Descovich Martina, Lau Evan, Hasse Katelyn, Gottschalk Alexander
Department of Radiation Oncology, University of California San Francisco, San Francisco, USA.
Cureus. 2025 May 11;17(5):e83935. doi: 10.7759/cureus.83935. eCollection 2025 May.
Real-time adaptive motion management enables the synchronization of radiation delivery with the patient's breathing motion, thus reducing target margins and normal tissue exposure. The respiratory model is created by correlating the position of external markers placed on the patient's chest with the internal target position extracted from planar X-ray images. While a fiducial-less tracking algorithm is available for lung lesions with high radiographic contrast, many patients require the implantation of radio-opaque markers for localization. To limit the incidence of complications from the implantation procedure, a single fiducial marker may be implanted. As fiducials can migrate following implantation, it is important to verify the relationship between the tumor and the fiducial prior to treatment. The goal of this technical report is to provide a quality control (QC) procedure to assess the possibility of fiducial migration in lung patients treated on the robotic radiosurgery platform.
实时自适应运动管理能够使放射治疗与患者的呼吸运动同步，从而减少靶区边界并降低正常组织受照剂量。通过将放置在患者胸部的外部标记物的位置与从平面X射线图像中提取的内部靶区位置相关联来创建呼吸模型。虽然对于具有高放射对比度的肺部病变可采用无标记跟踪算法，但许多患者仍需要植入不透射线的标记物进行定位。为了限制植入过程并发症的发生率，可植入单个基准标记物。由于标记物在植入后可能会移位，因此在治疗前验证肿瘤与标记物之间的关系很重要。本技术报告的目的是提供一种质量控制（QC）程序，以评估在机器人放射外科平台上接受治疗的肺部患者中标记物移位可能性。
