Gautam Buddh Technical University, Lucknow, Uttar Pradesh, India.
J Appl Clin Med Phys. 2013 May 6;14(3):4103. doi: 10.1120/jacmp.v14i3.4103.
The purpose of this study was to evaluate the capabilities of DMLC to deliver the respiratory motion-synchronized dynamic IMRT (MS-IMRT) treatments under various dose rates. In order to create MS-IMRT plans, the DMLC leaf motions in dynamic IMRT plans of eight lung patients were synchronized with the respiratory motion of breathing period 4 sec and amplitude 2 cm (peak to peak) using an in-house developed leaf position modification program. The MS-IMRT plans were generated for the dose rates of 100 MU/min, 400 MU/min, and 600 MU/min. All the MS-IMRT plans were delivered in a medical linear accelerator, and the fluences were measured using a 2D ion chamber array, placed over a moving platform. The accuracy of MS-IMRT deliveries was evaluated with respect to static deliveries (no compensation for target motion) using gamma test. In addition, the fluences of gated delivery of 30% duty cycle and non- MS-IMRT deliveries were also measured and compared with static deliveries. The MS-IMRT was better in terms of dosimetric accuracy, compared to gated and non-MS-IMRT deliveries. The dosimetric accuracy was observed to be significantly better for 100 MU/min MS-IMRT. However, the use of high-dose rate in a MS-IMRT delivery introduced dose-rate modulation/beam hold-offs that affected the synchronization between the DMLC leaf motion and target motion. This resulted in more dose deviations in MS-IMRT deliveries at the dose rate of 600 MU/min.
本研究旨在评估在不同剂量率下,动态多叶准直器(DMLC)实现呼吸运动同步动态调强放疗(MS-IMRT)的能力。为了生成 MS-IMRT 计划,我们使用内部开发的叶片位置修正程序,将 8 名肺癌患者的动态调强放疗计划中的 DMLC 叶片运动与呼吸周期 4 秒和 2 厘米(峰峰值)的呼吸运动同步。为剂量率为 100 MU/min、400 MU/min 和 600 MU/min 生成了 MS-IMRT 计划。所有的 MS-IMRT 计划都在医用直线加速器中实施,并使用放置在移动平台上的二维离子室阵列测量剂量。通过伽马测试,针对无靶区运动补偿的静态放疗(static deliveries)评估了 MS-IMRT 放疗的准确性。此外,还测量和比较了 30%占空比的门控放疗和非 MS-IMRT 放疗的剂量。与门控放疗和非 MS-IMRT 放疗相比,MS-IMRT 在剂量学准确性方面表现更好。在剂量率为 100 MU/min 时,MS-IMRT 的剂量学准确性明显更好。然而,在 MS-IMRT 放疗中使用高剂量率会引入剂量率调制/束暂停,这会影响 DMLC 叶片运动和靶区运动之间的同步性。这导致在剂量率为 600 MU/min 时 MS-IMRT 放疗中的剂量偏差更大。