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两种商用剂量仪在检测螺旋断层放疗治疗交付误差方面的灵敏度评估。

Sensitivity evaluation of two commercial dosimeters in detecting Helical TomoTherapy treatment delivery errors.

作者信息

Deshpande Shrikant, Geurts Mark, Vial Philip, Metcalfe Peter, Holloway Lois

机构信息

Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute, Sydney, NSW, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.

Department of Human Oncology, School of Medicine and Public Health, University of Wisconsin-Madison, USA.

出版信息

Phys Med. 2017 May;37:68-74. doi: 10.1016/j.ejmp.2017.04.011. Epub 2017 Apr 24.

Abstract

PURPOSE

To assess the sensitivity of two commercial dosimetry systems in detecting Helical TomoTherapy (HT) delivery errors.

METHOD

Two commercial dosimeters i) MatriXX and ii) ArcCHECK® were considered. Ten retrospective nasopharynx HT patients were analysed. For each patient, error plans were created by independently introducing systematic offsets in: a) Jaw width error ±1, ±1.5 and ±2mm, b) Couch speed error ±2%, ±2.5, ±3% and ±4%, and c) MLC Leaf Open Time (MLCLOT) errors (3 separate MLC errors: either leaf 32 open or leaf 42 remains open during delivery, and 4% random reductions in MLCLOT). All error plans, along with the no error plan for each patient, were measured using both dosimeters in the same session. Gamma evaluation (3%/3mm) was applied to quantitatively compare the measured dose from each dosimeter to the treatment planning system. The error sensitivity was quantified as the rate of decrease in gamma pass rate.

RESULTS

The gamma pass rate decreases with increase in error magnitude for both dosimeters. ArcCHECK was insensitive for couch speed error up to 2.5% and jaw width error up to -1.5mm while MatriXX was found to be insensitive to couch speed error up to 2% and couch speed up to -1mm. Both of the detectors show similar sensitivity to all the MLCLOT errors that were clinically relevant.

CONCLUSION

No statistically significant (p>0.05) differences exist in detecting the simulated delivery errors between MatriXX and ArcCHECK dosimeter systems for HT plans. Both dosimeters were able to pick up clinically relevant delivery errors.

摘要

目的

评估两种商用剂量测定系统在检测螺旋断层放射治疗(HT)输送误差方面的灵敏度。

方法

考虑了两种商用剂量仪:i)MatriXX和ii)ArcCHECK®。分析了10例回顾性鼻咽癌HT患者。对于每位患者,通过在以下方面独立引入系统偏移来创建误差计划:a)颌宽误差±1、±1.5和±2mm,b)治疗床速度误差±2%、±2.5、±3%和±4%,以及c)多叶准直器叶片开启时间(MLCLOT)误差(3种单独的多叶准直器误差:在输送过程中叶片32开启或叶片42保持开启,以及MLCLOT随机减少4%)。在同一次测量中,使用这两种剂量仪对所有误差计划以及每位患者的无误差计划进行测量。应用伽马评估(3%/3mm)来定量比较每种剂量仪测量的剂量与治疗计划系统。误差灵敏度被量化为伽马通过率的下降率。

结果

两种剂量仪的伽马通过率均随误差幅度的增加而降低。对于高达2.5%的治疗床速度误差和高达 -1.5mm的颌宽误差,ArcCHECK不敏感,而MatriXX对于高达2%的治疗床速度误差和高达 -1mm的颌宽误差不敏感。两种探测器对所有临床相关的MLCLOT误差显示出相似的灵敏度。

结论

对于HT计划,MatriXX和ArcCHECK剂量仪系统在检测模拟输送误差方面不存在统计学显著差异(p>0.05)。两种剂量仪都能够检测出临床相关的输送误差。

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