Stock Markus, Georg Dietmar, Ableitinger Alexander, Zechner Andrea, Utz Alexander, Mumot Marta, Kragl Gabriele, Hopfgartner Johannes, Gora Joanna, Böhlen Till, Grevillot Loïc, Kuess Peter, Steininger Phil, Deutschmann Heinz, Vatnitsky Stanislav
Division of Medical Physics, EBG MedAustron GmbH, Wiener Neustadt, Austria.
Department of Radiation Oncology, Medical University of Vienna/AKH, Vienna, Austria; Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna, Vienna, Austria.
Z Med Phys. 2018 Aug;28(3):196-210. doi: 10.1016/j.zemedi.2017.09.007. Epub 2017 Oct 27.
The ratio of patients who need a treatment adaptation due to anatomical variations at least once during the treatment course is significantly higher in light ion beam therapy (LIBT) than in photon therapy. The ballistic behaviour of ion beams makes them more sensitive to changes. Hence, the delivery of LIBT has always been supported by state of art image guidance. On the contrary CBCT technology was adapted for LIBT quite late. Adaptive concepts are being implemented more frequently in photon therapy and also efficient workflows are needed for LIBT. The MedAustron Ion Beam Therapy Centre was designed to allow the clinical implementation of adaptive image-guided concepts. The aim of this paper is to describe the current status and the potential future use of the technology installed at MedAustron. Specifically addressed is the beam delivery system, the patient alignment system, the treatment planning system as well as the Record & Verify system. Finally, an outlook is given on how high quality X-ray imaging, MR image guidance, fast and automated treatment planning as well as in vivo range verification methods could be integrated.
在治疗过程中，至少有一次因解剖结构变异而需要调整治疗方案的患者比例，在轻离子束治疗（LIBT）中显著高于光子治疗。离子束的弹道特性使其对变化更为敏感。因此，LIBT的治疗实施一直依靠先进的图像引导技术。相反，CBCT技术很晚才应用于LIBT。自适应概念在光子治疗中应用得越来越频繁，LIBT也需要高效的工作流程。MedAustron离子束治疗中心的设计允许临床实施自适应图像引导概念。本文旨在描述MedAustron所安装技术的现状以及未来的潜在用途。具体涉及束流传输系统、患者定位系统、治疗计划系统以及记录与验证系统。最后，展望了如何整合高质量X射线成像、磁共振图像引导、快速自动治疗计划以及体内射程验证方法。
