Breathing-synchronized delivery: A potential four-dimensional tomotherapy treatment technique
Breathing-synchronized delivery: A potential four-dimensional tomotherapy treatment technique
复制标题
DOI：
10.1016/j.ijrobp.2007.02.054
复制
发表时间：
2007-08-01
影响因子：
7
通讯作者：
Paliwal, Bhudatt
中科院分区：
文献类型：
--
作者：
Zhang, Tiezhi;Lu, Weiguo;Paliwal, Bhudatt
目的：介绍一种四维 (4D) 断层放射治疗技术，可改善运动控制和患者耐受性。方法和材料：获取 10 个呼吸阶段的计算机断层扫描图像以用于治疗计划。选择完全呼气阶段作为计划阶段，并将该阶段的CT图像用作治疗计划图像。感兴趣区域的勾画与传统治疗计划中的相同，只是临床靶区计划靶区扩张中不使用呼吸运动裕度。假定机架速度恒定和呼吸周期固定，设置输送和呼吸阶段之间的相关性。可变形图像配准产生了相对于规划阶段的每个阶段的变形场。利用递送/呼吸相位相关性和每个呼吸相位的体素位移，通过将运动纳入逆治疗计划优化来获得 4D 断层放射治疗计划。已开发出激光/肺活量计组合呼吸跟踪系统来监测患者呼吸。该系统能够产生代表潮气量的稳定且可重复的呼吸信号。结果：我们将 4D 断层放射治疗治疗计划方法与静态目标上的传统断层放射治疗进行了比较。结果表明，4D 断层放射治疗可以在移动目标上实现与在固定目标上采用传统输送方式获得的剂量分布相似的剂量分布。规律的呼吸运动可以通过运动结合的呼吸同步输送计划得到充分补偿。四维断层放射治疗还具有接近100%的占空比，并且不会延长治疗时间。结论：呼吸同步输送是一种可行的4D断层放射治疗技术，具有改善的运动控制和患者耐受性。 (c) 2007 爱思唯尔公司
Purpose: To introduce a four-dimensional (4D) tomotherapy treatment technique with improved motion control and patient tolerance.Methods and Materials: Computed tomographic images at 10 breathing phases were acquired for treatment planning. The full exhalation phase was chosen as the planning phase, and the CT images at this phase were used as treatment-planning images. Region of interest delineation was the same as in traditional treatment planning, except that no breathing motion margin was used in clinical target volume-planning target volume expansion. The correlation between delivery and breathing phases was set assuming a constant gantry speed and a fixed breathing period. Deformable image registration yielded the deformation fields at each phase relative to the planning phase. With the delivery/breathing phase correlation and voxel displacements at each breathing phase, a 4D tomotherapy plan was obtained by incorporating the motion into inverse treatment plan optimization. A combined laser/spirometer breathing tracking system has been developed to monitor patient breathing. This system is able to produce stable and reproducible breathing signals representing tidal volume.Results: We compared the 4D tomotherapy treatment planning method with conventional tomotherapy on a static target. The results showed that 4D tomotherapy can achieve dose distributions on a moving target similar to those obtained with conventional delivery on a stationary target. Regular breathing motion is fully compensated by motion-incorporated breathing-synchronized delivery planning. Four-dimensional tomotherapy also has close to 100% duty cycle and does not prolong treatment time.Conclusion: Breathing-synchronized delivery is a feasible 4D tomotherapy treatment technique with improved motion control and patient tolerance. (c) 2007 Elsevier Inc.