例VMAT计划,依次使用EPID、Matri XX、Arc CHECK及CC13指形电离室对计划进行验证测量,并在不同Gamma标准下(5 mm,3%;3 mm,3%;2 mm,2%)比较不同工具验证的剂量通过率。结果:IMRT计划和VMAT计划用EPID验证的Gamma通过率依次为(99.86±0.13)%和(99.77±0.21)%、(99.06±0.45)%和(97.75±1.20)%、(92.17±4.89)%和(85.91±6.82)%,用Matri XX验证的Gamma通过率为(99.47±0.95)%和(99.51±0.40)%、(98.60±1.10)%和(97.24±1.05)%、(90.56±5.07)%和(87.21±4.17)%,用Arc CHECK验证的Gamma通过率为(99.34±0.46)%和(99.93±0.08)%、(98.21±1.31)%和(98.66±0.35)%、(89.89±1.70)%和(96.03±2.90)%,用电离室CC13验证的剂量偏差为(1.10±1.84)%和(90.59±1.31)%。通过两两配对t检验比较验证结果可知,IMRT和VMAT计划用3种设备验证的测量结果均符合临床要求。结论:使用Rapidose剂量分析软件结合EPID设备,可以在临床上满足调强计划的剂量验证要求。
Objective To explore the practicability of dose verification of intensity-modulated radiotherapy(IMRT) and volume modulated arc therapy(VMAT) on Elekta(Synergy) linear accelerator via Rapidose dose analysis software combined with electronic portal imaging device(EPID). Methods Eleven IMRT plans and 6 VMAT plans were randomly selected. The gamma passing rates of these plans were measured with different validation devices(EPID, Matri XX, Arc CHECK and CC13 ionization chamber) and compared under different gamma standards(5 mm, 3%; 3 mm, 3%; 2 mm, 2%). Results The gamma passing rates measured with EPID were(99.86±0.13)%,(99.06±0.45)%,(92.17±4.89)% for IMRT plans, and(99.77±0.21)%,(97.75±1.20)%,(85.91±6.82)% for VMAT plans. The gamma passing rates measured with Matri XX were(99.47±0.95)%,(98.60±1.10)%,(90.56±5.07)% for IMRT plans, and(99.51±0.40)%,(97.24±1.05)%,(87.21±4.17)% for VMAT plans. The gamma passing rates measured with Arc CHECK were(99.34±0.46)%,(98.21±1.31)%,(89.89±1.70)% for IMRT plans, and(99.93±0.08)%,(98.66±0.35)% and(96.03±2.90)% for VMAT plans. The dose deviation of CC13 ionization chamber was(1.10±1.84)% and(0.59±1.31)% for IMRT plans and VMAT plans, respectively. The paired-t test comparison results revealed that all measurements of the 3 devices met the clinical requirements. Conclusion EPID can be combined with Rapidose dose analysis software to meet the clinical dose verification requirements of IMRT plans and VMAT plans.
Objective To explore the practicability of dose verification of intensity-modulated radiotherapy(IMRT) and volume modulated arc therapy(VMAT) on Elekta(Synergy) linear accelerator via Rapidose dose analysis software combined with electronic portal imaging device(EPID). Methods Eleven IMRT plans and 6 VMAT plans were randomly selected. The gamma passing rates of these plans were measured with different validation devices(EPID, Matri XX, Arc CHECK and CC13 ionization chamber) and compared under different gamma standards(5 mm, 3%; 3 mm, 3%; 2 mm, 2%). Results The gamma passing rates measured with EPID were(99.86±0.13)%,(99.06±0.45)%,(92.17±4.89)% for IMRT plans, and(99.77±0.21)%,(97.75±1.20)%,(85.91±6.82)% for VMAT plans. The gamma passing rates measured with Matri XX were(99.47±0.95)%,(98.60±1.10)%,(90.56±5.07)% for IMRT plans, and(99.51±0.40)%,(97.24±1.05)%,(87.21±4.17)% for VMAT plans. The gamma passing rates measured with Arc CHECK were(99.34±0.46)%,(98.21±1.31)%,(89.89±1.70)% for IMRT plans, and(99.93±0.08)%,(98.66±0.35)% and(96.03±2.90)% for VMAT plans. The dose deviation of CC13 ionization chamber was(1.10±1.84)% and(0.59±1.31)% for IMRT plans and VMAT plans, respectively. The paired-t test comparison results revealed that all measurements of the 3 devices met the clinical requirements. Conclusion EPID can be combined with Rapidose dose analysis software to meet the clinical dose verification requirements of IMRT plans and VMAT plans.
引文
[1]苗利,孙彦泽,李新民.放射治疗剂量验证中常用剂量分布比较方法及分析[J].辐射研究与辐射工艺学报,2012,30(4):247-251.MIAO L,SUN Y Z,LI X M.Analysis of the most commonly used dose distribution comparison methods in radiotherapy dosimetric verification[J].Journal of Radiation Research and Radiation,Processing,2012,30(4):247-251.
[2]卢文婷.二维电离室矩阵与电子射野影像系统在剂量验证中的初步研究[D].广州:南方医科大学,2009.LU W T.The preliminary study of two dimensional ionization chamber array and electronic protal imaging devices system in dosimetric verification[D].Guangzhou:Southern Medical University,2009.
[3]曹剑云.调强放射治疗剂量验证的发展[J].医学信息,2015,28(31):346-347.CAO J Y.The dose verification development of intensity-modulated radiation therapy[J].Medical Information,2015,28(31):346-347.
[4]昌胜,李光俊,柏森,等.放射治疗计划系统独立剂量验证的发展[J].中华放射医学与防护杂志,2016,36(10):790-796.CHANG S,LI G J,BO S,et al.Development of the independent dose verification for treatment planning system in radiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2016,36(10):790-796.
[5]翟贺争,程金生.二维矩阵探测器在IMRT剂量验证中的研究进展[J].中华放射医学与防护杂志,2013,33(2):215-217.ZHAI H Z,CHENG J S.The research progress of two-dimensional Matrix detector in IMRT dose verification[J].Chinese Journal of Radiological Medicine and Protection,2013,33(2):215-217.
[6]李成强,李光俊,冀传仙,等.Arc CHECK半导体探头特性及在容积调强弧形治疗剂量验证应用研究[J].中华放射肿瘤学杂志,2013,22(3):253-257.LI C Q,LI G J,JI C X,et al.The characteristics and clinical application of the Arc CHECK diode array for volumetricmodulated arc therapy verification[J].Chinese Journal of Radiation Oncology,2013,22(3):253-257.
[7]戴越,胡春红,李小东,等.Matri XX两种调强放疗剂量验证方法的比较分析[J].中华放射肿瘤学杂志,2013,22(4):312-314.DAI Y,HU C H,LI X D,et al.Analyse two kinds of intensitymodulated radiotherapy verification methods comparatively by using the Matri XX[J].Chinese Journal of Radiation Oncology,2013,22(4):312-314.
[8]FREDH A.Patient QA systems for rotational radiation therapy:a comparative experimental study with intentional errors[J].Med Phys,2013,40(3):031716.
[9]HUSSEIN M.A critical evaluation of the PTW 2D-ARRAY seven29and OCTAVIUS II phantom for IMRT and VMAT verification[J].J Appl Clin Med Phys,2013,14(6):4460.
[10]POPPE B,BLECHSCHMIDT A,DJOUGUELA A,et al.Twodimensional ionization chamber arrays of IMRT plan verification[J].Med Phys,2006,33(4):1005-1015.
[11]BLAKE S J.Characterization of a novel EPID designed for simultaneous imaging and dose verification in radiotherapy[J].Med Phys,2013,40(9):091902.
[12]朱金汉,陈立新,靳光华,等.基于电子射野影像装置的容积调强弧形治疗二维剂量验证研究[J].中华放射肿瘤学杂志,2012,21(6):550-553.ZHU J H,CHEN L X,JIN G H,et al.The study of two-dimensional dosimetric verifications of volumetric intensity-modulated arc therapy based on electronic portal imaging devices[J].Chinese Journal of Radiation Oncology,2012,21(6):550-553.
[13]孟慧鹏,孙小喆,王昊,等.Varian EPID和PTW Detector 729在容积旋转调强剂量验证中的比较分析[J].辐射研究与辐射工艺学报,2015,33(5):25-29.MENG H P,SUN X Z,WANG H,et al.Comparative analysis for dose verification of volumetric modulated arc therapy by Varian EPID and PTW Detector 729[J].Journal of Radiation Research and Radiation Processing,2015,33(5):25-29.
[14]窦文,钟青松,胡丽娟,等.调强放射治疗射野和剂量的验证[J].中国医学物理学杂志,2012,29(1):3085-3087.DOU W,ZHONG Q S,HU L J,et al.Field shape and dose verification of intensity modulated radiotherapy[J].Chinese Journal of Medical Physics,2012,29(1):3085-3087.
[15]HUSSEIN M,ROWSHANFARZAD P,EBERT M A,et al.A comparison of the gamma index analysis in various commercial IMRT/VAMT QA systems[J].Radiother Oncol,2013,109(3):370-376.
[16]MCDERMOTT L N,LOUWE R J,SONKE J J,et al.Dose-response and ghosting effects of an amorphous silicon electronic portal imaging device[J].Med Phys,2004,31:285-295.
[17]BERRY S L,POLVOROSA C S,WUU C S.A field size specific backscatter correction algorithm for accurate EPID dosimery[J].Med Phys,2010,37:2425-2434.
[18]WINKLER P,GEORG D.An intercomparison of 11 amorphous silicon EPIDs of the same type:implications for portal dosimetry[J].Phys Med Biol,2006,51:4189-4200
[19]陈阿龙,陈立新,陈利,等.基于三维影像解剖结构的调强剂量验证的初步研究[J].中华放射肿瘤学杂志,2014,23(4):352-356.CHEN A L,CHEN L X,CHEN L,et al.A primary research of intensity-modulated dose verification based on anatomic structure of three-dimensional images[J].Chinese Journal of Radiation Oncology,2014,23(4):352-356.
[20]ZHU J H,CHEN L X,JIN G H,et al.A comparison of VMAT dosimetric verifications between fixed and rotating gantry positions[J].Phys Med Biol,2013,58(5):1315-1322.
[21]孙彦泽,苗利,殷旭君,等.非晶硅电子射野影像装置的性能研究[J].辐射研究与辐射工艺学报,2012,30(3):178-182.SUN Y Z,MIAO L,YIN X J,et al.Study on dose-response characteristics with amorphous silicon electronic portal imaging device[J].Journal of Radiation Research and Radiation Processing,2012,30(3):178-182.
[2]卢文婷.二维电离室矩阵与电子射野影像系统在剂量验证中的初步研究[D].广州:南方医科大学,2009.LU W T.The preliminary study of two dimensional ionization chamber array and electronic protal imaging devices system in dosimetric verification[D].Guangzhou:Southern Medical University,2009.
[3]曹剑云.调强放射治疗剂量验证的发展[J].医学信息,2015,28(31):346-347.CAO J Y.The dose verification development of intensity-modulated radiation therapy[J].Medical Information,2015,28(31):346-347.
[4]昌胜,李光俊,柏森,等.放射治疗计划系统独立剂量验证的发展[J].中华放射医学与防护杂志,2016,36(10):790-796.CHANG S,LI G J,BO S,et al.Development of the independent dose verification for treatment planning system in radiotherapy[J].Chinese Journal of Radiological Medicine and Protection,2016,36(10):790-796.
[5]翟贺争,程金生.二维矩阵探测器在IMRT剂量验证中的研究进展[J].中华放射医学与防护杂志,2013,33(2):215-217.ZHAI H Z,CHENG J S.The research progress of two-dimensional Matrix detector in IMRT dose verification[J].Chinese Journal of Radiological Medicine and Protection,2013,33(2):215-217.
[6]李成强,李光俊,冀传仙,等.Arc CHECK半导体探头特性及在容积调强弧形治疗剂量验证应用研究[J].中华放射肿瘤学杂志,2013,22(3):253-257.LI C Q,LI G J,JI C X,et al.The characteristics and clinical application of the Arc CHECK diode array for volumetricmodulated arc therapy verification[J].Chinese Journal of Radiation Oncology,2013,22(3):253-257.
[7]戴越,胡春红,李小东,等.Matri XX两种调强放疗剂量验证方法的比较分析[J].中华放射肿瘤学杂志,2013,22(4):312-314.DAI Y,HU C H,LI X D,et al.Analyse two kinds of intensitymodulated radiotherapy verification methods comparatively by using the Matri XX[J].Chinese Journal of Radiation Oncology,2013,22(4):312-314.
[8]FREDH A.Patient QA systems for rotational radiation therapy:a comparative experimental study with intentional errors[J].Med Phys,2013,40(3):031716.
[9]HUSSEIN M.A critical evaluation of the PTW 2D-ARRAY seven29and OCTAVIUS II phantom for IMRT and VMAT verification[J].J Appl Clin Med Phys,2013,14(6):4460.
[10]POPPE B,BLECHSCHMIDT A,DJOUGUELA A,et al.Twodimensional ionization chamber arrays of IMRT plan verification[J].Med Phys,2006,33(4):1005-1015.
[11]BLAKE S J.Characterization of a novel EPID designed for simultaneous imaging and dose verification in radiotherapy[J].Med Phys,2013,40(9):091902.
[12]朱金汉,陈立新,靳光华,等.基于电子射野影像装置的容积调强弧形治疗二维剂量验证研究[J].中华放射肿瘤学杂志,2012,21(6):550-553.ZHU J H,CHEN L X,JIN G H,et al.The study of two-dimensional dosimetric verifications of volumetric intensity-modulated arc therapy based on electronic portal imaging devices[J].Chinese Journal of Radiation Oncology,2012,21(6):550-553.
[13]孟慧鹏,孙小喆,王昊,等.Varian EPID和PTW Detector 729在容积旋转调强剂量验证中的比较分析[J].辐射研究与辐射工艺学报,2015,33(5):25-29.MENG H P,SUN X Z,WANG H,et al.Comparative analysis for dose verification of volumetric modulated arc therapy by Varian EPID and PTW Detector 729[J].Journal of Radiation Research and Radiation Processing,2015,33(5):25-29.
[14]窦文,钟青松,胡丽娟,等.调强放射治疗射野和剂量的验证[J].中国医学物理学杂志,2012,29(1):3085-3087.DOU W,ZHONG Q S,HU L J,et al.Field shape and dose verification of intensity modulated radiotherapy[J].Chinese Journal of Medical Physics,2012,29(1):3085-3087.
[15]HUSSEIN M,ROWSHANFARZAD P,EBERT M A,et al.A comparison of the gamma index analysis in various commercial IMRT/VAMT QA systems[J].Radiother Oncol,2013,109(3):370-376.
[16]MCDERMOTT L N,LOUWE R J,SONKE J J,et al.Dose-response and ghosting effects of an amorphous silicon electronic portal imaging device[J].Med Phys,2004,31:285-295.
[17]BERRY S L,POLVOROSA C S,WUU C S.A field size specific backscatter correction algorithm for accurate EPID dosimery[J].Med Phys,2010,37:2425-2434.
[18]WINKLER P,GEORG D.An intercomparison of 11 amorphous silicon EPIDs of the same type:implications for portal dosimetry[J].Phys Med Biol,2006,51:4189-4200
[19]陈阿龙,陈立新,陈利,等.基于三维影像解剖结构的调强剂量验证的初步研究[J].中华放射肿瘤学杂志,2014,23(4):352-356.CHEN A L,CHEN L X,CHEN L,et al.A primary research of intensity-modulated dose verification based on anatomic structure of three-dimensional images[J].Chinese Journal of Radiation Oncology,2014,23(4):352-356.
[20]ZHU J H,CHEN L X,JIN G H,et al.A comparison of VMAT dosimetric verifications between fixed and rotating gantry positions[J].Phys Med Biol,2013,58(5):1315-1322.
[21]孙彦泽,苗利,殷旭君,等.非晶硅电子射野影像装置的性能研究[J].辐射研究与辐射工艺学报,2012,30(3):178-182.SUN Y Z,MIAO L,YIN X J,et al.Study on dose-response characteristics with amorphous silicon electronic portal imaging device[J].Journal of Radiation Research and Radiation Processing,2012,30(3):178-182.