| 林海磊,沙翔燕,王丹,等.SunCHECK与ArcCHECK两种放疗剂量验证系统基于γ通过率的容差与干预限值设定及一致性研究[J].中华放射医学与防护杂志,2025,45(12):1259-1265.Lin Hailei,Sha Xiangyan,Wang Dan,et al.SunCHECK and ArcCHECK dosimetric verification systems for radiotherapy: Tolerance and action limit settings and consistency of gamma passing rates[J].Chin J Radiol Med Prot,2025,45(12):1259-1265 |
| SunCHECK与ArcCHECK两种放疗剂量验证系统基于γ通过率的容差与干预限值设定及一致性研究 |
| SunCHECK and ArcCHECK dosimetric verification systems for radiotherapy: Tolerance and action limit settings and consistency of gamma passing rates |
| 投稿时间：2025-04-25 |
| DOI：10.3760/cma.j.cn112271-20250425-00150 |
| 中文关键词: 调强放疗 患者特异性质量保证 剂量验证 γ通过率 |
| 英文关键词:Intensity modulated radiation therapy Patient-specific quality assurance Dosimetric verification Gamma passing rate |
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| 中文摘要: |
| 目的 对比SunCHECK与ArcCHECK剂量验证系统在调强放疗中γ通过率、剂量偏差及相关性参数，明确两者容差与干预限值设定差异及γ通过率一致性。方法 回顾性纳入71例接受调强放疗的头颈部、胸部及腹盆部肿瘤患者，分别使用SunCHECK和ArcCHECK系统进行调强剂量验证，基于γ通过率计算不同组别的容差与干预限值，分析靶区和危及器官的体积剂量偏差及其与γ通过率的Pearson相关性，并通过Bland-Altman方法检验两系统的γ通过率一致性。结果 在3%/3 mm及3%/2 mm标准下，两系统γ通过率差异较小且Bland-Altman差值均位于95%的置信区间以内，但在2%/2 mm标准下，胸部与腹盆部的γ通过率差异显著且一致性偏离置信区间。在3%/2 mm标准下，头颈部和腹盆部的容差限值≥95.27%且干预限值≥93.52%，胸部的容差限值≥93.90%且干预限值≥90.92%。SunCHECK验证系统中靶区的体积剂量偏差与γ通过率呈负相关(r=-0.77 ~ -0.43，P＜0.05)，而危及器官体积剂量偏差与γ通过率的相关性不统一，且整体显示较弱或无相关性。结论 SunCHECK与ArcCHECK两种剂量验证系统在3%/3 mm及3%/2 mm标准下γ通过率结果有很高的一致性，动态调整容差与干预限值设定及结合体积剂量学参数偏差评估是优化患者特异性质量保证的关键。 |
| 英文摘要: |
| Objective To clarify the differences in the tolerance limit (TL) and action limit (AL) settings, as well as the consistency of gamma passing rates (GPRs), between two dosimetric verification systems SunCHECK and ArcCHECK for radiotherapy based on a comparison of the GPRs, dose deviations, and related parameters of both systems in intensity modulated radiation therapy (IMRT).Methods A retrospective study was conducted based on 71 patients with head and neck tumors, thoracic tumors, and abdominal-pelvic tumors who received IMRT. Their doses in IMRT were verified using both the SunCHECK and ArcCHECK systems. Based on the GPR, the TLs and ALs of different tumor groups were calculated. Then, the volumetric dose deviations of the target volumes and organs at risk (OARs), as well as their Pearson correlations with the GPR, were analyzed. Additionally, the consistency of the GPRs between both systems was assessed using the Bland-Altman method.Results Under the criteria of 3%/3 mm and 3%/2 mm, the two systems exhibited small differences in GPRs, with all differences derived from the Bland-Altman analysis falling within the 95% confidence interval. However, under the 2%/2 mm criterion, both systems presented significant GPR differences between the thoracic and the abdominal-pelvic tumor groups, with the GPR consistency exceeding the 95% confidence interval. Under the 3%/2 mm criterion, both systems displayed TLs ≥ 95.27% and ALs ≥ 93.52% for the head and neck tumor group and abdominal-pelvic tumor group, as well as TLs ≥ 93.90% and ALs ≥ 90.92% for the thoracic tumor group. In addition, the SunCHECK system yielded a strong negative correlation between the volumetric dose deviation of the target volumes and the GPR (r = -0.77 to -0.43, P < 0.05). Conversely, the SunCHECK system showed inconsistent correlations, which were weak or insignificant overall, between the volumetric dose deviation of OARs.Conclusions The SunCHECK and ArcCHECK systems demonstrate highly consistent GPRs under the criteria of 3%/3 mm and 3%/2 mm. Furthermore, the dynamic adjustment of TL and AL settings and the deviation evaluation in combination with volumetric dosimetry parameters are crucial to optimizing patient-specific quality assurance (PSQA). |
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