利用快速 GPU 蒙特卡罗实现 IOeRT 常规和 FLASH 治疗计划系统:乳腺癌的案例。
IOeRT conventional and FLASH treatment planning system implementation exploiting fast GPU Monte Carlo: The case of breast cancer.
机构信息
Sapienza, University of Rome, Department of Scienze di Base e Applicate all'Ingegneria, Rome, Italy; National Institute of Nuclear Physics, INFN, Section of Rome I, Rome, Italy.
Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitatio Campus-Bio Medico, Rome, Italy.
出版信息
Phys Med. 2024 May;121:103346. doi: 10.1016/j.ejmp.2024.103346. Epub 2024 Apr 11.
Partial breast irradiation for the treatment of early-stage breast cancer patients can be performed by means of Intra Operative electron Radiation Therapy (IOeRT). One of the main limitations of this technique is the absence of a treatment planning system (TPS) that could greatly help in ensuring a proper coverage of the target volume during irradiation. An IOeRT TPS has been developed using a fast Monte Carlo (MC) and an ultrasound imaging system to provide the best irradiation strategy (electron beam energy, applicator position and bevel angle) and to facilitate the optimisation of dose prescription and delivery to the target volume while maximising the organs at risk sparing. The study has been performed in silico, exploiting MC simulations of a breast cancer treatment. Ultrasound-based input has been used to compute the absorbed dose maps in different irradiation strategies and a quantitative comparison between the different options was carried out using Dose Volume Histograms. The system was capable of exploring different beam energies and applicator positions in few minutes, identifying the best strategy with an overall computation time that was found to be completely compatible with clinical implementation. The systematic uncertainty related to tissue deformation during treatment delivery with respect to imaging acquisition was taken into account. The potential and feasibility of a GPU based full MC TPS implementation of IOeRT breast cancer treatments has been demonstrated in-silico. This long awaited tool will greatly improve the treatment safety and efficacy, overcoming the limits identified within the clinical trials carried out so far.
术中电子放射治疗(IOeRT)可用于治疗早期乳腺癌患者的部分乳房照射。该技术的主要局限性之一是缺乏治疗计划系统(TPS),该系统在照射过程中有助于确保目标体积得到适当覆盖。已经开发了一种 IOeRT TPS,该系统使用快速蒙特卡罗(MC)和超声成像系统来提供最佳的照射策略(电子束能量、施源器位置和斜角),并促进目标体积的剂量规定和输送的优化,同时最大限度地减少风险器官的损伤。该研究是在计算机模拟的基础上进行的,利用 MC 模拟了乳腺癌的治疗过程。基于超声的输入被用于计算不同照射策略下的吸收剂量图,并使用剂量体积直方图对不同方案进行了定量比较。该系统能够在几分钟内探索不同的束能和施源器位置,通过整体计算时间确定最佳策略,发现其与临床实施完全兼容。还考虑了与成像采集相比,在治疗输送过程中组织变形的系统不确定性。已经在计算机模拟中证明了基于 GPU 的 IOeRT 乳腺癌治疗全 MC TPS 实现的潜力和可行性。这个期待已久的工具将极大地提高治疗的安全性和有效性,克服迄今为止进行的临床试验中确定的局限性。