In vivo range verification in particle therapy.

In vivo range verification in particle therapy.
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DOI:
10.1002/mp.12960
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发表时间:
2018-11
期刊:
影响因子:
3.8
通讯作者:
Polf JC
Polf JC
中科院分区:
医学3区
文献类型:
--
作者:
Parodi K;Polf JC

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在临床实践中充分发挥离子束的潜力仍然受到多种治疗不确定性的阻碍,特别是与我们定位肿瘤中布拉格峰位置的能力的限制有关。为此,人们正在进行多项努力,以改善治疗前患者位置、解剖结构和组织阻止功率特性的表征,以及在治疗期间或治疗后不久对实际剂量输送或至少射束范围进行体内验证。该贡献批判性地审查了正在开发或临床测试的离子疗法验证方法,基于治疗前范围和组织探测以及治疗期间和治疗后二次发射或生理变化的检测,试图将普遍适用性的方法与针对某些解剖位置的更具体的方法区分开来。此外,它还讨论了未来的方向,这些方向可能受益于多种模式的整合,或者解决生物适应疗法的可测量信号的新开发。
Exploitation of the full potential offered by ion beams in clinical practice is still hampered by several sources of treatment uncertainties, particularly related to limitations of our ability to locate the position of the Bragg peak in the tumour. To this end, several efforts are ongoing to improve the characterization of patient position, anatomy and tissue stopping power properties prior to treatment, as well as to enable in-vivo verification of the actual dose delivery, or at least beam range, during or shortly after treatment. This contribution critically reviews methods under development or clinical testing for verification of ion therapy, based on pre-treatment range and tissue probing as well as detection of secondary emissions or physiological changes during and after treatment, trying to disentangle approaches of general applicability from those more specific to certain anatomical locations. Moreover, it discusses future directions, which could benefit from integration of multiple modalities or address novel exploitation of the measurable signals for biologically adapted therapy.
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