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3D凝胶剂量测定法在功能性Leksell伽玛刀放射外科手术中作为质量保证工具的应用。

Application of 3D Gel Dosimetry as a Quality Assurance Tool in Functional Leksell Gamma Knife Radiosurgery.

作者信息

Kudrevicius Linas, Jaselske Evelina, Adliene Diana, Rudzianskas Viktoras, Radziunas Andrius, Tamasauskas Arimantas

机构信息

Physics Department, Kaunas University of Technology, 44249 Kaunas, Lithuania.

Neurosurgery Department, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania.

出版信息

Gels. 2022 Jan 20;8(2):69. doi: 10.3390/gels8020069.

DOI:10.3390/gels8020069
PMID:35200451
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8871505/
Abstract

Highly precise dose delivery to the target (tumor or cancerous tissue) is a key point when brain diseases are treated applying recent stereotactic techniques: intensity-modulated, image-guided radiotherapy, volumetric modulated arc therapy, Gamma knife radiosurgery. The doses in one single shot may vary between tens and hundreds of Gy and cause significant cell/tissue/organ damages. This indicates the need for implementation of quality assurance (QA) measures which are realized performing treatment dose verification with more than one calibrated quality assurance method or tool, especially when functional radiosurgery with a high dose (up to 40 Gy in our case) shall be delivered to the target using small 4 mm collimator. Application of two dosimetry methods: radiochromic film dosimetry using RTQA2 and EBT3 films and dose gel dosimetry using modified nPAG polymer gels for quality assurance purposes in stereotactic radiosurgery treatments using Leksell Gamma Knife© Icon™ facility is discussed in this paper. It is shown that due to their polymerization ability upon irradiation nPAG gels might be potentially used as a quality assurance tool in Gamma knife radiosurgery: they indicate well pronounced linear dose response in hypo-fractionated (up to 10 Gy) dose range and are sensitive enough to irradiation dose changes with a high (at least 0.2 mm) spatial resolution. Dose assessment sensitivity of gels depends on parameters of a dose evaluation method (optical or magnetic resonance imaging), however, is similar to this estimated using film dosimetry, which is set as a standard dosimetry method for dose verification in radiotherapy.

摘要

当应用最新的立体定向技术治疗脑部疾病时,向靶区(肿瘤或癌组织)进行高度精确的剂量输送是一个关键要点,这些技术包括调强放疗、图像引导放疗、容积调强弧形放疗、伽玛刀放射外科手术。单次剂量可能在几十到几百戈瑞之间变化,并会导致显著的细胞/组织/器官损伤。这表明需要实施质量保证(QA)措施,通过不止一种校准的质量保证方法或工具来进行治疗剂量验证,特别是当使用4毫米小准直器向靶区输送高剂量(在我们的案例中高达40戈瑞)的功能放射外科手术时。本文讨论了两种剂量测定方法在使用Leksell Gamma Knife© Icon™设备的立体定向放射外科治疗中的质量保证应用:使用RTQA2和EBT3薄膜的放射变色薄膜剂量测定法以及使用改良的nPAG聚合物凝胶的剂量凝胶剂量测定法。结果表明,由于nPAG凝胶在辐照时具有聚合能力,它们有可能用作伽玛刀放射外科的质量保证工具:在低分割(高达10戈瑞)剂量范围内,它们显示出明显的线性剂量响应,并且对辐照剂量变化足够敏感,具有高(至少0.2毫米)空间分辨率。凝胶的剂量评估灵敏度取决于剂量评估方法(光学或磁共振成像)的参数,然而,与使用薄膜剂量测定法估计的灵敏度相似,薄膜剂量测定法被设定为放射治疗中剂量验证的标准剂量测定方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d1/8871505/9e26b1aca52a/gels-08-00069-g013.jpg
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