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Optimization of 3D Wedged-Pair Radiation Therapy Planning: Geometrical Alignment of Wedge Orientation

三度空間成對楔形濾板放射治療最佳化研究

摘要


成對楔化(wedged-pair)照野是一種常被使用的放射治療技術。這是因為利用成對楔化照野的方位設計,可以得到在腫瘤部位均勻的放射劑量分布,而且遠端的放射劑量只有腫瘤劑量的一半以下。成對楔化照野使用的楔形濾板之角度取決於此成對照野之間的夾角(hinge angle)。在傳統的二度空間放射治療中,治療床大多固定在0度、90度或270度的方位,成對照野之間的夾角也因此很容易計算得知。但此理想狀況在複雜的三度空間放射治療中,因為治療床的任意角度之旋轉所造成的非同面性(non-coplanar)照野方位設計,已不復適用。除了成對非同面性照野之間的夾角不容易計算,另外楔形濾板厚薄之方向也並不在同一平面上形成相對的最佳位置。如要使楔形濾板厚薄之方向在同一平面上形成相對的最佳位置,必須先將成對非同面性照野各自旋轉準值儀(collimator)至某一角度,而此角度取決於成對非同面性照野三度空間入射方位互相關係。本研究推導演算出成對楔化照野最佳化幾何及向量方程式;並將此最佳化幾何及向量方程式撰寫成電腦程式,以便臨床應用。此最佳化程式僅需兩組參數:成對楔化照野的治療床旋轉角度及治療頭旋轉角度。經最佳化演算後,此程式會提供(一)個別照野準值儀應旋轉之角度,使得楔形濾板的方向會互相對位在三度空間的某一平面上;(二)兩成對楔化照野之間在三度空間的夾角,以及最佳化之楔形濾板角度。此最佳化程式可以減少互動式放射治療計劃時嚐試錯誤、修改正確所需的時間,進而提昇放射治療計劃的效率與品質。

並列摘要


A wedged-pair setup of two cross-fired radiation fields is a common practice in radiation therapy to achieve a homogeneous dose distribution over the irradiation volume. It is a simple way to keep the radiation dose to the distal normal tissue below one half of the tumor dose. The optimum wedge angle depends on the hinge angle between the wedged-pair fields. The hinge angle can be easily determined in conventional 2D radiation planning, because the two wedged-pair fields are usually coplanar with treatment couch set at 0? 90?or 270? In non-coplanar 3D radiation planning, hinge angle is difficult to be calculated. In addition, the wedge orientations are most likely not opposed to one another. An accurate mathematics formula to align two wedged-pair fields into coplanar orientation in 3D space is derived and implemented into a computer program. The optimization program requires only two parameters, gantry angle and couch angle, for each of the wedged-pair fields. It calculates the collimator angles of the wedged-pair fields and aligns the wedge direction and the isocenter on a single plane. It also calculates the hinge angle of the wedged-pair fields and suggests a wedge angle for optimal dose distribution. Through the reduction of the try-and-error optimization of collimator angle/wedge angle setting, this program increases the efficiency and throughput of an interactive 3D radiation therapy planning.

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