在使用1.5特斯拉磁共振装备的线性加速器 (MR-Linac) 进行适应性辐射治疗规划期间,对正常器官运动的量化和剂量影响
David Wittmann1, Eric S Paulson1, Anjishnu Banerjee1
1Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Advances in radiation oncology
|April 28, 2025
概括
在适应性辐射疗法规划期间,器官运动会导致显著的剂量变化,特别是在小肠. 核实MRI扫描对于确认风险位置的器官至关重要,并考虑到它们在自适应MRgRT中的动态性质.
科学领域:
- 辐射瘤学 辐射瘤学
- 医疗成像医学成像
- 人体解剖学 解剖学 解剖学
背景情况:
- 适应性磁共振引导辐射疗法 (MRgRT) 涉及在治疗前进行轮修改,这一过程可能需要15到60分钟以上.
- 在这个规划间隔内器官的移动可能会导致附近危险器官 (OAR) 的显著剂量变化.
研究的目的:
- 在自适应MRgRT规划过程中量化OAR运动的剂量学影响.
- 评估接受适应性MRgRT的患者器官运动的意义.
主要方法:
- 预期招募31名患有各种癌症 (胰腺癌,前列腺癌,肝细胞癌,形转移) 的患者,在1.5T MR-Linac.上接受MRgRT.
- 获得每小部分两次MRI扫描:预治疗MRI用于规划和验证MRI立即在beam-on之前.
- 在验证MRI上对OAR (结肠,十二指肠,小肠,胃) 的离线重构,以确定器官运动和计算剂量差异 (Dmax,D0.5cc,V30,V20).
主要成果:
- 对小肠 (488.27 cGy,P < .01) 观察到Dmax的显著差异.
- 小肠也显示了D0.5cc和V30.0的统计学上显著的差异.
- 虽然结肠/直肠,十二指肠和胃表现出剂量差异,但它们在本研究中没有达到统计学意义.
结论:
- 在适应性MRgRT规划期间的器官运动导致了统计学上显著的剂量测量变化,特别是在小肠.
- 验证MRI采集在自适应MRgRT中至关重要,以确认OAR位置.
- 管理OAR的动态性质的策略对于准确的自适应MRgRT交付是必要的.
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