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使用每日锥形束CT评估质子剂量及相关射程不确定性

Evaluating Proton Dose and Associated Range Uncertainty Using Daily Cone-Beam CT.

作者信息

Li Heng, Hrinivich William T, Chen Hao, Sheikh Khadija, Ho Meng Wei, Ger Rachel, Liu Dezhi, Hales Russell Kenneth, Voong Khinh Ranh, Halthore Aditya, Deville Curtiland

机构信息

Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

出版信息

Front Oncol. 2022 Apr 5;12:830981. doi: 10.3389/fonc.2022.830981. eCollection 2022.

DOI:10.3389/fonc.2022.830981
PMID:35449577
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9016186/
Abstract

PURPOSE

This study aimed to quantitatively evaluate the range uncertainties that arise from daily cone-beam CT (CBCT) images for proton dose calculation compared to CT using a measurement-based technique.

METHODS

For head and thorax phantoms, wedge-shaped intensity-modulated proton therapy (IMPT) treatment plans were created such that the gradient of the wedge intersected and was measured with a 2D ion chamber array. The measured 2D dose distributions were compared with 2D dose planes extracted from the dose distributions using the IMPT plan calculated on CT and CBCT. Treatment plans of a thymoma cancer patient treated with breath-hold (BH) IMPT were recalculated on 28 CBCTs and 9 CTs, and the resulting dose distributions were compared.

RESULTS

The range uncertainties for the head phantom were determined to be 1.2% with CBCT, compared to 0.5% for CT, whereas the range uncertainties for the thorax phantom were 2.1% with CBCT, compared to 0.8% for CT. The doses calculated on CBCT and CT were similar with similar anatomy changes. For the thymoma patient, the primary source of anatomy change was the BH uncertainty, which could be up to 8 mm in the superior-inferior (SI) direction.

CONCLUSION

We developed a measurement-based range uncertainty evaluation method with high sensitivity and used it to validate the accuracy of CBCT-based range and dose calculation. Our study demonstrated that the CBCT-based dose calculation could be used for daily dose validation in selected proton patients.

摘要

目的

本研究旨在使用基于测量的技术，定量评估与CT相比，每日锥形束CT（CBCT）图像用于质子剂量计算时产生的射程不确定性。

方法

对于头部和胸部体模，创建楔形强度调制质子治疗（IMPT）治疗计划，使楔形的梯度相交并用二维电离室阵列进行测量。将测量的二维剂量分布与使用在CT和CBCT上计算的IMPT计划从剂量分布中提取的二维剂量平面进行比较。对一名接受屏气（BH）IMPT治疗的胸腺瘤患者的治疗计划在28幅CBCT图像和9幅CT图像上重新计算，并比较所得的剂量分布。

结果

头部体模的CBCT射程不确定性确定为1.2%，而CT为0.5%；胸部体模的CBCT射程不确定性为2.1%，而CT为0.8%。在解剖结构变化相似的情况下，CBCT和CT上计算的剂量相似。对于胸腺瘤患者，解剖结构变化的主要来源是屏气不确定性，在上下（SI）方向上可达8mm。

结论

我们开发了一种高灵敏度的基于测量的射程不确定性评估方法，并用于验证基于CBCT的射程和剂量计算的准确性。我们的研究表明，基于CBCT的剂量计算可用于选定质子治疗患者的每日剂量验证。

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