X-ray-induced acoustic computed tomography for guiding prone stereotactic partial breast irradiation: a simulation study.
X-ray-induced acoustic computed tomography for guiding prone stereotactic partial breast irradiation: a simulation study.
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DOI：
10.1002/mp.14245
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发表时间：
2020-09
期刊：
影响因子：
3.8
通讯作者：
Xiang L
中科院分区：
文献类型：
--
作者：
Zheng Y;Samant P;Merill J;Chen Y;Ahmad S;Li D;Xiang L
本研究的目的是调查 X 射线诱导声学计算机断层扫描 (XACT) 作为图像引导工具的可行性，用于跟踪 X 射线束位置并监测立体定向部分乳腺照射 (SPBI) 期间传递给患者的辐射剂量。开发了内部模拟工作流程来评估 XACT 作为 SPBI 体内剂量测定工具的能力。为了评估该模拟工作流程，通过患者的一系列二维 (2D) 乳房 CT 切片创建了三维 (3D) 数字乳房模型。分割三种不同的组织类型（皮肤、脂肪组织和腺体组织），并在数字乳房模型内模拟肿块切除术后血清。采用三个射束角度制定治疗计划，将辐射剂量传递到乳房浆液以模拟 SPBI。 2D 模拟的三个光束角度分别为 17°、90° 和 159°（沙发角度为 0 度），而 3D 模拟中的角度为 90 度（沙发角度为 0°、27°、90°）。开发了能够对 XACT 进行建模的多步仿真平台。首先，将剂量分布转换为初始压力分布。然后使用 k-wave MATLAB 工具箱对这种压力扰动以感应声波形式的传播进行建模。然后，半球形超声换能器阵列（分布在乳房表面的 6320 个换能器位置）检测到这些波。最后，使用 3D 时间反转重建算法，使用在每个换能器位置检测到的时变压力信号来重建初始压力分布的图像。最后，将辐射束的重建 XACT 图像叠加到结构乳腺 CT 上。结果发现，XACT 能够重建 SPBI 的 3D 剂量分布。在重建的3D体积剂量分布中，GTV（总目标体积）和PTV（规划目标体积）的平均剂量分别为86.15%和80.89%。与治疗计划相比，GTV 和 PTV 中的 XACT 重建剂量分布在所有像素上的 RMSE（均方根误差）分别为 2.408% 和 2.299%。采用时间反转重建算法的3D乳腺XACT成像重建可在几分钟内完成。这项工作探讨了使用 XACT 的新型成像方式作为 SPBI 放射治疗体内剂量计的可行性。这表明XACT成像可以在3D中实时提供治疗过程中深部组织中的X射线束位置和剂量信息。这项研究为未来与使用 XACT 作为不同癌症部位的剂量计相关的各种研究奠定了基础。
The aim of this study is to investigate the feasibility of x-ray-induced acoustic computed tomography (XACT) as an image guidance tool for tracking x-ray beam location and monitoring radiation dose delivered to the patient during stereotactic partial breast irradiation (SPBI). An in-house simulation workflow was developed to assess the ability of XACT to act as an in vivo dosimetry tool for SPBI. To evaluate this simulation workflow, a three-dimensional (3D) digital breast phantom was created by a series of two-dimensional (2D) breast CT slices from a patient. Three different tissue types (skin, adipose tissue, and glandular tissue) were segmented and the postlumpectomy seroma was simulated inside the digital breast phantom. A treatment plan was made with three beam angles to deliver radiation dose to the seroma in breast to simulate SPBI. The three beam angles for 2D simulations were 17°, 90° and 159° (couch angles were 0 degrees) while the angles were 90 degrees (couch angles were 0°, 27°, 90°) in 3D simulation. A multi-step simulation platform capable of modelling XACT was developed. First, the dose distribution was converted to an initial pressure distribution. The propagation of this pressure disturbance in the form of induced acoustic waves was then modeled using the k-wave MATLAB toolbox. The waves were then detected by a hemispherical-shaped ultrasound transducer array (6320 transducer locations distributed on the surface of the breast). Finally, the time-varying pressure signals detected at each transducer location were used to reconstruct an image of the initial pressure distribution using a 3D time-reversal reconstruction algorithm. Finally, the reconstructed XACT images of the radiation beams were overlaid onto the structure breast CT. It was found that XACT was able to reconstruct the dose distribution of SPBI in 3D. In the reconstructed 3D volumetric dose distribution, the average doses in the GTV (Gross Target Volume) and PTV (Planning Target Volume) were 86.15% and 80.89%, respectively. When compared to the treatment plan, the XACT reconstructed dose distribution in the GTV and PTV had a RMSE (root mean square error) of 2.408 % and 2.299 % over all pixels. The 3D breast XACT imaging reconstruction with time-reversal reconstruction algorithm can be finished within several minutes. This work explores the feasibility of using the novel imaging modality of XACT as an in vivo dosimeter for SPBI radiotherapy. It shows that XACT imaging can provide the x-ray beam location and dose information in deep tissue during the treatment in real time in 3D. This study lays the groundwork for a variety of future studies related to the use of XACT as a dosimeter at different cancer sites.
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