| 王钦,郁艳军,王秀楠,等.独立三维剂量验证系统在全脑全脊髓放疗中的应用研究[J].中华放射医学与防护杂志,2026,46(4):382-388.Wang Qin,Yu Yanjun,Wang Xiunan,et al.Application of independent three-dimensional dose verification system ArcherQA in craniospinal irradiation[J].Chin J Radiol Med Prot,2026,46(4):382-388 |
| 独立三维剂量验证系统在全脑全脊髓放疗中的应用研究 |
| Application of independent three-dimensional dose verification system ArcherQA in craniospinal irradiation |
| 投稿时间：2025-02-11 |
| DOI：10.3760/cma.j.cn112271-20250211-00048 |
| 中文关键词: 独立三维剂量验证系统|ArcherQA|全脑全脊髓放疗|剂量验证 |
| 英文关键词:Independent three-dimensional dose verification system|ArcherQA|Craniospinal irradiation|Dose verification |
| 基金项目:北京市计划专项课题(Z181100001718011) |
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| 中文摘要: |
| 目的 评估独立三维剂量验证系统ArcherQA在医用直线加速器(LA)和螺旋断层放疗系统(HT)在全脑全脊髓放疗(CSI)中的临床应用价值。方法 纳入2023年1月—2024年1月首都医科大学附属北京世纪坛医院40例CSI放疗病例。其中20例采用Eclipse治疗计划系统(TPS)设计,在LA上执行,使用Portal Dosimetry(PD)与ArcherQA系统进行剂量验证;另20例基于Precision TPS设计,在HT上执行,使用Matrixx与ArcherQA系统进行剂量验证。比较ArcherQA与PD及Matrixx在不同γ标准(3%/3 mm、2%/3 mm、3%/2 mm、2%/2 mm,TH = 10%)下的通过率,并分析ArcherQA与TPS在靶区及危及器官剂量的差异。结果 ArcherQA验证显示,LA与HT计划的全局γ通过率均＞95%。在2%/2 mm最严格标准下,整体靶区通过率相对较低,LA为87.9(78.6,91.7)、HT为92.6(81.8,97.4),其他标准下均＞97%;头颈段、脊柱段靶区和射野交叠区在该标准下通过率同样最低。总体而言,HT计划通过率优于LA计划。剂量学比较显示,LA计划中,计划靶区(PTV)、交叠区1和交叠区2的Dmean差异无统计学意义(P > 0.05);PTV的Dmax指标中ArcherQA计算结果与TPS相比高1.53 Gy(95% CI:-1.93~1.12,P ＜ 0.001),D95%低0.36 Gy(95% CI:-0.45~-0.27,P ＜ 0.001);HT计划中,PTV的D95%指标低0.39 Gy(95% CI:-0.49~-0.29,P ＜ 0.001)。所有危及器官剂量均满足临床要求;通过率对比显示,PD测量通过率普遍高于ArcherQA计算值(P < 0.001);与Matrixx对比,ArcherQA在头颈段靶区通过率更高(P < 0.005),脊柱段靶区差异无统计学意义(P > 0.05)。结论 ArcherQA系统能基于患者CT图像快速重建三维剂量分布并进行剂量体积直方图分析,实现CSI的一体化剂量验证,且无需占用设备时间,显著提升工作效率。 |
| 英文摘要: |
| Objective To assess the clinical application value of the ArcherQA independent three-dimensional dose verification system in craniospinal irradiation (CSI) delivered by a linear accelerator (LA) and a helical tomotherapy system (HT) Methods Totally 40 patients receiving CSI in Beijing Shijitan Hospital, Capital Medical University from January 2023 to January 2024 were included in this study. Twenty plans were designed using the Eclipse treatment planning system (TPS) and delivered on an LA (also referred to as the LA plans), with dose verification performed using Portal Dosimetry (PD) and ArcherQA. Another twenty plans were designed utilizing the Precision TPS and delivered on an HT (also referred to as the HT plans), with dose verified using the Matrixx ionization chamber array and ArcherQA. The γ-pass rates calculated by ArcherQA under different γ criteria (3%/3 mm, 2%/3 mm, 3%/2 mm, 2%/2 mm, TH=10%) were compared with those measured using PD and Matrixx. The differences in doses to target volumes and organs at risk (OARs) between ArcherQA and TPSs were analyzed. Results The ArcherQA verification result showed that the global γ pass rates of both the LA and HT plans exceeded 95%. Under the most stringent criterion of 2%/2 mm, the γ pass rates of the overall target volumes were relatively low: 87.9 (78.6, 91.7) and 92.6 (81.8, 97.4) for LA and the HT plans, respectively. In contrast, the γ pass rates under other criteria all exceeded 97%. The head-neck section, spinal section, and field overlap regions Overlap1 and Overlap2 showed the lowest γ pass rates under the 2%/2 mm criterion. Overall, the HT plans demonstrated higher γ pass rates than the LA plans. The dosimetric comparison revealed that in the LA plans, the differences in Dmean of planning target volume (PTV), Overlap1, and Overlap2 were insignificant (P > 0.05). For these plans, the Dmax of PTV calculated by ArcherQA was 1.53 Gy higher than that from the Eclipse TPS (95% CI: -1.93 to 1.12, P < 0.001), while D95% was 0.36 Gy lower (95% CI: -0.45 to -0.27, P < 0.001). In the HT plans, the D95% of PTV calculated by ArcherQA was 0.39 Gy lower than that determined using the Precision TPS (95% CI: -0.49 to -0.29, P < 0.001). Doses to all OARs met clinical requirements. The comparison of γ-pass rates indicated that PD generally yielded higher γ pass rates than ArcherQA calculations (P < 0.001). Compared to Matrixx, ArcherQA showed higher γ pass rates in the head-neck section (P < 0.005), but no significant difference was observed in the γ pass rate in the spinal section (P > 0.05). Conclusions The ArcherQA system enables both the rapid reconstruction of the three-dimensional dose distributions based on patients'CT images and dose-volume histogram analyses. This system achieves integrated dose verification for CSI without consuming additional device time, thereby significantly improving work efficiency. |
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