한국의학물리학회지:의학물리 (Progress in Medical Physics)

  • 제25권4호
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  • Pages.210-217
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  • 2014
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  • 2508-4445(pISSN)
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  • 2508-4453(eISSN)
한국의학물리학회 (Korean Society of Medical Physics)
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비편평화여과기 빔을 이용한 폐 정위절제방사선치료를 위한 AAA와 Acuros XB 계산 알고리즘의 치료계획 비교

Comparison of Anisotropic Analytic Algorithm Plan and Acuros XB Plan for Lung Stereotactic Ablative Radiotherapy Using Flattening Filter-Free Beams

  • 정진범 (분당서울대학교병원 방사선종양학과) ;
  • 엄근용 (분당서울대학교병원 방사선종양학과) ;
  • 김인아 (분당서울대학교병원 방사선종양학과) ;
  • 김재성 (건국대학교병원 방사선종양학과) ;
  • 이정우 (건국대학교병원 방사선종양학과) ;
  • 홍세미 (건국대학교병원 방사선종양학과) ;
  • 김연래 (춘혜대학 방사선과) ;
  • 박병문 (건국대학교병원 방사선종양학과) ;
  • 강상원 (가톨릭대학교 의공학교실) ;
  • 서태석 (가톨릭대학교 의공학교실)
  • Chung, Jin-Beom (Department of Radiation Oncology, Seoul National University Bundang Hospital) ;
  • Eom, Keun-Yong (Department of Radiation Oncology, Seoul National University Bundang Hospital) ;
  • Kim, In-Ah (Department of Radiation Oncology, Seoul National University Bundang Hospital) ;
  • Kim, Jae-Sung (Department of Radiation Oncology, Konkuk University Medical Center) ;
  • Lee, Jeong-Woo (Department of Radiation Oncology, Konkuk University Medical Center) ;
  • Hong, Semie (Department of Radiation Oncology, Konkuk University Medical Center) ;
  • Kim, Yon-Lae (Department of Radiologic Technology, Choonhae College of Health Sciences) ;
  • Park, Byung-Moon (Department of Radiation Oncology, Konkuk University Medical Center) ;
  • Kang, Sang-Won (Department of Biomedical Engineering, The Catholic University of Korea) ;
  • Suh, Tae-Suk (Department of Biomedical Engineering, The Catholic University of Korea)
  • 투고 : 2014.12.08
  • 심사 : 2014.12.19
  • 발행 : 2014.12.30
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초록

이 연구는 비편평화여과기(flattening filter-free, FFF) 빔을 이용한 폐 정위절제방사선치료(stereotactic ablative radiotherapy, SABR)에 대하여 서로 다른 선량계산 알고리즘의 선량적 효과를 조사하였다. SABR를 받은 10명의 폐암 환자를 대상으로하여 평가하였다. 모든 치료계획은 Eclipse 치료계획시스템의 Acuros XB (AXB) 알고리즘을 이용하여 수립되었다. 다른 선량계산 알고리즘과 비교를 위하여, 추가적으로 anisotropic analytic algorithm (AAA) 알고리즘을 적용한 치료계획을 재 수립하였다. 두 알고리즘 평가를 위해서, 치료표적과 손상위험장기의 선량체적히스토그램(dose-volume histogrim, DVH)를 분석하였다. 그리고 기술적 인자로써 계산시간과 총 MU 값을 평가하였다. DVH 비교분석을 통해, PTV의 최대선량은 AXB이 AAA 보다 5.2% 높았으며 최소선량은 4.4% 낮게 나타났다. PTV의 $V_{105%}$에서 7.06%까지 큰 차이를 나타났다. 폐의 최대선량은 AXB 치료계획에서 약간 크게 나타났다. 동측성 폐에 5, 10과 20 Gy 선량이 조사되는 체적은 AAA 보다 AXB에서 더 크게 나타났으나 대측성 폐에 대해서는 거의 비슷하게 나타났다. 척수와 심장에서 최대선량의 차이도 크지 않았다. 계산시간의 경우, AXB가 AAA보다 13.7% 정도 소요시간이 적었고 MU 값은 AXB에서 3.47% 더 많았다. 이 연구의 결과들은 회전조절치료 기법을 포함하여 FFF 빔이 적용된 폐 SABR 치료계획에서 AXB 알고리즘은 선량계산의 정확성과 계산시간의 감소의 장점을 제공할 수 있을 것이다.

This study investigated the dosimetric effects of different dose calculation algorithm for lung stereotactic ablative radiotherapy (SABR) using flattening filter-free (FFF) beams. A total of 10 patients with lung cancer who were treated with SABR were evaluated. All treatment plans were created using an Acuros XB (AXB) of an Eclipse treatment planning system. An additional plans for comparison of different alagorithm recalcuated with anisotropic analytic algorithm (AAA) algorithm. To address both algorithms, the cumulative dose-volume histogram (DVH) was analyzed for the planning target volume (PTV) and organs at risk (OARs). Technical parameters, such as the computation times and total monitor units (MUs), were also evaluated. A comparison analysis of DVHs from these plans revealed the PTV for AXB estimated a higher maximum dose (5.2%) and lower minimum dose (4.2%) than that of the AAA. The highest dose difference observed 7.06% for the PTV $V_{105%}$. The maximum dose to the lung was also slightly larger in the AXB plans. The percentate volumes of the ipsilateral lung ($V_5$, $V_{10}$, $V_{20}$) receiving 5, 10, and 20 Gy were also larger in AXB plans than for AAA plans. However, these parameters were comparable between both AAA and AXB plans for the contralateral lung. The differences of the maximum dose for the spinal cord and heart were also small. The computation time of AXB plans was 13.7% shorter than that of AAA plans. The average MUs were 3.47% larger for AXB plans than for AAA plans. The results of this study suggest that AXB algorithm can provide advantages such as accurate dose calculations and reduced computation time in lung SABR plan using FFF beams, especially for volumetric modulated arc therapy technique.

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피인용 문헌

  1. Comparison of VMAT‐SABR treatment plans with flattening filter (FF) and flattening filter‐free (FFF) beam for localized prostate cancer vol.16, pp.6, 2014, https://doi.org/10.1120/jacmp.v16i6.5728
  2. Dosimetric comparison of a 6-MV flattening-filter and a flattening-filter-free beam for lung stereotactic ablative radiotherapy treatment vol.67, pp.9, 2014, https://doi.org/10.3938/jkps.67.1672
  3. Dosimetric accuracy of AAA and acuros XB dose calculations within an air cavity for small fields of a 6-MV flattening filter-free beam vol.67, pp.12, 2015, https://doi.org/10.3938/jkps.67.2138
  4. Comparison of Dosimetric Performance among Commercial Quality Assurance Systems for Verifying Pretreatment Plans of Stereotactic Body Radiotherapy Using Flattening-Filter-Free Beams vol.31, pp.11, 2014, https://doi.org/10.3346/jkms.2016.31.11.1742