Application of OSMS in radiotherapy of children's tumors
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摘要:
目的探讨光学体表追踪技术（OSMS）在儿童肿瘤精准放射治疗中的摆位精度及其应用价值。 方法选取6例儿童肿瘤患者，应用体表标记、激光灯配合OSMS协助摆位，每次摆位后治疗前进行锥形束CT（CBCT）扫描。分别记录OSMS及CBCT的左右、头脚、上下方向移动的误差。分析两组摆位误差关系，应用Bland-Altman法评估两种系统的一致性。治疗期间利用OSMS监测患者体位变化。 结果CBCT与OSMS的左右、头脚、上下方向的移动误差分别是：0.207±0.076 cm，0.207±0.073 cm；0.186±0.072 cm，0.183±0.069 cm；0.206±0.068 cm，0.198±0.071 cm，差异均无统计学意义（P>0.05）。在CBCT与OSMS的左右、头脚、上下方向的移动差值分别有4.65%（6/129）、5.43%（7/129）、3.88%（5/129）在95% LoA之外，在其一致性范围内，差值的绝对值最大分别为0.06、0.09、0.11 cm。 结论OSMS是一种高精度、高效的图像引导方式，能精准地减少摆位误差，提高摆位的效率，适合于儿童肿瘤的精准放疗。 Abstract:ObjectiveTo explore the positioning accuracy and application value of optical body surface tracking technology (OSMS) in precision radiotherapy for children's tumors. MethodsSix pediatric tumor patients were included. The body surface marking, laser light and optical surface tracking technology (OSMS) were applied to verified the patients pretreatment position, and perform CBCT scan before treatment after each positioning. The error of the left and right, head and foot, up and down directions of OSMS and CBCT were record. The χ2 test was used to compare the two groups to analyze the set-up error relationship between the two groups, and the Bland-Altman method was used to evaluate the consistency of the two systems. During treatment, the patient's posture changes were observed by OSMS monitors. ResultsThe movement errors of CBCT and OSMS in the left and right, head and foot, and up and down directions were: 0.207±0.076 cm, 0.207±0.073 cm; 0.186±0.072 cm, 0.183±0.069 cm; 0.206±0.068 cm, 0.198±0.071 cm, which had no significant difference (P>0.05). There were 4.65% (6/129), 5.43% (7/129), 3.88% (5/129) of movement differences between CBCT and OSMS in the left and right, head and foot, up and down directions Outside of 95% LoA. In the consistency range, the maximum absolute values of the differences were 0.06, 0.09, 0.11 cm, respectively. ConclusionOSMS is a high-precision and high-efficiency image guidance method, which can accurately reduce positioning errors and improve positioning efficiency. It is suitable for precise radiotherapy of childhood tumors. -
Key words:
- childhood tumors /
- image-guided radiotherapy /
- OSMS /
- CBCT /
- set-up error
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图 2 皮肤表面的红色区域为OSMS激光投射区
Figure 2. The red area of the skin surface is the OSMS laser projection area.
图 4 CBCT与OSMS在左右方向位移的相关性
Figure 4. The correlation between CBCT and OSMS displacement in the left and right directions.
图 5 CBCT与OSMS在头脚方向位移的相关性
Figure 5. The correlation between CBCT and OSMS displacement in the head-to-foot direction.
图 6 CBCT与OSMS在上下方向位移的相关性
Figure 6. The correlation between CBCT and OSMS displacement in the up and down direction.
表 1 患者摆位移动统计
Table 1. Statistics of patient position movement(cm)
参数 左右 头脚 上下 CBCT OSMS CBCT OSMS CBCT OSMS 均数 0.207 0.207 0.187 0.183 0.206 0.198 标准差 0.076 0.073 0.072 0.073 0.068 0.071 t 0.037 0.724 1.710 P 0.971 0.471 0.090 CBCT: 锥形束CT; OSMS: 光学体表追踪技术. 
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