Physica Medica-European Journal of Medical Physics最新文献

英文中文

Implications of the partial volume effect correction on the spatial quantification of hypoxia based on [18F]FMISO PET/CT data 基于[18F]FMISO PET/CT 数据的部分容积效应校正对缺氧空间量化的影响。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-09 DOI: 10.1016/j.ejmp.2024.104853

Athanasios Kafkaletos , Ilias Sachpazidis , Michael Mix , Montserrat Carles , Henning Schäfer , Alexander Rühle , Nils H. Nicolay , Marta Lazzeroni , Iuliana Toma-Dasu , Anca L. Grosu , Dimos Baltas

Purpose

This study evaluates the impact of partial volume effect (PVE) correction on [¹⁸F]fluoromisonidazole (FMISO) PET images, focusing on the conversion of standardized uptake values (SUV) to partial oxygen pressure (pO₂) and the subsequent determination of hypoxic tumor volume (HTV).

Methods

FMISO PET images from 49 head and neck squamous cell carcinoma cases were retrospectively corrected for PVE and converted to pO₂. A pO₂ threshold of 10 mmHg was used to delineate the HTV (HTV_pO2). Comparisons of pO₂ distribution and HTV_pO2 between corrected and uncorrected images were made, with pO₂ distributions evaluated against published polarographic data. HTV_pO2 was compared to HTV defined by the conventional tumor-to-muscle ratio (TMR) method (HTV_TMR) in terms of volume and topography (DICE coefficient, Hausdorff distance, and center-of-gravity distance) across different TMR cutoff levels. The cutoff level where the segmentation results from both methods were most similar was identified (TMR_best).

Results

The PVE correction led to decreased minimum pO₂, increased HTV_pO2 and the identification of more hypoxic cases (HTV > 0). The pO₂ distribution demonstrated improved alignment with published polarographic data. At TMR_best 1.6, the center-of-gravity distance between HTV_TMR and HTV_pO2 demonstrated a low median at 1.5 mm, while the wide range (0.0 to 9.6 mm) indicated high interpatient variability. The shape of HTV exhibited considerable variation with DICE 0.74 (0.03 to 1.00) and Hausdorff distance 8.5 mm (2.0 to 42.8 mm).

Conclusions

PVE correction is recommended before converting SUV to pO₂ for the spatially resolved quantification of hypoxia.

目的：本研究评估了部分容积效应（PVE）校正对[18F]氟咪唑（FMISO）PET图像的影响，重点是将标准化摄取值（SUV）转换为部分氧压（pO2）以及随后确定缺氧肿瘤体积（HTV）：方法：对 49 例头颈部鳞状细胞癌的 FMISO PET 图像进行回顾性 PVE 校正并转换为 pO2。采用 10 mmHg 的 pO2 阈值来划分 HTV（HTVpO2）。比较校正和未校正图像的 pO2 分布和 HTVpO2，并根据已发表的极谱数据评估 pO2 分布。HTVpO2 与传统肿瘤肌肉比（TMR）方法定义的 HTV（HTVTMR）在体积和地形（DICE 系数、豪斯多夫距离和重心距离）方面在不同的 TMR 截断水平上进行了比较。确定了两种方法分割结果最接近的截断水平（TMRbest）：结果：PVE 校正降低了最小 pO2，增加了 HTVpO2，并识别出更多缺氧病例（HTV > 0）。pO2 分布与已公布的极谱数据的吻合度有所提高。在 TMRbest 1.6 时，HTVTMR 和 HTVpO2 之间的重心距离中位数较低，为 1.5 毫米，而范围较宽（0.0 至 9.6 毫米），表明患者之间的变异性较大。HTV 的形状变化很大，DICE 为 0.74（0.03 至 1.00），Hausdorff 距离为 8.5 毫米（2.0 至 42.8 毫米）：结论：建议在将 SUV 转换为 pO2 之前进行 PVE 校正，以便对缺氧进行空间分辨量化。

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引用次数: 0

Exploring stereotactic radiosurgery for tremor using the Varian cone planning system 探索使用瓦里安锥形规划系统进行震颤的立体定向放射外科治疗。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-08 DOI: 10.1016/j.ejmp.2024.104858

Kyra N. McComas , Guozhen Luo , George X. Ding , Stephen Martinez , Michael J. Price , Austin N. Kirschner

Background

Stereotactic radiosurgery (SRS) is an effective treatment for essential tremor (ET) and Parkinsonian tremor (PT). However, current treatment methods can be time-consuming and expose patients to unnecessary radiation. This study investigates the use of the Varian TrueBeam system with FFF beam modes as a potential solution for these issues.

Methods

We recreated and evaluated treatment plans using the Varian TrueBeam and Eclipse Cone Planning system for ten patients previously treated for tremor cessation using a Novalis Tx linear accelerator with Brainlab planning system prescribed a maximum dose of 160 Gy. Analyses included beam-on delivery time, total MU, dose to brain and brainstem tissues, and confirmation of SRS cone accuracy.

Results

The TrueBeam cone delivery system is highly accurate. Our results demonstrated a significant reduction in monitor units (MU) and treatment delivery time shortened to 17-26 min beam-on time for all-Varian plans compared to 39 min for non-Varian (iPlan) plans (p < 0.0001). Furthermore, the Varian plans showed improved or similar dose fall-off and radiation dose to brainstem normal tissue.

Conclusion

Our findings suggest that the Varian TrueBeam system offers a safe and effective option for SRS tremor treatment, providing similar or superior treatment parameters compared to other LINAC-based SRS treatments. The reduced treatment times and improved patient comfort offered by this system make it a promising solution for future tremor treatments.

背景：立体定向放射手术（SRS）是治疗本质性震颤（ET）和帕金森震颤（PT）的有效方法。然而，目前的治疗方法可能会耗费大量时间，并使患者遭受不必要的辐射。本研究探讨了使用瓦里安 TrueBeam 系统的 FFF 射束模式作为解决这些问题的潜在方案：我们使用瓦里安TrueBeam和Eclipse锥形规划系统重新创建并评估了10名患者的治疗计划，这些患者之前使用Novalis Tx直线加速器和Brainlab规划系统接受过震颤停止治疗，最大剂量为160 Gy。分析内容包括光束发射时间、总MU、大脑和脑干组织的剂量，以及SRS锥体准确性的确认：结果：TrueBeam锥体投射系统的精确度很高。我们的结果表明，所有瓦里安计划的监测单位（MU）显著减少，治疗投放时间缩短至17-26分钟，而非瓦里安（iPlan）计划的投放时间为39分钟（P 结论：我们的研究结果表明，瓦里安TrueBeam锥体投放系统能显著减少监测单位（MU），治疗投放时间缩短至17-26分钟：我们的研究结果表明，瓦里安 TrueBeam 系统为震颤 SRS 治疗提供了一个安全有效的选择，与其他基于 LINAC 的 SRS 治疗相比，它能提供相似或更优越的治疗参数。该系统缩短了治疗时间，提高了患者的舒适度，是未来震颤治疗的理想解决方案。

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引用次数: 0

Predicting radiotoxic effects after BNCT for brain cancer using a novel dose calculation model 利用新型剂量计算模型预测脑癌 BNCT 治疗后的放射性毒性效应。

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-08 DOI: 10.1016/j.ejmp.2024.104840

Ana Mailén Dattoli Viegas , Daniel Carando , Hanna Koivunoro , Heikki Joensuu , Sara Josefina González

Purpose:

The normal brain is an important dose-limiting organ for brain cancer patients undergoing radiotherapy. This study aims to develop a model to calculate photon isoeffective doses (

D_{I s o E}

) to normal brain that can explain the incidence of grade 2 or higher somnolence syndrome (SS

⩾

2) after Boron Neutron Capture Therapy (BNCT).

Methods:

D_{I s o E}

model was constructed to find the reference photon dose that equals the Normal Tissue Complication Probability (NTCP) of the absorbed dose from BNCT. Limb paralysis rates from the rat spinal cord model exposed to conventional or BNCT irradiation were used to determine model parameters. NTCP expressions for both irradiations were constructed based on Lyman’s model accordingly.

D_{I s o E}

values were calculated for BNCT treatments performed in Finland and USA. An equivalent uniform dose (EUD) based on peak and average whole-brain doses and treatment fields was also introduced. Combining

D_{I s o E}

and EUD models, a dose–response curve for SS

⩾

2 in BNCT patients was constructed and compared to conventional radiotherapy outcomes.

Results:

The

D_{I s o E}

model reveals higher than expected photon-equivalent doses in the brain, indicating the need to modify standard dose calculation methods. Neither peak dose nor average whole-brain dose alone predicts SS

⩾

2 development. However, the dose–response curve derived from combining

D_{I s o E}

and EUD models effectively explains the incidence of SS

⩾

2 after BNCT.

Conclusions:

The introduced

D_{I s o E}

and EUD models predict the incidence of somnolence syndrome after BNCT. The first dose–response relationship for SS

⩾

2 derived entirely from brain tumour patients treated with BNCT, consistent with photon radiotherapy responses, is presented.

目的：正常脑部是脑癌患者接受放射治疗的重要剂量限制器官。本研究旨在建立一个模型来计算正常脑部的光子等效剂量（DIsoE），以解释硼中子俘获疗法（BNCT）后2级或2级以上嗜睡综合征（SS⩾2）的发生率：方法：构建了一个 DIsoE 模型，以找到与 BNCT 吸收剂量的正常组织并发症概率 (NTCP) 相等的参考光子剂量。大鼠脊髓模型接受常规或 BNCT 照射后的肢体瘫痪率被用来确定模型参数。根据莱曼模型构建了两种辐照的 NTCP 表达式。计算了在芬兰和美国进行的 BNCT 治疗的 DIsoE 值。还引入了基于峰值和平均全脑剂量及治疗野的等效均匀剂量（EUD）。结合 DIsoE 和 EUD 模型，构建了 BNCT 患者 SS⩾2 的剂量反应曲线，并与传统放疗结果进行了比较：结果：DIsoE 模型显示大脑中的光子当量剂量高于预期，表明需要修改标准剂量计算方法。无论是峰值剂量还是全脑平均剂量，都不能单独预测 SS⩾2 的发展。然而，结合 DIsoE 和 EUD 模型得出的剂量反应曲线能有效解释 BNCT 后 SS⩾2 的发病率：结论：引入的 DIsoE 和 EUD 模型可预测 BNCT 后嗜睡综合征的发病率。结论：引入的 DIsoE 和 EUD 模型可预测 BNCT 后嗜睡综合征的发病率，首次提出了完全来自接受 BNCT 治疗的脑肿瘤患者的 SS⩾2 剂量-反应关系，与光子放疗反应一致。

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引用次数: 0

The BeamSplitter – An algorithm providing the dose per control point of radiation therapy treatment plans BeamSplitter - 一种提供放射治疗计划每个控制点剂量的算法

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-06 DOI: 10.1016/j.ejmp.2024.104845

Mathieu Gaudreault , Alex Burton , Vanessa Panettieri , Nicholas Hardcastle

Purpose

Commercial radiation therapy treatment planning systems (TPS) provide the three-dimensional time-integrated planned dose distribution. A four-dimensional (4D) dose calculation is essential to minimise dose-rate effects on pacemaker or in total body irradiation treatment or for time-dependent patient-specific quality assurance. We introduce the BeamSplitter, an algorithm in a commercial TPS generating 4D dose calculation.

Methods

Automation was performed with the Eclipse Scripting Application Programming Interface (ESAPI, v16, Varian Medical System). The accumulated and reference dose distributions of twenty-one patients treated in 2022 at our institution were compared. The patients were selected to cover a broad range of modulated delivery techniques and plan complexity, quantified with the average leaf pair opening (ALPO). The dose distributions were compared with gamma passing rates (γPR). Moreover, the mean absolute percentage error (MAPE) between accumulated and reference dose metrics (planning target volume (PTV) D99% / D95% in stereotactic / non-stereotactic treatment, organs at risk (OAR) D5cc / D0.03 cc, and mean dose) was calculated. Dose accumulation was validated by point dose measurement.

Results

The ALPO ranged from 11.6 mm to 77 mm. The accumulated and reference dose distributions were similar (

{γ P R}_{0 m m}^{1 %}

> 90 % in all patients). The MAPE between reference and accumulated dose metrics was lower than 1 % in all cases. The average dose difference through time between the accumulated and measured dose was lower than our clinical tolerance of 3 %.

Conclusions

The BeamSplitter is the first validated algorithm generating a 4D dose calculation of radiation therapy treatment plans within a commercial TPS.

目的商业放射治疗计划系统（TPS）提供三维时间积分计划剂量分布。四维（4D）剂量计算对于减少剂量率对心脏起搏器的影响、全身照射治疗或因时间而异的患者质量保证至关重要。方法使用 Eclipse 脚本应用编程接口（ESAPI，v16，瓦里安医疗系统）进行自动化。比较了本机构 2022 年治疗的 21 名患者的累积剂量分布和参考剂量分布。这些患者的选择涵盖了广泛的调制给药技术和计划复杂性，并以平均叶对开度（ALPO）进行量化。剂量分布与伽马通过率（γPR）进行了比较。此外，还计算了累积剂量与参考剂量指标（立体定向/非立体定向治疗中的计划靶体积（PTV）D99%/D95%、危险器官（OAR）D5cc/D0.03 cc和平均剂量）之间的平均绝对百分比误差（MAPE）。结果ALPO的范围从11.6毫米到77毫米。所有患者的累积剂量分布与参考剂量分布相似（γPR0mm1% > 90%）。在所有病例中，参考剂量和累积剂量指标之间的 MAPE 均低于 1%。累积剂量和测量剂量之间的平均剂量差低于我们临床上可容忍的 3%。结论BeamSplitter 是首个经过验证的算法，可在商用 TPS 中生成放射治疗计划的 4D 剂量计算。

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引用次数: 0

Patient and treatment-related factors that influence dose to heart and heart substructures in left-sided breast cancer radiotherapy 影响左侧乳腺癌放疗中心脏和心脏下结构剂量的患者和治疗相关因素

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-05 DOI: 10.1016/j.ejmp.2024.104851

Ioana-Claudia Costin , Loredana G. Marcu

Background

Cardiac substructures are critical organs at risk in left-sided breast cancer radiotherapy being often overlooked during treatment planning. The treatment technique plays an important role in diminishing dose to critical structures. This review aims to analyze the impact of treatment- and patient-related factors on heart substructure dosimetry and to identify the gaps in literature regarding dosimetric reporting of cardiac substructures.

Methods

A systematic search of the literature was conducted in Medline/Pubmed database incorporating data published over the past 10 years, leading to 81 eligible studies. Treatment-related factors analyzed for their impact on patient outcome included the number of treatment fields, field geometry, treatment time and monitor units. Additionally, patient-related parameters such as breast size and tumor shape were considered for cardiac dosimetry evaluation.

Results

Limited number of fields appeared to be an advantage for mean heart dose reduction when tangential IMRT versus multiple fields IMRT was evaluated. Larger breast size (910.20 ± 439.80 cm³) is linked to larger treatment fields and higher heart doses. Internal mammary node irradiation further escalates cardiac substructures dosimetry treated with 3DCRT and IMRT/VMAT. Proton therapy delivers lower mean heart dose regardless of breathing condition (free or respiratory-gated).

Conclusion

The management of treatment- and patient-related factors must be taken into account regardless of the treatment technique when evaluating cardiac dose. Furthermore, the gap found in the literature regarding heart toxicity assessment in left-sided breast cancer patients emphasizes the need for cardiac substructure contouring to better manage and control radiation-induced cardiac toxicities in this patient group.

背景心脏下结构是左侧乳腺癌放疗中面临风险的关键器官，在治疗计划中经常被忽视。治疗技术在减少关键结构的剂量方面发挥着重要作用。本综述旨在分析与治疗和患者相关的因素对心脏亚结构剂量测定的影响，并找出有关心脏亚结构剂量测定报告方面的文献空白。分析了治疗相关因素对患者预后的影响，包括治疗区域数量、区域几何形状、治疗时间和监控单元。此外，还考虑了与患者相关的参数，如乳房大小和肿瘤形状，以进行心脏剂量学评估。结果在评估切向 IMRT 与多场 IMRT 时，有限的场数似乎是减少平均心脏剂量的一个优势。较大的乳房大小（910.20 ± 439.80 cm3）与较大的治疗野和较高的心脏剂量有关。乳腺内结节照射进一步提高了采用 3DCRT 和 IMRT/VMAT 治疗的心脏下结构剂量。结论无论采用哪种治疗技术，在评估心脏剂量时都必须考虑到治疗和患者相关因素的管理。此外，文献中关于左侧乳腺癌患者心脏毒性评估的空白强调了对心脏下结构轮廓进行调整的必要性，以便更好地管理和控制这一患者群体由放射引起的心脏毒性。

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引用次数: 0

O.1.7 KNOWLEDGE-BASED PLANNING (KBP) MODELS OF BREAST INTENSITY MODULATED RADIOTHERAPY (IMRT) TREATMENT PLANS O.1.7 基于知识的乳腺调强放射治疗（IMRT）治疗计划规划（KBP）模型

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-01 DOI: 10.1016/j.ejmp.2024.104533

E. Mourati, G. Patatoukas, M. Chalkia, N. Kollaros, K. Zourari, E. Kypraiou, V. Kouloulias, K. Platoni

引用次数: 0

O.3.1 ANTITUMOR EFFECTS OF VANILLIC ACID IN A HEPATOCELLULAR CARCINOMA MOUSE MODEL: EVIDENCE FROM PET/CT IMAGING O.3.1 香草酸在肝细胞癌小鼠模型中的抗肿瘤作用：PET/CT 成像的证据

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-01 DOI: 10.1016/j.ejmp.2024.104541

M.A. Kouri, A. Gaitanis, C. Nikolaou, E.P. Efstathopoulos, A. Tsaroucha

引用次数: 0

O.8.2 CUSTOM-MADE PLA FILAMENT DOPED WITH THERMOLUMINESCENCE POWDER, FOR CONSTRUCTING 3D PRINTED RADIATION DETECTORS: PRELIMINARY RESULTS o.8.2 用于制造 3d 打印辐射探测器的掺有热释光粉末的定制 pla 长丝：初步结果

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-01 DOI: 10.1016/j.ejmp.2024.104570

G. Giakoumettis, N. Okkalidis, F. Okkalidis, C. Chatsigeorgiou, H. Yordanov, M. Gelev, A. Siountas, E. Papanastasiou

引用次数: 0

IL.3 DUAL-MODALITY HIGH-FLOW IMAGING SCHEME FOR CELL DISCRIMINATION COMBINING NEUROMORPHIC 2D CAMERA AND NIR TIME-STRETCH IMAGER il.3 结合神经形态 2d 相机和 nir 时间拉伸成像仪的用于细胞分辨的双模态高流量成像方案

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-01 DOI: 10.1016/j.ejmp.2024.104520

C. Mesaritakis, I. Tsilikas, S. Deligiannidis, G.A. Karydis, D. Syvridis, A. Bogris

引用次数: 0

IL.4 ARTIFICIAL INTELLIGENCE IN RADIONUCLIDE THERAPY APPLICATIONS IL.4 人工智能在放射性核素治疗中的应用

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2024-11-01 DOI: 10.1016/j.ejmp.2024.104521

P. Papadimitroulas

引用次数: 0

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