Single-Arc IMRT?
Single-Arc IMRT?
复制标题
DOI：
10.1088/0031-9155/54/1/n02
复制
发表时间：
2009-01-07
影响因子：
3.5
通讯作者：
Webb, Steve
中科院分区：
文献类型：
--
作者：
Bortfeld, Thomas;Webb, Steve
最近，利用多叶准直器在机架单次旋转期间以连续动态模式提供调强放射治疗(IMRT)的想法在研究和工业中都得到了推动。在这篇笔记中，我们在概念性水平上研究这种单弧形调强放射治疗技术的潜力。我们考虑了Brahme等人开创调强放射治疗领域的最初的理论例子。使用分析方法，我们得出了单弧形以及标准调强放射治疗和放射治疗的可提供强度“景观”。我们发现，断层放射治疗在塑造强度景观方面提供了最大的灵活性，它允许人们以一种接近横断面理想情况的方式进行调强放射治疗。单弧和标准调强放射治疗在不同的领域做出了妥协。只有在相对简单的情况下，不需要实质性的强度调制，单弧形放射治疗才能在剂量学上与放射治疗相媲美。与标准的调强放射治疗相比，如果人们愿意接受将低剂量值扩散到大量正常组织上，单弧形放射治疗在某些情况下可能具有剂量学上的优势。在治疗计划方面，单弧形放射治疗比放射治疗或标准调强放疗提出了更具挑战性的优化问题。我们得出结论，单弧作为一种有效的调强放射治疗技术具有潜力，特别是对于相对简单的病例。在非常复杂的情况下，如果试图将治疗时间保持在2分钟左右，单弧可能会不适当地损害剂量分布的质量。与所有调强放射治疗技术一样，对于每个病例，仔细探索计划质量和交付效率之间的权衡是很重要的。
The idea of delivering intensity-modulated radiation therapy (IMRT) with a multileaf collimator in a continuous dynamic mode during a single rotation of the gantry has recently gained momentum both in research and industry. In this note we investigate the potential of this Single-Arc IMRT technique at a conceptual level. We consider the original theoretical example case from Brahme et al that got the field of IMRT started. Using analytical methods, we derive deliverable intensity 'landscapes' for Single-Arc as well as standard IMRT and Tomotherapy. We find that Tomotherapy provides the greatest flexibility in shaping intensity landscapes and that it allows one to deliver IMRT in a way that comes close to the ideal case in the transverse plane. Single-Arc and standard IMRT make compromises in different areas. Only in relatively simple cases that do not require substantial intensity modulation will Single-Arc be dosimetrically comparable to Tomotherapy. Compared with standard IMRT, Single-Arc could be dosimetrically superior in certain cases if one is willing to accept the spreading of low dose values over large volumes of normal tissue. In terms of treatment planning, Single-Arc poses a more challenging optimization problem than Tomotherapy or standard IMRT. We conclude that Single-Arc holds potential as an efficient IMRT technique especially for relatively simple cases. In very complex cases, Single-Arc may unduly compromise the quality of the dose distribution, if one tries to keep the treatment time below 2 min or so. As with all IMRT techniques, it is important to explore the tradeoff between plan quality and the efficiency of its delivery carefully for each individual case.