Real-time intrafraction motion monitoring in external beam radiotherapy.
Real-time intrafraction motion monitoring in external beam radiotherapy.
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外束放疗中的实时肢体内运动监测。
DOI：
10.1088/1361-6560/ab2ba8
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发表时间：
2019-08-07
影响因子：
3.5
通讯作者：
Oelfke U
中科院分区：
文献类型：
--
作者：
Bertholet J;Knopf A;Eiben B;McClelland J;Grimwood A;Harris E;Menten M;Poulsen P;Nguyen DT;Keall P;Oelfke U
放射治疗（RT）旨在向肿瘤提供空间适形剂量的辐射，同时最大限度地节省健康组织的剂量。然而，由于呼吸、心脏、胃肠道和泌尿活动，患者内部解剖结构不断移动。RT社区的长期目标是“看到我们治疗的东西，就像我们治疗的一样”，并立即对这些信息采取行动，这导致了快速的技术创新。专门的治疗机器，如机器人或万向节操纵的直线加速器（直线加速器）与室内成像套件，已被开发专门用于实时治疗适应。额外的设备，如立体千伏（kV）成像，超声换能器和电磁转发器，已被开发用于在传统的直线加速器上的分数内运动监测。磁共振成像（MRI）已与钴治疗单位，最近与直线加速器。除了硬件创新，软件开发在基于呼吸运动替代物和平面kV或兆伏（MV）成像的运动监测方法的开发中发挥了重要作用，该成像可在标准配备的直线加速器上获得。在本文中，我们回顾和比较不同的术中运动监测方法提出的文献中，并在实时的临床数据，以及他们可能的未来发展。然后，我们讨论了临床实施的验证和质量保证的一般考虑因素。除了光子RT，粒子治疗越来越多地用于治疗移动目标。然而，将运动监测技术从直线加速器转移到粒子束线提出了实质性的挑战。从光子RT的实时级分内监测的实施中吸取的经验教训将被用作讨论这些方法的粒子RT的实施的基础。
Radiotherapy (RT) aims to deliver a spatially conformal dose of radiation to tumours while maximizing the dose sparing to healthy tissues. However, the internal patient anatomy is constantly moving due to respiratory, cardiac, gastrointestinal and urinary activity. The long term goal of the RT community to ‘see what we treat, as we treat’ and to act on this information instantaneously has resulted in rapid technological innovation. Specialized treatment machines, such as robotic or gimbal-steered linear accelerators (linac) with in-room imaging suites, have been developed specifically for real-time treatment adaptation. Additional equipment, such as stereoscopic kilovoltage (kV) imaging, ultrasound transducers and electromagnetic transponders, has been developed for intrafraction motion monitoring on conventional linacs. Magnetic resonance imaging (MRI) has been integrated with cobalt treatment units and more recently with linacs. In addition to hardware innovation, software development has played a substantial role in the development of motion monitoring methods based on respiratory motion surrogates and planar kV or Megavoltage (MV) imaging that is available on standard equipped linacs. In this paper, we review and compare the different intrafraction motion monitoring methods proposed in the literature and demonstrated in real-time on clinical data as well as their possible future developments. We then discuss general considerations on validation and quality assurance for clinical implementation. Besides photon RT, particle therapy is increasingly used to treat moving targets. However, transferring motion monitoring technologies from linacs to particle beam lines presents substantial challenges. Lessons learned from the implementation of real-time intrafraction monitoring for photon RT will be used as a basis to discuss the implementation of these methods for particle RT.
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影响因子：
2.4
作者：
Ahn, YC;Shimizuz, S;Miyasaka, K
通讯作者：
Miyasaka, K
DOI：
10.1016/j.ijrobp.2009.09.040
发表时间：
2010-03-01
影响因子：
7
作者：
Bentzen, Soren M.;Constine, Louis S.;Deasy, Joseph O.;Eisbruch, Avi;Jackson, Andrew;Marks, Lawrence B.;Ten Haken, Randall K.;Yorke, Ellen D.
通讯作者：
Yorke, Ellen D.
影响因子：
3.5
作者：
Bjerre, Troels;Crijns, Sjoerd;Keall, Paul
通讯作者：
Keall, Paul
影响因子：
3.8
作者：
Aristophanous, M.;Rottmann, J.;Berbeco, R. I.
通讯作者：
Berbeco, R. I.
影响因子：
1.7
作者：
Adler, JR;Chang, SD;Hancock, SL
通讯作者：
Hancock, SL