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Karolina A Klucznik¹, Thomas Ravkilde², Simon Skouboe¹

¹Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.

Physics and imaging in radiation oncology

|July 18, 2025

概括

在放射治疗期间使用治疗后的圆束CT (CBCT) 估计前列腺定位错误是有效的. 这种方法准确地检测到分数内运动和相关的剂量缺陷,为运动管理提供了可靠的方法.

科学领域:

医学物理医学物理
辐射瘤学辐射瘤学
放射疗法成像技术放射疗法成像技术

背景情况:

前列腺内断片运动,包括六度自由度 (6DoF) 的转移和旋转运动,可以导致放射治疗期间显著的剂量扭曲.
由于没有实时的分数内运动监测,因此需要使用替代方法来评估和减轻这些影响.

研究的目的:

为了比较三种不同的方法,使用治疗前和后的圆束CT (CBCT) 来估计辐射输送期间前列腺定位错误.
为了评估这些估计的定位错误对治疗准确性的剂量测量影响.

主要方法:

总共分析了来自18名前列腺癌患者的174个治疗部分,在beam-on期间每3秒获得一次kV图像,并在治疗后进行CBCT.
前列腺6DoF位置错误是使用kV图像作为基准确定,并通过三个基于CBCT的场景进行估计:静态CBCT前,静态CBCT前和后之间的线性漂移以及静态CBCT后.
位置错误及其对前列腺剂量的影响与每个场景的基本真相进行了比较.

主要成果:

与CBCT前静态位置 (情景1) 相比,CBCT后静态位置 (情景3) 和线性漂移 (情景2) 方法在估计前列腺位置错误方面表现出更高的准确性.
场景2和3在各个方向 (LR,AP,CC) 实现了1毫米以下的平方根平均误差,明显优于场景1.
检测剂量缺陷的灵敏度 (降低CTV D99.5%) 在第2场景 (68-76%) 和第3场景 (86-91%) 与第1场景 (9-16%),相比,在所有场景显示高特异性 (93-99%).

结论:

利用从治疗后CBCT中获得的前列腺位置提供了检测分数内定位错误和相关剂量缺陷的最有效方法.
该方法提供了可扩展和保守的运动诱导剂量扭曲估计,提高前列腺放射治疗的治疗精度.

关键词:

圆束CT CT 圆束图像指导放射疗法是指导图像的放射疗法.在分数内部的动作.前列腺放射治疗前列腺放射治疗

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