Journal of Applied Clinical Medical Physics最新文献_第3页

Assessment of lesion insertion tool in pelvis PET/MR data with applications to attenuation correction method development 评估骨盆 PET/MR 数据中的病灶插入工具，并将其应用于衰减校正方法的开发。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-09-04 DOI: 10.1002/acm2.14507

Yutaka Natsuaki, Andrew Leynes, Kristen Wangerin, Mahdjoub Hamdi, Abhejit Rajagopal, Paul E. Kinahan, Richard Laforest, Peder E. Z. Larson, Thomas A. Hope, Sara St. James

Background

In modern positron emission tomography (PET) with multi-modality imaging (e.g., PET/CT and PET/MR), the attenuation correction (AC) is the single largest correction factor for image reconstruction. One way to assess AC methods and other reconstruction parameters is to utilize software-based simulation tools, such as a lesion insertion tool. Extensive validation of these simulation tools is required to ensure results of the study are clinically meaningful.

Purpose

To evaluate different PET AC methods using a synthetic lesion insertion tool that simulates lesions in a patient cohort that has both PET/MR and PET/CT images. To further demonstrate how lesion insertion tool may be used to extend knowledge of PET reconstruction parameters, including but not limited to AC.

Methods

Lesion quantitation is compared using conventional Dixon-based MR-based AC (MRAC) to that of using CT-based AC (CTAC, a “ground truth”). First, the pre-existing lesions were simulated in a similar environment; a total of 71 lesions were identified in 18 pelvic PET/MR patient images acquired with a time-of-flight simultaneous PET/MR scanner, and matched lesions were inserted contralaterally on the same axial slice. Second, synthetic lesions were inserted into four anatomic target locations in a cohort of four patients who didn't have any observed clinical lesions in the pelvis.

Results

The matched lesion insertions resulted in unity between the lesion error ratios (mean SUVs), demonstrating that the inserted lesions successfully simulated the original lesions. In the second study, the inserted lesions had distinct characteristics by target locations and demonstrated negative max-SUV%diff trends for bone-dominant sites across the patient cohort.

Conclusions

The current work demonstrates that the applied lesion insertion tool can simulate uptake in pelvic lesions and their expected SUV values, and that the lesion insertion tool can be extended to evaluate further PET reconstruction corrections and algorithms and their impact on quantitation accuracy and precision.

背景：在现代正电子发射断层扫描（PET）的多模态成像（如 PET/CT 和 PET/MR）中，衰减校正（AC）是图像重建的最大校正因子。评估衰减校正方法和其他重建参数的一种方法是利用基于软件的模拟工具，如病灶插入工具。目的：使用合成病灶插入工具评估不同的 PET AC 方法，该工具可在同时具有 PET/MR 和 PET/CT 图像的患者队列中模拟病灶。进一步展示病灶插入工具如何用于扩展 PET 重建参数知识，包括但不限于 AC：方法：将使用传统的基于 Dixon-based MR 的 AC（MRAC）与使用基于 CT 的 AC（CTAC，"地面实况"）的病变定量进行比较。首先，在相似的环境中模拟预先存在的病灶；在使用飞行时间同步 PET/MR 扫描仪获取的 18 幅盆腔 PET/MR 患者图像中识别出 71 个病灶，并在同一轴切片上对侧插入匹配的病灶。其次，将合成病灶插入骨盆中未观察到任何临床病灶的四名患者的四个解剖靶点：结果：匹配的病灶插入导致病灶误差比（平均 SUVs）达到统一，表明插入的病灶成功模拟了原始病灶。在第二项研究中，插入的病灶在目标位置上具有明显的特征，在整个患者队列中，以骨为主的部位显示出负的最大 SUV%diff 趋势：目前的工作表明，应用病灶插入工具可以模拟盆腔病灶的摄取及其预期 SUV 值，而且病灶插入工具可以扩展，以评估进一步的 PET 重建修正和算法及其对定量准确性和精确性的影响。

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引用次数: 0

The implementation of low instantaneous dose rate total body irradiation with linear accelerator in small-size treatment rooms 在小型治疗室利用直线加速器实施低瞬时剂量率全身照射。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-09-04 DOI: 10.1002/acm2.14502

Zhengxin Gao, Qiuyi Xu, Fengjiao Zhang, Yaling Hong, Qiaoying Hu, Qi Yu, Shen Fu, Qing Gong

Purpose

This paper describes the implementation of an instantaneous low-dose-rate total body irradiation (TBI) technique using block-filtered 6 MV X-rays with a linear accelerator (LINAC) to reduce pulmonary toxicity.

Methods

In the absence of dedicated TBI-specific meter-set dose rates in LINAC and sufficient treatment room size, a 2-cm-thick transmission block was used together with a 200-cm source-to-surface distance (SSD) to reduce the instantaneous dose rates of 6 MV x-rays down to 10 cGy/min, thus alteration to the beam properties. A TBI-specific dose calculation model was built with data acquired at the treatment planning system (TPS)-permitted maximum 140-cm SSD and was validated in phantoms at a 180-cm SSD. As for planning strategies, we adopted large anterior-to-posterior/posterior-to-anterior (AP/PA) open fields with multi-leaf collimator shielding for lungs to achieve target coverage, lung protection, and efficient dose delivery. A custom-designed sliding couch (Patent No. ZL202123085880.1) was manufactured to support patients during treatment. Measures to control the quality and safety of TBI treatment include machine interlocks, pretreatment checklists, and in-vivo dose monitoring.

Results

The instantaneous dose rate of block-filtered 6MV X-ray was reduced to approximately 7.0 cGy/min at 12.5–7.5 cm depth with a 185–200 cm SSD. The dose calculated by TPS differs from the measurements by 0.15%–1.55% in the homogeneous phantom and 1.2%–4.85% in the CIRS thorax phantom. The open-field TBI technique achieved V_90% (PTV) ≈ 96.8% and MLD = 6.6 Gy with 1-h planning and 50-min beam delivery in a single fraction. From February 2021 to July 2023, 30 patients received TBI treatments in our center, and in-vivo monitoring results differed from TPS calculations by −1.49%–2.10%. After 6–12 months of follow-ups, all the patients treated in our center showed no pulmonary toxicities of grade 2 or higher.

Conclusion

A low instantaneous dose rate TBI technique can be implemented in the clinic.

目的：本文介绍了在直线加速器（LINAC）上使用块滤波6 MV X射线实施瞬时低剂量率全身照射（TBI）技术以减少肺毒性的方法：方法：在LINAC中没有专门针对TBI的仪表设定剂量率和足够的治疗室面积的情况下，使用2厘米厚的传输块和200厘米的源到表面距离（SSD）将6 MV X射线的瞬时剂量率降低到10 cGy/min，从而改变了射线束的特性。我们利用在治疗计划系统（TPS）允许的最大 140 厘米 SSD 下获得的数据建立了 TBI 特定剂量计算模型，并在 180 厘米 SSD 下的模型中进行了验证。在计划策略方面，我们采用了大的前-后/后-前（AP/PA）开放区域，并对肺部进行了多叶准直器屏蔽，以实现目标覆盖、肺部保护和高效剂量输送。在治疗过程中，定制设计的滑动沙发（专利号：ZL202123085880.1）为患者提供支撑。控制创伤性脑损伤治疗质量和安全的措施包括机器联锁、治疗前检查表和体内剂量监测：结果：在深度为 12.5-7.5 厘米、SSD 为 185-200 厘米的情况下，块状滤波 6MV X 射线的瞬时剂量率降至约 7.0 cGy/min。在均质模型中，TPS 计算出的剂量与测量值相差 0.15%-1.55%，在 CIRS 胸部模型中相差 1.2%-4.85%。开场 TBI 技术的 V90% (PTV) ≈ 96.8%，MLD = 6.6 Gy，单次分次计划 1 小时，射束传输 50 分钟。2021年2月至2023年7月，30名患者在我中心接受了TBI治疗，体内监测结果与TPS计算结果相差-1.49%-2.10%。经过6-12个月的随访，所有在本中心接受治疗的患者均未出现2级或2级以上的肺部毒性反应：结论：低瞬时剂量率 TBI 技术可在临床中应用。

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引用次数: 0

Simultaneous high-pitch multi-energy CT pulmonary angiography using a dual-source photon-counting-detector CT: A phantom experiment 使用双源光子计数探测器 CT 同步进行高间距多能量 CT 肺血管造影：模型实验。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-08-29 DOI: 10.1002/acm2.14496

Jelena M. Mihailovic, Michael R. Bruesewitz, Joseph R. Swicklik, Mariana Yalon, Prabhakar S. Rajiah, Joel G. Fletcher, Cynthia H. McCollough, Lifeng Yu

Purpose

A dual-source CT system can be operated in a high-pitch helical mode to provide a temporal resolution of 66 ms, which reduces motion artifacts in CT pulmonary angiography (CTPA). It can also be operated in a multi-energy (ME) mode to provide iodine maps, beneficial in the evaluation of pulmonary embolism (PE). No energy-integrating detector (EID) CT can perform simultaneous ME and high-pitch acquisition. This phantom study aimed to evaluate the ability of a photon-counting-detector (PCD) CT to perform simultaneous high-pitch and ME imaging for CTPA.

Methods

A motion phantom was used to mimic the respiratory motion. Two tubes filled with iodine with intravascular thrombus mimicked by injecting glue within the tubes were placed along with 5, 10, and 15 mg/mL iodine samples, on a motion phantom at 20 and 30 revolutions per minute. Separate high-pitch and ME EID-CT scans and a single high-pitch ME PCD scan were acquired and virtual monoenergetic images and iodine maps reconstructed. Percent thrombus occlusion was measured and compared between static and moving images.

Results

When there was motion, EID-CT ME suffered from significant motion artifacts. The measured iodine concentrations with PCD-CT in high-pitch ME were more stable when there was a motion, with a lower standard deviation than EID-CT in ME mode. The estimated percent thrombus occlusion dropped significantly with applied motion on EID-CT, while PCD-CT high-pitch ME mode showed good agreement between measurements on static or moving images.

Conclusion

PCD-CT with combined ME and high-pitch mode facilitates simultaneous accurate iodine quantification and assessment of intravascular occlusion.

目的：双源 CT 系统可在高螺距螺旋模式下运行，提供 66 毫秒的时间分辨率，从而减少 CT 肺血管造影（CTPA）中的运动伪影。它还可以在多能量（ME）模式下运行，提供碘图，有利于评估肺栓塞（PE）。目前还没有一种能量积分探测器（EID）CT 可以同时进行多能量和高螺距采集。这项模型研究旨在评估光子计数探测器（PCD）CT 为 CTPA 同时进行高螺距和 ME 成像的能力：方法：使用运动模型模拟呼吸运动。在运动模型上以每分钟 20 转和 30 转的速度放置两支装有碘的试管，并在试管内注射胶水模拟血管内血栓，同时放置 5、10 和 15 毫克/毫升的碘样本。分别采集了高幅宽和 ME EID-CT 扫描以及单个高幅宽 ME PCD 扫描，并重建了虚拟单能图像和碘图。测量血栓闭塞的百分比，并在静态和动态图像之间进行比较：结果：当有运动时，EID-CT ME 存在明显的运动伪影。当有运动时，PCD-CT 在高调 ME 模式下测得的碘浓度更稳定，标准偏差低于 EID-CT ME 模式下的标准偏差。在 EID-CT 上，随着运动的发生，血栓闭塞的估计百分比会明显下降，而 PCD-CT 高螺距 ME 模式在静态或动态图像上的测量结果显示出良好的一致性：结论：PCD-CT 联合 ME 和高阶梯模式有助于同时进行准确的碘定量和血管内闭塞评估。

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引用次数: 0

Artificial intelligence-based motion tracking in cancer radiotherapy: A review 癌症放疗中基于人工智能的运动跟踪：综述。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-08-28 DOI: 10.1002/acm2.14500

Elahheh Salari, Jing Wang, Jacob Frank Wynne, Chih-Wei Chang, Yizhou Wu, Xiaofeng Yang

Radiotherapy aims to deliver a prescribed dose to the tumor while sparing neighboring organs at risk (OARs). Increasingly complex treatment techniques such as volumetric modulated arc therapy (VMAT), stereotactic radiosurgery (SRS), stereotactic body radiotherapy (SBRT), and proton therapy have been developed to deliver doses more precisely to the target. While such technologies have improved dose delivery, the implementation of intra-fraction motion management to verify tumor position at the time of treatment has become increasingly relevant. Artificial intelligence (AI) has recently demonstrated great potential for real-time tracking of tumors during treatment. However, AI-based motion management faces several challenges, including bias in training data, poor transparency, difficult data collection, complex workflows and quality assurance, and limited sample sizes. This review presents the AI algorithms used for chest, abdomen, and pelvic tumor motion management/tracking for radiotherapy and provides a literature summary on the topic. We will also discuss the limitations of these AI-based studies and propose potential improvements.

放疗的目的是将规定的剂量输送到肿瘤，同时保护邻近的危险器官（OARs）。目前已开发出越来越复杂的治疗技术，如体积调制弧治疗（VMAT）、立体定向放射外科（SRS）、立体定向体放射治疗（SBRT）和质子治疗，以更精确地向靶点投放剂量。虽然这些技术改善了剂量投放，但在治疗时实施分段内运动管理以验证肿瘤位置也变得越来越重要。最近，人工智能（AI）在治疗过程中实时跟踪肿瘤方面展现出巨大潜力。然而，基于人工智能的运动管理面临着一些挑战，包括训练数据的偏差、透明度差、数据收集困难、工作流程和质量保证复杂以及样本量有限。本综述介绍了用于放射治疗的胸部、腹部和盆腔肿瘤运动管理/跟踪的人工智能算法，并提供了有关该主题的文献摘要。我们还将讨论这些基于人工智能的研究的局限性，并提出潜在的改进建议。

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引用次数: 0

Implementation of optically simulated luminescent dosimeter for quality control of gamma ray dose of an accelerator-based neutron source 采用光学模拟发光剂量计对加速器中子源的伽马射线剂量进行质量控制。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-08-27 DOI: 10.1002/acm2.14493

Naonori Hu, Taiki Nakamura, Ryusuke Kataura, Keita Suga, Tetsuya Mukawa, Kazuhiko Akita, Akinori Sasaki, Mai Nojiri, Nishiki Matsubayashi, Takushi Takata, Hiroki Tanaka, Keiji Nihei, Koji Ono

<div> <section> <h3> Background</h3> <p>Neutron beams utilized for performing BNCT are composed of a mixture of neutrons and gamma rays. Although much of the dose delivered to the cancer cells comes from the high LET particles produced by the boron neutron capture reaction, the dose delivered to the healthy tissues from unwanted gamma rays cannot be ignored. With the increase in the number of accelerators for BNCT, a detector system that is capable of measuring gamma ray dose in a mixed neutron/gamma irradiation field is crucial. Currently, BeO TLDs encased in quartz glass are used to measure gamma ray dose in a BNCT irradiation field. However, this type of TLD is no longer commercially available. A replacement dosimetry system is required to perform the recommended ongoing quality assurance of gamma ray measurement for a clinical BNCT system.</p> </section> <section> <h3> Purpose</h3> <p>The purpose of this study is to evaluate the characteristics of a BeO OSLD detector system under a mixed neutron and gamma ray irradiation field and to assess the suitability of the system for routine quality assurance measurements of an accelerator-based BNCT facility.</p> </section> <section> <h3> Methods</h3> <p>The myOSLD system by RadPro International GmbH was evaluated using the accelerator-based neutron source designed for clinical BNCT (NeuCure BNCT system). The readout constancy, linearity, dose rate effect, and fading effect of the OSLD were evaluated. Free-in-air and water phantom measurements were performed and compared with the TLD results and Monte Carlo simulation results. The PHITS Monte Carlo code was used for this study.</p> </section> <section> <h3> Results</h3> <p>The readout constancy was found to be stable over a month-long period and similar to the TLD results. The OSLD readout signal was found to be linear, with a high coefficient of determination (<i>R</i><sup>2</sup> ≥ 0.999) up to a proton charge of 3.6 C. There was no significant signal fading or dose rate dependency. The central axis depth dose and off-axis dose profile measurements agreed with both the TLD and Monte Carlo simulation results, within one standard deviation.</p> </section> <section> <h3> Conclusion</h3> <p>The myOSLD system was characterized using an accelerator system designed for clinical BNCT. The experimental measurements confirmed the OSLD achieved similar, if not superior to, the currently utilized dosimetry system for routine QA of an accelerator-based BNCT system

背景：用于进行 BNCT 的中子束是由中子和伽马射线混合组成的。虽然癌细胞受到的大部分剂量来自硼中子俘获反应产生的高 LET 粒子，但健康组织受到的不需要的伽马射线剂量也不容忽视。随着用于 BNCT 的加速器数量的增加，能够测量中子/伽马混合辐照场中伽马射线剂量的探测器系统变得至关重要。目前，BeO TLD 封装在石英玻璃中，用于测量 BNCT 辐照场中的伽马射线剂量。然而，这种类型的 TLD 已不再在市场上销售。目的：本研究的目的是评估 BeO OSLD 探测器系统在中子和伽马射线混合辐照场下的特性，并评估该系统是否适合用于基于加速器的 BNCT 设备的常规质量保证测量：方法：使用为临床 BNCT 设计的加速器中子源（NeuCure BNCT 系统）对 RadPro International GmbH 的 myOSLD 系统进行了评估。对 OSLD 的读出恒定性、线性度、剂量率效应和衰减效应进行了评估。对自由空气和水模型进行了测量，并与 TLD 结果和蒙特卡罗模拟结果进行了比较。本研究使用了 PHITS 蒙特卡罗代码：结果：在长达一个月的时间里，读出恒定性保持稳定，与 TLD 结果相似。OSLD 的读出信号是线性的，在质子电荷为 3.6 C 时具有较高的决定系数（R2 ≥ 0.999）。中心轴深度剂量和离轴剂量曲线测量结果与 TLD 和蒙特卡罗模拟结果一致，误差在一个标准偏差以内：使用为临床 BNCT 设计的加速器系统对 myOSLD 系统进行了鉴定。实验测量结果证实，在基于加速器的 BNCT 系统的常规质量保证方面，OSLD 与目前使用的剂量测定系统具有相似甚至更高的性能。在对 BNCT 辐照场中的伽马射线剂量测量进行常规质量保证时，OSLD 系统将成为当前 TLD 系统的合适替代品。

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引用次数: 0

Comprehensive clinical implementation, workflow, and FMEA of bespoke silicone bolus cast from 3D printed molds using open-source resources 利用开源资源，从 3D 打印模具中铸造定制硅胶栓的全面临床实施、工作流程和 FMEA。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-08-27 DOI: 10.1002/acm2.14498

Dean Hobbis, Michael D. Armstrong, Samir H. Patel, Riley C. Tegtmeier, Brady S. Laughlin, Shadi Chitsazzadeh, Edward L. Clouser, Jennifer L. Smetanick, Justin Pettit, Justin D. Gagneur, Joshua B. Stoker, Yi Rong, Courtney R. Buckey

Background

Bolus materials have been used for decades in radiotherapy. Most frequently, these materials are utilized to bring dose closer to the skin surface to cover superficial targets optimally. While cavity filling, such as nasal cavities, is desirable, traditional commercial bolus is lacking, requiring other solutions. Recently, investigators have worked on utilizing 3D printing technology, including commercially available solutions, which can overcome some challenges with traditional bolus.

Purpose

To utilize failure modes and effects analysis (FMEA) to successfully implement a comprehensive 3D printed bolus solution to replace commercial bolus in our clinic using a series of open-source (or free) software products.

Methods

3D printed molds for bespoke bolus were created by exporting the DICOM structures of the bolus designed in the treatment planning system and manipulated to create a multipart mold for 3D printing. A silicone (Ecoflex 00–30) mixture is poured into the mold and cured to form the bolus. Molds for sheet bolus of five thicknesses were also created. A comprehensive FMEA was performed to guide workflow adjustments and QA steps.

Results

The process map identified 39 and 30 distinct steps for the bespoke and flat sheet bolus workflows, respectively. The corresponding FMEA highlighted 119 and 86 failure modes, with 69 shared between the processes. Misunderstanding of plan intent was a potential cause for most of the highest-scoring failure modes, indicating that physics and dosimetry involvement early in the process is paramount.

Conclusion

FMEA informed the design and implementation of QA steps to guarantee a safe and high-quality comprehensive implementation of silicone bolus from 3D printed molds. This approach allows for greater adaptability not afforded by traditional bolus, as well as potential dissemination to other clinics due to the open-source nature of the workflow.

背景：放射治疗中使用注射材料已有几十年的历史。这些材料最常用于使剂量更接近皮肤表面，以最佳方式覆盖浅表靶点。虽然空腔填充（如鼻腔）是可取的，但缺乏传统的商用栓剂，需要其他解决方案。目的：利用失效模式和效应分析（FMEA），在我们的诊所中使用一系列开源（或免费）软件产品，成功实施了全面的三维打印栓剂解决方案，以取代商用栓剂。方法：通过导出治疗计划系统中设计的栓剂 DICOM 结构，创建定制栓剂的三维打印模具，并对其进行处理，以创建用于三维打印的多部件模具。将硅酮（Ecoflex 00-30）混合物倒入模具并固化，形成栓剂。此外，还制作了五种厚度的片状栓剂模具。进行了全面的 FMEA，以指导工作流程调整和质量保证步骤：结果：流程图分别为定制和平板栓剂工作流程确定了 39 个和 30 个不同步骤。相应的 FMEA 强调了 119 种和 86 种故障模式，其中 69 种在流程之间共享。对计划意图的误解是大多数得分最高的故障模式的潜在原因，这表明物理和剂量测定在流程早期的参与至关重要：结论：FMEA 为质量保证步骤的设计和实施提供了依据，以确保利用 3D 打印模具全面实施硅胶栓的安全和高质量。这种方法具有传统栓剂所不具备的更强的适应性，而且由于工作流程的开源性，有可能推广到其他诊所。

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引用次数: 0

Semi-automated vertex placement for lattice radiotherapy and dosimetric verification using 3D polymer gel dosimetry 利用三维聚合物凝胶剂量测定技术，对格子放射治疗进行半自动顶点放置和剂量测定验证。

IF 2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics

Pub Date : 2024-08-26 DOI: 10.1002/acm2.14489

Tenzin Kunkyab, Anthony Magliari, Andrew Jirasek, Benjamin Mou, Derek Hyde

Purpose

To evaluate the feasibility of an open-source, semi-automated, and reproducible vertex placement tool to improve the efficiency of lattice radiotherapy (LRT) planning. We used polymer gel dosimetry with a Cone Beam CT (CBCT) readout to commission this LRT technique.

Material and methods

We generated a volumetric modulated arc therapy (VMAT)-based LRT plan on a 2 L NIPAM polymer gel dosimeter using our Eclipse Acuros version 15.6 AcurosXB beam model, and also recalculated the plan with a pre-clinical Acuros v18.0 dose calculation algorithm with the enhanced leaf modelling (ELM). With the assistance of the MAAS-SFRThelper software, a lattice vertex diameter of 1.5 cm and center-to-center spacing of 3 cm were used to place the spheres in a hexagonal, closed packed structure. The verification plan included four gantry arcs with 15°, 345°, 75°, 105° collimator angles. The spheres were prescribed 20 Gy to 50% of their combined volume. The 6 MV Flattening Filter Free beam energy was used to deliver the verification plan. The dosimetric accuracy of the LRT delivery was evaluated with 1D dose profiles, 2D isodose maps, and a 3D global gamma analysis.

Results

Qualitative comparisons between the 1D dose profiles of the Eclipse plan and measured gel showed good consistency at the prescription dose mark. The average diameter measured 13.3 ± 0.2 mm (gel for v15.6), 12.6 mm (v15.6 plan), 13.1 ± 0.2 mm (gel for v18.0), and 12.3 mm (v18.0 plan). 3D gamma analysis showed that all gamma pass percent were > 95% except at 1% and 2% at the 1 mm distance to agreement criteria.

Conclusion

This study presents a novel application of gel dosimetry in verifying the dosimetric accuracy of LRT, achieving excellent 3D gamma results. The treatment planning was facilitated by publicly available software that automatically placed the vertices for consistency and efficiency.

目的：评估一种开源、半自动、可重复的顶点放置工具的可行性，以提高格子放射治疗（LRT）计划的效率。我们使用聚合物凝胶剂量计和锥形束 CT（CBCT）读数来调试这种 LRT 技术：我们使用 Eclipse Acuros 15.6 版 AcurosXB 射束模型在 2 L NIPAM 聚合物凝胶剂量计上生成了基于容积调制弧治疗 (VMAT) 的 LRT 计划，并使用临床前 Acuros v18.0 剂量计算算法和增强叶片建模 (ELM) 重新计算了计划。在 MAAS-SFRThelper 软件的协助下，使用了 1.5 厘米的晶格顶点直径和 3 厘米的中心到中心间距，将球体放置在六边形封闭包装结构中。验证计划包括四条龙门弧线，准直角分别为 15°、345°、75° 和 105°。球体的规定剂量为 20 Gy，占其总体积的 50%。验证计划使用了 6 MV 扁平化滤波器自由束能量。通过一维剂量曲线、二维等剂量图和三维全伽马分析，对 LRT 输送的剂量学准确性进行了评估：结果：Eclipse 计划的一维剂量曲线与测量的凝胶之间的定性比较显示，在处方剂量标记处具有良好的一致性。平均直径分别为 13.3 ± 0.2 毫米（v15.6 版凝胶）、12.6 毫米（v15.6 版平面）、13.1 ± 0.2 毫米（v18.0 版凝胶）和 12.3 毫米（v18.0 版平面）。三维伽马分析表明，除了在距离一致标准 1 毫米处的 1%和 2%之外，所有伽马通过率都大于 95%：这项研究展示了凝胶剂量测定在验证 LRT 剂量测定准确性方面的新应用，取得了极佳的三维伽马结果。公共可用软件自动放置顶点，提高了一致性和效率，为治疗规划提供了便利。

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引用次数: 0