Potential of image-guidance, gating and real-time tracking to improve accuracy in pulmonary stereotactic body radiotherapy
Potential of image-guidance, gating and real-time tracking to improve accuracy in pulmonary stereotactic body radiotherapy
复制标题
DOI：
10.1016/j.radonc.2008.08.010
复制
发表时间：
2009-06-01
影响因子：
5.7
通讯作者：
Flentje, Michael
中科院分区：
文献类型：
--
作者：
Guckenberger, Matthias;Krieger, Thomas;Flentje, Michael
目的：探讨影像引导、门控和实时肿瘤跟踪技术在提高肺立体定向放射治疗（SBRT）准确性中的应用潜力。材料和方法：基于43例术前和术后锥形束CT成像患者的SBRT治疗，计算补偿靶位置分数间和分数内不确定性的安全裕度。采用呼吸相关CT、基于模型的4D-CT图像分割和基于体素的剂量累积对17例肺肿瘤进行呼吸运动补偿的安全裕度评估；中间通风位置的目标为参考。结果：由于肿瘤在分数间的基线移动较大，基于骨解剖的立体定向患者定位和图像引导分别需要12 mm和9 mm的安全边界。针对肿瘤本身的四维图像引导和分数段内肿瘤跟踪将边缘减小到
Purpose: To evaluate the potential of image-guidance, gating and real-time tumor tracking to improve accuracy in pulmonary stereotactic body radiotherapy (SBRT).Materials and methods: Safety margins for compensation of inter- and intra-fractional uncertainties of the target position were calculated based on SBRT treatments of 43 patients with pre- and post-treatment cone-beam CT imaging. Safety margins for compensation of breathing motion were evaluated for 17 pulmonary tumors using respiratory correlated CT, model-based segmentation of 4D-CT images and voxel-based dose accumulation; the target in the mid-ventilation position was the reference.Results: Because of large inter-fractional base-line shifts of the tumor, stereotactic patient positioning and image-guidance based on the bony anatomy required safety margins of 12 mm and 9 mm, respectively. Four-dimensional image-guidance targeting the tumor itself and intra-fractional tumor tracking reduced margins to