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首页> 外文期刊>Medical Physics >Image-guided method for TLD-based in vivo rectal dose verification with endorectal balloon in proton therapy for prostate cancer.
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Image-guided method for TLD-based in vivo rectal dose verification with endorectal balloon in proton therapy for prostate cancer.

机译：基于TLD的TLD的图像引导方法，具有前列腺癌的质子疗法中胸腔的体内直肠剂量验证。

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摘要

To present a practical image-guided method to position an endorectal balloon that improves in vivo thermoluminiscent dosimeter (TLD) measurements of rectal doses in proton therapy for prostate cancer.TLDs were combined with endorectal balloons to measure dose at the anterior rectal wall during daily proton treatment delivery. Radiopaque metallic markers were employed as surrogates for balloon position reproducibility in rotation and translation. The markers were utilized to guide the balloon orientation during daily treatment employing orthogonal x-ray image-guided patient positioning. TLDs were placed at the 12 o'clock position on the anterior balloon surface at the midprostatic plane. Markers were placed at the 3 and 9 o'clock positions on the balloon to align it with respect to the planned orientation. The balloon rotation along its stem axis, referred to as roll, causes TLD displacement along the anterior-posterior direction. The magnitude of TLD displacement is revealed by the separation distance between markers at opposite sides of the balloon on sagittal x-ray images.A total of 81 in vivo TLD measurements were performed on six patients. Eighty-three percent of all measurements (65 TLD readings) were within +5% and -10% of the planning dose with a mean of -2.1% and a standard deviation of 3.5%. Examination of marker positions with in-room x-ray images of measured doses between -10% and -20% of the planned dose revealed a strong correlation between balloon roll and TLD displacement posteriorly from the planned position. The magnitude of the roll was confirmed by separations of 10-20 mm between the markers which could be corrected by manually adjusting the balloon position and verified by a repeat x-ray image prior to proton delivery. This approach could properly correct the balloon roll, resulting in TLD positioning within 2 mm along the anterior-posterior direction.Our results show that image-guided TLD-based in vivo dosimetry for rectal dose verification can be perfomed reliably and reproducibly for proton therapy in prostate cancer.
机译：为了提出一种正确的图像引导方法来定位一种胸腔的胸腔球囊，其在前列腺癌的质子疗法中提高了体内热敏激活剂量（TLD）测量直肠剂量的测量.TLD与胸腔气球结合在每日质子期间在前直肠壁上测量剂量治疗递送。在旋转和翻译中，radiopaque金属标记用作球囊位置再现性的替代品。使用标记物用于引导在使用正交X射线图像引导患者定位的日常处理期间的球囊取向。将TLD放置在中间促平面上的前气球表面上的12点钟位置。将标记放置在球囊上的3和9点位置，以将其与计划取向对齐。沿其杆轴的球囊旋转称为辊，导致沿前后方向的TLD位移。在矢状X射线图像上的球囊相对侧的标记之间的分离距离揭示了TLD位移的幅度。在六名患者中进行总共81例中的81例。所有测量的百分之八十三个（65个TLD读数）在+ 5％和-10％的计划剂量内，平均值为-2.1％，标准差为3.5％。在预计的测量剂量的测量剂量的标记位置检查--10％和-20％的计划剂量揭示了从计划位置后面的球囊辊和TLD位移之间的强烈相关性。通过在标记之间的分离通过10-20mm的分离来确认辊的大小，这可以通过在质子递送之前通过手动调节球囊位置并通过重复X射线图像验证来校正。这种方法可以正确校正球囊辊，导致沿前后方向的2毫米内的TLD定位。结果表明，用于直肠剂量验证的基于体内Dosimetry的图像引导的TLD可用于质子疗法可靠和可重复的前列腺癌。

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