基于体积调节弧疗法计算断层扫描的体积调节弧疗法四维适应的可行性
Xiaodong Zhao1, Rui Zhang2,3
1Department of Radiation Oncology, Washington University in St. Louis, St. Louis, Missouri, USA.
Journal of medical physics
|August 14, 2023
概括
使用VMAT计算机断层扫描的四维自适应VMAT对于癌症患者来说是可行的. 这种新的方法允许进行适应性重新规划和剂量升级,改善目标覆盖率,并在治疗期间保护正常组织.
科学领域:
- 辐射瘤学 辐射瘤学
- 医疗成像医学成像
- 癌症治疗方法 癌症治疗方法
背景情况:
- 卷度调制弧线疗法 (VMAT) 提供了高效的辐射输送.
- 适应性放射治疗 (ART) 通过调整患者的解剖学来改善治疗.
- 目前的成像在VMAT中缺乏用于运动管理的4D功能.
研究的目的:
- 评估4D自适应VMAT的可行性,使用一种新的VMAT计算机断层扫描 (VMAT-CT) 成像工具.
- 评估VMAT-CT在VMAT期间获得实时解剖和剂量信息的潜力.
主要方法:
- 使用了QUASAR呼吸系统和室内可变形的肺幻影,以及一个真实的患者病例.
- 生成的4D VMAT计划,包括基于4D VMAT-CT的适应计划.
- 使用4D VMAT-CT为真实患者创建剂量升级计划.
主要成果:
- 在适应性重新规划后,在幻影中实现了95%的PTV覆盖率.
- 在真实患者中,重新规划和剂量升级的可行性已被证明,节省了正常组织.
- 使用VMAT-CT的4D ART计划需要比标准的4D计划更小的利.
结论:
- 基于4D VMAT-CT的4D适应性放射治疗是可行的.
- 这种技术可以促进适应性重新规划和剂量升级VMAT患者的运动.
- 在运动控制放射治疗中,VMAT-CT显示出提高精度的前景.
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