分析心肺呼吸运动及其对立体性心律失常的剂量效应:一个STOPSTORM.eu联盟研究
Luuk H G van der Pol1, Stefano Mandija1, Brian V Balgobind2
1Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the Netherlands.
International journal of radiation oncology, biology, physics
|October 28, 2025
概括
静态心律失常放射切除 (STAR) 过程中的心肺呼吸运动对于心室心律失常有类似的剂量影响跨设置. 呼吸追踪显著减少了运动的运动量.
科学领域:
- 医学物理 医学物理
- 放射治疗瘤学 放射治疗瘤学
- 心脏电生理学 心脏电生理学
背景情况:
- 立体性心律失常放射移除 (STAR) 是一种新兴的治疗方法,用于耐火性心室性心律失常.
- 了解心肺呼吸运动对STAR的影响对于治疗的有效性和安全性至关重要.
- STOPSTORM.eu注册表提供多中心数据来调查这些影响.
研究的目的:
- 在STAR程序期间量化心肺呼吸运动.
- 评估这种运动在不同处理技术中的剂量测量后果.
- 为了比较运动估计方法,包括可变形图像注册和自动轮.
主要方法:
- 收集了来自61名接受STAR.治疗的室腔心动减速症患者的数据.
- 使用了各种治疗方法:自由呼吸与内部目标体积 (FB:ITV),自由呼吸与呼吸追踪 (FB:TR),腹部压缩 (AC) 和深呼吸喘息 (BH).
- 使用可变形图像记录和自动轮结构估计的运动;计算的运动调整剂量分布和符合性指数.
主要成果:
- 计划目标体积运动的中位数在4.9毫米 (BH) 到6.0毫米 (FB) 之间.
- 左心室表现出最高的运动 (中位数第95百分位数:5.5-6.8毫米).
- 由于运动导致的符合性指数下降因技术而异,FB:TR显示影响最小 (-1.3%).
- 危险器官的平均和最大剂量增加,特别是对于小结构.
结论:
- 心肺呼吸运动及其剂量测量影响在STAR中对于心室动脉冲动有意义.
- 在可变形图像记录和自动轮之间观察到运动估计的一致性.
- 呼吸追踪是减轻运动对量度影响的最有效方法.
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