基于不同剂量工具实施患者个体化调强验证的评价研究  

Evaluation research of implementing intensity-modulated verification of individualization for patient based on various dosimetric tools

作　　者：杨涛[1] 曲宝林[1] 徐寿平[1] 戴相昆[1] 解传滨[1] 丛小虎[1] 王小深[1] 王金媛[1] 龚璇[1] YANG Tao;QU Bao-lin;XU Shou-ping(（Department of Radiotherapy,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院放射治疗科,北京100853

出　　处：《中国医学装备》2018年第7期1-7,共7页China Medical Equipment

基　　金：国家自然科学基金(61601012)"基于摆位CBCT透视图像的呼吸运动模型构建方法研究及其在肿瘤定位中的应用";国家重点研发计划(2017YFC0112100)"原发性肝癌与胰腺癌精确放疗解决方案的研究"

摘　　要：目的:评价不同剂量工具实施患者个体化放射治疗调强验证的方法,为临床工作提供依据和选择。方法:随机选取12例待验证的患者容积旋转调强放射治疗(VMAT)计划,均采用配有电子射野影像装置(EPID)的Varian Clinac i X加速器实施照射。通过绝对剂量验证、治疗前计划验证以及治疗中在体剂量验证,分别用不同剂量工具进行定量评价分析。采用Mobius FX、EPIgray/EPIbeam、SNCPatient/3DVH和Eclipse计划系统软件用于剂量重建;剂量测量硬件包括A1SL型电离室、Cheese模体、Arc Check探测器和EPID。采集计划执行的日志文件(logfiles)用于剂量验证。结果:EPIgray、Mobius FX和电离室测得的射野中心点剂量与治疗计划系统(TPS)理论值的平均相对偏差分别为(1.78±1.22)%、(2.38±0.88)%和(2.96±0.86)%,均在5%的标准范围内。治疗前12例患者计划验证的2D Gamma通过率分别为(98.20±2.16)%和(98.15±1.73)%,EPIbeam略优于SNCPatient,但差异无统计学意义(t=-0.078,P>0.05);3D Gamma通过率分别为(99.16±1.81)%和(98.12±1.36)%,3D VH略优于Mobuis FX,均体现了很好的一致性;在体剂量验证中EPIgray所测的平均剂量偏差为(-2.47±1.48)%,Mobius FX平均3D Gamma通过率为(97.73±1.95)%。结论:3种不同的剂量验证工具均能切实有效地实施患者个体化质量控制,提高了患者治疗的安全性。Objective： To evaluate the method that implemented intensity-modulated verification of individualization for patient based on various dosimetric tool so as to provide some bases and choices for clinical work. Methods： The volumetric modulated arc therapy（VMAT） plans of 12 patients who were waiting verification were randomly selected, and all of them were radiated by using Varian Clinac iX accelerator with electronic portal imaging device（EPID）. Through the verification of absolute dosage, the verification pre-treatment plan and the in-vivo verification of dosage in treatment, the different dosage tools were applied to carry out quantitative evaluation analysis. And series of treatment planning system software included the MobiusFX, EPIgray/EPIbeam, SNCPatient/3DVH and Eclipse were used to reconstruct dosage, and the hardware of dosage measure included A1SL ionization chamber, Cheese phantom, ArcCheck and EPID. Besides, the logfiles of implemented plan were adopted to carry out dosage verification. Results： The mean relative deviations between the central point of field, that measured by using EPIgray, MobiusFX and ionization chamber, and the theoretical value of treatment plan system（TPS） were（1.78±1.22）%, （2.38±0.88）% and（2.96±0.86）%, respectively, which were within the standard range of 5%. Before treatment, the passing rates of 2D Gamma of planning verification （EPIbeam and SNCPatient） of 12 patients were （98.20±2.16%） and （98.15±1.73%）, respectively, and the difference of passing rate between them was no significant（t=-0.078, P〉0.05）. And the passing rates of 3D Gamma of 3D VH（99.16±1.81%） was slightly better than that of MobiusFX（98.12±1.36%）, and all of them appeared better consistency. In dosage verification of in-vivo, the mean dosage deviation of EPIgray was（-2.47±1.48）%, and average passing rate of 3D Gamma of MobiusFX was（97.73±1.95）%. Conclusion： All of three different dosage verification tools can effectively implement patient

关 键 词：患者个体化质量控制 调强验证 患者计划验证 在体剂量验证 

分 类 号：R814.2[医药卫生—影像医学与核医学]