| 李俊禹,吴昊,杨敬贤,李廷廷,于松茂,卢子红,王美娇,李晨光,李玮博,张艺宝.基于品质因素评价瓦里安锥束CT成像质量与辐射剂量风险收益比[J].中华放射医学与防护杂志,2020,40(8):595-599 |
| 基于品质因素评价瓦里安锥束CT成像质量与辐射剂量风险收益比 |
| Evaluation of cost-effective ratio (imaging quality vs. radiation dose) of Varian cone beam CT based on figure of merit (FOM) |
| 投稿时间：2019-12-11 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.08.004 |
| 中文关键词: 图像引导放疗 千伏锥形束CT 辐射剂量 成像质量 |
| 英文关键词:Image guided radiotherapy kV cone beam CT Radiation dose Image quality |
| 基金项目:首都卫生发展科研专项（首发2018-4-1027）；教育部科技发展中心产学研创新基金-"智融兴教"基金（2018A01019）；国家自然科学基金（11505012，11905150，81672969）；国家重点研发计划资助项目（2019YFF01014405）；四川省科技计划资助项目（2018HH0099）；北京市自然科学基金（7172048，1202009） |
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| 中文摘要: |
| 目的 分析比对不同Varian加速器平台机载千伏锥束CT（kV CBCT）系统的辐射剂量和成像质量，指导临床选用风险收益比（成像质量/辐射剂量）最高的图像引导方案。方法 利用CT剂量指数模体（CTDI模体）和CT电离室，以及Catphan604模体分别获取Edge、Truebeam、新旧两台ix加速器机载CBCT典型扫描模式的辐射剂量和成像质量参数，使用品质因素（figure of merit，FOM）值评估各图像引导方案的风险收益比。结果 不同型号的瓦里安加速器配置的kV CBCT系统的FOM不同，差异广泛分布于0.65（温和成像一圈）~48.46（温和成像半圈）区间；各扫描参数间FOM也存在较大差异，均值为22.14±13.47。结论 由于设备间和参数间存在显著差异，基于实际测量的验证评估有助于临床选择合理的影像引导方案，剂量敏感患者应优先选择加权CT剂量指数（CTDIw）低的参数和设备；对图像质量要求高的患者应优选对比度噪声比（CNR）高的方案；而普通患者则可依据风险收益比进行选择，此时品质因素FOM可为临床决策提供有利工具。 |
| 英文摘要: |
| Objective To analyze and compare the radiation dose and image quality of kilo-voltage cone beam CT systems on different Varian accelerator platforms, providing data to support clinical decisions on selecting optimal protocols for image-guided radiotherapy based on cost-effective ratio (image quality/radiation dose). Methods The radiation dose and image quality of various CBCT systems and scanning protocols on Varian Edge, Truebeam and ix (new and old) LINACs were obtained using a CT dose index (CTDI) phantom combined with a CT ionization chamber and a Catphan604 phantom, respectively. Figure of merit (FOM) was used to evaluate the cost-effective ratio of the image guidance schemes. Results Considerable inter-system varieties of FOMs were observed, varying from 0.65 (Image Gently-full trajectory) to 48.46 (Image Gently-half trajectory). The inter-protocol varieties were also large, where the mean±SD was 22.14±13.47. Conclusions Considering the explicit inter-system and inter-protocol varieties, it is clinically favorable to evaluate the image guidance schemes based on machine-specific measurement. For instance, parameters and equipment with low CTDIw can be beneficial for dose-sensitive patients. High CNR regimen favors patients with high image quality requirements. For ordinary patients, cost-effective ratio in terms of FOM can be very helpful to guide the decision-making of clinical image-guided radiotherapy. |
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