本文選題：呼吸運(yùn)動(dòng)幅度 + Smartsequence��； 參考：《中華腫瘤防治雜志》2017年09期

【摘要】：目的呼吸運(yùn)動(dòng)影響患者實(shí)際照射劑量,不同多頁(yè)光柵(multi-leaf collimator,MLC)的運(yùn)動(dòng)方式對(duì)呼吸運(yùn)動(dòng)造成劑量偏差的敏感性不同。本研究旨在定量分析兩種子野分割算法受呼吸幅度影響的劑量偏差大小。方法收集2013-06-10-2015-04-15中國(guó)科學(xué)院合肥腫瘤醫(yī)院收治的肺癌患者10例,兩種類型放療計(jì)劃各制定10例。呼吸運(yùn)動(dòng)儀帶動(dòng)QA模體正弦運(yùn)動(dòng)模擬患者頭腳方向不同呼吸幅度的呼吸運(yùn)動(dòng),分別采集等中心層面劑量。通過(guò)Verisoft分析采集數(shù)據(jù)的射野通過(guò)率和劑量分布。結(jié)果 10例肺癌患者Slidingwnd和Smartsequence子野分割方式產(chǎn)生的子野數(shù)分別為40±5.2和20±7.7,P=0.007;機(jī)器跳數(shù)分別為(388±56.6)和(346±60.4)MU,P=0.007。隨著呼吸幅度的增加,射野通過(guò)率變小。Smartsequence和Slidingwnd在8 mm幅度時(shí)射野通過(guò)率分別為(85.27±4.57)%和(87.26±5.25)%,t=3.435,P=0.007;在10mm幅度時(shí)射野通過(guò)率分別為(74.95±5.98)%和(79.13±5.11)%,t=6.05,P0.001。Smartsequence比Slidingwnd射野通過(guò)率低,且通過(guò)率90%;呼吸幅度=6mm時(shí),兩種計(jì)劃通過(guò)率為(91.81±3.65)%和(92.67±4.55)%,差異無(wú)統(tǒng)計(jì)學(xué)意義,P0.05。呼吸幅度6mm時(shí),兩種計(jì)劃通過(guò)率差異無(wú)統(tǒng)計(jì)學(xué)意義,P0.05;通過(guò)率90%,滿足臨床劑量驗(yàn)證要求。結(jié)論 Smartsequence子野分割算法對(duì)呼吸運(yùn)動(dòng)造成的劑量偏差敏感性大,建議選擇Slidingwnd子野分割方式。
[Abstract]:Objective Respiratory motion affects the actual dose of irradiation in patients. The sensitivity of different multi-leaf collimator (MLCC) motion patterns to dose deviation caused by respiratory movement is different. The purpose of this study was to quantitatively analyze the dose deviation of the two-seed field segmentation algorithm affected by respiratory amplitude. Methods Ten patients with lung cancer admitted to Hefei Oncology Hospital, Chinese Academy of Sciences, 2013-06-10-2015-04-15, 10 patients with two types of radiotherapy were selected. The respiratory motif drives the QA motif sinusoidal motion to simulate the respiratory movement of the patient with different respiration amplitude in the head and foot direction and collects the dose of isocentric level respectively. The radiation pass rate and dose distribution of the collected data were analyzed by Verisoft. Results the number of subfields produced by Slidingwnd and Smart sequence subfields in 10 patients with lung cancer were 40 鹵5.2 and 20 鹵7.7, respectively, and the number of machine hops were 388 鹵56.6) and 346 鹵60.4 respectively. With the increase of respiratory amplitude, the passing rates of Smartsequence and Slidingwnd were 85.27 鹵4.57% and 87.26 鹵5.25 5% respectively at the amplitude of 8 mm, and the passing rates of passing through the field were 74.95 鹵5.98% and 79.13 鹵5.11% at the amplitude of 10mm, respectively, and the passing rate was 90000 when the respiratory amplitude was 6mm, respectively, and the passage rate of Sliwnd was lower than that of Sliwnd at the amplitude of 8 mm, and the rate of passing through the field was lower than that of Sliwnd when the amplitude of respiration was 6mm, the rate of passing through was 74.95 鹵5.98% and 79.13 鹵5.11% respectively, and the passing rate of Sliwnd was lower than that of Sliwnd at the amplitude of 8mm. The pass rates of the two plans were 91.81 鹵3.65% and 92.67 鹵4.55%, respectively. The difference was not statistically significant (P 0.05). There was no significant difference in the pass rate between the two plans when the respiratory amplitude was 6mm (P 0.05), and the pass rate was 90%, which met the requirement of clinical dose verification. Conclusion Smartsequence field segmentation algorithm is sensitive to dose deviation caused by respiratory movement, so Slidingwnd subfield segmentation method is recommended.
【作者單位】： 中國(guó)科學(xué)院合肥物質(zhì)科學(xué)研究院醫(yī)學(xué)物理與技術(shù)中心·中國(guó)科學(xué)院合肥腫瘤醫(yī)院放療中心;中國(guó)解放軍第一零五醫(yī)院腫瘤診療中心;
【基金】：中國(guó)科學(xué)院合肥物質(zhì)科學(xué)研究院院長(zhǎng)基金(YZJJ201325)
【分類號(hào)】：R730.55;R734.2

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