一种新型热塑膜定位器在放疗体位固定中的摆位精度和剂量精度  

Positioning accuracy and dose accuracy in radiotherapy using a novel positioner for thermoplastic immobilization

作　　者：朱远湖 佘广南 王学涛 谭翔 朱琳 何强 简婉薇 张白霖 孟皓宇 甄鑫[1] ZHU Yuanhu;SHE Guangnan;WANG Xuetao;TAN Xiang;ZHU Lin;HE Qiang;JIAN Wanwei;ZHANG Bailin;MENG Haoyu;ZHEN Xin(School of Biomedical Engineering,Southern Medical University,Guangzhou 510515,China;Department of Radiation Therapy,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Department of Digital Hospital Construction,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]南方医科大学生物医学工程学院,广东广州510515 [2]广州中医药大学第二附属医院放射治疗区,广东广州510006 [3]中山大学附属第六医院数字医院建设处,广东广州510655

出　　处：《中国医学物理学杂志》2023年第7期801-807,共7页Chinese Journal of Medical Physics

基　　金：国家自然科学基金(81874216);广东省基础与应用基础研究基金(2022A1515011410);广州市基础研究计划基础与应用基础研究项目(81874216);广州市科技计划项目(202102010264)。

摘　　要：目的:研究放疗热塑膜固定中有无热塑膜定位器的摆位时间差异、体位精度差异和剂量精度差异。方法:随机选取需应用热塑膜固定的放疗患者3例,每个病人有一半的治疗次数不使用定位器,有一半的治疗次数使用定位器。记录摆位时间、MVCT扫描匹配后的三维方向摆位误差、三维空间矢量位移误差和剂量精度误差,应用2.5∑+0.7σ来计算计划靶区(PTV)外扩边界。结果:无热塑膜定位器组和有热塑膜定位器组的误差在X轴方向分别为6.90(2.85,12.10)mm和2.60(1.45,8.10)mm(P=0.007),Y轴方向分别为9.30(4.05,16.15)mm和5.00(2.60,9.50)mm(P=0.002),Z轴方向分别为3.40(2.05,4.10)mm和1.90(1.30,3.65)mm(P=0.017)。无热塑膜定位器组和有热塑膜定位器组在X、Y、Z轴的PTV外扩边界分别为9.15、14.62、2.15 mm和6.50、7.04、2.97 mm。结论:热塑膜定位器在热塑膜固定中的应用能够减少放疗患者三维空间摆位误差,并且减少PTV外扩边界。Objective To investigate the differences in positioning time,positional accuracy,and dose accuracy between the use and non-use of thermoplastic film positioners in radiotherapy immobilization.Methods Three patients requiring thermoplastic immobilization for radiotherapy were enrolled,with half of the treatments using a thermoplastic film positioner and the other half without.The positioning time,three-dimensional directional positioning errors after MVCT scanning matching,three-dimensional spatial vector displacement errors,and dose accuracy errors were recorded.The PTV margin was calculated using 2.5Σ+0.7σ.Results The errors of no-positioner group and positioner group were 6.90(2.85,12.10)mm versus 2.60(1.45,8.10)mm in the X-axis direction(P=0.007),9.30(4.05,16.15)mm versus 5.00(2.60,9.50)mm in the Yaxis direction(P=0.002),3.40(2.05,4.10)mm versus 1.90(1.30,3.65)mm in the Z-axis direction(P=0.017),respectively.The PTV margins in the X,Y and Z axes were 9.15,14.62,2.15 mm in no-positioner group,and 6.50,7.04,2.97 mm in positioner group,respectively.Conclusion The application of positioners in thermoplastic immobilization can reduce the three-dimensional spatial positioning errors and minimize PTV margin.

关 键 词：放射治疗 体位固定 热塑膜 定位器 

分 类 号：R318[医药卫生—生物医学工程] R811.1[医药卫生—基础医学]