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Source-detector trajectory optimization for CBCT metal artifact reduction based on PICCS reconstruction 基于 PICCS 重建的 CBCT 金属伪影减少源-探测器轨迹优化。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.02.001
Sepideh Hatamikia , Ander Biguri , Gernot Kronreif , Tom Russ , Joachim Kettenbach , Wolfgang Birkfellner
Precise instrument placement plays a critical role in all interventional procedures, especially percutaneous procedures such as needle biopsies, to achieve successful tumor targeting and increased diagnostic accuracy. C-arm cone beam computed tomography (CBCT) has the potential to precisely visualize the anatomy in direct vicinity of the needle and evaluate the adequacy of needle placement during the intervention, allowing for instantaneous adjustment in case of misplacement. However, even with the most advanced C-arm CBCT devices, it can be difficult to identify the exact needle position on CBCT images due to the strong metal artifacts around the needle. In this study, we proposed a framework for customized trajectory design in CBCT imaging based on Prior Image Constrained Compressed Sensing (PICCS) reconstruction with the goal of reducing metal artifacts in needle-based procedures. We proposed to optimize out-of-plane rotations in three-dimensional (3D) space and minimize projection views while reducing metal artifacts at specific volume of interests (VOIs). An anthropomorphic thorax phantom with a needle inserted inside and two tumor models as the imaging targets were used to validate the proposed approach. The performance of the proposed approach was also evaluated for CBCT imaging under kinematic constraints by simulating some collision areas on the geometry of the C-arm. We compared the result of optimized 3D trajectories using the PICCS algorithm and 20 projections with the result of a circular trajectory with sparse view using PICCS and Feldkamp, Davis, and Kress (FDK), both using 20 projections, and the circular FDK method with 313 projections. For imaging targets 1 and 2, the highest values of structural similarity index measure (SSIM) and universal quality index (UQI) between the reconstructed image from the optimized trajectories and the initial CBCT image at the VOI was calculated 0.7521, 0.7308 and 0.7308, 0.7248 respectively. These results significantly outperformed the FDK method (with 20 and 313 projections) and the PICCS method (20 projections) both using the circular trajectory. Our results showed that the proposed optimized trajectories not only significantly reduce metal artifacts but also suggest a dose reduction for needle-based CBCT interventions, considering the small number of projections used. Furthermore, our results showed that the optimized trajectories are compatible with spatially constrained situations and enable CBCT imaging under kinematic constraints when the standard circular trajectory is not feasible.
精确的器械放置在所有介入手术中都起着至关重要的作用,尤其是经皮手术,如针穿活检,这样才能成功瞄准肿瘤并提高诊断准确性。C 型臂锥形束计算机断层扫描(CBCT)可以精确地观察到穿刺针直接附近的解剖结构,并在介入过程中评估穿刺针放置的适当性,以便在放置错误时立即进行调整。然而,即使是最先进的 C 型臂 CBCT 设备,也很难在 CBCT 图像上确定针的准确位置,因为针周围有很强的金属伪影。在这项研究中,我们提出了一个基于先验图像约束压缩传感(PICCS)重建的 CBCT 成像定制轨迹设计框架,目的是减少针式手术中的金属伪影。我们建议优化三维(3D)空间中的平面外旋转,尽量减少投影视图,同时减少特定感兴趣容积(VOI)上的金属伪影。为了验证所提出的方法,我们使用了一个拟人胸腔模型,模型内部插入了一根针,并使用两个肿瘤模型作为成像目标。我们还通过模拟 C 臂几何形状上的一些碰撞区域,评估了所提方法在运动学约束条件下的 CBCT 成像性能。我们比较了使用 PICCS 算法和 20 个投影的优化三维轨迹结果,以及使用 PICCS 和 Feldkamp、Davis 和 Kress(FDK)(均使用 20 个投影)的稀疏视图圆形轨迹结果,以及使用 313 个投影的圆形 FDK 方法。对于目标 1 和目标 2 的成像,优化轨迹重建图像与 VOI 处初始 CBCT 图像之间的结构相似性指数(SSIM)和通用质量指数(UQI)的最高值分别为 0.7521、0.7308 和 0.7308、0.7248。这些结果明显优于使用圆形轨迹的 FDK 方法(20 个和 313 个投影)和 PICCS 方法(20 个投影)。我们的结果表明,考虑到所使用的投影数量较少,建议的优化轨迹不仅能显著减少金属伪影,还能减少针式 CBCT 介入的剂量。此外,我们的结果表明,优化轨迹与空间受限情况兼容,当标准圆形轨迹不可行时,可在运动学受限的情况下进行 CBCT 成像。
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引用次数: 0
Acknowledgements to the Consulting Editorial Board and the Reviewers 向顾问编委会和审稿人致谢
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2024.10.001
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引用次数: 0
Quantifying myocardial perfusion during MR-guided interventions without exogenous contrast agents: intra-arterial spin labeling 在无外源性造影剂的磁共振引导下进行介入治疗时量化心肌灌注:动脉内自旋标记。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.01.002
Simon Reiss , Kevin Wäscher , Ali Caglar Özen , Thomas Lottner , Timo Heidt , Constantin von zur Mühlen , Michael Bock

Purpose

To test intra-arterial spin labeling (iASL) using active guiding catheters for myocardial perfusion measurements during magnetic resonance (MR)-guided interventions in a pig study.

Methods

In this work, a single-loop radiofrequency (RF) coil at the tip of a 6F active coronary catheter was used as a transmit coil for local spin labeling. The transmit magnetic RF field (B1) of the coil and the labeling efficiency were determined, and iASL was tested in two pigs after the catheter was engaged in the aortic root, the ostium of the left coronary artery (LCA) under MR-guidance. The iASL effect was assessed by the signal difference between spin-labeling On and control (spin-labeling OFF) images, and in a cross-correlation between ON/Off states of spin-labeling a binary labeling paradigm. In addition, quantitative myocardial perfusion was calculated from the iASL experiments.

Results

The maximum B1 in the vicinity of the catheter coil was 2.1 µT. A strong local labeling effect with a labeling efficiency of 0.45 was achieved with iASL both in vitro and in vivo. In both pigs, the proximal myocardial segments supplied by the LCA showed significant labelling effect up to distances of 60 mm from the aortic root with a relative signal difference of (3.14 ± 2.89)% in the first and (3.50 ± 1.25)% in the second animal. The mean correlation coefficients were R = 0.63 ± 0.22 and 0.42 ± 0.16, respectively. The corresponding computed myocardial perfusion values in this region of the myocardium were similar to those obtained with contrast perfusion methods ((1.2 ± 1.1) mL/min/g and (0.8 ± 0.6) mL/min/g).

Conclusion

The proposed iASL method demonstrates the feasibility of selective myocardial perfusion measurements during MR-guided coronary interventions, which with further technical improvements may provide an alternative to exogenous contrast-based perfusion. Due to the invasive nature of the iASL method, it can potentially be used in concert with MRI-guided coronary angioplasty.
目的:在一项猪研究中测试使用主动引导导管进行动脉内自旋标记(iASL),以便在磁共振(MR)引导下进行介入治疗时测量心肌灌注:在这项研究中,6F 有源冠状动脉导管顶端的单环射频线圈被用作局部自旋标记的发射线圈。测定了线圈的射频发射磁场(B1)和标记效率,并在磁共振引导下将导管插入左冠状动脉(LCA)的主动脉根部后,在两头猪身上测试了 iASL。iASL 的效果通过自旋标记打开和对照(自旋标记关闭)图像之间的信号差异,以及二元标记范式下自旋标记打开/关闭状态之间的交叉相关性进行评估。此外,iASL 实验还计算了定量心肌灌注:导管线圈附近的最大 B1 为 2.1 µT。iASL 在体外和体内都实现了很强的局部标记效果,标记效率为 0.45。在两头猪身上,由 LCA 供血的近端心肌节段在距离主动脉根部 60 mm 的范围内都显示出显著的标记效果,第一头猪和第二头猪的相对信号差分别为 (3.14 ± 2.89)% 和 (3.50 ± 1.25)%。平均相关系数分别为 R = 0.63 ± 0.22 和 0.42 ± 0.16。该心肌区域相应的计算心肌灌注值与对比灌注法获得的值相似((1.2 ± 1.1) mL/min/g 和 (0.8 ± 0.6) mL/min/g):拟议的 iASL 方法证明了在磁共振引导下冠状动脉介入治疗期间进行选择性心肌灌注测量的可行性,随着技术的进一步改进,该方法可能成为外源性造影剂灌注的替代方法。由于 iASL 方法的侵入性,它有可能与 MRI 引导下的冠状动脉血管成形术配合使用。
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引用次数: 0
Reduction of patient specific quality assurance through plan complexity metrics for VMAT plans with an open-source TPS script 通过使用开源 TPS 脚本的 VMAT 计划复杂性指标,减少针对患者的质量保证。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.02.003
Klara Uher, Stefanie Ehrbar, Stephanie Tanadini-Lang, Riccardo Dal Bello

Purpose

Volumetric modulated arc therapy (VMAT) is a widespread technique for the delivery of normo-fractionated radiation therapy (NFRT) and stereotactic body radiation therapy (SBRT). It is associated with a significant hardware burden requiring dose rate modulation, collimator movement and gantry rotation synchronisation. Patient specific quality assurance (PSQA) guarantees that the linacs can precisely and accurately deliver the planned dose. However, PSQA requires a significant time allocation and class solutions to reduce this while guaranteeing the deliverability of the plans should be investigated.

Methods

In this study, an in-house developed Eclipse Scripting API (ESAPI) script was used to extract five independent plan complexity metrics from N = 667 VMAT treatment fields. The correlation between metrics and portal dosimetry measurements was investigated with Pearson correlation, box plot analysis and receiver operating characteristic curves, which were used to defined the best performing metric and its threshold.

Results

The incidence of fields failing the clinical PSQA criteria of 3%/2mm (NFRT) and 3%/1.5mm (SBRT) was low (N = 1). The mean MLC opening was the metric with the highest correlation with the portal dosimetry data and among the best in discriminating the requirement of PSQA. The thresholds of 16.12 mm (NFRT) and 7.96 mm (SBRT) corresponded to true positive rates higher than 90%.

Conclusions

This work presents a quantitative approach to reduce the time allocation for PSQA by identifying the most complex plans demanding a dedicated measurement. The proposed method requires PSQA for approximately 10% of the plans. The ESAPI script is distributed open-source to ease the investigation and implementation at other institutions.
目的:容积调制弧形疗法(VMAT)是一种广泛应用于普通分次放射治疗(NFRT)和立体定向体放射治疗(SBRT)的技术。该技术需要进行剂量率调制、准直器移动和龙门旋转同步,硬件负担很重。患者特定质量保证(PSQA)可确保直列加速器能够精确地提供计划剂量。然而,PSQA需要花费大量时间,因此应研究既能减少时间又能保证计划可实施性的一类解决方案:本研究使用内部开发的 Eclipse Scripting API (ESAPI) 脚本从 N = 667 个 VMAT 治疗区域中提取五个独立的计划复杂性指标。利用皮尔逊相关性、箱形图分析和接收器操作特征曲线研究了指标与门户剂量测定测量之间的相关性,并以此确定了性能最佳的指标及其阈值:未达到临床 PSQA 标准 3%/2mm(NFRT)和 3%/1.5mm(SBRT)的视野发生率较低(N = 1)。平均 MLC 开口是与门静脉剂量测定数据相关性最高的指标,也是区分 PSQA 要求的最佳指标之一。16.12毫米(NFRT)和7.96毫米(SBRT)的阈值对应的真实阳性率高于90%:这项工作提出了一种定量方法,通过识别需要专门测量的最复杂计划来减少 PSQA 的时间分配。所提出的方法需要对大约 10% 的计划进行 PSQA。ESAPI 脚本是开源的,便于其他机构进行研究和实施。
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引用次数: 0
Development of a PTV margin for preclinical irradiation of orthotopic pancreatic tumors derived from a well-known recipe for humans 为临床前照射正位胰腺肿瘤开发 PTV 边界,该边界源自著名的人体配方。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.03.005
Severin Kampfer , Sophie Dobiasch , Stephanie E. Combs , Jan J. Wilkens
In human radiotherapy a safety margin (PTV margin) is essential for successful irradiation and is usually part of clinical treatment planning. In preclinical radiotherapy research with small animals, most uncertainties and inaccuracies are present as well, but according to the literature a margin is used only scarcely. In addition, there is only little experience about the appropriate size of the margin, which should carefully be investigated and considered, since sparing of organs at risk or normal tissue is affected.
Here we estimate the needed margin for preclinical irradiation by adapting a well-known human margin recipe from van Herck et al. to the dimensions and requirements of the specimen on a small animal radiation research platform (SARRP). We adjusted the factors of the described formula to the specific challenges in an orthotopic pancreatic tumor mouse model to establish an appropriate margin concept. The SARRP was used with its image-guidance irradiation possibility for arc irradiation with a field size of 10 × 10 mm2 for 5 fractions. Our goal was to irradiate the clinical target volume (CTV) of at least 90% of our mice with at least 95% of the prescribed dose. By carefully analyzing all relevant factors we gain a CTV to planning target volume (PTV) margin of 1.5 mm for our preclinical setup.
The stated safety margin is strongly dependent on the exact setting of the experiment and has to be adjusted for other experimental settings. The few stated values in literature correspond well to our result. Even if using margins in the preclinical setting might be an additional challenge, we think it is crucial to use them to produce reliable results and improve the efficacy of radiotherapy.
在人类放射治疗中,安全裕度(PTV裕度)是成功照射的必要条件,通常也是临床治疗计划的一部分。在使用小动物进行临床前放疗研究时,也存在着大多数不确定性和不准确性,但根据文献资料,很少使用安全边际。此外,关于边缘的适当大小也鲜有经验可循,这一点应仔细研究和考虑,因为这将影响对危险器官或正常组织的保护。在此,我们根据小动物辐射研究平台(SARRP)上标本的尺寸和要求,对 van Herck 等人的著名人体边缘配方进行了调整,从而估算出临床前辐照所需的边缘。我们根据正位胰腺肿瘤小鼠模型所面临的具体挑战调整了所述公式中的系数,以建立适当的边缘概念。SARRP 可在图像引导下进行弧形照射,照射野大小为 10 × 10 平方毫米,共照射 5 次。我们的目标是用至少 95% 的规定剂量照射至少 90% 的小鼠的临床靶体积(CTV)。通过仔细分析所有相关因素,我们将临床前设置的 CTV 与规划靶体积 (PTV) 的裕度定为 1.5 毫米。所述安全裕度在很大程度上取决于实验的具体设置,必须根据其他实验设置进行调整。文献中给出的几个数值与我们的结果非常吻合。尽管在临床前设置中使用安全裕度可能是一个额外的挑战,但我们认为使用安全裕度对产生可靠的结果和提高放疗疗效至关重要。
{"title":"Development of a PTV margin for preclinical irradiation of orthotopic pancreatic tumors derived from a well-known recipe for humans","authors":"Severin Kampfer ,&nbsp;Sophie Dobiasch ,&nbsp;Stephanie E. Combs ,&nbsp;Jan J. Wilkens","doi":"10.1016/j.zemedi.2023.03.005","DOIUrl":"10.1016/j.zemedi.2023.03.005","url":null,"abstract":"<div><div>In human radiotherapy a safety margin (PTV margin) is essential for successful irradiation and is usually part of clinical treatment planning. In preclinical radiotherapy research with small animals, most uncertainties and inaccuracies are present as well, but according to the literature a margin is used only scarcely. In addition, there is only little experience about the appropriate size of the margin, which should carefully be investigated and considered, since sparing of organs at risk or normal tissue is affected.</div><div>Here we estimate the needed margin for preclinical irradiation by adapting a well-known human margin recipe from van Herck et al. to the dimensions and requirements of the specimen on a small animal radiation research platform (SARRP). We adjusted the factors of the described formula to the specific challenges in an orthotopic pancreatic tumor mouse model to establish an appropriate margin concept. The SARRP was used with its image-guidance irradiation possibility for arc irradiation with a field size of 10 × 10 mm<sup>2</sup> for 5 fractions. Our goal was to irradiate the clinical target volume (CTV) of at least 90% of our mice with at least 95% of the prescribed dose. By carefully analyzing all relevant factors we gain a CTV to planning target volume (PTV) margin of 1.5 mm for our preclinical setup.</div><div>The stated safety margin is strongly dependent on the exact setting of the experiment and has to be adjusted for other experimental settings. The few stated values in literature correspond well to our result. Even if using margins in the preclinical setting might be an additional challenge, we think it is crucial to use them to produce reliable results and improve the efficacy of radiotherapy.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 4","pages":"Pages 533-541"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9516757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multi-stage image registration based on list-mode proton radiographies for small animal proton irradiation: A simulation study 基于列表模式质子射线照片的小动物质子照射多级图像配准:模拟研究。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.04.003
Prasannakumar Palaniappan, Yana Knudsen, Sebastian Meyer , Chiara Gianoli, Katrin Schnürle, Matthias Würl, Jonathan Bortfeldt, Katia Parodi , Marco Riboldi
We present a multi-stage and multi-resolution deformable image registration framework for image-guidance at a small animal proton irradiation platform. The framework is based on list-mode proton radiographies acquired at different angles, which are used to deform a 3D treatment planning CT relying on normalized mutual information (NMI) or root mean square error (RMSE) in the projection domain.
We utilized a mouse X-ray micro-CT expressed in relative stopping power (RSP), and obtained Monte Carlo simulations of proton images in list-mode for three different treatment sites (brain, head and neck, lung). Rigid transformations and controlled artificial deformation were applied to mimic position misalignments, weight loss and breathing changes. Results were evaluated based on the residual RMSE of RSP in the image domain including the comparison of extracted local features, i.e. between the reference micro-CT and the one transformed taking into account the calculated deformation.
The residual RMSE of the RSP showed that the accuracy of the registration framework is promising for compensating rigid (>97% accuracy) and non-rigid (∼95% accuracy) transformations with respect to a conventional 3D-3D registration. Results showed that the registration accuracy is degraded when considering the realistic detector performance and NMI as a metric, whereas the RMSE in projection domain is rather insensitive.
This work demonstrates the pre-clinical feasibility of the registration framework on different treatment sites and its use for small animal imaging with a realistic detector. Further computational optimization of the framework is required to enable the use of this tool for online estimation of the deformation.
我们提出了一种多阶段、多分辨率的可变形图像配准框架,用于小动物质子照射平台的图像制导。该框架基于从不同角度获取的列表模式质子射线照片,并根据投影域中的归一化互信息(NMI)或均方根误差(RMSE)对三维治疗计划 CT 进行变形。我们利用以相对停止功率(RSP)表示的小鼠 X 射线微型 CT,对三个不同治疗部位(大脑、头颈部、肺部)的列表模式质子图像进行了蒙特卡罗模拟。应用刚性变换和受控人工变形来模拟位置错位、体重减轻和呼吸变化。结果根据图像域中 RSP 的残差均方根(RMSE)进行评估,包括对提取的局部特征进行比较,即参考 micro-CT 与考虑到计算变形而变换的 micro-CT 之间的比较。RSP 的残差均方根值表明,相对于传统的三维-三维配准,配准框架在补偿刚性(精度>97%)和非刚性(精度∼95%)变换方面具有良好的精度。结果表明,如果将现实探测器的性能和 NMI 作为衡量标准,配准精度会下降,而投影域的 RMSE 则相当不敏感。这项工作证明了该配准框架在不同治疗部位的临床前可行性,以及它在使用真实探测器进行小动物成像时的应用。需要对该框架进行进一步的计算优化,以便将这一工具用于变形的在线估计。
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引用次数: 0
Post-mastectomy radiotherapy: Impact of bolus thickness and irradiation technique on skin dose 乳房切除术后放疗:栓剂厚度和照射技术对皮肤剂量的影响。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2023.03.004
Frédéric A. Miéville, Nicolas Pitteloud, Vérane Achard, Giorgio Lamanna, Olivier Pisaturo, Pierre-Alain Tercier, Abdelkarim S. Allal

Purpose

To determine 10 MV IMRT and VMAT based protocols with a daily bolus targeting a skin dose of 45 Gy in order to replace the 6 MV tangential fields with a 5 mm thick bolus on alternate days method for post-mastectomy radiotherapy.

Method

We measured the mean surface dose along the chest wall PTV as a function of different bolus thicknesses for sliding window IMRT and VMAT plans. We analyzed surface dose profiles and dose homogeneities and compared them to our standard 6 MV strategy. All measurements were performed on a thorax phantom with Gafchromic films while dosimetric plans were computed using the Acuros XB algorithm (Varian).

Results

We obtained the best compromise between measured surface dose (mean dose and homogeneity) and skin toxicity threshold obtained from the literature using a daily 3 mm thick bolus. Mean surface doses were 91.4 ± 2.8% [85.7% – 95.4%] and 92.2 ± 2.3% [85.6% – 95.2%] of the prescribed dose with IMRT and VMAT techniques, respectively. Our standard 6 MV alternate days 5 mm thick bolus leads to 89.0 ± 3.7% [83.6% – 95.5%]. Mean dose differences between measured and TPS results were < 3.2% for depths as low as 2 mm depth.

Conclusion

10 MV IMRT-based protocols with a daily 3 mm thick bolus produce a surface dose comparable to the standard 6 MV 5 mm thick bolus on alternate days method but with an improved surface dose homogeneity. This allows for a better control of skin toxicity and target volume coverage.
目的:确定以 10 MV IMRT 和 VMAT 为基础的方案,每天注射以 45 Gy 皮肤剂量为目标的栓剂,以便在乳房切除术后的放射治疗中用隔天注射 5 mm 厚栓剂的方法取代 6 MV 切向场:我们测量了滑动窗口 IMRT 和 VMAT 计划中不同栓剂厚度对胸壁 PTV 平均表面剂量的影响。我们分析了表面剂量曲线和剂量均匀性,并与我们的标准 6 MV 策略进行了比较。所有测量都是在带有 Gafchromic 胶片的胸腔模型上进行的,而剂量测定计划则是使用 Acuros XB 算法(瓦里安)计算的:我们利用每天 3 毫米厚的栓剂,在测得的表面剂量(平均剂量和均匀性)与文献中获得的皮肤毒性阈值之间取得了最佳折衷。IMRT 和 VMAT 技术的平均表面剂量分别为规定剂量的 91.4 ± 2.8% [85.7% - 95.4%] 和 92.2 ± 2.3% [85.6% - 95.2%]。我们的标准 6 MV 隔天 5 mm 厚的栓剂可达到 89.0 ± 3.7% [83.6% - 95.5%]。结论:基于 10 MV IMRT 的方案,每天使用 3 毫米厚的栓剂,产生的表面剂量与隔天使用标准 6 MV 5 毫米厚栓剂的方法相当,但表面剂量均匀性有所提高。这可以更好地控制皮肤毒性和靶体积覆盖。
{"title":"Post-mastectomy radiotherapy: Impact of bolus thickness and irradiation technique on skin dose","authors":"Frédéric A. Miéville,&nbsp;Nicolas Pitteloud,&nbsp;Vérane Achard,&nbsp;Giorgio Lamanna,&nbsp;Olivier Pisaturo,&nbsp;Pierre-Alain Tercier,&nbsp;Abdelkarim S. Allal","doi":"10.1016/j.zemedi.2023.03.004","DOIUrl":"10.1016/j.zemedi.2023.03.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine 10 MV IMRT and VMAT based protocols with a daily bolus targeting a skin dose of 45 Gy in order to replace the 6 MV tangential fields with a 5 mm thick bolus on alternate days method for post-mastectomy radiotherapy.</div></div><div><h3>Method</h3><div>We measured the mean surface dose along the chest wall PTV as a function of different bolus thicknesses for sliding window IMRT and VMAT plans. We analyzed surface dose profiles and dose homogeneities and compared them to our standard 6 MV strategy. All measurements were performed on a thorax phantom with Gafchromic films while dosimetric plans were computed using the Acuros XB algorithm (Varian).</div></div><div><h3>Results</h3><div>We obtained the best compromise between measured surface dose (mean dose and homogeneity) and skin toxicity threshold obtained from the literature using a daily 3 mm thick bolus. Mean surface doses were 91.4 ± 2.8% [85.7% – 95.4%] and 92.2 ± 2.3% [85.6% – 95.2%] of the prescribed dose with IMRT and VMAT techniques, respectively. Our standard 6 MV alternate days 5 mm thick bolus leads to 89.0 ± 3.7% [83.6% – 95.5%]. Mean dose differences between measured and TPS results were &lt; 3.2% for depths as low as 2 mm depth.</div></div><div><h3>Conclusion</h3><div>10 MV IMRT-based protocols with a daily 3 mm thick bolus produce a surface dose comparable to the standard 6 MV 5 mm thick bolus on alternate days method but with an improved surface dose homogeneity. This allows for a better control of skin toxicity and target volume coverage.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 4","pages":"Pages 542-554"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9480352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
35 Jahre im Dienste des Strahlenschutzes: Verantwortung, Fortschritt, Innovation 为辐射防护服务 35 年:责任、进步、创新。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/j.zemedi.2024.09.001
Inge Paulini
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引用次数: 0
Editorial Board + Consulting Editorial Board 编辑委员会 + 咨询编辑委员会
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-11-01 DOI: 10.1016/S0939-3889(24)00103-X
{"title":"Editorial Board + Consulting Editorial Board","authors":"","doi":"10.1016/S0939-3889(24)00103-X","DOIUrl":"10.1016/S0939-3889(24)00103-X","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 4","pages":"Page iii"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk management in radiation-based therapies 放射治疗的风险管理。
IF 2.4 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-01 DOI: 10.1016/j.zemedi.2024.05.002
{"title":"Risk management in radiation-based therapies","authors":"","doi":"10.1016/j.zemedi.2024.05.002","DOIUrl":"10.1016/j.zemedi.2024.05.002","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"34 3","pages":"Pages 355-356"},"PeriodicalIF":2.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0939388924000503/pdfft?md5=99b38827af2117ecd295bc9dd7a2269f&pid=1-s2.0-S0939388924000503-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Zeitschrift fur Medizinische Physik
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