乳房和胸壁的自动皮肤闪光优化VMAT与静态角度调节端口:HU和闪光边缘大小对图形质量和强度的影响
Emily Hubley1, Brandon Koger1, Taoran Li1,2
1Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Journal of applied clinical medical physics
|February 22, 2025
概括
在RapidArc动态 (RAD) 计划中优化皮肤闪光可以确保强大的乳腺癌放射治疗. 建议在治疗期间使用7-10毫米的闪光灯和-350霍恩斯菲尔德单位 (HU) 来准确覆盖目标.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 在乳房和胸壁放射治疗中,皮肤闪光对于强大的目标覆盖至关重要,因为它可以弥补运动和设置变化.
- 目前在体积调制弧线疗法 (VMAT) 中添加皮肤闪光的方法是手动和代的.
- 带有自动皮肤闪光 (ASF) 工具的RapidArc动态 (RAD) 为自动皮肤闪光实现提供了一个潜在的解决方案.
研究的目的:
- 确定RapidArc动态 (RAD) VMAT计划中自动皮肤闪光 (ASF) 工具的最佳参数 (厚度和霍恩斯菲尔德单位).
- 评估不同皮肤闪光设置对乳房和胸壁放射治疗计划质量和稳健性的影响.
主要方法:
- 为13名患有不同ASF厚度 (5-20毫米) 和Hounsfield单位 (HU: -500至0) 的患者创建了RAD计划.
- 用风险器官的DVH指标和计划目标体积 (PTV) 来评估计划质量.
- 通过模拟5毫米前方同心位移和测量CTV剂量覆盖范围的变化来评估计划的稳定性.
主要成果:
- 发现最低皮肤闪光厚度为7毫米,可以产生坚固的平面,而HU的变化不会显著影响坚固度.
- 皮肤闪光厚度超过10毫米的增加导致PTV V105%的更大增加,特别是在0 HU设置下.
- 该研究确定了-350 HU和7-10 mm作为预期的5 mm间和内部分数运动的最佳参数.
结论:
- 在RAD VMAT中的自动皮肤闪光工具可以为乳房和胸壁病例提供高效和强大的放射治疗计划.
- 推的参数为-350 HU和7-10毫米的皮肤闪光厚度,确保充分覆盖目标和规划的稳定性.
- 这些发现为优化VMAT规划和改善临床实践中的治疗准确性提供了宝贵的指导.
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