Assessment of intraoperative 3D imaging alternatives for IOERT dose estimation.

Autor: García-Vázquez V; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. Electronic address: vgarcia@mce.hggm.es., Marinetto E; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain., Guerra P; Departamento de Ingeniería Electrónica, ETSI Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain., Valdivieso-Casique MF; GMV SA, Madrid, Spain., Calvo FÁ; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Oncología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain., Alvarado-Vásquez E; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Servicio de Oncología Radioterápica, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Sole CV; Service of Radiation Oncology, Instituto de Radiomedicina, Santiago, Chile; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain., Vosburgh KG; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA., Desco M; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain., Pascau J; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Jazyk: angličtina
Zdroj: Zeitschrift fur medizinische Physik [Z Med Phys] 2017 Sep; Vol. 27 (3), pp. 218-231. Date of Electronic Publication: 2016 Aug 23.
DOI: 10.1016/j.zemedi.2016.07.002
Abstrakt: Intraoperative electron radiation therapy (IOERT) involves irradiation of an unresected tumour or a post-resection tumour bed. The dose distribution is calculated from a preoperative computed tomography (CT) study acquired using a CT simulator. However, differences between the actual IOERT field and that calculated from the preoperative study arise as a result of patient position, surgical access, tumour resection and the IOERT set-up. Intraoperative CT imaging may then enable a more accurate estimation of dose distribution. In this study, we evaluated three kilovoltage (kV) CT scanners with the ability to acquire intraoperative images. Our findings indicate that current IOERT plans may be improved using data based on actual anatomical conditions during radiation. The systems studied were two portable systems ("O-arm", a cone-beam CT [CBCT] system, and "BodyTom", a multislice CT [MSCT] system) and one CBCT integrated in a conventional linear accelerator (LINAC) ("TrueBeam"). TrueBeam and BodyTom showed good results, as the gamma pass rates of their dose distributions compared to the gold standard (dose distributions calculated from images acquired with a CT simulator) were above 97% in most cases. The O-arm yielded a lower percentage of voxels fulfilling gamma criteria owing to its reduced field of view (which left it prone to truncation artefacts). Our results show that the images acquired using a portable CT or even a LINAC with on-board kV CBCT could be used to estimate the dose of IOERT and improve the possibility to evaluate and register the treatment administered to the patient.
(Copyright © 2016. Published by Elsevier GmbH.)
Databáze: MEDLINE
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