Motion management with phase-adapted 4D-optimization.

Motion management with phase-adapted 4D-optimization.
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DOI:
10.1088/0031-9155/55/17/019
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发表时间:
2010-09-07
影响因子:
3.5
通讯作者:
Bortfeld T
Bortfeld T
中科院分区:
工程技术2区
文献类型:
--
作者:
Nohadani O;Seco J;Bortfeld T

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用电离辐射进行的癌症治疗经常受到器官运动的影响,特别是对于肺部病例。运动不确定性会显著降低原本优化的治疗计划。我们提出了一种时空优化方法,该方法通过相应的4D-CT考虑到呼吸的所有阶段,并提供了一个4D最佳计划,可以在所有呼吸阶段提供。蒙特卡罗剂量计算,以保证最高的剂量准确性,相关的研究运动在肺中的影响。我们证明了这种优化方法与临床肺癌病例的性能,并比较传统的门控技术的结果。我们报告了在目标覆盖率和健康组织保留在一个相当的计算费用显着改善。此外,我们表明,相适应的4D优化计划是强大的不规则呼吸,而不是门控。这种技术有可能产生更高的输送效率和更短的输送时间。
Cancer treatment with ionizing radiation is often compromised by organ motion, in particular for lung cases. Motion uncertainties can significantly degrade an otherwise optimized treatment plan. We present a spatiotemporal optimization method, which takes into account all phases of breathing via the corresponding 4D-CTs and provides a 4D-optimal plan that can be delivered throughout all breathing phases. Monte Carlo dose calculations are employed to warrant for highest dosimetric accuracy, as pertinent to study motion effects in lung. We demonstrate the performance of this optimization method with clinical lung cancer cases and compare the outcomes to conventional gating techniques. We report significant improvements in target coverage and in healthy tissue sparing at a comparable computational expense. Furthermore, we show that the phase-adapted 4D-optimized plans are robust against irregular breathing, as opposed to gating. This technique has the potential to yield a higher delivery efficiency and a decisively shorter delivery time.
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