[1]陈傲强,王亚娟,黄晓彤,等.AlignRT引导摆位流程在盆腔肿瘤放疗中的应用评估[J].中国医学物理学杂志,2025,42(2):141-147.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.001]
　CHEN Aoqiang,WANG Yajuan,HUANG Xiaotong,et al.Evaluation of AlignRT-guided positioning workflow in pelvic tumor radiotherapy[J].Chinese Journal of Medical Physics,2025,42(2):141-147.[doi:DOI:10.3969/j.issn.1005-202X.2025.02.001]
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AlignRT引导摆位流程在盆腔肿瘤放疗中的应用评估()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第2期
页码:
141-147
栏目:
医学放射物理
出版日期:
2025-01-20

文章信息/Info

Title:
Evaluation of AlignRT-guided positioning workflow in pelvic tumor radiotherapy
文章编号:
1005-202X（2025）02-0141-07
作者:
陈傲强1; 王亚娟1; 黄晓彤1; 吴露2; 谢德欢2; 陈雪梅1
1.华南恶性肿瘤防治全国重点实验室/广东省恶性肿瘤临床医学研究中心/中山大学肿瘤防治中心放疗科， 广东 广州 510060； 2.南方医科大学附属广东省人民医院/广东省医学科学院放疗科， 广东 广州 510080
Author(s):
CHEN Aoqiang1;  WANG Yajuan1;  HUANG Xiaotong1;  WU Lu2;  XIE Dehuan2;  CHEN Xuemei1
1. Department of Radiotherapy, State Key Laboratory of Oncology in South China/Guangdong Provincial Clinical Research Center for Cancer/Sun Yat-sen University Cancer Center, Guangzhou 510060, China 2. Department of Radiation Oncology, Guangdong Academy of Medical Sciences/Guangdong Provincial Peoples Hospital, Southern Medical University, Guangzhou 510080, China
关键词:
表面引导放射治疗; AlignRT; 盆腔放疗; 皮肤标记线; PTV外扩边界; 摆位误差
Keywords:
Keywords: surface guided radiotherapy AlignRT pelvic radiotherapy skin marker planning target volume margin setup error
分类号:
R318；R815
DOI:
DOI:10.3969/j.issn.1005-202X.2025.02.001
文献标志码:
A
摘要:
目的：通过对比两种不同的盆腔肿瘤放疗摆位工作流程，评估光学体表引导系统AlignRT的定位准确性和可重复性，进一步探讨其替代皮肤标记线摆位的可行性。方法：选取2022年3月至2023年3月在中山大学肿瘤防治中心Infinity加速器放疗的40例盆腔肿瘤患者，其中20例采用传统的体表标记线摆位流程，另外20例采用AlignRT引导摆位流程。治疗前扫描锥形束CT（CBCT）与计划CT进行配准获得六维方向上的平移（左右LAT、头脚LNG、前后VRT）和旋转（冠状位Yaw、矢状位Pitch、横断位Roll）误差。比较两种摆位流程的CBCT配准误差、误差偏移量分布，计算计划靶区（PTV）外扩边缘，对6个维度误差、体质量指数和摆位误差之间进行相关性分析。结果：在传统标记线摆位流程中，平移和旋转误差的中位数范围分别为0.19~0.34 cm和0.50°~1.30°，最大偏移量范围分别为1.20~1.70 cm和2.00°~5.50°。在AlignRT引导摆位的工作流程中，平移和旋转误差的中位数范围为0.10~0.15 cm和0.50°~0.70°，最大偏移量范围为0.42~0.47 cm和1.80°~2.00°。此外，传统标记线摆位显示分次间误差>0.5 cm和>3°的比例分别为23.3%和9.8%。计算得到两组摆位方式在LR、SI、AP方向的PTV外扩值：AlignRT引导（0.37、0.38和0.34 cm），皮肤标记线摆位（0.67、1.22和0.95 cm）。两个摆位工作流程的6个维度的误差之间均没有发现相关性。当使用AlignRT引导摆位时，LAT、LNG和Pitch方向与体质量指数呈低度相关。结论：AlignRT引导盆腔肿瘤放疗可以减少六维平移和旋转误差，实现精准的摆位精度，治疗分次间的重复性和稳定性高，与CBCT联合使用可取代传统的皮肤标记线摆位流程。
Abstract:
Abstract: Objective To evaluate the accuracy and reproducibility of AlignRT-guided positioning by comparing two positioning workflows for pelvic tumor radiotherapy, and to further explore the feasibility of using it to replace skin marker alignment. Methods Forty cases of pelvic tumor treated with radiotherapy using Infinity accelerator in Sun Yat-sen University Cancer Center between March 2022 and March 2023 were included in the study, with 20 cases using the skin marker alignment workflow and the other 20 adopting AlignRT-guided positioning workflow. The translational errors (LAT, LNG, VRT) and rotational errors (Yaw, Pitch, Roll) were determined by the registration of pre-treatment cone-beam CT (CBCT) with planned CT. Both CBCT shifts and error offset distributions were analyzed planning target volume (PTV) margins were calculated and correlation analyses were conducted among six-dimensional errors, and between body mass index and setup errors. Results The median translational and rotational setup errors of skin marker alignment workflow vs AlignRT-guided positioning workflow were 0.19-0.34 cm vs 0.10-0.15 cm and 0.50°-1.30° vs 0.50°-0.70°, with the maximum offset ranges of 1.20-1.70 cm vs 0.42-0.47 cm and 2.00°-5.50° vs 1.80°-2.00°, respectively. Additionally, for skin marker alignment workflow, inter-fractional errors >0.5 cm and >3° were observed in 23.3% and 9.8% of fractions. The PTV margins of AlignRT-guided positioning workflow were 0.37, 0.38 and 0.34 cm in the left-right, superior-inferior and anterior-posterior directions, respectively, which were much smaller than those of skin marker alignment workflow (0.67, 1.22 and 0.95 cm). No correlation was found between six-dimensional errors in two positioning workflows. When using AlignRT-guided positioning workflow, the setup errors in LAT, LNG and Pitch directions had low correlations with body mass index. Conclusion In pelvic tumor radiotherapy, AlignRT-guided positioning can reduce translational and rotational errors, achieve precise setup and excellent inter-fractional reproducibility and stability, and replace traditional skin marker alignment while being used in conjunction with CBCT.

备注/Memo

备注/Memo:
【收稿日期】2024-10-22 【基金项目】国家自然科学基金青年基金（82404187）；广东省医学科学技术研究基金（A2024736） 【作者简介】陈傲强，硕士，初级技师，研究方向：放射治疗，E-mail: chenaoq@sysucc.org.cn 【通信作者】陈雪梅，硕士，研究方向：放射治疗，E-mail: chenxuem@sysucc.org.cn
更新日期/Last Update: 2025-01-22