Image-guided radiosurgery for the spine and pancreas.
Image-guided radiosurgery for the spine and pancreas.
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DOI：
10.1002/1097-0150(2000)5:4
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发表时间：
2000-01-01
期刊：
影响因子：
--
通讯作者：
Poen, J
中科院分区：
文献类型：
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作者：
Murphy, M J;Adler, J R Jr;Poen, J
一种机器人图像引导的放射外科系统已经被改进，可以使用植入的基准和骨骼地标来定位治疗靶点来治疗颅外部位。该系统已用于治疗颈椎的动静脉畸形、胸椎的复发性神经鞘瘤、腰椎的转移性腺癌和三例胰腺癌。在每次治疗过程中，图像制导系统监测目标位置，并以离散的间隔将目标坐标传递给波束指向系统。然后，定点系统将治疗光束与病变动态对准，自动补偿目标位置的变化。胰腺病变的呼吸相关运动由患者通过协调射束门控和屏气来管理。该系统与脊柱病变的对齐平均为+/-0.2 mm，胰腺肿瘤的对齐平均为+/-1 mm。这一经验证明了使用影像引导的机器人颅外放射外科手术的可行性。
A robotic image-guided radiosurgical system has been modified to treat extra-cranial sites using implanted fiducials and skeletal landmarks to locate the treatment targets. The system has been used to treat an artero-venous malformation in the cervical spine, a recurrent schwannoma of the thoracic spine, a metastatic adenocarcinoma of the lumbar spine, and three pancreatic cancers. During each treatment, the image guidance system monitored the position of the target site and relayed the target coordinates to the beam-pointing system at discrete intervals. The pointing system then dynamically aligned the therapy beam with the lesion, automatically compensating for shifts in target position. Breathing-related motion of the pancreas lesions was managed by coordinating beam gating with breath-holding by the patient. The system maintained alignment with the spine lesions to within +/- 0.2 mm on average, and to within +/- 1 mm for the pancreatic tumors. This experience has demonstrated the feasibility of using image-guided robotic radiosurgery outside the cranium.