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间断呼吸运动变化的影响,在动态符合弧度肺的立体体辐射疗法剂量递送的准确性:一个幻影研究
Bong Kyung Bae1, Sung Joon Kim2, Jae-Chul Kim1
1Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, Korea.
PloS one
|December 4, 2025
概括
呼吸运动显著影响肺SBRT剂量准确性. 增加的运动幅度,特别是≥10毫米,导致不可接受的目标剂量不足,损害了立体身体放射疗法的有效性.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 精确的剂量输送在肺部立体体辐射疗法 (SBRT) 中至关重要.
- 呼吸运动在目标定位和剂量分配方面带来不确定性.
- 了解呼吸运动变化的影响对于优化SBRT技术至关重要.
研究的目的:
- 评估呼吸运动幅度和频率的变化如何影响动态符合弧度肺SBRT中的剂量递送精度.
- 用玻璃剂量计评估在不同呼吸条件下输送剂量的临床可接受性.
主要方法:
- 四维计算机断层扫描 (4D-CT) 用于模拟呼吸运动 (幅度10毫米,每分钟20次呼吸[BPM]).
- 玻璃剂量计被放置在QUASARTM呼吸运动幻影中,以测量关键目标位置的剂量.
- 内部目标体积 (ITV) -SBRT和门式-SBRT计划在不同的呼吸条件下 (10-30 BPM,5-30 mm振幅) 交付.
主要成果:
- 每分钟呼吸 (BPM) 对ITV-SBRT的剂量递送的影响最小.
- 增加的呼吸运动幅度显著影响了SBRT的准确性,导致目标上下两边的剂量不足.
- 与ITV-SBRT相比,Gated-SBRT显示了较高幅度的上端低剂量增加.
结论:
- 呼吸运动幅度是影响肺SBRT中剂量递送精度的关键因素.
- 从计划CT采集增加10毫米或更多的振幅显著导致目标剂量低于可接受的临床值 (D95%).
- 这些发现强调了在肺SBRT中需要精确的运动管理策略.
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