基于光学表面监测系统进行头部肿瘤放疗实时定位准确性的初步研究
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摘要
目的:评估瓦里安直线加速器EDGE上搭载的光学表面监测系统(OSMS)对偏差探测的准确性(或纠错能力)。方法:使用一个颅脑体模,评估OSMS治疗前摆位准确性、治疗中监测偏移精确度、特定条件下(非零床角和仅双摄像头工作)能否正常使用。结果:OSMS实现治疗前摆位,其等中心与锥形束CT(CBCT)摆位的偏差范围为(0.6±0.5)mm,角度最大偏差为0.3°;治疗中监测偏移精确度,探测平移偏差范围(0.1±0.2)mm,探测角度偏差范围0.10°±0.07°;不同的床角下OSMS的精确度接近,挡住其中一个摄像头产生约0.5 mm的不确定度。结论:OSMS配合CBCT能够为头部肿瘤放疗的治疗前摆位及治疗中实时监测提供保证。
Objective To evaluate the deviation detection accuracy of optical surface monitoring system(OSMS) in Varian linear accelerator EDGE. Methods A head phantom was used to evaluate the positioning accuracy before treatment, monitor the position shift during treatment and assess the performance of OSMS under certain conditions(non-zero couch angle or only two cameras at work). Results OSMS achieved the positioning before treatment, and the deviation range between the positioning with CBCT and that with OSMS was(0.6±0.5) mm, with a maximum angle deviation of 0.3°. Moreover, the deviation range of position shift during treatment between OSMS and CBCT was(0.1±0.2) mm, and the deviation range of detection angle was 0.10°±0.07°. Even at different couch angles, the accuracy of OSMS was similar. However, an uncertainty of 0.5 mm was generated when one of cameras was blocked. Conclusion OSMS combined with CBCT in radiotherapy for head tumors can provide guarantee for positioning before treatment and real-time monitoring during treatment.
Objective To evaluate the deviation detection accuracy of optical surface monitoring system(OSMS) in Varian linear accelerator EDGE. Methods A head phantom was used to evaluate the positioning accuracy before treatment, monitor the position shift during treatment and assess the performance of OSMS under certain conditions(non-zero couch angle or only two cameras at work). Results OSMS achieved the positioning before treatment, and the deviation range between the positioning with CBCT and that with OSMS was(0.6±0.5) mm, with a maximum angle deviation of 0.3°. Moreover, the deviation range of position shift during treatment between OSMS and CBCT was(0.1±0.2) mm, and the deviation range of detection angle was 0.10°±0.07°. Even at different couch angles, the accuracy of OSMS was similar. However, an uncertainty of 0.5 mm was generated when one of cameras was blocked. Conclusion OSMS combined with CBCT in radiotherapy for head tumors can provide guarantee for positioning before treatment and real-time monitoring during treatment.
引文
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[18]董百强,陈明.立体定向放疗在非小细胞肺癌治疗中的应用[J].中华放射医学与防护杂志, 2016, 36(10):732-735.DONG B Q, CHEN M. The application of stereotactic body radiotherapy in treatment of non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection, 2016, 36(10):732-735.
[19]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.
[20]IONASCU D, JIANG S B, NISHIOKA S, et al. Internal-external correlation investigations of respiratory induced motion of lung tumors[J]. Med Phys, 2007, 34(10):3893-3903.
[2] BRENEMAN J C, STEINMETZ R, SMITH A, et al. Frameless imageguided intracranial stereotactic radiosurgery:clinical outcomes for brain metastases[J]. Int J Radiat Oncol Biol Phys, 2009, 74(3):702-706.
[3] RAMAKRISHNA N, ROSCA F, FRIESEN S, et al. A clinical comparison of patient setup and intra-fraction motion using framebased radiosurgery versus a frameless image-guided radiosurgery system for intracranial lesions[J]. Radiother Oncol, 2010, 95(1):109-115.
[4] OHTAKARA K, HAYASHI S, TANAKA H, et al. Clinical comparison of positional accuracy and stability between dedicated versus conventional masks for immobilization in cranial stereotactic radiotherapy using 6-degree-of-freedom image guidance systemintegrated platform[J]. Radiother Oncol, 2012, 102(2):198-205.
[5]邓小武.放射治疗的物理质量控制与质量保证[J].中国肿瘤, 2008,17(8):660-665.DENG X W. Quality control and quality assurance for radiotherapy[J]. China Cancer, 2008, 17(8):660-665.
[6] CERVI?O L I, PAWLICKI T, LAWSONJ D, et al. Frame-less and mask-less cranial stereotactic radiosurgery:a feasibility study[J]. Phys Med Biol, 2010, 55(7):1863-1873.
[7] PENG J L, KAHLER D, LI J G, et al. Characterization of a real-time surface image-guided stereotactic positioning system[J]. Med Phys,2010, 37(10):5421-5433.
[8] BERT C, METHEANY K G, DOPPKE K, et al. A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup[J]. Med Phys, 2005, 32(9):2753.
[9] BERT C, METHEANY K G, DOPPKE K P, et al. Clinical experience with a 3D surface patient setup system for alignment of partial-breast irradiation patients[J]. Int J Radiat Oncol Biol Phys, 2006, 64(4):1265-1274.
[10]ROGUS R D, STERN R L, KUBO H D. Accuracy of a photogrammetry-based patient positioning and monitoring system for radiation therapy[J]. Med Phys, 1999, 26(5):721-728.
[11]GAO S, DU W, BALTER P, et al. Evaluation of IsoCal geometric calibration system for Varian linacs equipped with on-board imager and electronic portal imaging device imaging systems[J]. J Appl Clin Med Phys, 2014, 15(3):4688.
[12]STEINKE M F, BEZAK E. Technological approaches to in-room CBCT imaging[J]. Australas Phys Eng Sci Med, 2008, 31(3):167-179.
[13]DOWNES P, JARVIS R, RADU E, et al. Monte Carlo simulation and patient dosimetry for a kilovoltage cone-beam CT unit[J]. Med Phys,2009, 36(9):4156-4167.
[14]YI Y, LAI C J, HAN T, et al. Radiation doses in cone-beam breast computed tomography:a Monte Carlo simulation study[J]. Med Phys,2011, 38(2):589.
[15]AL-OKSHI A, LINDH C, SALéH, et al. Effective dose of cone beam CT(CBCT)of the facial skeleton:a systematic review[J]. Br J Radiol,2014, 88(1045):20140658.
[16]NATH S K, LAWSON J D, WANG J Z, et al. Optically-guided frameless linac-based radiosurgery for brain metastases:clinical experience[J]. J Neurooncol, 2010, 97(1):67-72.
[17]CERVI?O L I, DETORIE N, TAYLOR M, et al. Initial clinical experience with a frameless and mask less stereotactic radiosurgery treatment[J]. Pract Radiat Oncol, 2012, 2(1):54-62.
[18]董百强,陈明.立体定向放疗在非小细胞肺癌治疗中的应用[J].中华放射医学与防护杂志, 2016, 36(10):732-735.DONG B Q, CHEN M. The application of stereotactic body radiotherapy in treatment of non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection, 2016, 36(10):732-735.
[19]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.
[20]IONASCU D, JIANG S B, NISHIOKA S, et al. Internal-external correlation investigations of respiratory induced motion of lung tumors[J]. Med Phys, 2007, 34(10):3893-3903.