Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device.
Anatomic and dosimetric changes in patients with head and neck cancer treated with an integrated MRI-tri-60Co teletherapy device.
复制标题
使用集成 MRI-tri-60Co 远程治疗设备治疗的头颈癌患者的解剖学和剂量学变化。
DOI：
10.1259/bjr.20160624
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
A. Chen
中科院分区：
文献类型：
--
作者：
G. Raghavan;A. Kishan;M. Cao;A. Chen
目标
先前的研究依靠 CT 来评估接受头颈癌放射治疗的患者的解剖结构变化。我们试图确定使用基于 MRI 的图像引导放射治疗来量化这些变化并确定其潜在的剂量学影响的可行性。
方法
6 名头颈癌患者在配备 0.35-T MRI（VR，ViewRay Incorporated，奥克伍德村，俄亥俄州）的新型 tri-60Co 远程治疗系统上接受调强放射治疗 (IMRT)，剂量为 66-70Gy，分 33 次 (fx)。将 Fx 1、5、10、15、20、25、30 和 33 上的治疗前 MRI 导入轮廓界面，在其中勾画出原发性肉眼肿瘤体积 (GTV) 和腮腺。相对于第一天评估这些结构的质心 (COM) 偏移。剂量测定数据与 MRI 共同注册，并评估 GTV 和腮腺的剂量。
结果
在 IMRT 过程中，原发性 GTV 显着下降（中位体积损失百分比，38.7%；范围，29.5-72.0%；p< 0.05），中位率为 1.2%/fx（范围，0.92-2.2%/fx）。在 IMRT 期间，同侧和对侧腮腺都经历了显着的体积损失（p<0.05）并且向内侧移动。体重减轻与腮腺体积减少和内侧 COM 移位显着相关 (p<<0.05)。
结论
集成机载 MRI 可用于在 IMRT 过程中准确勾画和分析主要 GTV 和腮腺。观察到 COM 变化和显着的体积减小，证实了之前基于 CT 的练习的结果。知识进步：机载 MRI 的卓越分辨率可能有助于未来的在线自适应重新规划。
OBJECTIVE
Prior studies have relied on CT to assess alterations in anatomy among patients undergoing radiation for head and neck cancer. We sought to determine the feasibility of using MRI-based image-guided radiotherapy to quantify these changes and to ascertain their potential dosimetric implications.
METHODS
6 patients with head and neck cancer were treated with intensity-modulated radiotherapy (IMRT) on a novel tri-60Co teletherapy system equipped with a 0.35-T MRI (VR, ViewRay Incorporated, Oakwood Village, OH) to 66-70 Gy in 33 fractions (fx). Pre-treatment MRIs on Fx 1, 5, 10, 15, 20, 25, 30 and 33 were imported into a contouring interface, where the primary gross tumour volume (GTV) and parotid glands were delineated. The centre of mass (COM) shifts for these structures were assessed relative to Day 1. Dosimetric data were co-registered with the MRIs, and doses to the GTV and parotid glands were assessed.
RESULTS
Primary GTVs decreased significantly over the course of IMRT (median % volume loss, 38.7%; range, 29.5-72.0%; p < 0.05) at a median rate of 1.2%/fx (range, 0.92-2.2%/fx). Both the ipsilateral and contralateral parotid glands experienced significant volume loss (p < 0.05, for all) and shifted medially during IMRT. Weight loss correlated significantly with parotid gland volume loss and medial COM shift (p < 0.05).
CONCLUSION
Integrated on-board MRI can be used to accurately contour and analyze primary GTVs and parotid glands over the course of IMRT. COM shifts and significant volume reductions were observed, confirming the results of prior CT-based exercises. Advances in knowledge: The superior resolution of on-board MRI may facilitate online adaptive replanning in the future.
DOI：
10.1016/j.ijrobp.2011.08.017
发表时间：
2012-07-01
影响因子：
7
作者：
Schwartz, David L.;Garden, Adam S.;Thomas, Jimmy;Chen, Yipei;Zhang, Yongbin;Lewin, Jan;Chambers, Mark S.;Dong, Lei
通讯作者：
Dong, Lei
DOI：
10.1016/j.ijrobp.2007.07.2345
发表时间：
2007-11-15
影响因子：
7
作者：
O'Daniel, Jennifer C.;Garden, Adam S.;Dong, Lei
通讯作者：
Dong, Lei