Du M N, Yu C X, Symons M, Yan D, Taylor R, Matter R C, Gustafson G, Martinez A, Wong J W
William Beaumont Hospital, Royal Oak, MI 48073, USA.
Int J Radiat Oncol Biol Phys. 1995 May 15;32(2):513-20. doi: 10.1016/0360-3016(95)00153-p.
The purpose of this work is to develop a prescription preparation system for efficient field shaping using a multileaf collimator that can be used in community settings as well as research institutions. The efficiency advantage of the computer-controlled multileaf collimator, over cerrobend blocks, to shape radiation fields has been shown in conformal treatments, which typically require complete volumetric computerized tomographic data for three-dimensional radiation treatment planning--a utility not readily available to the general community. As a result, most patients today are treated with conventional radiation therapy. Therefore, we believe that it is very important to fully use the same efficiency advantage of multileaf collimator as a block replacement in conventional practice.
The multileaf collimator prescription preparation system developed by us acquires prescription images from different sources, including film scanner and radiation treatment planning systems. The multileaf collimator angle and leaf positions are set from the desired field contour defined on the prescription image, by minimizing the area discrepancies. Interactive graphical tools include manual adjustment of collimator angle and leaf positions, and definition of portions of the field edges that require maximal conformation. Data files of the final leaf positions are transferred to the multileaf collimator controller via a dedicated communication link.
We have implemented the field prescription preparation system and a network model for integrating the multileaf collimator and other radiotherapy modalities for routine treatments. For routine plan evaluation, isodose contours measured with film in solid water phantom at prescription depth are overlaid on the prescription image. Preliminary study indicates that the efficiency advantage of the MLC over cerrobend blocks in conformal therapy also holds true for conventional treatments.
Our model of computer-controlled prescription, evaluation, and treatment using multileaf collimators can be effectively implemented in both community settings and research institutions. The resultant increase in treatment efficiency and accuracy is now available for conventional radiotherapy.
本研究旨在开发一种处方制备系统,该系统利用多叶准直器实现高效的射野塑形,可应用于社区医疗机构以及研究机构。计算机控制的多叶准直器在射野塑形方面相较于铅挡块具有效率优势,这一点已在适形治疗中得到体现,适形治疗通常需要完整的容积计算机断层扫描数据用于三维放射治疗计划——而这一资源普通社区难以获取。因此,目前大多数患者接受的是传统放射治疗。所以,我们认为在传统治疗实践中充分利用多叶准直器作为挡块替代物的相同效率优势非常重要。
我们研发的多叶准直器处方制备系统可从不同来源获取处方图像,包括胶片扫描仪和放射治疗计划系统。通过最小化面积差异,根据处方图像上定义的所需射野轮廓设置多叶准直器角度和叶片位置。交互式图形工具包括手动调整准直器角度和叶片位置,以及定义需要最大适形度的射野边缘部分。最终叶片位置的数据文件通过专用通信链路传输到多叶准直器控制器。
我们已实施射野处方制备系统以及用于将多叶准直器与其他放射治疗方式整合用于常规治疗的网络模型。对于常规计划评估,在固体水模体中处方深度处用胶片测量的等剂量线轮廓叠加在处方图像上。初步研究表明,多叶准直器在适形治疗中相对于铅挡块的效率优势在传统治疗中同样成立。
我们使用多叶准直器进行计算机控制的处方、评估和治疗的模型可在社区医疗机构和研究机构中有效实施。由此带来的治疗效率和准确性的提高现在也可应用于传统放射治疗。