Singh Teekendra, Singh Dimpi, Murphy Sinead Catherine, Bin Sumaida Abdulrahman, Shanbhag Nandan M
Oncology and Radiosurgery, Neuro Spinal Hospital, Dubai, ARE.
Health Informatics, Mahatma Gandhi Institute of Health Informatics, Jaipur, IND.
Cureus. 2024 Jan 11;16(1):e52143. doi: 10.7759/cureus.52143. eCollection 2024 Jan.
Introduction The introduction of the CyberKnife® system has marked a significant advancement in the field of radiosurgery, offering unparalleled precision in targeting and treating cranial and extracranial lesions. This paper details the first experience from the United Arab Emirates in implementing 6D skull tracking and intrafractional motion monitoring in CyberKnife® radiosurgery. The study aims to evaluate the system's efficacy in tracking and adjusting patient movement during treatment, enhancing treatment accuracy and patient safety. Methods and materials This retrospective study analyzed 732 images from six patients treated at the UAE's first CyberKnife® center. Patients were divided into two groups based on their treatment regimens: Patients 1 to 4 (P1 to P4) received multifractionated stereotactic radiotherapy, while Patients 5 and 6 (P5 and P6) underwent single-fraction stereotactic radiosurgery (SRS). The movements recorded included supero-inferior, lateral, antero-posterior, roll, pitch, and yaw. Statistical tools were employed to interpret the data, including heat maps, box-and-whisker plots, and correlation analysis. Results The study's results indicate varied patterns of intrafractional movement across the different axes and between the two treatment groups. Multifractionated therapy patients exhibited a specific range and frequency of movements compared to those undergoing single-fraction treatment. The most significant movements were observed in the supero-inferior and lateral axes. Discussion The findings suggest that the CyberKnife® system's real-time tracking and adaptive capabilities are crucial in managing patient movements, especially in prolonged treatment sessions. The differences in movement patterns between multifractionated and single-fraction treatments underscore the need for tailored approaches in intrafractional motion monitoring. Conclusion The initial experience of the UAE's first CyberKnife® center demonstrates the system's effectiveness in addressing intrafractional movements, enhancing the precision and safety of radiosurgery treatments. This study contributes valuable insights into optimizing treatment protocols and underscores the importance of continuous monitoring and adaptive strategies in advanced radiosurgery.
引言
射波刀®系统的引入标志着放射外科领域的重大进步，在颅部和颅外病变的靶向和治疗方面提供了无与伦比的精准度。本文详细介绍了阿拉伯联合酋长国在射波刀®放射外科中实施6D颅骨追踪和分次内运动监测的首次经验。该研究旨在评估该系统在治疗期间追踪和调整患者运动、提高治疗准确性和患者安全性方面的疗效。
方法和材料
这项回顾性研究分析了阿联酋首个射波刀®中心治疗的6名患者的732张图像。根据治疗方案将患者分为两组：患者1至4（P1至P4）接受多分次立体定向放射治疗，而患者5和6（P5和P6）接受单次立体定向放射外科治疗（SRS）。记录的运动包括上下、左右、前后、滚动、俯仰和偏航。采用统计工具对数据进行解读，包括热图、箱线图和相关性分析。
结果
研究结果表明，不同轴向上以及两个治疗组之间的分次内运动模式各不相同。与接受单次治疗的患者相比，多分次治疗患者表现出特定的运动范围和频率。在上下和左右轴上观察到的运动最为显著。
讨论
研究结果表明，射波刀®系统的实时追踪和自适应能力对于管理患者运动至关重要，尤其是在长时间治疗过程中。多分次和单次治疗之间运动模式的差异凸显了在分次内运动监测中采用定制方法的必要性。
结论
阿联酋首个射波刀®中心的初步经验证明了该系统在解决分次内运动方面的有效性，提高了放射外科治疗的精准度和安全性。这项研究为优化治疗方案提供了宝贵的见解，并强调了在先进放射外科中持续监测和自适应策略的重要性。
