| MVCT图像引导调强放疗在线检验靶区位置及修正剂量分布的临床应用 | |
| 李丹 ; 邓小武 ; 包尚联 ; LI Dan ; DENG Xiao-wu ; BAO Shang-lian | |
| 2010-07-19 ; 2010-07-19 | |
| 关键词 | 体层摄影术,高能X线计算机 图像引导 调强放疗 剂量验证 High-voltage computed tomography Image guided radiotherapy Intensity modulated radiation therapy Dose verification R739.91 R737.25 |
| 其他题名 | Megavoltage computerized tomography image guided intensity modulated radiation therapy: clinical application of on-board verification and correction of target position and dose distribution |
| 中文摘要 | 目的利用在线高能X线计算机体层摄影术(MVCT)重建两组共45例调强放疗患者的三维图像,研究头颈部与前列腺肿瘤患者的治疗摆位在未经修正情况下的体位和靶区位置偏差,及其对照射剂量分布的影响,探索MVCT图像引导放疗的临床应用方法与意义。方法对实施切层调强放疗患者的计划分布分别以电离室和剂量胶片方法进行体模验证测量,在验证合格前提下用在线MVCT图像与模拟定位的CT图像进行三维融合比较,测量两组患者体位和靶区中心点的偏差,分析两组摆位的系统误差与随机误差。以测量的体位和靶区位移偏差值模拟体位偏差条件,比较模拟条件下测量得到的体模剂量分布与计划剂量分布和正常摆位时的剂量分布差别。结果头颈部和前列腺肿瘤治疗摆位未经修正时靶区的三维位移偏差值分别为(-3.0±2.8)、(-5.4±2.3)、(2.1±2.4)mm和(3.2±2.5)(、-6.4±5.3)、(8.7±3.6)mm。上述位移偏差条件下体模测量的头颈和前列腺照射剂量分布与计划剂量分布的误差分别为8.2%和6.9%。结论在线HVCT能精确快速测量患者体位和靶区位置空间误差,为修正摆位提供准确依据。未经修正时靶区位移误差导致的剂量分布误差可能超出临床允许范围,调强放疗应以在线图像引导验证基础上进行才能保证剂量分布精度。; Objective Utilizing on-board megavoltage computerized tomography(MVCT) to reconstruct 3D images for head & neck and prostate patients.Forty five patients were treated by intensity modulated radiation therapy(IMRT).The errors was investigated both patient placement and target position before the treatment position adjustment.The influence of the positional error during dose delivery was also evaluated to explore the clinical application of MVCT for image guided radiotherapy.Methods Phantom measurement was done for all patients using ion chamber and film dosimeter to verify the planned dose distribution.Under the condition of approved verification:(1)3D image fusion technique was used to compare with on-board MVCT and simulation CT images.The errors of patient placement and central target position were measured in terms of systematic and random errors.(2)Dose distribution deviation was evaluated using the measured average displacement of target to simulate the error in patient placement.Results The average 3D positional displacement value was(-3.0�8)?mm,(-5.4�(2.3)?mm),(2.1�4)?mm and(3.2�5)?mm,(-6.4�3)?mm,(8.7�6)?mm in head & neck and prostate patients before correction,respectively.Under the above displacement condition measured in phantom,the error of the planned dose distribution was 8.2% and 6.9% in head & neck and prostate,respectively.Conclusions The on-board MVCT can accurately measure the spatial error of the patient position and target localization,and therefore offers guidance to correct the positional error.Before such correction,the dose deviation caused by the target positional error may exceed the clinical tolerance.In order to guarantee the accuracy of dose delivery,IMRT treatment quality should be assured based on on-board image guidance. |
| 语种 | 中文 ; 中文 |
| 内容类型 | 期刊论文 |
| 源URL | [http://hdl.handle.net/123456789/77300]  |
| 专题 | 清华大学 |
| 推荐引用方式 GB/T 7714 | 李丹,邓小武,包尚联,等. MVCT图像引导调强放疗在线检验靶区位置及修正剂量分布的临床应用[J],2010, 2010. |
| APA | 李丹,邓小武,包尚联,LI Dan,DENG Xiao-wu,&BAO Shang-lian.(2010).MVCT图像引导调强放疗在线检验靶区位置及修正剂量分布的临床应用.. |
| MLA | 李丹,et al."MVCT图像引导调强放疗在线检验靶区位置及修正剂量分布的临床应用".(2010). |
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