眼球质子规划中的不确定性及其对所需边际的影响
Jörg Wulff1, Benjamin Koska1, Dalia Ahmad Khalil2
1West German Proton Therapy Centre Essen (WPE), Essen, Germany; University Hospital Essen, Essen, Germany; West German Cancer Centre (WTZ), Essen, Germany.
概括
对眼性质子疗法 (OPT) 边缘进行了审查,验证了2.5毫米的光圈边缘. 对于较低的范围,范围边缘可以减少,但成像和患者设置的不确定性需要仔细考虑有效治疗.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
- 眼科医生 眼科 眼科
背景情况:
- 眼睛质子疗法 (OPT) 需要精确的辐射传递到眼睛中的瘤.
- 精确的边缘测定至关重要,以确保充分覆盖瘤,同时尽量减少对健康组织的剂量.
- 治疗规划和交付的不确定性需要强大的保证金策略.
研究的目的:
- 评估眼睛质子疗法当前边缘建议的充分性.
- 将已确定的保证金值与从不确定性估计得出的保证金值进行比较.
- 在3D治疗模型中研究与使用注册囊镜图像相关的不确定性.
主要方法:
- 为规划和交付建立了一个不确定性预算,以确定孔径和范围的边际.
- 从患者数据分析了设置不确定性,并在最坏的情况下进行了测试.
- 根据缩放,旋转和转换量化了镜图像注册的不确定性.
主要成果:
- 在文献中报告的2.5毫米光圈边缘被验证为0.5毫米以下的设置不确定性,取决于横向半阴影.
- 范围边缘取决于治疗深度和组织密度的变化.
- 由于投射差异,镜图像注册可以引入超过2毫米的边缘,特别是在眼睛赤道附近.
结论:
- 2.5毫米的光圈边缘是合适的,对于较低能量的质子,范围边缘可能会减少.
- 目前的边际没有完全解决边界不确定性和潜在的微观瘤传播问题.
- 已注册的 funduscopy 图像带来了显著的不确定性,强调了眼睛质子治疗中多式成像的必要性.
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