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首页> 外文期刊>Physics in medicine and biology. >Tissue modeling schemes in low energy breast brachytherapy.
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Tissue modeling schemes in low energy breast brachytherapy.

机译：低能量乳房近距离放射治疗中的组织建模方案。

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Breast tissue is heterogeneous and is mainly composed of glandular (G) and adipose (A) tissues. The proportion of G versus A varies considerably among the population. The absorbed dose distributions in accelerated partial breast irradiation therapy with low energy photon brachytherapy sources are very sensitive to tissue heterogeneities. Current clinical algorithms use the recommendations of the AAPM TG43 report which approximates the human tissues by unit density water. The aim of this study is to investigate various breast tissue modeling schemes for low energy brachytherapy. A special case of breast permanent seed implant is considered here. Six modeling schemes are considered. Uniform and non-uniform water breast (UWB and NUWB) consider the density but neglect the effect of the composition of tissues. The uniform and the non-uniform G/A breast (UGAB and NUGAB) as well the age-dependent breast (ADB) models consider the effect of the composition. The segmented breast tissue (SBT) method uses a density threshold to distinguish between G and A tissues. The PTV D(90) metric is used for the analysis and is based on the dose to water (D(90(w,m))). D(90(m,m)) is also reported for comparison to D(90(w,m)). The two-month post-implant D(90(w,m)) averaged over 38 patients is smaller in NUWB than in UWB by about 4.6% on average (ranging from 5% to 13%). Large average differences of G/A breast models with TG43 (17% and 26% in UGAB and NUGAB, respectively) show that the effect of the chemical composition dominates the effect of the density on dose distributions. D(90(w,m)) is 12% larger in SBT than in TG43 when averaged. These differences can be as low as 4% or as high as 20% when the individual patients are considered. The high sensitivity of dosimetry on the modeling scheme argues in favor of an agreement on a standard tissue modeling approach to be used in low energy breast brachytherapy. SBT appears to generate the most geometrically reliable breast tissue models in this report.
机译：乳房组织是异质的，主要由腺组织（G）和脂肪组织（A）组成。在人群中，G与A的比例差异很大。在低能量光子近距离放射治疗源的加速部分乳房放射治疗中，吸收剂量分布对组织异质性非常敏感。当前的临床算法使用AAPM TG43报告中的建议，该报告通过单位密度的水近似人体组织。这项研究的目的是研究用于低能量近距离放射治疗的各种乳房组织建模方案。这里考虑乳房永久性种子植入的一种特殊情况。考虑了六个建模方案。均匀和不均匀的水胸（UWB和NUWB）考虑了密度，但忽略了组织组成的影响。均匀和不均匀的G / A乳房（UGAB和NUGAB）模型以及年龄依赖性乳房（ADB）模型都考虑了该成分的作用。分割乳腺组织（SBT）方法使用密度阈值来区分G组织和A组织。 PTV D（90）度量用于分析，并基于对水的剂量（D（90（w，m）））。还报告了D（90（m，m））与D（90（w，m））的比较。 NUWB的平均两个月植入后D（90（w，m））在NUWB中比在UWB中平均小约4.6％（从5％到13％）。 G / A乳腺模型与TG43的较大平均差异（分别在UGAB和NUGAB中分别为17％和26％）表明，化学成分的影响主导了密度对剂量分布的影响。平均时，SBT中的D（90（w，m））比TG43大12％。当考虑个别患者时，这些差异可能低至4％或高达20％。剂量学对建模方案的高度敏感性表明，人们同意在低能量乳房近距离放射治疗中使用标准组织建模方法。在本报告中，SBT似乎生成了几何上最可靠的乳房组织模型。

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