WE‐D‐ValA‐04: Synchrony — Real‐Time Respiratory Compensation System for the CyberKnife
WE‐D‐ValA‐04: Synchrony — Real‐Time Respiratory Compensation System for the CyberKnife
复制标题
WE-D-ValA-04：同步 — CyberKnife 的实时呼吸补偿系统
DOI：
10.1118/1.2241768
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发表时间：
2006
期刊：
影响因子：
3.8
通讯作者：
C. Ozhasoglu
中科院分区：
文献类型：
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作者：
C. Ozhasoglu
对胸部和腹部器官的透视、超声波和 4D CT 研究表明，某些器官可能因呼吸运动而移动多达 4 厘米。如果在外束放射治疗期间未对运动进行补偿，则目标的剂量覆盖范围可能会受到影响。另一方面，如果通过增加余量来补偿运动，则可能会不必要地照射大量正常组织。呼吸代偿问题对于大分割治疗变得更加重要，对于单分割颅外放射外科应用更是如此。 CyberKnife 是一种图像引导放射外科系统，由安装在机械臂上的 6MV LINAC 组成，通过控制回路与数字诊断 X 射线成像系统耦合。机械臂可以将光束以六个自由度指向空间中的任何位置，而不受传统等角点的限制。 CyberKnife 最近进行了升级，配备了名为 Synchrony 的实时呼吸跟踪和补偿系统。使用外部标记与诊断 X 射线图像相结合，Synchrony 有助于引导机械臂实时移动辐射束，使光束始终与目标保持对齐。借助同步，可以在三维空间中跟踪肿瘤运动，并且可以在不增加余量的情况下最小化运动引起的靶剂量变化。我们将讨论这项新技术的工作原理、优点、局限性以及我们的临床经验。
Fluoroscopic, ultrasonic and 4D CT studies of the organs in the thorax and abdomen have shown that some organs may move as much as 4 cm due to respiratory motion. If the motion is not compensated for during external beam radiation therapy, the dose coverage to target may be compromised. On the other hand, if the motion is compensated for with an increase of margin, a significant amount of normal tissue may be irradiated unnecessarily. The issue of respiratory compensation becomes more important for hypofractionated treatments and even more so for single‐fraction extracranial radiosurgery applications. CyberKnife is an image‐guidedradiosurgery system that consists of a 6‐MV LINAC mounted to a robotic arm coupled through a control loop to a digital diagnostic x‐ray imaging system. The robotic arm can point the beam anywhere in space with six degrees of freedom, without being constrained to a conventional isocenter. The CyberKnife has been recently upgraded with a real‐time respiratory tracking and compensation system called Synchrony. Using external markers in conjunction with diagnostic x‐ray images, Synchrony helps to guide the robotic arm to move the radiation beam in real time such that the beam always remains aligned with the target. With the aid of the Synchrony, the tumor motion can be tracked in three dimensional space, and the motion induced dosimetric change to target can be minimized without an increase in margin. The working principles, advantages, limitations and our clinical experience with this new technology will be discussed.