Progress in Medical Physics (한국의학물리학회지:의학물리)

Korean Society of Medical Physics (한국의학물리학회)
권호 표지

An Analysis of Intra-Fractional Movement during Image-Guided Frameless Radiosurgery for Brain Tumor Using CyberKnife

사이버나이프를 이용한 무고정틀 두개 방사선 수술 중 발생한 환자의 치료 중 움직임 분석

  • Kang, Ki Mun (Department of Radiation Oncology, School of Medicine, Gyeongsang National University) ;
  • Chai, Gyu Young (Department of Radiation Oncology, School of Medicine, Gyeongsang National University) ;
  • Jeong, Bae Gwon (Department of Radiation Oncology, School of Medicine, Gyeongsang National University) ;
  • Ha, In-Bong (Department of Radiation Oncology, School of Medicine, Gyeongsang National University) ;
  • Park, Kyung Bum (Department of Neurosurgery, School of Medicine, Gyeongsang National University) ;
  • Jung, Jin-Myung (Department of Neurosurgery, School of Medicine, Gyeongsang National University) ;
  • Lim, Young Kyung (Proton Therapy Center, National Cancer Center) ;
  • Jeong, Hojin (Department of Radiation Oncology, School of Medicine, Gyeongsang National University)
  • 강기문 (경상대학교 의학전문대학원 방사선종양학교실) ;
  • 채규영 (경상대학교 의학전문대학원 방사선종양학교실) ;
  • 정배권 (경상대학교 의학전문대학원 방사선종양학교실) ;
  • 하인봉 (경상대학교 의학전문대학원 방사선종양학교실) ;
  • 박경범 (경상대학교 의학전문대학원 신경외과학교실) ;
  • 정진명 (경상대학교 의학전문대학원 신경외과학교실) ;
  • 임영경 (국립암센터 양성자치료센터) ;
  • 정호진 (경상대학교 의학전문대학원 방사선종양학교실)
  • Received : 2012.06.08
  • Accepted : 2012.08.30
  • Published : 2012.09.30
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Abstract

Frameless method in brain radiosurgery has advantages relative to rigid head-frame method in terms of patient friendly and flexible application of multi-fractionation. However, it has also disadvantages and the most negative point is that it cannot control the patient motion during treatment as lowly as the level of the frame-based radiosurgery, which could affect to the treatment accuracy. In the present study, we analyzed the geometric uncertainty of the intra-fraction motion using the actual treatment records of 294-CyberKnife treatments for brain tumors. Based on the analysis, we statistically presented the magnitude of intra-fraction motion in frameless radiosurgy. The result could provide the quantitative information to determine the adequate treatment margins to compensate the intra-fraction movements.

무고정틀 두개 방사선 시술은 두개 고정틀 방식에 비해 환자 친화적이며 다중 분할 치료의 적용이 용이하다는 장점을 가진다. 그러나, 환자의 움직임을 완전히 제어할 수 없기 때문에 치료 중 움직임으로 인해 시술의 정확도가 영향을 받을 수 있다. 본 연구에서는 종양 추적 방식의 무고정틀 방사선 치료를 시행 받은 환자의 실제 치료 기록을 분석하여 무고정틀 방사선 치료 시 발생할 수 있는 치료 중 환자의 움직임을 분석하였다. 사이버나이프(CyberKnife, Accuray Inc, CA)를 이용한 294회의 뇌종양 방사선 수술 기록을 분석하였으며, 이를 토대로 치료시간에 따른 치료 중 움직임의 크기를 통계적으로 제시하였다. 본 연구의 결과는 무고정틀 방사선 수술 시 고려되어야 할 치료 중 움직임에 대한 기본 지표로 활용될 수 있을 것으로 생각된다.

Keywords

References

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