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ExacTrac 6D影像精确引导系统在脑转移瘤SRS中的应用 被引量:7

Application of ExacTrac 6D Image-Guidance System in Stereotactic Radiotherapy Surgery Treatment of Brain Metastasis
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摘要 目的使用ExacTrac 6D红外/X线DR影像精确引导系统对脑转移瘤立体定向放射治疗(Stereotactic Radiotherapy Surgery,SRS)进行摆位,比较一键复位前后的摆位精度,评估6D治疗床在SRS非共面弧治疗中的重要性。方法选择我院89例脑转移瘤SRS治疗的患者,在治疗前和治疗床旋转至固定角度后,采用ExacTrac系统的X光影像装置拍摄靶点区域的两幅X光图像,与计划系统中CT数据自动处理所得的数字化重建X光照片进行匹配,得到前者在X、Y、Z轴3个方向的平移误差和旋转误差(6D误差),并进行一键复位摆位修正。摆位修正后,再以ExacTrac 6D红外/X线DR影像精确引导系统验证患者体位的6D误差。结果治疗前0°床角摆位,经X线图像引导一键复位修正后的3个线性误差均<1.0 mm,3个旋转误差均<0.5°,满足SRS放疗要求。且6D误差明显小于修正前的摆位误差,差异有统计学意义(P<0.05)。治疗床旋转至计划设计角度后,经X线图像引导一键复位修正后的3个线性误差和3个旋转误差均明显小于修正前的摆位误差,差异有统计学意义(P<0.05)。结论应用ExacTrac 6D红外/X线DR影像精确引导系统在非共面弧立体定向放射外科治疗时可行的,并可明显减少患者因治疗床旋转引起的摆位误差。 Objective To evaluate the importance of the application of ExacTrac6D image-guidance system in non-coplanar arcs stereotactic radiosurgery treatment of stereotactic radiotherapy surgery(SRS)based on comparing the setup error before and after the reset.Methods From August2014to December2015,a total of89brain metastases patients who were treated with SRS were chosen to perform the research.Firstly,the X-ray imaging device of ExacTrac system was used to shoot2X-ray images on the target area before treatment and after the table were rotated to a fixed angle,respectively.Then,they were separately matched with the X-ray images that were automatic processed based on the CT data.In this case,the X,Y,Z direction of3translation and rotation errors(6D error)of the former were gained.In the following,a key reset placement correction was performed.Finally,ExacTrac6D image-guidance system were utilized to validate the6D error of the patients'position.Results Before the treatment when the table placed in0°angle,three linear error was less than1.0mm and3rotation error was less than0.5°after using the X-ray images to guide a key reset,which satisfied the requirement of the SRS radiotherapy.Meanwhile,the6D errors were much smaller than the positioning error correction before,the differences were significant(P<0.05).When the table was rotated to the setting angle,the use of verification images could adequately reduce the error associated with intrafraction patient movement in all3translations and rotations.The differences were significant(P<0.05).Conclusion Application of ExacTrac6D image-guidance system in non-coplanar arcs stereotactic radiosurgery treatment is feasible.In addition,it can obviously reduce the positioning error caused by rotating the table during frameless stereotactic radiosurgery.
作者 张平 罗龙辉 戴鹏 周巧敏 吴伟 黄庆 ZHANG Ping;LUO Long-hui;DAI Peng;ZHOU Qiao-min;WU Wei;HUANG Qing(Department of Oncology Guangdong 999 Brain Hospital, Guangzhou Guangdong 510510,China;Department of Equipment, Guangdong 999 Brain Hospital, Guangzhou Guangdong 510510,China)
出处 《中国医疗设备》 2017年第5期40-43,共4页 China Medical Devices
关键词 脑转移瘤 ExacTrac6D图像引导系统 立体定向放射治疗 摆位误差 brain metastases ExacTrac 6D image-guidance system stereotactic radiotherapy surgery setup error
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