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首页> 美国卫生研究院文献>Medical Physics >The impact of leaf width and plan complexity on DMLC tracking of prostate intensity modulated arc therapy
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The impact of leaf width and plan complexity on DMLC tracking of prostate intensity modulated arc therapy

机译：叶宽和计划复杂度对前列腺强度调制弧光治疗的DMLC跟踪的影响

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>Purpose: Intensity modulated arc therapy (IMAT) is commonly used to treat prostate cancer. The purpose of this study was to evaluate the impact of leaf width and plan complexity on dynamic multileaf collimator (DMLC) tracking for prostate motion management during IMAT treatments.>Methods: Prostate IMAT plans were delivered with either a high-definition MLC (HDMLC) or a Millennium MLC (M-MLC) (0.25 and 0.50 cm central leaf width, respectively), with and without DMLC tracking, to a dosimetric phantom that reproduced four prostate motion traces. The plan complexity was varied by applying leaf position constraints during plan optimization. A subset of the M-MLC plans was converted for delivery with the HDMLC, isolating the effect of the different leaf widths. The gamma index was used for evaluation. Tracking errors caused by target localization, leaf fitting, and leaf adjustment were analyzed.>Results: The gamma pass rate was significantly improved with DMLC tracking compared to no tracking (p < 0.001). With DMLC tracking, the average gamma index pass rate was 98.6% (range 94.8%–100%) with the HDMLC and 98.1% (range 95.4%–99.7%) with the M-MLC, using 3%, 3 mm criteria and the planned dose as reference. The corresponding pass rates without tracking were 87.6% (range 76.2%–94.7%) and 91.1% (range 81.4%–97.6%), respectively. Decreased plan complexity improved the pass rate when static target measurements were used as reference, but not with the planned dose as reference. The main cause of tracking errors was leaf fitting errors, which were decreased by 42% by halving the leaf width.>Conclusions: DMLC tracking successfully compensated for the prostate motion. The finer leaf width of the HDMLC improved the tracking accuracy compared to the M-MLC. The tracking improvement with limited plan complexity was small and not discernible when using the planned dose as reference.
机译：>目的：调强弧光疗法（IMAT）通常用于治疗前列腺癌。这项研究的目的是评估IMAT治疗期间叶片宽度和计划复杂度对动态多叶准直器（DMLC）跟踪以进行前列腺运动管理的影响。>方法： -定义MLC（HDMLC）或Millennium MLC（M-MLC）（分别具有0.25和0.50 cm的中央叶宽），带有和不带有DMLC跟踪，复制到剂量幻影，该幻影复制了四个前列腺运动轨迹。通过在计划优化期间应用叶子位置约束，可以改变计划的复杂性。 M-MLC计划的子集已转换为与HDMLC一起交付，从而隔离了不同叶宽的影响。伽玛指数用于评估。分析了由目标定位，叶片拟合和叶片调整引起的跟踪误差。>结果：与无跟踪相比，DMLC跟踪显着提高了伽玛通过率（p <0.001）。使用DMLC跟踪时，使用3％，3 mm的标准，使用HDMLC时，平均伽玛指数通过率为98.6％（范围为94.8％–100％），而使用M-MLC时为98.1％（范围为95.4％–99.7％）。计划剂量作为参考。没有跟踪的相应通过率分别为87.6％（范围76.2％–94.7％）和91.1％（范围81.4％–97.6％）。当使用静态目标测量值作为参考，但未使用计划剂量作为参考时，降低计划复杂性可提高通过率。跟踪误差的主要原因是叶片拟合误差，该误差通过将叶片宽度减半而减少了42％。>结论： DMLC跟踪成功地补偿了前列腺运动。与M-MLC相比，HDMLC的细叶宽度提高了跟踪精度。使用计划的剂量作为参考时，计划复杂度受到限制的跟踪改进很小且无法辨别。

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