Control, Correction, and Modeling of Setup Errors and Organ Motion.
Control, Correction, and Modeling of Setup Errors and Organ Motion.
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DOI：
10.1016/s1053-4296(95)80006-9
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发表时间：
1995-04-01
影响因子：
3.5
通讯作者：
Liebel
中科院分区：
文献类型：
--
作者：
Kutcher;Mageras;Liebel
随着放射治疗技术的进步使治疗精度更高，了解导致治疗不确定性的因素变得越来越重要。成像模式和计算机算法的最新发展，使治疗的不确定性的定量测量统计上显着的患者数量，这导致了新的战略，减少以及将其纳入治疗计划过程。本文回顾了目前的文献中被认为是重要的光子治疗，即患者定位（设置）错误和器官运动的不确定性的两个来源。在患者定位的领域中，已经有越来越多的关于使用电子射野成像设备来校正设置错误的协议的工作。这些方案源自基于患者人群设置错误知识的概率分析以及定义的临床终点。器官运动的测量以及纠正或控制器官运动的方法受到了更多限制，部分原因是成像和运动表征方面存在更大的困难。我们还回顾了两种范式占治疗计划的不确定性：传统的方法，它增加了一个利润率周围的肿瘤体积，和一个替代的，其中包括直接在肿瘤体积和附近的正常器官的剂量分布的不确定性。
As advances in radiotherapy technology enable higher precision treatments, it becomes increasingly important to understand the factors that contribute to treatment uncertainty. The recent developments in imaging modalities and computer algorithms have made possible quantitative measurements of treatment uncertainties on statistically significant numbers of patients, which has led to new strategies for reducing as well as incorporating them into the treatment planning process. This article reviews the current literature on two sources of uncertainties deemed important in photon therapy, namely, patient localization (setup) errors and organ motion. In the area of patient localization there has been increasing work on protocols using electronic portal imaging devices to correct setup errors. These protocols are derived from probability analyses based on knowledge of setup errors for a population of patients in combination with defined clinical endpoints. Measurements of organ motion and methods to correct or control it have been more limited, due partly to the larger difficulties in imaging and motion characterization. We also review two paradigms for accounting for uncertainties in treatment plans: the conventional approach, which adds a margin around the tumor volume, and an alternative one, which includes uncertainties directly in the dose distributions of the tumor volume and nearby normal organs.