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锥形束CT扫描程序对放射治疗患者照射剂量的评估

Dosimetric assessment of the exposure of radiotherapy patients due to cone-beam CT procedures.

作者信息

Baptista Mariana, Di Maria Salvatore, Vieira Sandra, Santos Joana, Pereira Joana, Pereira Miguel, Vaz Pedro

机构信息

Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Campus Tecnológico e Nuclear, Estrada Nacional 10, km 139,7, 2695-066, Bobadela LRS, Portugal.

Fundação Champalimaud, Centro Clínico Champalimaud, Avenida de Brasília, 1400-038, Lisbon, Portugal.

出版信息

Radiat Environ Biophys. 2019 Mar;58(1):21-37. doi: 10.1007/s00411-018-0760-7. Epub 2018 Nov 3.

Abstract

Cone-beam computed tomography (CBCT) is widely used for pre-treatment verification and patient setup in image-guided radiation therapy (IGRT). CBCT imaging is employed daily and several times per patient, resulting in potentially high cumulative imaging doses to healthy tissues that surround exposed target organs. Computed tomography dose index (CTDI) is the parameter used by CBCT equipment as indication of the radiation output to patients. This study aimed to increase the knowledge on the relation between CBCT organ doses and weighted CTDI (CTDI) for a thorax scanning protocol. A CBCT system was modelled using the Monte Carlo (MC) radiation transport program MCNPX2.7.0. Simulation results were validated against half-value layer (HVL), axial beam profile, patient skin dose (PSD) and CTDI measurements. For organ dose calculations, a male voxel phantom ("Golem") was implemented with the CBCT scanner computational model. After a successful MC model validation with measurements, a systematic comparison was performed between organ doses (and their distribution) and CTDI dosimetry concepts [CTDI and cumulative dose quantities f(150) and [Formula: see text]]. The results obtained show that CBCT organ doses vary between 1.2 ± 0.1 mGy and 3.3 ± 0.2 mGy for organs located within the primary beam. It was also verified that CTDI allows prediction of absorbed doses to tissues at distances of about 5 cm from the isocentre of the CBCT system, whereas f(150) allows prediction of organ doses at distances of about 10 cm from the isocentre, independently from its location. This study demonstrates that these dosimetric concepts are suitable methods that easily allow a good approximation of the additional CBCT imaging doses during a typical lung cancer IGRT treatment.

摘要

锥形束计算机断层扫描(CBCT)在图像引导放射治疗(IGRT)中被广泛用于治疗前验证和患者摆位。CBCT成像每天用于每位患者多次,这可能会给暴露的靶器官周围的健康组织带来较高的累积成像剂量。计算机断层扫描剂量指数(CTDI)是CBCT设备用于指示对患者辐射输出的参数。本研究旨在增加对胸部扫描方案中CBCT器官剂量与加权CTDI(CTDIw)之间关系的认识。使用蒙特卡罗(MC)辐射传输程序MCNPX2.7.0对CBCT系统进行建模。针对半值层(HVL)、轴向束轮廓、患者皮肤剂量(PSD)和CTDI测量对模拟结果进行了验证。为了进行器官剂量计算,将男性体素模型(“Golem”)与CBCT扫描仪计算模型相结合。在通过测量成功验证MC模型后,对器官剂量(及其分布)与CTDI剂量学概念[CTDI和累积剂量量f(150)以及[公式:见原文]]进行了系统比较。所得结果表明,对于位于主射束内的器官,CBCT器官剂量在1.2±0.1 mGy至3.3±0.2 mGy之间变化。还验证了CTDI能够预测距CBCT系统等中心约5 cm处组织的吸收剂量,而f(150)能够预测距等中心约10 cm处器官的剂量,且与器官位置无关。本研究表明,这些剂量学概念是合适的方法,能够轻松地对典型肺癌IGRT治疗期间额外的CBCT成像剂量进行良好近似。

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