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针对可变形IMRT/IMPT剂量积累的患者特异性质量保证:基于节能的验证标准的建议和验证

Xin Wu^1,2, Florian Amstutz^1,3, Damien C Weber^1,4,5

¹Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland.

Medical physics

|June 22, 2023

概括

基于可变形图像注册的剂量积累 (DDA) 需要对显著的解剖变化保持谨慎. 节能验证对于在适应性放射治疗中确保DDA准确性至关重要,特别是在肺癌患者中.

科学领域:

医学物理医学物理
放射治疗研究放射治疗研究
图像分析图像分析

背景情况:

基于可变形图像记录 (DIR) 的剂量积累 (DDA) 在适应性放射治疗研究中至关重要.
对于DDA在临床使用中的可靠性存在担忧,特别是在显著的解剖学变化导致节能问题时.

研究的目的:

展示和验证基于节能 (EC) 的DDA工作流程.
在实际患者数据中评估工作流的实用性,重点关注肺癌病例.

主要方法:

用五种DIR方法和各种治疗计划 (IMRT,IMPT,CPPT) 计算了五名非小细胞肺癌 (NSCLC) 患者的DDA.
在重复CT扫描和扭曲的分量剂量上重新优化治疗计划,回到计划CT.
实施并将基于EC的验证应用于所有DDA结果,并使用贝叶斯线性回归 (BLR) 分析了与质量/体积变化的相关性.

主要成果:

大多数处于风险的器官 (OARs) 在10%以内显示出EC违规.
在PTVs和GTVs中,分数能量的显著高估发生了实质性的回归,无论处理类型或DIR方法如何.
BLR证实了EC违规和相对质量/体积变化之间的强有力的线性相关性 (质量为R^2>0.95,体积为R^2>0.60).

结论:

在使用基于强度的DIR时,DDA结果需要在具有高质量/体积变异的区域保持谨慎.
基于EC的验证为放射治疗中的DDA有效性提供了一种有价值的患者特异性质量保证方法.

关键词:

剂量积累剂量积累可变形图像的注册变形图像的注册肺癌是一种肺癌.光子疗法是一种光子疗法.质子疗法是一种质子疗法.

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