Journal of Medical Imaging and Radiation Sciences最新文献_第9页

Radiation Therapists' role in COVID-19 testing: Detecting asymptomatic carriers during Ontario's Omicron BA.2 wave 放射治疗师在COVID-19检测中的作用：在安大略省Omicron BA.2波期间检测无症状携带者

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-08-05 DOI: 10.1016/j.jmir.2025.102075

Kayli Chen , Kitty Chan , Colin Robertson , Nelissa Chaudhry , Anne Di Tomasso , Vickie Kong , Karen Tse , Tara Rosewall

Background

In November 2021, the highly transmissible Omicron BA.2 variant led to a surge in demand for COVID-19 testing within Ontario's cancer care system, overwhelming established testing clinics and delaying radiation therapy (RT) start dates. To address this, a small team of Radiation Therapists (RTTs) was trained to conduct nasopharyngeal swabs (NPS) on the same day as CT simulation for eligible patients.

Methods

This single-centre quality improvement project, approved by the institution, involved collecting data on patient demographics, RTT swab clinic throughput, and test outcomes via a retrospective chart review. An online questionnaire gathered insights from RTTs about their experiences, and training procedures were documented.

Results

An urgent medical delegation was obtained from the hospital's Office of Medical Directives, and eight RTTs were trained to perform NPS. Over 4.5 months, 402 new RT patients were swabbed. The positivity rate for asymptomatic patients was 2 %. None of the patients with negative NPS results developed symptoms or tested positive during the Omicron incubation period. Initiation of the RTT swab clinic significantly reduced the decision-to-treat to treat time (p = 0.01). All involved RTTs felt the initiative enhanced patient and staff safety.

Conclusions

RTTs successfully and safely performed NPS on the same day as CT simulation, helping identify asymptomatic COVID-19 patients before starting RT. This approach minimized exposures to asymptomatic cases, prevented treatment delays, and reduced the radiobiological risks associated with COVID-related RT interruptions.

2021年11月，高度传染性的欧米克隆BA.2变异导致安大略省癌症护理系统内对COVID-19检测的需求激增，使现有的检测诊所不堪重负，并推迟了放射治疗（RT）的开始日期。为了解决这个问题，一个小的放射治疗师（rtt）团队接受了培训，在符合条件的患者进行CT模拟的同一天进行鼻咽拭子（NPS）。方法本项目为单中心质量改进项目，经该机构批准，通过回顾性图表审查收集患者人口统计数据、RTT拭子临床吞吐量和测试结果。一份在线调查问卷收集了rtt对其经验的见解，并记录了培训程序。结果从医院医嘱办公室获得了一个紧急医疗代表团，并培训了8名rtt执行NPS。在4.5个月的时间里，402名新的RT患者被拭子擦拭。无症状者阳性率为2%。NPS结果阴性的患者在Omicron潜伏期均未出现症状或检测呈阳性。RTT拭子门诊的开始显著缩短了决定治疗到治疗的时间（p = 0.01）。所有参与的rtt都认为这一举措提高了患者和工作人员的安全。结论srtt在CT模拟的同一天成功安全地进行了NPS，有助于在开始RT之前识别无症状的COVID-19患者。这种方法最大限度地减少了与无症状病例的接触，防止了治疗延误，降低了与COVID-19相关的RT中断相关的放射生物学风险。

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引用次数: 0

An exploration of radiation-induced side effects for palliative patients treated with volumetric modulated arc therapy versus conventional radiotherapy to the spine 对采用体积调节弧线治疗的姑息性患者与传统脊柱放射治疗的放射诱导副作用的探讨

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-31 DOI: 10.1016/j.jmir.2025.102031

Asvena Sriharan , John San Miguel , Charles Cho , Zishan Allibhai , Natalie Rozanec

Purpose

Given the increased frequency of volumetric modulated arc therapy (VMAT) in palliative radiation therapy planning, this study compares differences in patient-reported side effects for palliative patients treated with radiation therapy to the spine using VMAT versus conventional radiation therapy (CRT) techniques.

Methods and Materials

A single-centre retrospective study examined patient-reported Edmonton Symptom Assessment Scores (ESAS) for palliative patients with spinal metastases. Scores were stratified by technique and site (C/CT Spine, T/TL Spine & L/LS Spine). Average ESAS scores were calculated, and T-tests were used to detect significant differences (p<0.05) between ESAS baseline and treatment scores. The planning target volume (PTV) length of each treated site was measured, and Pearson’s r correlational coefficients were calculated to identify correlations between PTV length and patient-reported symptoms.

Results

For CRT patients treated to the lumbar/lumbosacral (L/LS) spine, significantly lower anxiety scores (p=0.0498) were noted on treatment (n=9) when compared with baseline (n=24). CRT patients treated to the T/TL spine were significantly more tired and drowsy during treatment (n=32) when compared with CRT baseline scores (n=53; p_Tiredness=0.0175; p_Drowsiness= 0.0102), which was not observed in the VMAT study group. All CRT patient subgroups also experienced more drowsiness and tiredness on treatment compared with VMAT patients (p_Drowsiness=0.2003; p_Tiredness=0.0852). VMAT patients treated to the thoracic/thoracolumbar (T/TL) spine (n=43) reported a significant decrease in appetite compared with CRT patients (n=24; p=0.0357). The remaining scores demonstrate no significant differences between cohorts for the t-test analysis. A moderate positive correlation (r=0.5741, n=10) between PTV length and nausea scores was detected in CRT patients treated to the L/LS spine, which was not observed in the VMAT study group.

Conclusions

Although differences in patient-reported symptoms exist when comparing CRT versus VMAT for palliative spine radiation therapy, these differences are not clinically significant, and both techniques are well-tolerated.

鉴于体积调制弧线治疗（VMAT）在姑息性放射治疗计划中的使用频率增加，本研究比较了使用VMAT和传统放射治疗（CRT）技术进行脊柱放射治疗的姑息性患者报告的副作用的差异。方法和材料一项单中心回顾性研究检查了患者报告的埃德蒙顿症状评估评分（ESAS）对脊柱转移姑息治疗患者的影响。评分按技术和部位分层(C/CT脊柱，T/TL脊柱；L / LS脊柱)。计算ESAS平均评分，并采用t检验检测ESAS基线与治疗评分之间的显著差异（p<0.05）。测量每个治疗部位的计划靶体积（PTV）长度，并计算Pearson 's r相关系数，以确定PTV长度与患者报告的症状之间的相关性。结果对于治疗腰椎/腰骶（L/LS）脊柱的CRT患者，治疗（n=9）与基线（n=24）相比，焦虑评分显著降低（p=0.0498）。治疗T/TL脊柱的CRT患者在治疗期间（n=32）比CRT基线评分(n=53；pTiredness = 0.0175;嗜睡= 0.0102)，VMAT研究组未观察到这一现象。与VMAT患者相比，所有CRT患者亚组在治疗期间也经历了更多的嗜睡和疲劳(pdrowiness =0.2003；pTiredness = 0.0852)。VMAT治疗至胸/胸腰椎（T/TL）脊柱的患者（n=43）与CRT患者(n=24；p = 0.0357)。其余的分数在t检验分析中没有显着差异。在接受L/LS脊柱治疗的CRT患者中，PTV长度与恶心评分之间存在中度正相关（r=0.5741, n=10），而在VMAT研究组中未观察到这一现象。结论虽然CRT与VMAT在脊柱姑息性放射治疗中患者报告的症状存在差异，但这些差异在临床上并不显著，两种技术均具有良好的耐受性。

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引用次数: 0

Variation in gastric emptying scintigraphy protocols in Australia and New Zealand: An online survey 澳大利亚和新西兰胃排空扫描协议的差异：一项在线调查

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-29 DOI: 10.1016/j.jmir.2025.102015

Iliana N. Angelidakis , Cristina Blefari , Karen L. Jones

Introduction

Standardisation of nuclear medicine practice is important for high-quality patient care. Variation in protocols limits the ability to compare results between departments and may reduce confidence in results. The aim of this study was to determine the current extent of variation in gastric emptying scintigraphy (GES) protocols in Australian and New Zealand departments of nuclear medicine.

Methods

A cross-sectional, online survey of Nuclear Medicine Technologists (NMTs) was conducted using ‘LimeSurvey’. The survey was distributed to 442 NMT members of the Australian and New Zealand Society of Nuclear Medicine over a period of two months. The survey comprised 27 questions relating to participant information, patient preparation, test meal, scanning, processing, and alternative meals used as part of their departmental protocol; the number of questions increased to 34 if the department had an alternative meal/technique.

Results

A total of 141 responses were received, resulting in a response rate of 31.9 %. Once responses were reviewed for completeness or duplicates (data coming from the same department), a total of 37 responses from NMTs, representing their department, (31 from Australia and six from New Zealand) were included in the final analysis. Nineteen (51.3 %) NMTs had a variation of a meal based on the Society of Nuclear Medicine and Molecular Imaging (SNMMI) / American Neurogastroenterology Motility Society (ANMS) guidelines. The majority (n = 30, 81.0 %) of participants utilised a single isotope technique, labelling the solid component only. All but two (94.6 %) NMTs included an egg component to their test meal. For scanning, the majority (n = 25,67.6 %) of NMTs acquired the scintigraphic data with the patient supine. Only 30 % (n = 11) of NMTs corrected for attenuation when processing GES data. Of the 32 (86.4 %) NMTs that had an alternative meal, only one (2.7 %) had a normal range specific to the meal.

Conclusion

The results demonstrated marked variation amongst departmental protocols in Australia and New Zealand, particularly in relation to appropriate normal ranges. This study highlights the importance of a current lack of standardisation of practice in Australian and New Zealand departments in relation to GES protocols.

核医学实践的标准化对高质量的患者护理至关重要。方案的差异限制了部门间比较结果的能力，并可能降低结果的可信度。本研究的目的是确定澳大利亚和新西兰核医学部门胃排空闪烁成像（GES）方案的当前变化程度。方法采用“石灰调查”软件对核医学技术人员进行横断面在线调查。这项调查在两个月的时间里分发给了澳大利亚和新西兰核医学学会的442名NMT成员。该调查包括27个问题，涉及参与者信息、患者准备、试验餐、扫描、处理和作为其部门协议一部分的替代餐；如果部门有替代膳食/技术，问题数量增加到34个。结果共收到回复141份，回复率为31.9%。一旦审查了回复的完整性或重复（数据来自同一部门），代表其部门的nmt的37份回复（31份来自澳大利亚，6份来自新西兰）被纳入最终分析。根据核医学和分子成像学会(SNMMI) /美国神经胃肠病学运动学会（ANMS）指南，19名（51.3%）nmt的饮食发生了变化。大多数参与者（n = 30,81.0%）使用单一同位素技术，仅标记固体成分。除了两个（94.6%）的nmt外，所有的nmt在他们的测试餐中都含有鸡蛋成分。对于扫描，大多数（n = 25, 67.6%）的NMTs在患者仰卧位时获得了显像数据。在处理GES数据时，只有30% （n = 11）的nmt对衰减进行了校正。在32个（86.4%）有替代膳食的nmt中，只有一个（2.7%）有正常的特定膳食范围。结论澳大利亚和新西兰的科室规程存在明显差异，特别是在适当的正常范围方面。这项研究强调了目前澳大利亚和新西兰各部门在GES协议方面缺乏标准化实践的重要性。

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引用次数: 0

Resilience in medical radiation science students: A concept analysis in the context of challenging clinical interactions 医学放射学学生的弹性：在具有挑战性的临床相互作用背景下的概念分析

IF 2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-28 DOI: 10.1016/j.jmir.2025.102064

Jacob Leonard Ago, Andrew Kilgour, Clare L. Smith

Background

Medical radiation science students experiences many challenging clinical interactions (CCIs) during work-integrated learning (WIL). These challenges can negatively impact their wellbeing, professional development, and patient outcomes. Resilience has been noted as a contributing factor to achieving positive outcomes, such as enabling students to achieve their clinical learning objectives despite these challenges. This implies the need to incorporate resilience training into medical radiation science curricula. However, resilience has differing contextual and general definitions which could hinder medical radiation educators’ efforts to develop appropriate resilience-building strategies. This concept analysis provides a discipline-specific understanding of resilience in medical radiation science students, and how it relates to other concepts.

Methods

A concept analysis design, regarded as a philosophical inquiry, was used. Specifically, this study adopted Walker and Avant’s eight-step approach to concept analysis. Included literature were purposively selected from PubMed, Scopus, Web of Science, CINAHL, Google Scholar, and English dictionaries. The data were analysed in terms of clusters of recurring phenomena.

Results

The analysis identified different understanding of resilience as used in medical radiations. Adversity/perceived adversity was identified as the main antecedent of resilience, with many factors. These informed the identification of key defining attributes (n=6), consequences (n=6), and related cases (n=2), with coping seen to have a cyclical relationship with resilience. The contextual definition of resilience in medical radiation science students was identified as using effective coping strategies and available resources to build confidence, push through, survive, and thrive in CCIs.

Conclusion

The consequences of resilience identified highlight the need to develop resilience in medical radiation science students. Researchers and educators may adopt the antecedents, defining attributes, empirical referents, related cases, consequences, and contextual definition identified in this study to guide the development of a resilience framework in medical radiation science education. It is advised that strategies to build resilience in medical radiation science students should consider both personal and societal factors due to the multifaceted nature of the concept.

医学放射科学专业的学生在工作结合学习（WIL）过程中经历了许多具有挑战性的临床互动（CCIs）。这些挑战会对他们的健康、专业发展和病人的治疗结果产生负面影响。弹性已被认为是取得积极成果的一个促进因素，例如使学生能够在面临这些挑战的情况下实现临床学习目标。这意味着需要将弹性训练纳入医疗辐射科学课程。然而，复原力有不同的背景和一般定义，这可能会阻碍医学辐射教育者制定适当的复原力建设战略的努力。这个概念分析提供了医学放射科学学生对弹性的学科特定理解，以及它与其他概念的关系。方法采用哲学探究的概念分析设计。具体来说，本研究采用了Walker和Avant的八步概念分析方法。纳入的文献有目的地从PubMed、Scopus、Web of Science、CINAHL、b谷歌Scholar和英语词典中选择。这些数据是根据反复出现的现象进行分析的。结果分析确定了医疗辐射中对弹性的不同理解。逆境/感知逆境被认为是心理弹性的主要前因，其影响因素很多。这些信息表明了关键定义属性（n=6）、结果（n=6）和相关案例（n=2）的识别，应对被认为与弹性具有周期性关系。医学放射学学生弹性的语境定义被确定为使用有效的应对策略和可用资源在cci中建立信心，推动，生存和发展。结论心理弹性的后果识别突出了医学放射学学生心理弹性培养的必要性。研究人员和教育工作者可以采用本研究确定的前因由、定义属性、经验参照、相关案例、后果和语境定义来指导医学放射科学教育弹性框架的发展。鉴于医学放射学概念的多面性，建议在医学放射学学生中建立恢复力的策略应考虑个人和社会因素。

{"title":"Resilience in medical radiation science students: A concept analysis in the context of challenging clinical interactions","authors":"Jacob Leonard Ago, Andrew Kilgour, Clare L. Smith","doi":"10.1016/j.jmir.2025.102064","DOIUrl":"10.1016/j.jmir.2025.102064","url":null,"abstract":"<div><h3>Background</h3><div>Medical radiation science students experiences many challenging clinical interactions (CCIs) during work-integrated learning (WIL). These challenges can negatively impact their wellbeing, professional development, and patient outcomes. Resilience has been noted as a contributing factor to achieving positive outcomes, such as enabling students to achieve their clinical learning objectives despite these challenges. This implies the need to incorporate resilience training into medical radiation science curricula. However, resilience has differing contextual and general definitions which could hinder medical radiation educators’ efforts to develop appropriate resilience-building strategies. This concept analysis provides a discipline-specific understanding of resilience in medical radiation science students, and how it relates to other concepts.</div></div><div><h3>Methods</h3><div>A concept analysis design, regarded as a philosophical inquiry, was used. Specifically, this study adopted Walker and Avant’s eight-step approach to concept analysis. Included literature were purposively selected from PubMed, Scopus, Web of Science, CINAHL, Google Scholar, and English dictionaries. The data were analysed in terms of clusters of recurring phenomena.</div></div><div><h3>Results</h3><div>The analysis identified different understanding of resilience as used in medical radiations. Adversity/perceived adversity was identified as the main antecedent of resilience, with many factors. These informed the identification of key defining attributes (n=6), consequences (n=6), and related cases (n=2), with coping seen to have a cyclical relationship with resilience. The contextual definition of resilience in medical radiation science students was identified as using effective coping strategies and available resources to build confidence, push through, survive, and thrive in CCIs.</div></div><div><h3>Conclusion</h3><div>The consequences of resilience identified highlight the need to develop resilience in medical radiation science students. Researchers and educators may adopt the antecedents, defining attributes, empirical referents, related cases, consequences, and contextual definition identified in this study to guide the development of a resilience framework in medical radiation science education. It is advised that strategies to build resilience in medical radiation science students should consider both personal and societal factors due to the multifaceted nature of the concept.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":"56 6","pages":"Article 102064"},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144720894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clarifying the role of full-body VR simulation in radiography education: A response to Brage et al. (2025) 阐明全身VR模拟在放射学教育中的作用：对Brage等人（2025）的回应

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-25 DOI: 10.1016/j.jmir.2025.102065

James Hayes

引用次数: 0

The many hats of MRTs 捷运的许多帽子

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-24 DOI: 10.1016/j.jmir.2025.102067

Megan Brydon

引用次数: 0

Beyond tradition: The possibility and impact of MRT expertise 超越传统：捷运专业技术的可能性和影响

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-24 DOI: 10.1016/j.jmir.2025.102066

Mikki Campbell

引用次数: 0

Embedding social accountability in radiography education and practice: A call to lead, educate, and serve 在放射学教育和实践中嵌入社会责任：领导、教育和服务的号召

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-11 DOI: 10.1016/j.jmir.2025.102030

Wiam Elshami , Mohamed Abuzaid , Mohamed H. Taha

引用次数: 0

Explainable artificial intelligence for pneumonia classification: Clinical insights into deformable prototypical part network in pediatric chest x-ray images 可解释的肺炎分类人工智能：儿童胸部x线图像中可变形的原型部分网络的临床见解

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-11 DOI: 10.1016/j.jmir.2025.102023

Elmira Yazdani , Aryan Neizehbaz , Najme Karamzade-Ziarati , Saeed Reza Kheradpisheh

Background

Pneumonia detection in chest X-rays (CXR) increasingly relies on AI-driven diagnostic systems. However, their “black-box” nature often lacks transparency, underscoring the need for interpretability to improve patient outcomes. This study presents the first application of the Deformable Prototypical Part Network (D-ProtoPNet), an ante-hoc interpretable deep learning (DL) model, for pneumonia classification in pediatric patients' CXR images. Clinical insights were integrated through expert radiologist evaluation of the model's learned prototypes and activated image patches, ensuring that explanations aligned with medically meaningful features.

Methods

The model was developed and tested on a retrospective dataset of 5,856 CXR images of pediatric patients, ages 1–5 years. The images were originally acquired at a tertiary academic medical center as part of routine clinical care and were publicly hosted on a Kaggle platform. This dataset comprised anterior-posterior images labeled normal, viral, and bacterial. It was divided into 80 % training and 20 % validation splits, and utilised in a supervised five-fold cross-validation. Performance metrics were compared with the original ProtoPNet, utilising ResNet50 as the base model. An experienced radiologist assessed the clinical relevance of the learned prototypes, patch activations, and model explanations.

Results

The D-ProtoPNet achieved an accuracy of 86 %, precision of 86 %, recall of 85 %, and AUC of 93 %, marking a 3 % improvement over the original ProtoPNet. While further optimisation is required before clinical use, the radiologist praised D-ProtoPNet's intuitive explanations, highlighting its interpretability and potential to aid clinical decision-making.

Conclusion

Prototypical part learning offers a balance between classification performance and explanation quality, but requires improvements to match the accuracy of black-box models. This study underscores the importance of integrating domain expertise during model evaluation to ensure the interpretability of XAI models is grounded in clinically valid insights.

胸部x光（CXR）中的肺炎检测越来越依赖于人工智能驱动的诊断系统。然而，它们的“黑箱”性质往往缺乏透明度，强调了可解释性以改善患者预后的必要性。本研究首次提出了可变形原型部分网络（D-ProtoPNet）的应用，这是一种预先可解释的深度学习（DL）模型，用于儿科患者CXR图像中的肺炎分类。通过放射科专家对模型学习的原型和激活的图像补丁的评估，整合了临床见解，确保解释与医学上有意义的特征保持一致。方法建立该模型，并在5856张1-5岁儿童CXR图像的回顾性数据集上进行测试。这些图像最初是在一家三级学术医疗中心获得的，作为常规临床护理的一部分，并公开托管在Kaggle平台上。该数据集包括标记为正常、病毒和细菌的前后图像。它被分为80个 %训练和20个 %验证分割，并在监督五倍交叉验证中使用。使用ResNet50作为基本模型，将性能指标与原始ProtoPNet进行比较。一位经验丰富的放射科医生评估了学习到的原型、贴片激活和模型解释的临床相关性。结果D-ProtoPNet的准确率为86 %，精密度为86 %，召回率为85 %，AUC为93 %，比原ProtoPNet提高了3 %。虽然在临床使用之前需要进一步优化，但放射科医生赞扬了D-ProtoPNet的直观解释，强调了其可解释性和帮助临床决策的潜力。结论原型零件学习在分类性能和解释质量之间取得了平衡，但需要改进以匹配黑箱模型的准确性。本研究强调了在模型评估过程中整合领域专业知识的重要性，以确保XAI模型的可解释性以临床有效的见解为基础。

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引用次数: 0

Evaluation of a novel mask balloon immobilization system for reducing intra-fractional setup errors in spinal stereotactic body radiation therapy 评估一种新型的面罩球囊固定系统，以减少脊柱立体定向放射治疗中分数内设置错误

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences

Pub Date : 2025-07-03 DOI: 10.1016/j.jmir.2025.102016

Kamimura Kazushi, Yoshihiro Ueda, Masaru Isono, Shoki Inui, Yuya Nitta, Seiya Murata, Hayate Washio, Koji Konishi

Background

Accurate immobilization is vital in spinal stereotactic body radiation therapy (SBRT) to minimize intra-fractional setup errors (IntraSE) and optimize therapeutic outcomes. Traditional methods, such as evacuated cushions, may lack sufficient stability, highlighting the need for improved systems. This study evaluates the accuracy and efficacy of a mask-balloon immobilization system, combining a body mask and a specialized balloon, for spinal SBRT.

Methods

Seventy-five patients undergoing spinal SBRT for thoracic or lumbar metastases were analyzed. Of these, 40 patients were immobilized using an evacuated cushion, while 35 used the mask balloon system. Cone-beam computed tomography (CBCT) scans were acquired three times during treatment, and the bony anatomy registration measured translational setup errors in anterior-posterior (AP), superior-inferior (SI), and right-left (RL) directions.

Result

For the evacuated cushion, the mean ± standard deviation of absolute IntraSE post-first arc was 0.4 ± 0.7 mm (AP), 0.5 ± 0.7 mm (SI), and 0.5 ± 0.6 mm (RL). For the mask-balloon system, the corresponding values were 0.2 ± 0.2 mm, 0.3 ± 0.3 mm, and 0.3 ± 0.3 mm. After treatment completion, the IntraSE values were 0.7 ± 0.9 mm, 0.8 ± 0.9 mm, and 0.9 ± 0.8 mm for the evacuated cushion and 0.4 ± 0.3 mm, 0.4 ± 0.4 mm, and 0.6 ± 0.4 mm for the mask-balloon system. In all three translational directions, the mask-balloon system had a significantly smaller IntraSE than the evacuated cushion (p < 0.0001).

Conclusion

The mask-balloon system improves setup accuracy and is a promising immobilization system for spinal SBRT.

背景：在脊柱立体定向放射治疗（SBRT）中，准确的固定对于减少片段内设置错误（IntraSE）和优化治疗结果至关重要。传统的方法，如真空缓冲垫，可能缺乏足够的稳定性，这突出了改进系统的必要性。本研究评估了面罩-球囊固定系统的准确性和有效性，该系统结合了身体面罩和专门的球囊，用于脊柱SBRT。方法对75例胸腰椎转移性肿瘤行脊柱SBRT的患者进行分析。其中，40例患者使用疏散垫固定，35例使用面罩气囊系统。治疗期间进行了三次锥形束计算机断层扫描（CBCT），骨解剖配准测量了前后（AP）、上下（SI）和左右（RL）方向的平移设置误差。结果真空缓冲垫的绝对IntraSE首弧平均±标准差分别为0.4±0.7 mm （AP）、0.5±0.7 mm （SI）和0.5±0.6 mm （RL）。对于掩模-气球系统，对应的值分别为0.2±0.2 mm、0.3±0.3 mm和0.3±0.3 mm。治疗结束后，真空缓冲垫的IntraSE值分别为0.7±0.9 mm、0.8±0.9 mm和0.9±0.8 mm，掩膜气囊系统的IntraSE值分别为0.4±0.3 mm、0.4±0.4 mm和0.6±0.4 mm。在所有三个平移方向上，掩膜气球系统的IntraSE明显小于真空垫(p <；0.0001)。结论面罩-球囊系统提高了固定精度，是一种很有前途的脊柱SBRT固定系统。

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引用次数: 0