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在瓦里安锥形束CT系统中减少患者剂量的简单方法,用于盆腔放射治疗中的剂量验证。

Simple methods to reduce patient dose in a Varian cone beam CT system for delivery verification in pelvic radiotherapy.

作者信息

Roxby P, Kron T, Foroudi F, Haworth A, Fox C, Mullen A, Cramb J

机构信息

Peter MacCallum Cancer Centre, Department of Physical Sciences, St Andrews Place, East Melbourne, Victoria 3002, Australia.

出版信息

Br J Radiol. 2009 Oct;82(982):855-9. doi: 10.1259/bjr/37579222. Epub 2009 Mar 16.

Abstract

Cone-beam computed tomography (CBCT) is a three-dimensional imaging modality that has recently become available on linear accelerators for radiotherapy patient position verification. It was the aim of the present study to implement simple strategies for reduction of the dose delivered in a commercial CBCT system. The dose delivered in a CBCT procedure (Varian, half-fan acquisition, 650 projections, 125 kVp) was assessed using a cylindrical Perspex phantom (diameter, 32 cm) with a calibrated Farmer type ionisation chamber. A copper filter (thickness, 0.15 mm) was introduced increasing the half value layer of the beam from 5.5 mm Al to 8 mm Al. Image quality and noise were assessed using an image quality phantom (CatPhan) while the exposure settings per projection were varied from 25 ms/80 mA to 2 ms/2 mA per projection. Using the copper filter reduced the dose to the phantom from approximately 45 mGy to 30 mGy at standard settings (centre/periphery weighting 1/3 to 2/3). Multiple CBCT images were acquired for six patients with pelvic malignancies to compare CBCTs with and without a copper filter. Although the reconstructed image is somewhat noisier with the filter, it features similar contrast in the centre of the patient and was often preferred by the radiation oncologist because of greater image uniformity. The X-ray shutters were adjusted to the minimum size required to obtain the desired image volume for a given patient diameter. The simple methods described here reduce the effective dose to patients undergoing daily CBCT and are easy to implement, and initial evidence suggests that they do not affect the ability to identify soft tissue for the purpose of treatment verification.

摘要

锥形束计算机断层扫描(CBCT)是一种三维成像方式,最近已应用于直线加速器上,用于放射治疗患者的位置验证。本研究的目的是实施简单策略,以降低商用CBCT系统的剂量。使用带有校准的 Farmer 型电离室的圆柱形有机玻璃体模(直径32 cm)评估CBCT程序(瓦里安,半扇形采集,650个投影,125 kVp)中的剂量。引入了一个铜滤过器(厚度0.15 mm),将线束的半值层从5.5 mm铝增加到8 mm铝。使用图像质量体模(CatPhan)评估图像质量和噪声,同时将每个投影的曝光设置从25 ms/80 mA变化到2 ms/2 mA。在标准设置下(中心/周边加权1/3至2/3),使用铜滤过器可将体模剂量从约45 mGy降低至30 mGy。为6例盆腔恶性肿瘤患者采集了多张CBCT图像,以比较有无铜滤过器时的CBCT图像。尽管使用滤过器重建的图像噪声稍大,但在患者中心具有相似的对比度,并且由于图像均匀性更好,常受到放射肿瘤学家的青睐。将X射线快门调整到为给定患者直径获取所需图像体积所需的最小尺寸。本文所述的简单方法可降低接受每日CBCT检查患者的有效剂量,且易于实施,初步证据表明,这些方法不会影响为治疗验证而识别软组织的能力。

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