ArcCHECK用于全脑全脊髓容积旋转调强验证的研究
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摘要
目的本研究尝试利用ArcCHECK对容积旋转调强(Volumetric Modulated Arc Therapy,VMAT)全脑全脊髓长靶区及多个射野衔接处进行剂量验证,探索其可行性。方法选取2015年至2017年6例行VMAT全脑全脊髓治疗的成人患者,将计划移植到ArcCHECK模体上。ArcCHECK的Merge功能可以将验证范围扩展到36 cm,所以将全脑全脊髓VMAT计划拆分成头颈、胸及腹盆三段进行分开验证,并将射野衔接处确保在验证范围内。采用γ分析3 mm/3%标准,同时对计划的绝对剂量也做了验证。结果 6个计划的头颈、胸、腹盆的验证通过率均在96.4%以上,头颈(99.1±0.8)%、胸(97.5±1.1)%、腹盆(98.8±0.6)%,并且射野衔接处通过率都非常好。绝对剂量差异在-1.7%～1.5%之间,符合误差允许范围。结论 ArcCHECK的Merge功能能将射野验证范围扩大至36 cm,并能观察到衔接处的剂量分布,验证结果有较高的γ通过率,所以ArcCHECK可以用于全脑全脊髓容积旋转调强的验证。
Objective In this study, we attempted to perform dosimetric verification and evaluate the feasibility of volumetric modulated arc therapy(VMAT) on craniospinal long target area and multiple field junctions using the ArcCHECK. Methods Six adult patients who underwent Craniospinal VMAT from 2015 to 2017 were enrolled and planned to be transplanted to ArcCHECK. The Merge function of Arc CHECK could extend the validation range to 36 cm. Therefore, the craniospinal VMAT plan could be divided into three sections of headneck, chest, and abdomen to verify, and the field junctions should be ensured within the scope of verification. Verification results were analyzed using γ analysis(3 mm/3%), and the absolute dose was also verified. Results The verification pass rates of the headneck(99.1%±0.8%), chest(97.5%±1.1%) and abdomen(98.8%±0.6%) of 6 plans were all more than 96.4%. The verification results of field junction areas were also very good. The absolute dosimetric differences were between-1.7% and 1.5%, which were within tolerance range. Conclusion The Merge function of ArcCHECK can extend the validation range to 36 cm, and observe the dose distribution of the field junctions. The verification results have a high γ pass rate, thus ArcCHECK can be used to verify craniospinal VMAT plan.
Objective In this study, we attempted to perform dosimetric verification and evaluate the feasibility of volumetric modulated arc therapy(VMAT) on craniospinal long target area and multiple field junctions using the ArcCHECK. Methods Six adult patients who underwent Craniospinal VMAT from 2015 to 2017 were enrolled and planned to be transplanted to ArcCHECK. The Merge function of Arc CHECK could extend the validation range to 36 cm. Therefore, the craniospinal VMAT plan could be divided into three sections of headneck, chest, and abdomen to verify, and the field junctions should be ensured within the scope of verification. Verification results were analyzed using γ analysis(3 mm/3%), and the absolute dose was also verified. Results The verification pass rates of the headneck(99.1%±0.8%), chest(97.5%±1.1%) and abdomen(98.8%±0.6%) of 6 plans were all more than 96.4%. The verification results of field junction areas were also very good. The absolute dosimetric differences were between-1.7% and 1.5%, which were within tolerance range. Conclusion The Merge function of ArcCHECK can extend the validation range to 36 cm, and observe the dose distribution of the field junctions. The verification results have a high γ pass rate, thus ArcCHECK can be used to verify craniospinal VMAT plan.
引文
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[12]解传滨.基于旋转调强全骨髓照射新技术的研究[D].北京:清华大学,2014.
[13]鄢佳文,高靖琰,刘旭红,等.ArcCHECK用于VMAT计划剂量的验证[J].医疗装备,2017,30(5):26-27.
[14]Li G,Zhang Y,Jiang X,et al.Evaluation of the ArcCHECKQA system for IMRT and VMAT verification[J].Phys Med,2013,29(3):295-303.
[15]Infusino E,Mameli A,Conti R,et al.Initial experience of ArcCHECK and 3DVH software for RapidArc treatment plan verification[J].Med Dosim,2014,39(3):276-281.
[16]Saito M,Kadoya N,Sato K,et al.Comparison of DVH-based plan verification methods for VMAT:ArcCHECK-3DVHsystem and dynalog-based dose reconstruction[J].J Appl Clin Med Phys,2017,18(4):206-214.
[17]Low DA,Moran M,Dempsey JF,et al.Dosimetry tools and techniques for IMRT[J].Med Phys,2011,38(3):1313-1338.
[18]于红,夏云飞,王岩,等.全中枢放疗精确定位的CT模拟技术[J].中国神经肿瘤杂志,2008,6(4):279-281.
[19]Mailhos C,Modlich U,Lewis J,et al.Delta4,an endothelial specific notch ligand expressed at sites of physiological and tumor angiogenesis[J].Differentiation,2001,69(2-3):135-144.
[20]Nilsson J,Hauer AK,B?ck A.IMRT patient-specific QA using the Delta4 dosimetry system and evaluation based on ICRU 83recommendations[A].Journal of Physics:Conference Series[C].Bristol:IOP Publishing,2013,444(1):12048.
[21]张伟.全脑全脊髓简单调强方法研究[D].北京:清华大学,2013.
[2]蔡文栋,赵春燕.53例成人髓母细胞瘤临床特点治疗方法及预后分析[J].中国肿瘤临床与康复,2014,(7):843-845.
[3]Takahashi I,Kashiwado K,Sumida N,et al.A simplified three isocenter IMRT for craniospinal irradiation to minimize total treatment time[J].Int J Radiat Oncol Biol Phys,2015,93(3):E458.
[4]So TH,Ho P,Leung TW,et al.Pneumocystis jiroveci infection and craniospinal irradiation with arc therapy:a report of two cases[J].Hong Kong Journal of Radiology,2016,19(2):126-131.
[5]Fogliata A,Bergstr?m S,Cafaro I,et al.Cranio-spinal irradiation with volumetric modulated arc therapy:a multi-institutional treatment experience[J].Radiother Oncol,2011,99(1):79-85.
[6]Lee YK,Brooks CJ,Bedford JL,et al.Development and evaluation of multiple isocentric volumetric modulated arc therapy technique for craniospinal axis radiotherapy planning[J].Int J Radiat Oncol Biol Phys,2012,2(2):1006-1012.
[7]Wang K,Meng H,Chen J,et al.Plan quality and robustness in field junction region for craniospinal irradiation with VMAT[J].Phys Med,2018,48:21-26.
[8]胡彩容.三维验证系统在容积旋转调强剂量验证中的应用研究[D].北京:清华大学,2012.
[9]Valve A,Keyril?inen J,Kulmala J.Compass model-based quality assurance for stereotactic VMAT treatment plans[J].Phys Med,2017,44:42.
[10]李兵兵,刘苓苓,费振乐.Octavius4D验证系统用于VMAT剂量验证的研究[J].中华放射肿瘤学杂志,2015,24(3):323-326.
[11]Sukumar P,Irvine D,Hounsell A,et al.PTW 729 detector array degradation of response over time following VMAT pretreatment quality assurance using the Octavius 4D system[J].Phys Med,2016,32(2):415-416.
[12]解传滨.基于旋转调强全骨髓照射新技术的研究[D].北京:清华大学,2014.
[13]鄢佳文,高靖琰,刘旭红,等.ArcCHECK用于VMAT计划剂量的验证[J].医疗装备,2017,30(5):26-27.
[14]Li G,Zhang Y,Jiang X,et al.Evaluation of the ArcCHECKQA system for IMRT and VMAT verification[J].Phys Med,2013,29(3):295-303.
[15]Infusino E,Mameli A,Conti R,et al.Initial experience of ArcCHECK and 3DVH software for RapidArc treatment plan verification[J].Med Dosim,2014,39(3):276-281.
[16]Saito M,Kadoya N,Sato K,et al.Comparison of DVH-based plan verification methods for VMAT:ArcCHECK-3DVHsystem and dynalog-based dose reconstruction[J].J Appl Clin Med Phys,2017,18(4):206-214.
[17]Low DA,Moran M,Dempsey JF,et al.Dosimetry tools and techniques for IMRT[J].Med Phys,2011,38(3):1313-1338.
[18]于红,夏云飞,王岩,等.全中枢放疗精确定位的CT模拟技术[J].中国神经肿瘤杂志,2008,6(4):279-281.
[19]Mailhos C,Modlich U,Lewis J,et al.Delta4,an endothelial specific notch ligand expressed at sites of physiological and tumor angiogenesis[J].Differentiation,2001,69(2-3):135-144.
[20]Nilsson J,Hauer AK,B?ck A.IMRT patient-specific QA using the Delta4 dosimetry system and evaluation based on ICRU 83recommendations[A].Journal of Physics:Conference Series[C].Bristol:IOP Publishing,2013,444(1):12048.
[21]张伟.全脑全脊髓简单调强方法研究[D].北京:清华大学,2013.