M6型射波刀立体定向放疗系统的验收测试-《中国医学物理学杂志》

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Title:: Acceptance test of M6 CyberKnife stereotactic radiotherapy system

文章编号:: DOI:10.3969/j.issn.1005-202X.2023.07.004

作者:: 苏坤普; 周德力; 李林山; 司梦远; 肖姚; 刘岩海; 马俊刚; 李梦侠; 陈川; 陆军特色医学中心肿瘤科，重庆 400042

Author(s):: SU Kunpu; ZHOU Deli; LI Linshan; SI Mengyuan; XIAO Yao; LIU Yanhai; MA Jungang; LI Mengxia; CHEN Chuan; Department of Oncology, Army Medical Center of PLA, Chongqing 400042, China

关键词:: M6型射波刀; 剂量特性; 端到端测试; 验收测试

Keywords:: Keywords: M6 CyberKnife dose characteristics end-to-end test acceptance test

分类号:: R318；R811

DOI:: 1005-202X（2023）07-0814-08

文献标志码:: A

摘要:: 目的：对M6型射波刀立体定向放疗系统的各项技术指标进行临床验收测试，评估其安全性及精确性。方法：参考Accuray公司及国内外相关标准与方法，对M6型射波刀的KUKA机器臂、患者定位、目标定位、可变准直器、直线加速器、治疗计划等6个子系统及端到端综合照射精度进行检测与评估。结果：机器人系统所有节点到位偏差平均值≤0.08 mm，最大值≤0.311 mm。患者治疗床系统偏差：前后（x）方向=0.4 mm、左右（y）方向=0.1 mm、上下（z）方向=0 mm、左右旋转（r）方向=0.1°、头脚旋转（p）方向=0°。目标定位系统：A影像中心偏差x=0.23 mm、y=-0.31 mm，B影像中心偏差x=0.28 mm，y=-0.35 mm；目标定位追踪偏差x=0 mm、y=0.1 mm、z=0.1 mm、r=0.1°、p=-0.1°。iris准直器各尺寸重复性最大偏差0.32 mm。直线加速器系统：SAD=800 mm处光射野一致性精度为x=0.23 mm、y=0.35 mm；射束性能指标中剂量稳定性0.06%，剂量输出线性偏差≤0.53%，iris准直器透射率0.09%、fixed准直器透射率0.14%；孔径60 mm fixed准直器，其半影=4.2 mm、对称性=100.8%、平坦度=109.7%；最大剂量深度为15.5 mm，射线质[TPR2010]等于0.633。治疗计划系统：影像几何精度x=0.071 mm，y=-0.173 mm，z=0.361 mm；计划点剂量精度0.08%；机器跳数手工验算精度0.04%。E2E测试：fixed准直器追踪精度为0.47 mm（颅骨追踪）、0.45 mm（金标追踪）、0.77 mm（脊柱追踪）、0.50 mm（同步呼吸追踪）、0.42 mm（肺追踪），iris准直器相应的追踪精度为0.23、0.69、0.70、0.51、0.73 mm。结论：M6型射波刀作为亚毫米级的立体定向放疗外科设备，各项参数测试结果均优于验收标准，其精确性、可靠性均满足临床要求。

Abstract:: Abstract: Objective To conduct a clinical acceptance test on M6 CyberKnife stereotactic radiotherapy system for evaluating its safety and accuracy. Methods Referring to the standards and methods of Accuray and relevant domestic and international standards, the 6 subsystems of M6 CyberKnife including KUKA robot, patient positioning, target positioning, variable collimator, linear accelerator and treatment plan were evaluated, and an end-to-end test was carried out to analyze its overall irradiation accuracy. Results The average deviation of all nodes in the robot system was ≤ 0.08 mm, and the maximum was ≤ 0.311 mm. The system deviation of treatment couch was as follow: anterior-posterior (x)=0.4 mm, left-right (y)=0.1 mm, superior-inferior (z)=0 mm, left-to-right rotation (r)=0.1°, superior-to-inferior rotation (p)=0°. In target positioning system, A image center deviations were x=0.23 mm, y=-0.31 mm, and B image center deviations were x=0.28 mm, y=-0.35 mm the tracking deviations were as follow: x=0 mm, y=0.1 mm, z=0.1 mm, r=0.1°, p=-0.1°. The maximum repeatability deviation of each size of the iris collimator was 0.32 mm. For linear accelerator, the field consistency deviations at SAD=800 mm were x=0.23 mm, y=0.35 mm. The evaluation on beam performance showed that the dose stability, dose output linear deviation, iris transmittance and fixed transmittance were 0.06%, ≤0.53%, 0.09% and 0.14%, respectively. The penumbral, symmetry and flatness of 60 mm fixed collimator were 4.2 mm, 100.8% and 109.7%, respectively. The maximum dose depth was 15.5 mm, and the [TPR2010] was 0.633. For treatment planning system, the image geometric deviations were x=0.071 mm, y=-0.173 mm, z=0.361 mm planning point dose deviation was 0.08% and the deviation of monitor units in manual calculation was 0.04%. End-to-end test revealed that the accuracies of fixed collimator were 0.47 mm for 6D skull tracking, 0.45 mm for Fiducial tracking, 0.77 mm for Xsight spine tracking, 0.50 mm for synchrony respiratory tracking, -0.42 mm for lung tracking, and that the tracking accuracies of iris collimator were 0.23, 0.69, 0.70, 0.51 and 0.73 mm, respectively. Conclusion M6 CyberKnife as a sub-millimeter-level stereotactic radiosurgery equipment satisfy the acceptance criteria, and its accuracy and reliability meet the clinical requirements.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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