摘要
目的研究肝动脉化疗栓塞治疗后肝脏肿瘤内碘油沉积对碳离子放疗剂量的影响。方法对比纯碘油、纯凝胶和碘油凝胶混合物实际相对水阻止本领(RLSP)和其CT图像转化获得的RLSP。在7例典型有碘油沉积病例的CT图像上制定碳离子放疗计划,然后基于前述分析结果,将碘油沉积区域RLSP修正为正常肝组织,将先前制定碳离子放疗计划在修正后CT图像上重新计算,比较在不同CT图像上等效水深度和剂量分布的差异。结果依据CT图像HU值,碘油和碘油凝胶混合物转化的RLSP比实际测量值增加4.6%~139.0%。7例临床病例中,原始图像上碘油沉积可致射野路径上的等效水深度平均增加(0.89±0.41)cm,可使靶区远端1 cm区域内平均剂量升高(3.83±1.71)Gy(相对生物剂量)。结论在肝动脉化疗栓塞治疗后有碘油沉积的CT图像上制定碳离子治疗计划时需将碘油沉积部位的HU值或RLSP修正为正常肝组织。
Objective To investigate the effect of lipiodol as embolization agents in liver,after transcatheter arterial chemoembolization,on dose calculation under the carbon ion treatment plan.Methods The actual relative linear stopping powers(RLSP)in pure lipiodol,pure gel and lipiodol-gel mixture,together with the correctd RLSPs from their CT images,were compared.In seven typical cases with lipiodol deposition area,carbon ion treatment plan was performed for the original lipiodol images.Successively on the basis of analysis that has made,the RLSP in lipiodol deposition area was corrected to be as in normal liver tissue,for which the carbon ion treatment plan was again performed.A comparison was made of differences in water equivalent depth(WED)and dose distribution on different CT images.Results The RLSP value corrected according to CT image HU value,lipiodol,and lipiodol-gel mixture may increase by 4.6%-139.0%compared with the measured value.In seven typical cases,deposited lipiodol can cause WED to increase by(0.89±0.41)cm along the field track and RBE by(3.83±1.71)Gy within the 1 cm of distal area of target.Conclusions In order to improve the accuracy of dose distribution calculation,the HU value and/or RLSP in deposited lipiodol area in liver after transcatheter arterial chemoembolization should being corrected to be as in the normal liver tissue.
作者
尤丹
赵静芳
王巍伟
盛尹祥子
王征
黄志杰
Kambiz Shahnazi
陆嘉德
You Dan;Zhao Jingfang;Wang Weiwei;Sheng Yinxiangzi;Wang Zheng;Huang Zhijie;Kambiz Shahnazi;Lu Jiade(Department of Medical Physics,Shanghai Proton and Heavy Ion Center/Fudan University Cancer Hospital,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China;Department of Medical Physics,Shanghai Proton and Heavy Ion Center,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China;Department of Radiation Oncology,Shanghai Proton and Heavy Ion Center,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China)
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2019年第11期864-869,共6页
Chinese Journal of Radiological Medicine and Protection
基金
上海市卫生与计划生育委员会面上基金项目(201840235)。
关键词
肝动脉化疗栓塞
碘油
碳离子治疗
相对水阻止本领
Transcatheter arterial chemoembolization
Lipiodol
Carbon-ion
Relative stopping power
