Ferris William S, George Benjamin, Plichta Kristin A, Caster Joseph M, Hyer Daniel E, Smith Blake R, St-Aubin Joel J
Department of Radiation Oncology, University of Iowa, Iowa, IA, United States.
Front Oncol. 2024 Aug 9;14:1441227. doi: 10.3389/fonc.2024.1441227. eCollection 2024.
This work presents a method to treat stereotactic body radiation therapy (SBRT) for pancreatic cancer on a magnetic resonance-guided linear accelerator (MR-linac) using daily adaptation, real-time motion monitoring, and abdominal compression.
The motion management and treatment planning process involves a magnetic resonance imaging (MRI) simulation with cine and 3D images, a computed tomography (CT) simulation with a breath-hold CT and a 4DCT, pre-treatment verification and planning MRI, and intrafraction MRI cine images.
The results from 26 patients were included in this work. Our motion management process results in consistent motion analysis on the CT simulation, MRI simulation, and each treatment fraction. The liver dome was found to be an overestimate of tumor superior/inferior (SI) motion for most patients. Adding compression reduced SI liver dome motion by 6.2 mm on average. Clinical outcomes are similar to those observed in the literature.
In this work, we demonstrate how pancreatic SBRT can be successfully treated on an MR-linac using abdominal compression. This allows for an increased duty cycle compared to gating and/or breath-hold techniques.
本研究介绍了一种在磁共振引导直线加速器（MR直线加速器）上使用每日适应性调整、实时运动监测和腹部压迫来治疗胰腺癌立体定向体部放射治疗（SBRT）的方法。
运动管理和治疗计划过程包括使用电影成像和三维图像的磁共振成像（MRI）模拟、屏气CT和四维CT的计算机断层扫描（CT）模拟、治疗前验证和计划MRI以及分次治疗期间的MRI电影图像。
本研究纳入了26例患者的结果。我们的运动管理过程在CT模拟、MRI模拟和每次治疗分次中都能实现一致的运动分析。对于大多数患者，发现肝顶对肿瘤上下（SI）运动的估计过高。增加压迫后，肝顶SI运动平均减少6.2毫米。临床结果与文献中观察到的结果相似。
在本研究中，我们展示了如何在MR直线加速器上使用腹部压迫成功治疗胰腺癌SBRT。与门控和/或屏气技术相比，这使得治疗工作周期得以增加。
