INTEGRATION OF REAL-TIME INTERNAL ELECTROMAGNETIC POSITION MONITORING COUPLED WITH DYNAMIC MULTILEAF COLLIMATOR TRACKING: AN INTENSITY-MODULATED RADIATION THERAPY FEASIBILITY STUDY

被引:34
|
作者
Smith, Ryan L.
Sawant, Amit [2 ]
Santanam, Lakshmi
Venkat, Raghu B. [2 ]
Newell, Laurence J. [3 ]
Cho, Byung-chul [2 ]
Poulsen, Per [2 ]
Catell, Herbert [4 ]
Keall, Paul J. [2 ]
Parikh, Parag J. [1 ]
机构
[1] Washington Univ, Sch Med, Dept Radiat Oncol, St Louis, MO 63110 USA
[2] Stanford Univ, Palo Alto, CA 94304 USA
[3] Calypso Med Technol Inc, Seattle, WA USA
[4] Varian Med Syst, Palo Alto, CA USA
关键词
Radiation therapy; Intensity modulation; Lung; Cancer; DMLC; Tracking; ABDOMINAL-TUMOR MOTION; INTRA-FRACTION MOTION; BREATH-HOLD TECHNIQUE; CELL LUNG-CANCER; CLINICAL-EXPERIENCE; INTRAFRACTION MOTION; GATED RADIOTHERAPY; ORGAN MOTION; IMRT; SYSTEM;
D O I
10.1016/j.ijrobp.2009.01.031
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Continuous tumor position measurement coupled with a tumor tracking system would result in a highly accurate radiation therapy system. Previous internal position monitoring systems have been limited by fluoroscopic radiation dose and low delivery efficiency. We aimed to incorporate a continuous, electromagnetic, three-dimensional position tracking system (Calypso 4D Localization System) with a dynamic multileaf collimator (DMLC)-based dose delivery system. Methods and Materials: A research version of the Calypso System provided real-time position of three Beacon transponders. These real-time three-dimensional positions were sent to research MLC controller with a motion-tracking algorithm that changed the planned leaf sequence. Electromagnetic transponders were embedded in a solid water film phantom that moved with patient lung trajectories while being irradiated with two different plans: a step-and-shoot intensity-modulated radiation therapy (S-IMRT) field and a dynamic IMRT (D-IMRT) field. Dosimetric results were recorded under three conditions: no intervention, DMLC tracking, and a spatial gating system. Results: Dosimetric accuracy was comparable for gating and DMLC tracking. Failure rates for gating/DMLC tracking are as follows: +/-3 cGy 10.9/7.5% for S-IMRT, 3.3/7.2% for D-IMRT; gamma (3mm/3%) 0.2/1.2% for S-IMRT, 0.2/0.2% for D-IMRT. DMLC tracking proved to be as efficient as standard delivery, with a two- to five-fold efficiency increase over gating. Conclusions: Real-time target position information was successfully integrated into a DMLC effector system to modify dose delivery. Experimental results show both comparable dosimetric accuracy as well as improved efficiency compared with spatial gating. (C) 2009 Elsevier Inc.
引用
收藏
页码:868 / 875
页数:8
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