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周勇, 江泽莹, 苏宝锋, 周剑烽, 王骞, 王安婷, 刘静娴, 薛琰, 冯惠仪, 吴小亮, 肖明星, 谭文勇. 直线加速器机载千伏级扇形束CT和兆伏级锥形束CT系统在放疗摆位误差中的应用[J]. 肿瘤防治研究, 2023, 50(11): 1097-1102. DOI: 10.3971/j.issn.1000-8578.2023.23.0288
引用本文: 周勇, 江泽莹, 苏宝锋, 周剑烽, 王骞, 王安婷, 刘静娴, 薛琰, 冯惠仪, 吴小亮, 肖明星, 谭文勇. 直线加速器机载千伏级扇形束CT和兆伏级锥形束CT系统在放疗摆位误差中的应用[J]. 肿瘤防治研究, 2023, 50(11): 1097-1102. DOI: 10.3971/j.issn.1000-8578.2023.23.0288
ZHOU Yong, JIANG Zeying, SU Baofeng, ZHOU Jianfeng, WANG Qian, WANG Anting, LIU Jingxian, XUE Yan, FENG Huiyi, WU Xiaoliang, XIAO Mingxing, TAN Wenyong. Application of Linear Accelerator on Boarding Kilovolt Fan Beam CT and Megavolt Cone Beam CT System on Set-up Errors During Radiation Treatment[J]. Cancer Research on Prevention and Treatment, 2023, 50(11): 1097-1102. DOI: 10.3971/j.issn.1000-8578.2023.23.0288
Citation: ZHOU Yong, JIANG Zeying, SU Baofeng, ZHOU Jianfeng, WANG Qian, WANG Anting, LIU Jingxian, XUE Yan, FENG Huiyi, WU Xiaoliang, XIAO Mingxing, TAN Wenyong. Application of Linear Accelerator on Boarding Kilovolt Fan Beam CT and Megavolt Cone Beam CT System on Set-up Errors During Radiation Treatment[J]. Cancer Research on Prevention and Treatment, 2023, 50(11): 1097-1102. DOI: 10.3971/j.issn.1000-8578.2023.23.0288

直线加速器机载千伏级扇形束CT和兆伏级锥形束CT系统在放疗摆位误差中的应用

Application of Linear Accelerator on Boarding Kilovolt Fan Beam CT and Megavolt Cone Beam CT System on Set-up Errors During Radiation Treatment

  • 摘要:
    目的 应用直线加速器机载千伏级扇形束CT(kV-FBCT)及兆伏级锥形束CT(MV-CBCT)定量分析不同治疗部位的肿瘤患者调强放射治疗期间的摆位误差,为制定临床靶区外放边界提供参考。
    方法 回顾性分析我科行放射治疗的患者,分别于每次常规摆位后,调强放射治疗前行kV-FBCT和(或)MV-CBCT扫描,与计划CT配准,纠正摆位,获取每次摆位误差,根据患者的位移计算不同治疗部位患者在左右、前后、头脚方向上的平均位移M、系统误差(Σ)和随机误差(б),通过PTV边界公式(2.5Σ+0.7б)估计在该方向所需要的外放边界。根据同一个患者的单次放疗获得三维位移。
    结果 70例患者共记录到1 130人次位移偏差,根据外扩边界公式得出三个方向上所需的PTV边界。头颈1.9~3.1 mm,胸部2.8~5.1 mm,乳腺4.6~5.1 mm,上腹部3.0~5.5 mm及盆腔3.5~6.8 mm。3D平均位移头颈、胸部、乳腺、上腹部和盆腔分别为2.4±1.0 mm、4.0±1.6 mm、4.1±2.0 mm、4.6±2.1 mm及4.6±2.1 mm。利用kV-FBCT和MV-CBCT校位所得3D位移中位值分别为:4.1 mm和3.4 mm,差异无统计学意义(P=0.212)。
    结论 直线加速器机载FBCT均可获得相似的可定量的摆位误差数据,但非等中心的影像引导所致的潜在误差不能忽略。

     

    Abstract:
    Objective To quantify the setup errors for the different anatomical sites of patients who received intensity-modulated radiotherapy (IMRT) with linear accelerator on-board kilovolt fan beam CT(kV-FBCT) as non-isocenter IGRT and megavolt cone beam CT (MV-CBCT) as isocenter IGRT.
    Methods A retrospective analysis was performedon 70 patients who underwent radiotherapy, kV-FBCT, and/or MV-CBCT scans after each routine setup prior to IMRT. The average displacement (M), systematic error (Σ), and random error (б) at different treatment sites in the left-right, anterior-posterior, and cranial-caudal directions were calculated according to the individual displacements. The formula 2.5Σ+0.7б was used to estimate the PTV margin in respective direction. For each single patient, the root mean square in three directions was used as 3D displacement.
    Results A total of 1130 displacements were recorded in the 70 patients. The PTV margin was estimated to be 1.9-3.1 mm in head and neck cancer, 2.8-5.1 mm in thoracic cancer, 4.6-5.1 mm in breast cancer, 3.0-5.5 mm in upper abdominal cancer, and 3.5-6.8 mm in pelvic tumor. For the 3D mean displacements, the head and neck, thoracic, breast, upper abdominal, and pelvic cancer were 2.4±1.0, 4.0±1.6, 4.1±2.0, 4.6±2.1, and 4.6±2.1 mm, respectively. The average 3D displacement obtained by kV-FBCT and MV-CBCT were 4.1 and 3.4 mm, respectively (P=0.212).
    Conclusion The quantitative setup-error data can be obtained using linear accelerator on-board FBCT, and the non-isocenter IGRT induced set-up error cannot be negligible.

     

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