Comparison of treatment plan quality among MRI-based IMRT with a linac, MRI-based IMRT with tri-Co-60 sources, and VMAT for spine SABR
Comparison of treatment plan quality among MRI-based IMRT with a linac, MRI-based IMRT with tri-Co-60 sources, and VMAT for spine SABR
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DOI：
10.1371/journal.pone.0220039
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发表时间：
2019-07-22
期刊：
影响因子：
3.7
通讯作者：
Park, Jong Min
中科院分区：
文献类型：
--
作者：
Choi, Chang Heon;Kim, Jin Ho;Park, Jong Min
目的本研究比较了基于磁共振成像（MRI）的直线加速器调强放射治疗（MR-linac-IMRT）、基于MRI的三钴60源调强放射治疗（MR-Co-60-IMRT）以及脊柱立体定向消融放射治疗（SABR）的容积调制弧形治疗（VMAT）的计划质量。方法回顾性选择20例胸椎转移瘤患者进行本研究。研究。对于每位患者，MR-linac-IMRT、MR-Co-60-IMRT 和 VMAT 计划均使用相同的 CT 图像集和结构生成，但脊髓和脊髓计划危及器官体积 (PRV) 除外。这两个结构的轮廓基于用于 VMAT 规划的 CT 图像集，而这些结构的轮廓则基于用于 MR-linac-IMRT 和 MR-Co-60-IMRT 规划的 MR 图像集。本研究中每个计划的初始处方剂量为单次 18 Gy。如果未达到脊髓的耐受水平，则减少处方剂量以满足脊髓的耐受水平。分析每个计划的剂量体积参数。结果根据CT和MR图像绘制的平均脊髓体积分别为3.8+/-1.6cm(3)和1.1+/-1.0cm(3)(p
PurposeThis study compares the plan quality of magnetic-resonance image (MRI)-based intensity modulated radiation therapy (IMRT) using a linac (MR-linac-IMRT), MRI-based IMRT using tri-Co-60 sources (MR-Co-60-IMRT), and volumetric modulated arc therapy (VMAT) for spine stereotactic ablative radiotherapy (SABR).MethodsTwenty patients with thoracic spine metastasis were retrospectively selected for this study. For each patient, the MR-linac-IMRT, MR-Co-60-IMRT, and VMAT plans were generated using an identical CT image set and structures, except for the spinal cord and spinal cord planning organ-at-risk volume (PRV). Those two structures were contoured based on CT image sets for VMAT planning while those were contoured based on MR image sets for MR-linac-IMRT and MR-Co-60-IMRT planning. The initial prescription doses were 18 Gy in a single fraction for every plan in this study. If the tolerance level of the spinal cord was not met, the prescription doses were reduced to meet the tolerance level of the spinal cord. Dose-volumetric parameters of each plan were analyzed.ResultsThe average spinal cord volumes contoured based on the CT and MR images were 3.8 +/- 1.6 cm(3) and 1.1 +/- 1.0 cm(3), respectively (p