伽玛刀放射外科手术中的数字剂量绘制治疗规划方法

IF 2.2 Q3 ONCOLOGY Advances in Radiation Oncology Pub Date : 2024-05-01 DOI:10.1016/j.adro.2024.101534
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引用次数: 0

摘要

目的剂量涂抹放射治疗可向肿瘤提供不均匀的剂量,以考虑不同的放射敏感性。随着最近伽玛刀设备的不断发展,大容量脑肿瘤治疗变得更加实用,进行剂量涂抹治疗也越来越可行。处方复杂性的增加意味着自动化治疗计划大有裨益,而剂量涂抹对立体定向放射手术(SRS)计划质量的影响尚未得到研究。本研究调查了在治疗计划中使用优化技术和自动等中心放置时伽马刀 SRS 剂量涂敷治疗可达到的计划质量。方法和材料应用不同参数的剂量涂敷处方函数,将 10 个样本病例的体素图像强度转换为处方。为了研究可实现的计划质量和优化,每个剂量绘制处方都使用了临床放置的等中心,并使用半无限线性编程公式进行优化。为了研究自动等中心放置,我们使用了草火球体填充算法和临床可用的雷克塞伽马计划等中心填充算法。结果优化可用于寻找高质量的剂量涂敷计划,计划质量受剂量涂敷处方方法的影响。即使平均剂量提升较高,多项式函数处方也比西格玛函数处方显示出更高的可实现计划质量。自动等中心放置被证明是剂量涂敷 SRS 治疗的可行方法,增加等中心数量可提高计划质量。在大多数情况下,优化的计算求解时间不超过 5 分钟,适合临床规划。优化和自动等中心放置是获得高质量计划的可行治疗计划方法。
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Treatment Planning Methods for Dose Painting by Numbers Treatment in Gamma Knife Radiosurgery

Purpose

Dose painting radiation therapy delivers a nonuniform dose to tumors to account for heterogeneous radiosensitivity. With recent and ongoing development of Gamma Knife machines making large-volume brain tumor treatments more practical, it is increasingly feasible to deliver dose painting treatments. The increased prescription complexity means automated treatment planning is greatly beneficial, and the impact of dose painting on stereotactic radiosurgery (SRS) plan quality has not yet been studied. This research investigates the plan quality achievable for Gamma Knife SRS dose painting treatments when using optimization techniques and automated isocenter placement in treatment planning.

Methods and Materials

Dose painting prescription functions with varying parameters were applied to convert voxel image intensities to prescriptions for 10 sample cases. To study achievable plan quality and optimization, clinically placed isocenters were used with each dose painting prescription and optimized using a semi-infinite linear programming formulation. To study automated isocenter placement, a grassfire sphere-packing algorithm and a clinically available Leksell gamma plan isocenter fill algorithm were used. Plan quality for each optimized treatment plan was measured with dose painting SRS metrics.

Results

Optimization can be used to find high quality dose painting plans, and plan quality is affected by the dose painting prescription method. Polynomial function prescriptions show more achievable plan quality than sigmoid function prescriptions even with high mean dose boost. Automated isocenter placement is shown as a feasible method for dose painting SRS treatment, and increasing the number of isocenters improves plan quality. The computational solve time for optimization is within 5 minutes in most cases, which is suitable for clinical planning.

Conclusions

The impact of dose painting prescription method on achievable plan quality is quantified in this study. Optimization and automated isocenter placement are shown as possible treatment planning methods to obtain high quality plans.

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来源期刊
Advances in Radiation Oncology
Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.60
自引率
4.30%
发文量
208
审稿时长
98 days
期刊介绍: The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.
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