| 王鹏辉,宫帅,丁寿亮,阳露,王勐,裴曦,黄晓延,刘红冬.ArcherQA三维剂量验证系统在鼻咽癌调强放疗计划中的应用[J].中华放射医学与防护杂志,2022,42(8):598-604 |
| ArcherQA三维剂量验证系统在鼻咽癌调强放疗计划中的应用 |
| Application of the ArcherQA three-dimensional dose verification system in intensity-modulated radiotherapy plans for nasopharyngeal carcinoma |
| 投稿时间：2022-04-09 |
| DOI：10.3760/cma.j.cn112271-20220409-00150 |
| 中文关键词: ArcherQA 三维剂量验证 鼻咽癌 调强放疗 |
| 英文关键词:ArcherQA Three-dimensional dosimetric verification Nasopharyngeal carcinoma Intensity-modulated radiotherapy |
| 基金项目:国家自然科学基金（11805292）；广东省自然科学基金（2018A0303100020）；广东省基础与应用基础粤穗联合青年基金（2021A1515110642）；中华国际医学交流基金会肿瘤精准放疗星火计划（2019-N-11-34） |
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| 中文摘要: |
| 目的 探讨ArcherQA三维剂量独立验证系统在鼻咽癌调强放疗计划验证中的可行性。方法 回顾性选取Eclipse治疗计划系统（TPS）制定的105例鼻咽癌患者调强放疗计划，分别利用ArcherQA与Portal dosimetry （PD）验证系统进行剂量验证。比较ArcherQA与PD的γ通过率（3 mm/3%，TH=10%），以及ArcherQA与TPS在靶区剂量（Dmean、D90%）与危及器官剂量（Dmean）上的差异，并分析ArcherQA结果中各危及器官的三维γ通过率情况。结果 ArcherQA计算得到的平均三维γ通过率为（99.04±1.01）%，PD测量结果的平均二维γ通过率为（99.49±0.78）%，二者差异具有统计学意义（t=-3.35，P<0.05）。ArcherQA与TPS在靶区的剂量学差异为：GTV：Dmean（0.57±0.48）%，D90%（0.65±0.56）%；平均γ通过率：GTV （97.67±3.43）%，GTVnd-L （97.80±4.35）%，GTVnd-R （97.82±4.07）%，CTV1（97.88±2.44）%，CTV2（96.64±4.32）%；各靶区平均剂量差异为CTV1（0.57±0.46）%，GTVnd-L （0.85±0.55）%，GTVnd-R （0.73±0.55）%，CTV2（0.88±0.52）%；ArcherQA结果中各危及器官的平均γ通过率为脑干（99.93±0.22）%，视交叉（99.17±2.82）%，眼晶状体（100±0）%，脊髓（99.56±1.05）%，甲状腺（99.00±2.06）%，气管（87.86±10.42）%。各危及器官平均剂量，除左侧视神经、右侧海马、右侧腮腺外，差异均具有统计学意义（t=-14.62~4.82，P<0.05）。结论 ArcherQA基于高性能图形处理器平台，采用高精度蒙特卡罗算法，可根据患者CT图像快速并准确地计算出体内的三维剂量分布和γ通过率，并给出各感兴趣区域的剂量-体积直方图（DVH）指标参数比较，可用于鼻咽癌调强放疗计划验证，不占用加速器机时，有利于提高工作效率。 |
| 英文摘要: |
| Objective To investigate the feasibility of applying the ArcherQA three-dimensional (3D) dosimetric verification system in intensity-modulated radiotherapy (IMRT) plans for nasopharyngeal carcinoma (NPC).Methods A retrospective analysis was conducted for 105 NPC patients' IMRT plans developed using the Eclipse treatment planning system (TPS). Dose verification was conducted using the ArcherQA system and through portal dosimetry (PD). Moreover, this study compared γ passing rates (criteria:3 mm/3%, TH=10%) between ArcherQA and PD and the doses delivered to the target volume (Dmean, D90%) and organs at risk (OARs) (Dmean) between ArcherQA and TPS, and analyzed the 3D γ passing rates of each organ at risk calculated by ArcherQA.Results The average 3D γ passing rate calculated by ArcherQA was (99.04±1.01)%, and the average 2D γ passing rate measured by PD was (99.49±0.78)%, with statistically significant differences (t=-3.35, P< 0.05). The dosimetric differences to the target volume between ArcherQA and TPS were as follows:the average difference in Dmean to the gross tumor volume (GTV) was (0.57±0.48)%, and the average difference in D90% was (0.65±0.56)%. For the target volume, the average γ passing rate was (97.67±3.43)% for GTV, (97.80±4.35)% for GTVnd-L, (97.82±4.07)% for GTVnd-R, (97.88±2.44)% for CTV1, and (96.64±4.32)% for CTV2. The mean dose difference of each target volume was CTV1 (0.57±0.46)%, GTVnd-L (0.85±0.55)%, GTVnd-R (0.73±0.55)%, and CTV2 (0.88±0.52)%. For OARs, the mean γ passing rate was (99.93±0.22)% for the brainstem, (99.17±2.82)% for the optic chiasm, (100±0)% for the lens, (99.56±1.05)% for the spinal cord, (99.00±2.06)% for the thyroid, and (87.86±10.42)% for the trachea. Statistically significant differences in the average doses to OARs were observed (t=-14.62 to 4.82, P<0.05), except for those to the left optic nerve, the right hippocampus, and the right parotid gland.Conclusions Based on the high-performance GPU platform and the Monte Carlo dose algorithm, ArcherQA can provide accurate 3D dose distribution and 3D γ passing rates inside patients according to CT images and provide the dose volume histogram (DVH) of various regions of interest (ROIs). Therefore, the ArcherQA three-dimensional dose verification system can be applied to IMRT plans for NPC. Moreover, it is inducive to improve the treatment efficiency since it does not occupy the accelerator operation time. |
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