Effectiveness of a simple and real-time baseline shift monitoring system during stereotactic body radiation therapy of lung tumors
Effectiveness of a simple and real-time baseline shift monitoring system during stereotactic body radiation therapy of lung tumors
复制标题
DOI：
10.1016/j.ejmp.2017.11.001
复制
发表时间：
2017-11-01
影响因子：
3.4
通讯作者：
Kashihara, Kenichi
中科院分区：
文献类型：
--
作者：
Uchida, Yukihiro;Tachibana, Hidenobu;Kashihara, Kenichi
目的：本研究旨在临床验证一个简单的实时基线偏移监测系统在一项前瞻性研究中的连续患者接受立体定向放射治疗（SBRT）的肺肿瘤，并调查基线偏移由于部分内运动的患者的身体在肺SBRT。连续10例周围型肺肿瘤患者接受SBRT治疗，SBRT分为4个部分，每个部分12戈伊，总剂量为48戈伊。在治疗期间，使用实时监控网络摄像头系统测量每个患者在前后和左右方向上的几何位移（基线偏移）。使用X射线荧光成像系统测量治疗开始和结束之间的位移。比较两种系统的位移测量值，并对所有患者在治疗过程中监测系统获得的基线偏移测量值进行分析。监测系统与X射线成像系统之间无明显偏差，使用监测系统的测量表明，处理7分钟产生的位移大于1结论：基线偏移的病人的身体可以准确地测量在真实的时间，使用监测系统，而无需X射线曝光。胸骨的胸骨柄是用于始终测量患者身体的基线偏移的良好位置。实时监测系统可用于独立于门控系统测量患者身体的基线偏移。
Purpose: This study aimed to clinically validate a simple real-time baseline shift monitoring system in a prospective study of consecutive patients undergoing stereotactic body radiation therapy (SBRT) of lung tumors, and to investigate baseline shift due to intrafraction motion of the patient's body during lung SBRT.Methods: Ten consecutive patients with peripheral lung tumors were treated by SBRT consisting of four fractions of 12 Gy each, with a total dose of 48 Gy. During treatment, each patient's geometric displacement in the anterior-posterior and left-right directions (the baseline shift) was measured using a real-time monitoring webcam system. Displacement between the start and end of treatment was measured using an X-ray fluoroscopic imaging system. The displacement measurements of the two systems were compared, and the measurements of baseline shift acquired by the monitoring system during treatment were analyzed for all patients.Results: There was no significant deviation between the monitoring system and the X-ray imaging system, with the accuracy of measurement being within 1 mm. Measurements using the monitoring system showed that 7 min of treatment generated displacements of more than 1 mm in 50% of the patients.Conclusions: Baseline shift of a patient's body may be measured accurately in real time, using a monitoring system without X-ray exposure. The manubrium of the sternum is a good location for measuring the baseline shift of a patient's body at all times. The real-time monitoring system may be useful for measuring the baseline shift of a patient's body independently of a gating system.