BEAM PROFILE DISTURBANCES FROM IMPLANTABLE PACEMAKERS OR IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR INTERACTIONS
BEAM PROFILE DISTURBANCES FROM IMPLANTABLE PACEMAKERS OR IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR INTERACTIONS
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DOI：
10.1016/j.meddos.2010.09.003
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发表时间：
2011-12-01
影响因子：
1.2
通讯作者：
Wilkinson, Jeffrey
中科院分区：
文献类型：
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作者：
Gossman, Michael S.;Nagra, Bipinpreet;Wilkinson, Jeffrey
医学界正在倡导逐步改进植入型心律转复除颤器和植入型起搏器的设计，以适应剂量限制标准的提高。随着在一些方面已经取得磁共振成像兼容性的进步，当这样的设备在治疗性辐射束领域中时，更需要通知放射肿瘤学家和医学物理学家关于治疗计划束轮廓的改变。进行治疗计划建模，以模拟美敦力公司制造的设备对治疗辐射束的影响。作为赠款资助研究的继续，我们发现，与植入式起搏器和心律转复除颤器直接放置在束流中时相比，医用加速器的径向和横向开放波束的轮廓发生了变化。两种装置在轴面和矢状面的测量结果有显著差异。治疗射束在6 mV和18 mV X射线能量下也表现出巨大的差异。植入型心律转复除颤器在6 mV和18 mV时，深度剂量百分比变化最大，分别为9.3%和10.1%，最差距离分别为2.3 cm和1.3 cm。埋藏式起搏器在6 mV和18 mV时，深度剂量百分比变化最大，分别为10.7%和6.9%，与等剂量线最远的距离分别为2.5 cm和1.9 cm。除颤电极和起搏电极之间无明显差异。(C)2011年美国医学剂量师协会。
The medical community is advocating for progressive improvement in the design of implantable cardioverter-defibrillators and implantable pacemakers to accommodate elevations in dose limitation criteria. With advancement already made for magnetic resonance imaging compatibility in some, a greater need is present to inform the radiation oncologist and medical physicist regarding treatment planning beam profile changes when such devices are in the field of a therapeutic radiation beam. Treatment plan modeling was conducted to simulate effects induced by Medtronic, Inc.-manufactured devices on therapeutic radiation beams. As a continuation of grant-supported research, we show that radial and transverse open beam profiles of a medical accelerator were altered when compared with profiles resulting when implantable pacemakers and cardioverter-defibrillators are placed directly in the beam. Results are markedly different between the 2 devices in the axial plane and the sagittal planes. Vast differences are also presented for the therapeutic beams at 6-MV and 18-MV x-ray energies. Maximum changes in percentage depth dose are observed for the implantable cardioverter-defibrillator as 9.3% at 6 MV and 10.1% at 18 MV, with worst distance to agreement of isodose lines at 2.3 cm and 1.3 cm, respectively. For the implantable pacemaker, the maximum changes in percentage depth dose were observed as 10.7% at 6 MV and 6.9% at 18 MV, with worst distance to agreement of isodose lines at 2.5 cm and 1.9 cm, respectively. No differences were discernible for the defibrillation leads and the pacing lead. (C) 2011 American Association of Medical Dosimetrists.