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使用患者悬浮转运系统减少磁共振成像/计算机断层扫描引导下宫颈癌高剂量率近距离放疗中施源器的位移

Reduction of applicator displacement in MR/CT-guided cervical cancer HDR brachytherapy by the use of patient hover transport system.

作者信息

Andrew Megan, Kim Yusung, Ginader Timothy, Smith Brian J, Sun Wenqing, Wang Dongxu

机构信息

Department of Radiation Oncology, University of Iowa Hospitals and Clinics.

Holden Comprehensive Cancer Center, University of Iowa Hospitals and Clinics.

出版信息

J Contemp Brachytherapy. 2018 Feb;10(1):85-90. doi: 10.5114/jcb.2018.73755. Epub 2018 Feb 26.

Abstract

PURPOSE

To quantify the reduction of relative displacement between the implanted intracavitary applicator and the patient bony anatomy, due to the use of a hover transport system during the patient transports between the imaging table and the treatment table.

MATERIAL AND METHODS

The displacement of the applicator inside the patient was measured by comparing the distance between the tip of the tandem and the pubic bone on X-ray radiography images taken before and after moving a patient to magnetic resonance/computed tomography imaging. Displacements were evaluated for 27 fractions of treatment using hover transport and 185 fractions of treatment using manual transport.

RESULTS

The use of hover transport system reduced the percentage of fractions with displacements greater than 5 mm from 22.7% to 7.4%. The reduction of applicator displacement using hover transport is statistically significant, compared to the manual transport method (-value 0.0086; mean displacement 3.41 mm [95% CI: 2.96-3.97] for manual transport, and 2.27 mm [95% CI: 1.71-2.97] for hover transport fractions).

CONCLUSIONS

This study indicates that the hover transport system is effectively reducing displacement between tandem and patient bony anatomy during patient transports. The potential improvement in dosimetric accuracy due to this reduction warrants further study.

摘要

目的

量化在患者在成像台和治疗台之间转运期间使用气垫运输系统时,植入的腔内施源器与患者骨骼解剖结构之间相对位移的减少情况。

材料与方法

通过比较在将患者移至磁共振/计算机断层扫描成像前后所拍摄的X射线造影图像上,串联施源器尖端与耻骨之间的距离,来测量施源器在患者体内的位移。对使用气垫运输的27次治疗分次以及使用手动运输的185次治疗分次的位移进行了评估。

结果

使用气垫运输系统使位移大于5 mm的分次百分比从22.7%降至7.4%。与手动运输方法相比,使用气垫运输时施源器位移的减少具有统计学意义(-值0.0086;手动运输的平均位移为3.41 mm [95% CI:2.96 - 3.97],气垫运输分次的平均位移为2.27 mm [95% CI:1.71 - 2.97])。

结论

本研究表明,气垫运输系统在患者转运期间能有效减少串联施源器与患者骨骼解剖结构之间的位移。由于这种减少而在剂量测定准确性方面的潜在改善值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a307/5881589/1223b5e30657/JCB-10-31934-g001.jpg

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