MR引导的放疗系统临床应用

doi:10.3760/cma.j.cn113030-20200317-00118

摘要
图/表
参考文献
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的探讨MR引导的Unity放疗系统在临床应用中的可行性。方法临床试验入选24例患者,按治疗部位分为头颈组、胸腹组、盆腔组、脊柱组和肢体组,总共384个治疗分次。在无外置激光的情况下进行摆位,统计在线治疗流程中不同阶段所需时间和每个分次的配准误差。每周利用MR几何形变模体检测MR图像几何形变大小。并利用ArcCheck对参考计划、在线计划及离线计划进行剂量验证。结果头颈组、胸腹组、盆腔组、肢体组、脊柱组平均治疗时间分别为29.1、27.6、26.6、25.6、32.0min。5个组左右、上下、前后方向平均摆位误差分别为头颈组(0.08±0.06)、(0.16±0.13)、(0.08±0.05) cm,胸腹组(0.23±0.18)、(0.50±0.47)、(0.12±0.1) cm,盆腔组(0.25±0.19)、(0.32±0.25)、(0.11±0.09)cm,肢体组(0.46±0.38)、(0.26±0.26)、(0.13±0.07) cm,脊柱组(0.33±0.30)、(0.34±0.23)、(0.08±0.06) cm。在中心区域MR几何形变大小在0.3mm以内,直径500mm的球体区域内形变大小在2.1mm内。所有参考计划、在线计划、离线计划平均γ通过率分别为97.92%、97.84%、94.58%。结论 MR引导放疗具有较大临床应用潜力,但MR引导的Unity放疗系统流程较为复杂,各部门的协同性对治疗的影响较大,还需进一步优化。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘镖水
	郭旋
	丁寿亮
	王彬
	李永宝
	夏云飞
	欧阳翼
	黄晓延
	林承光

关键词 ：摆位误差, 恶性肿瘤/MR引导放射疗法, Unity加速器

Abstract：Objective To investigate the clinical feasibility of the Unity radiotherapy system guided by magnetic resonance imaging. Methods Twenty-four patients were enrolled and received a total of 384 fractions of treatment at Unity system. According to the treatment site, all patients were divided into head-neck, abdomen-thorax, pelvic, spine and limb groups. The patients were set-up without external laser. And then, the time required at different stages in online treatment process and the registration error of each fraction were separately calculated. The geometric deformations of MR images were weekly measured by using MR geometric deformation phantom. At last, the Arccheck was used to perform the dose verification of reference plan, online plan and offline plan. Results The mean duration of radiotherapy in the five groups were 29.1, 27.6, 26.6, 25.6 and 32.0min, respectively. The set-up errors in the left-right, superior-inferior and anterior-posterior direction in the five groups were:head-neck group (0.08±0.06cm, 0.16±0.13cm, 0.08±0.05cm), abdomen-thorax group (0.23±0.18cm, 0.50±0.47cm, 0.12±0.1cm), pelvic group (0.25±0.19cm, 0.32±0.25cm, 0.11±0.09cm), spine group (0.46±0.38cm, 0.26±0.26cm, 0.13±0.07cm) and limb group (0.33±0.30cm, 0.34±0.23cm, 0.08±0.06cm), respectively. In the central region, the geometric deformation of MR was less than 0.3mm, and that of the sphere with a diameter of 500mm was less than 2.1mm. The meanγ pass rate of the reference plan, online plan and offline plan were 97.92%, 97.84% and 94.58%, respectively. Conclusions MR-guided radiotherapy has great potential for clinical application, whereas the process of Unity system is relatively complex. The synergy of different departments has a great impact on the treatment, which needs further optimization.

Key words： Set-up error Malignant tumor neoplasm/magnetic resonance-guided radiotherapy Unity accelerator

收稿日期: 2020-03-17

基金资助:广东省自然科学基金(2018A0303100020)

通讯作者: 林承光,Email:linchg@sysucc.org.cn

引用本文:

刘镖水,郭旋,丁寿亮等. MR引导的放疗系统临床应用[J]. 中华放射肿瘤学杂志, 2021, 30(2): 134-139.

Liu Biaoshui,Guo Xuan,Ding Shouliang et al. The clinical application of magnetic resonance-guided radiotherapy[J]. Chinese Journal of Radiation Oncology, 2021, 30(2): 134-139.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20200317-00118 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2021/V30/I2/134

[1] Verellen D, De Ridder M, Linthout N, et al. Innovations in image-guided radiotherapy[J]. Nat Rev Cancer, 2007, 7(12):949-960. DOI:10.1038/nrc2288.
[2] Wachowicz K, Murray B, Fallone BG. On the direct acquisition of beam′s-eye-view images in MRI for integration with external beam radiotherapy[J]. Phys in Med Biol, 2018, 63(12):125002. DOI:10.1088/1361-6560/aac5b9.
[3] Corradini S, Alongi F, Andratschke N, et al. MR-guidance in clinical reality:current treatment challenges and future perspectives[J]. Radiat Oncol, 2019, 14(1):92. DOI:10.1186/s13014-019-1308-y.
[4] Pollard JM, Wen Z, Sadagopan R, et al. The future of image-guided radiotherapy will be MR guided[J]. Br J Radiol, 2017, 90(1073):20160667. DOI:10.1259/bjr.20160667.
[5] Winkel D, Kroon PS, Werensteijn-Honingh AM, et al. Simulated dosimetric impact of online replanning for stereotactic body radiation therapy of lymph node oligometastases on the 1.5 T MR-linac[J]. Acta Oncol, 2018, 57(12):1705-1712. DOI:10.1080/0284186X.2018.1512152.
[6] Lagendijk JJW, Raaymakers BW, Van den Berg CAT, et al. MR guidance in radiotherapy[J]. Phys Med Biol, 2014, 59(21):349-369. DOI:10.1088/0031-9155/59/21/R349.
[7] Freedman JN, Collins DJ, Gurney-Champion OJ, et al. Super-resolution T2-weighted 4D MRI for image guided radiotherapy[J]. Radiother Oncol, 2018, 129(3):486-493. DOI:10.1016/j.radonc.2018.05.015.
[8] Kontaxis C, Bol GH, Stemkens B, et al. Towards fast online intrafraction replanning for free-breathing stereotactic body radiation therapy with the MR-linac[J]. Phys Med Biol, 2017, 62(18):7233-7248. DOI:10.1088/1361-6560/aa82ae.
[9] Yang Y, Cao M, Sheng K, et al. Longitudinal diffusion MRI for treatment response assessment:preli minary experience using an MRI-guided tri-cobalt 60 radiotherapy system[J]. Med Phys, 2016, 43(3):1369-1373. DOI:10.1118/1.4942381.
[10] Padhani AR, Liu G, Mu-Koh D, et al. Diffusion-weighted magnetic resonance imaging as a cancer biomarker:consensus and recommendations[J]. Neoplasia, 2009, 11(2):102-125. DOI:10.1593/neo.81328.
[11] Noguerol TM, Sánchez-González J, Barbero JPM, et al. Clinical imaging of tumor metabolism with 1h magnetic resonance spectroscopy[J]. Magn Reson Imaging Clin N Am, 2016, 24(1):57-86. DOI:10.1016/j.mric.2015.09.002.
[12] Eric S, Sjoerd P, Brain M, et al. Consensus opinion on MRI simulation for external beam radiation treatment planning[J]. Radiother Oncol, 2016, 121(2):187-192. DOI:10.1016/j.radonc.2016.09.018.
[13] Gary P, Marinus A. Magnetic resonance imaging acquisition techniques for radiotherapy planning[J]. Se min Radiat Oncol, 2014, 24(3):160-168. DOI:10.1016/j.semradonc.2014.02.014.
[14] Werensteijn-Honingh AM, Kroon PS, Winkel D, et al. Feasibility of stereotactic radiotherapy using a 1.5 T MR-linac:multi-fraction treatment of pelvic lymph node oligometastases[J]. Radiother Oncol, 2019, 134(1):50-54. DOI:10.1016/j.radonc.2019.01.024.
[15] Bertelsen AS, Schytte T, Møller PK, et al. First clinical experiences with a high field 1.5 T MR linac[J]. Acta Oncol, 2019, 58(10):1352-1357. DOI:10.1080/0284186X.2019.1627417.
[16] 张英婷,刘炳忠,陈文芬,等. 聚氨酯发泡胶结合翼板个体化塑形与负压真空袋固定肺癌放疗摆位精度比较[J]. 中华放射肿瘤学杂志, 2018, 27(3):299-302. DOI:10.3760/cma.j.issn.1004-4221.2018.03.014.
Zhang YT, Liu BZ, Chen WF, et al, Comparison of positioning accuracy between personalized polyurethane foam with wing boards and negative pressure vacuum bag in radiotheraphy for lung cancer[J]. Chin J Radiat Oncol, 2018, 27(3):299-302. DOI:10.3760/cma.j.issn.1004-4221.2018.03.014.
[17] 高丽娟,黄嘉敏,黄峻,等. Orfit架和真空袋对宫颈癌放疗摆位误差比较[J]. 中华放射肿瘤学杂志, 2017, 26(9):1080-1083. DOI:10.3760/cma.j.issn.1004-4221.2017.09.020.
Gao LJ, Huang JM, Huang J, et al. Setup error of Orfit versus vacuum bag in radiotherapy for cervical cancer[J]. Chin J Radiat Oncol, 2017, 26(9):1080-1083. DOI:10.3760/cma.j.issn.1004-4221.2017.09.020.