Background Stereotactic body radiotherapy(SBRT)is an effective treatment for early-stage non-small cell lung cancer.However,patient breathing can affect treatment accuracy.Therefore,this study aimed to develop a bi-po...Background Stereotactic body radiotherapy(SBRT)is an effective treatment for early-stage non-small cell lung cancer.However,patient breathing can affect treatment accuracy.Therefore,this study aimed to develop a bi-polar(BP)gated motion management strategy for SBRT and evaluate its feasibility geometrically and dosimetrically.Methods The BP strategy involved instructing patients to hold their breath briefly at the end of both inhalation(EI)and exhalation(EE),with radiation delivered only during these breath-holding periods.Eight volunteers were included to evaluate breathing stability,repeatability,and patient comfort.Additionally,15 patients were retrospectively studied to evaluate the geometric and dosimetric efficiency of BP in intensity-modulated radiation therapy(IMRT)and volumetric modulated arc therapy(VMAT)modes.BP plans were compared with four common breathing strategies:free breathing(FB),gating at the end of inhalation(GI),gating at the end of exhalation(GE),and real-time tracking(RT).Results Volunteers could comfortably hold their breath for>3 minutes,demonstrating good stability and repeatability.Geometrically,the ratio of BP's internal target volume(ITV)to GI's ITV was the smallest at 0.65,compared to 1.89 for FB,1.05 for GE,and 0.68 for RT.In the dosimetric evaluation of IMRT plans,the lung V20Gy ratio for BP to GI was the smallest at 0.89.Similar trends were observed for VMAT plans.Conclusions The BP strategy is a feasible option for lung SBRT,offering reduced treatment volumes and normal tissue toxicity,with a high duty cycle and less technical complexity than other RT-based methods.展开更多
The aim of radiotherapy(RT)is to deliver prescribed doses to tumors while sparing neighboring organs at risk.As the demand for treatment precision increases in modern RT,intrafractional motion management becomes criti...The aim of radiotherapy(RT)is to deliver prescribed doses to tumors while sparing neighboring organs at risk.As the demand for treatment precision increases in modern RT,intrafractional motion management becomes critical for achieving high precision,particularly for tumors in the thorax and abdomen that are affected by respiration and other physiological motions.Deep learning(DL)has demonstrated strong po-tential in addressing the limitations of conventional methods by enabling rapid and accurate tumor motion detection,tumor location prediction,and management measures.This review provides a comprehensive overview of recent DL-based applications in intrafractional motion management,which are categorized into three areas:(1)tumor motion detection for real-time tumor localization,(2)tumor location prediction to compensate for the latency of the motion management system,and(3)management measures,including gating and real-time adaptive RT.In addition,this review discusses key challenges and their potential so-lutions for DL-based motion management.展开更多
文摘Background Stereotactic body radiotherapy(SBRT)is an effective treatment for early-stage non-small cell lung cancer.However,patient breathing can affect treatment accuracy.Therefore,this study aimed to develop a bi-polar(BP)gated motion management strategy for SBRT and evaluate its feasibility geometrically and dosimetrically.Methods The BP strategy involved instructing patients to hold their breath briefly at the end of both inhalation(EI)and exhalation(EE),with radiation delivered only during these breath-holding periods.Eight volunteers were included to evaluate breathing stability,repeatability,and patient comfort.Additionally,15 patients were retrospectively studied to evaluate the geometric and dosimetric efficiency of BP in intensity-modulated radiation therapy(IMRT)and volumetric modulated arc therapy(VMAT)modes.BP plans were compared with four common breathing strategies:free breathing(FB),gating at the end of inhalation(GI),gating at the end of exhalation(GE),and real-time tracking(RT).Results Volunteers could comfortably hold their breath for>3 minutes,demonstrating good stability and repeatability.Geometrically,the ratio of BP's internal target volume(ITV)to GI's ITV was the smallest at 0.65,compared to 1.89 for FB,1.05 for GE,and 0.68 for RT.In the dosimetric evaluation of IMRT plans,the lung V20Gy ratio for BP to GI was the smallest at 0.89.Similar trends were observed for VMAT plans.Conclusions The BP strategy is a feasible option for lung SBRT,offering reduced treatment volumes and normal tissue toxicity,with a high duty cycle and less technical complexity than other RT-based methods.
基金funded by Beijing Natural Science Foundation(Grant No.:7242112,1242036)the National Natural Science Foundation of China(Grant No.:12205375,12205376)Beijing Hope Run Special Fund of Cancer Foundation of China(Grant No.:LC2022B28).
文摘The aim of radiotherapy(RT)is to deliver prescribed doses to tumors while sparing neighboring organs at risk.As the demand for treatment precision increases in modern RT,intrafractional motion management becomes critical for achieving high precision,particularly for tumors in the thorax and abdomen that are affected by respiration and other physiological motions.Deep learning(DL)has demonstrated strong po-tential in addressing the limitations of conventional methods by enabling rapid and accurate tumor motion detection,tumor location prediction,and management measures.This review provides a comprehensive overview of recent DL-based applications in intrafractional motion management,which are categorized into three areas:(1)tumor motion detection for real-time tumor localization,(2)tumor location prediction to compensate for the latency of the motion management system,and(3)management measures,including gating and real-time adaptive RT.In addition,this review discusses key challenges and their potential so-lutions for DL-based motion management.
