Cumulative lung dose for several motion management strategies as a function of pretreatment patient parameters.
Cumulative lung dose for several motion management strategies as a function of pretreatment patient parameters.
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DOI：
10.1016/j.ijrobp.2008.12.069
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发表时间：
2009-06-01
影响因子：
7
通讯作者：
Yan, Di
中科院分区：
文献类型：
--
作者：
Hugo, Geoffrey D.;Campbell, Jonathon;Zhang, Tiezhi;Yan, Di
旨在评价可预测几种运动管理策略之间累积4D肺剂量相对差异的患者参数。变形图像配准和剂量累积被用来生成4D治疗计划的18例患者的4DCT扫描。生成了三个计划，以模拟正常吸气时的屏气、使用射束孔径的目标跟踪和中等通气孔径（在平均每日位置控制目标并应用迭代计算的裕度以补偿呼吸）。计算屏气与中等通气孔径之间的平均肺剂量（MLD）相对减少（ΔMLDBH）和靶跟踪与中等通气孔径之间的平均肺剂量（ΔMLDTT）。计算这两个变量与病变参数（偏移、大小、位置和变形）和剂量分布（靶附近的局部剂量梯度）之间的关联。屏气和中等通气孔径之间MLD的最大绝对值和百分比差异分别为1.0戈伊和21.5%。ΔMLDBH与肿瘤漂移显著相关（p<0.05）。ΔMLDTT与偏移、变形和局部剂量梯度显著相关。构建线性模型以表示Δ MLD与偏移。对于每5mm的偏移，与中等通气孔径计划相比，目标跟踪将MLD降低了4%。对于屏气，偏移每5 mm减少5%。不同运动管理策略之间MLD的相对差异随给定剂量靶区覆盖范围的患者和肿瘤特征而变化。肿瘤偏移有助于将患者分层到适当的运动管理策略中。
To evaluate patient parameters that may predict for relative differences in cumulative 4D lung dose among several motion management strategies. Deformable image registration and dose accumulation were used to generate 4D treatment plans for eighteen patients with 4DCT scans. Three plans were generated to simulate breath hold at normal inspiration, target tracking with the beam aperture, and mid-ventilation aperture (control of the target at the mean daily position and application of an iteratively-computed margin to compensate for respiration). The relative reduction in mean lung dose (MLD) between breath hold and mid-ventilation aperture (ΔMLDBH) and between target tracking and mid-ventilation aperture (ΔMLDTT) was calculated. Associations between these two variables and parameters of the lesion (excursion, size, location, and deformation) and dose distribution (local dose gradient near the target) were calculated. The largest absolute and percentage differences in MLD were 1.0 Gy and 21.5% between breath hold and mid-ventilation aperture. ΔMLDBH was significantly associated (p<0.05) with tumor excursion. ΔMLDTT was significantly associated with excursion, deformation, and local dose gradient. A linear model was constructed to represent Δ MLD versus excursion. For each 5mm of excursion, target tracking reduced the MLD by 4% compared to a mid-ventilation aperture plan. For breath hold, the reduction is 5% per 5mm of excursion. The relative difference in MLD among different motion management strategies varied with patient and tumor characteristics for a given dosimetric target coverage. Tumor excursion is useful to aid in stratifying patients into an appropriate motion management strategy.
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影响因子：
3.5
作者：
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通讯作者：
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作者：
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作者：
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DOI：
10.1016/s0360-3016(98)00130-8
发表时间：
1998-07-01
影响因子：
7
作者：
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通讯作者：
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DOI：
10.1016/j.ijrobp.2006.12.066
发表时间：
2007-06-01
影响因子：
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作者：
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通讯作者：
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