一个优化的框架,用于基于圆束计算机断层扫描的在线评估,用于质子疗法.
Chih-Wei Chang1, Rasmus Nilsson2, Sebastian Andersson2
1Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Medical physics
|July 14, 2023
概括
本研究引入了用于质子治疗的在线圆束CT (CBCT) 评估框架,提高了效率和准确性. 该框架有助于选择最佳的合成CT (sCT) 方法,以改善适应性放射治疗中患者的治疗结果.
科学领域:
- 医学物理 医学物理
- 辐射疗法 辐射疗法
- 图像指导疗法是指导图像的疗法.
背景情况:
- 质子疗法提供与光子疗法可比的瘤控制,减少了健康组织的毒性.
- 质子治疗对解剖学变异的敏感性需要强大的在线评估.
- 缺乏确定的指导方针阻碍了在线分数前评估工作流程的临床实施.
研究的目的:
- 开发和评估基于束CT (CBCT) 的质子疗法在线框架.
- 确保知识的透明度,并评估关键框架组件的效率和准确性.
- 为实施在线自适应性放射治疗工作流程提供基础.
主要方法:
- 一项回顾性研究,涉及23名患有不同病变部位的患者.
- 在RayStation 11B研究平台上实施CBCT评估框架.
- 两种合成CT (sCT) 方法 (纠正的CBCT和虚拟CT) 与同一天变形质量保证CT (dQACT) 的比较.
- 评估指标包括时间效率,剂量差异分布 (马通过率) 和水相当厚度 (WET) 分布.
主要成果:
- 平均在线CBCT评估时间为1.6 ± 0.3分钟 (cCBCT) 和1.9 ± 0.4分钟 (vCT).
- 剂量计算和可变形图像记录是主要的时间贡献者 (分别为33%和30%).
- 马射线通过率超过了91% (1%/1毫米) 和97% (2%/2毫米).
- 平均WET差异在适当的sCT选择下为<0.5mm.
- 纠正的CBCT (cCBCT) 在头部治疗中表现优异,而虚拟CT (vCT) 在肺部患者中表现更好.
结论:
- 成功开发了一个在线CBCT评估框架,优化了sCT选择的效率和准确性.
- 该框架可适应高级成像,并支持在线自适应性放射治疗.
- 拟议的框架具有未来临床整合的潜力,以改善患者的利益.
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