Frame-less and mask-less cranial stereotactic radiosurgery: a feasibility study
Frame-less and mask-less cranial stereotactic radiosurgery: a feasibility study
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DOI：
10.1088/0031-9155/55/7/005
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发表时间：
2010-04-07
影响因子：
3.5
通讯作者：
Jiang, Steve B.
中科院分区：
文献类型：
--
作者：
Cervino, Laura I.;Pawlicki, Todd;Jiang, Steve B.
目前，在立体定向放射外科(SRS)中，高精度的投放是通过高精度的靶点定位和患者的刚性固定来实现的。然而，僵硬的患者固定会导致患者不适，这种不适会因SRS治疗的持续时间过长而加剧，并可能导致患者移动。为了解决这个问题，我们开发了一种新的SRS技术，旨在将患者的不适降至最低，同时保持高精度的治疗，该技术基于较少僵硬的患者固定和连续的患者运动监测。在这篇文章中，我们研究了这项新技术的可行性。一个拟人化的头部模型被用来检查提供监测的3D表面成像系统的准确性。志愿者被用来研究病人在一种新型头模内的运动，这种头模用于最小限度的固定。结果表明，对于不同的床层角度，表面成像系统和红外光学跟踪系统记录的体模位置之间的位移差在1 mm以内，旋转差在1 mm以内。两个系统在沙发移动过程中检测到的运动在1 mm以内。在20min的间隔内，志愿者头部在任何方向上的最大运动平均为0.7 mm(范围为0.4~1.1 mm)。患者因卧床运动而产生的活动度始终小于0.2 mm。我们得出的结论是，最小限度固定头部模具内部的运动很小，可以通过实时表面成像准确地检测到。
Currently, high-precision delivery in stereotactic radiosurgery (SRS) is achieved via high-precision target localization and rigid patient immobilization. Rigid patient immobilization can result in, however, patient discomfort, which is exacerbated by the long duration of SRS treatments and may induce patient movement. To address this issue, we developed a new SRS technique that is aimed to minimize patient discomfort while maintaining high-precision treatment, based on a less-rigid patient immobilization combined with continuous patient motionmonitoring. In this paper, we examine the feasibility of this new technique. An anthropomorphic head phantom is used to check the accuracy of a 3D surface imaging system that provides the monitoring. Volunteers are used to study patient motion inside a new type of head mold that is used for minimal immobilization. Results show that for different couch angles, the difference between the phantom positions recorded by the surface imaging system and by an infrared optical tracking system was within 1 mm in displacements and 1. in rotation. The motion detected by both systems during couch shifts is within 1 mm agreement. The average maximum volunteer head motion in the head mold during the 20 min interval in any direction was 0.7 mm ( range: 0.4-1.1 mm). Patient motion due to couch motion was always less than 0.2 mm. We conclude that motion inside the minimally immobilizing head mold is small and can be accurately detected by real-time surface imaging.