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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Intra-fractional uncertainties in cone-beam CT based image-guided radiotherapy (IGRT) of pulmonary tumors.
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Intra-fractional uncertainties in cone-beam CT based image-guided radiotherapy (IGRT) of pulmonary tumors.

机译：基于锥形束CT的肺肿瘤影像引导放疗（IGRT）的分数内不确定性。

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PURPOSE: Intra-fractional variability of tumor position and breathing motion was evaluated in cone-beam CT (CB-CT) based image-guided radiotherapy (IGRT) of pulmonary tumors. MATERIALS AND METHODS: Twenty-four patients (27 lesions: prim. NSCLC n=6; metastases n=21) were treated with stereotactic body radiotherapy (SBRT) (one to eight fractions). Prior to every treatment fraction (n=66) and immediately after treatment a CB-CT was acquired. Patient motion, absolute drift and drift of the tumor relative to the bony anatomy were measured. Tumor motion was investigated based on the density distribution in the CB-CT. RESULTS: Absolute intra-fractional drift (3D vector) of the tumor position was 2.8 mm+/-1.6 mm (mean +/- SD), maximum 7.2 mm. Poor correlation between patient motion and absolute tumor drift was observed. Changes of the tumor position due to patient motion and due to drifts independently from the bony anatomy were of similar magnitude with 2.1 mm +/- 1.4 mm and 2.3 mm +/- 1.6 mm, respectively. No systematic increase or decrease of breathing motion was seen. The intra-fractional change of breathing motion was more than 2 mm and 3 mm in 39% and 16%, respectively. CONCLUSION: Intra-fractional tumor position and breathing motion were stable. In IGRT of pulmonary tumors we suggest an ITV-to-PTV margin of 5 mm to compensate intra-fractional changes.
机译：目的：在基于锥形束CT（CB-CT）的肺肿瘤影像引导放疗（IGRT）中评估肿瘤位置和呼吸运动的分数内变异性。材料与方法：24例患者（27处病变：原发性非小细胞肺癌，n = 6;转移物n = 21）接受了立体定向放射疗法（SBRT）治疗（1至8级）。在每次治疗前（n = 66）和治疗后立即获得CB-CT。测量患者的运动，绝对漂移和相对于骨解剖结构的肿瘤漂移。基于CB-CT中的密度分布研究了肿瘤运动。结果：肿瘤位置的绝对分数内漂移（3D向量）为2.8 mm +/- 1.6 mm（平均+/- SD），最大7.2 mm。观察到患者运动与绝对肿瘤漂移之间的相关性较差。由于患者运动和与骨骼解剖结构无关的漂移而导致的肿瘤位置变化的幅度相似，分别为2.1 mm +/- 1.4 mm和2.3 mm +/- 1.6 mm。没有观察到呼吸运动的系统性增加或减少。呼吸运动的分数内变化分别大于2 mm和3 mm，分别为39％和16％。结论：小规模肿瘤位置和呼吸运动稳定。在肺部肿瘤的IGRT中，我们建议ITV到PTV的边距为5 mm，以补偿部分内变化。

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