论文标题
伽马刀放射外科手术的计划质量控制方法
A plan quality control method of treatment planning for Gamma Knife radiosurgery
论文作者
论文摘要
随着许多变量进行调整,伽玛刀(GK)放射外科手术的常规手动远期计划非常复杂且繁琐。由此产生的计划质量在很大程度上取决于计划者的技能,经验和忠诚的努力,并且在案件,规划师和机构之间差异很大。希望GK计划的质量控制能够始终为每个患者提供高质量的计划。在这项研究中,我们通过构建高质量GK计划数据库提出了一种用于GK计划的质量控制方法。通过目标体积,目标形状复杂性以及目标和附近器官之间的空间关系描述了患者解剖结构,这确定了GK计划难度水平。使用目标覆盖率,选择性,中剂量溢出,最大剂量至0.1 cc的脑干,同侧耳蜗的平均剂量和束 - 束时间来评估计划质量。创建新计划时,将从数据库中识别具有最相似目标量大小和形状复杂性的高质量计划。还建立了一个模型,以根据其重叠体积直方图预测脑干和耳蜗的剂量。确定的参考计划和预测的器官剂量将帮助计划者相应地做出质量控制决策。为了验证这种方法,我们已经建立了一个用于前庭造型瘤的数据库,由于目标不规则及其与脑干和耳蜗的距离,这被认为对GK计划具有挑战性。测试了五起病例,其中一个案例被认为是高质量的,四个病例的计划质量低于预测。这四个案件被重新认可并大大改善。我们的结果证明了我们提出的质量控制方法的功效。该方法还可以用作计划质量预测方法,以促进为GK放射外科手术的自动治疗计划的制定。
With many variables to adjust, conventional manual forward planning for Gamma Knife (GK) radiosurgery is very complicated and cumbersome. The resulting plan quality heavily depends on planners skills, experiences and devoted efforts, and varies significantly among cases, planners, and institutions. Quality control for GK planning is desired to consistently provide high-quality plan to each patient. In this study, we proposed a quality control method for GK planning by building a database of high-quality GK plans. Patient anatomy was described by target volume, target shape complexity, and spatial relationship between target and nearby organs, which determine GK planning difficulty level. Plan quality was evaluated using target coverage, selectivity, intermediate dose spillage, maximum dose to 0.1 cc of brainstem, mean dose of ipsilateral cochlea, and beam-on time. When a new plan is created, a high-quality plan that has the most similar target volume size and shape complexity will be identified from the database. A model has also been built to predict the dose to brainstem and cochlea based on their overlap volume histograms. The identified reference plan and the predicted organ dose will help planners to make quality control decisions accordingly. To validate this method, we have built a database for vestibular schwannoma, which are considered to be challenging for GK planning due to the irregularly-shaped target and its proximity to brainstem and cochlea. Five cases were tested, among which one case was considered to be of high quality and four cases had a lower plan quality than prediction. These four cases were replanned and got substantially improved. Our results have demonstrated the efficacy of our proposed quality control method. This method may also be used as a plan quality prediction method to facilitate the development of automatic treatment planning for GK radiosurgery.