Optimisation of cone beam CT radiotherapy imaging protocols using a novel 3D printed head and neck anthropomorphic phantom.

IF 3.3 3区 医学 Q2 ENGINEERING, BIOMEDICAL Physics in medicine and biology Pub Date : 2024-10-28 DOI:10.1088/1361-6560/ad88d2
Meshal Alzahrani, Christopher O'Hara, David Bird, Jack P C Baldwin, Mitchell Naisbit, Irvin Teh, David A Broadbent, Bashar Al-Qaisieh, Emily Johnstone, Richard Speight
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Abstract

Objective.This study aimed to optimise Cone Beam Computed Tomography (CBCT) protocols for head and neck (H&N) radiotherapy treatments using a 3D printed anthropomorphic phantom. It focused on precise patient positioning in conventional treatment and adaptive radiotherapy (ART).Approach.Ten CBCT protocols were evaluated with the 3D-printed H&N anthropomorphic phantom, including one baseline protocol currently used at our centre and nine new protocols. Adjustments were made to milliamperage and exposure time to explore their impact on radiation dose and image quality. Additionally, the effect on image quality of varying the scatter correction parameter for each of the protocols was assessed. Each protocol was compared against a reference CT scan. Usability was assessed by three Clinical Scientists using a Likert scale, and statistical validation was performed on the findings.Main results. The work revealed variability in the effectiveness of protocols. Protocols optimised for lower radiation exposure maintained sufficient image quality for patient setup in a conventional radiotherapy pathway, suggesting the potential for reducing patient radiation dose by over 50% without compromising efficacy. Optimising ART protocols involves balancing accuracy across brain, bone, and soft tissue, as no single protocol or scatter correction parameter achieves optimal results for all simultaneously.Significance.This study underscores the importance of optimising CBCT protocols in H&N radiotherapy. Our findings highlight the potential to maintain the usability of CBCT for bony registration in patient setup while significantly reducing the radiation dose, emphasizing the significance of optimising imaging protocols for the task in hand (registering to soft tissue or bone) and aligning with the as low as reasonably achievable principle. More studies are needed to assess these protocols for ART, including CBCT dose measurements and CT comparisons. Furthermore, the novel 3D printed anthropomorphic phantom demonstrated to be a useful tool when optimising CBCT protocols.

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使用新型 3D 打印头颈部拟人模型优化锥形束 CT 放射治疗成像方案。
目的: 本研究旨在使用 3D 打印的拟人化模型优化头颈部 (H&N) 放射治疗的锥形束计算机断层扫描 (CBCT) 方案。方法: 使用 3D 打印的 H&N 拟人模型评估了十种 CBCT 方案,包括我们中心目前使用的一种基准方案和九种新方案。对毫安培数和曝光时间进行了调整,以探讨它们对辐射剂量和图像质量的影响。此外,还评估了改变每个方案的散射校正参数对图像质量的影响。每个方案都与参考 CT 扫描进行了比较。由三位临床科学家使用李克特量表对可用性进行评估,并对评估结果进行统计验证。为降低辐射量而优化的方案在传统放疗路径中保持了足够的图像质量,这表明在不影响疗效的情况下,有可能将患者的辐射剂量减少 50%以上。优化 ART 方案需要平衡脑、骨和软组织的精确度,因为没有一种方案或散射校正参数能同时达到所有方案的最佳效果。我们的研究结果突显了在患者设置中保持 CBCT 用于骨骼登记的可用性,同时大幅降低辐射剂量的潜力,强调了针对手头任务(登记到软组织或骨骼)优化成像方案的重要性,并符合 "尽可能低"(ALARA)的原则。需要进行更多的研究来评估这些 ART 方案,包括 CBCT 剂量测量和 CT 对比。此外,在优化 CBCT 方案时,新颖的 3D 打印拟人模型被证明是一种有用的工具。
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来源期刊
Physics in medicine and biology
Physics in medicine and biology 医学-工程:生物医学
CiteScore
6.50
自引率
14.30%
发文量
409
审稿时长
2 months
期刊介绍: The development and application of theoretical, computational and experimental physics to medicine, physiology and biology. Topics covered are: therapy physics (including ionizing and non-ionizing radiation); biomedical imaging (e.g. x-ray, magnetic resonance, ultrasound, optical and nuclear imaging); image-guided interventions; image reconstruction and analysis (including kinetic modelling); artificial intelligence in biomedical physics and analysis; nanoparticles in imaging and therapy; radiobiology; radiation protection and patient dose monitoring; radiation dosimetry
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