Analysis of dosimetric verification results of intensity-modulated radiotherapy for breast cancer based on EPID fraction images
10.19745/j.1003-8868.2025106
- VernacularTitle:基于EPID分次影像的乳腺癌调强放疗剂量验证结果分析
- Author:
Xiao-hui WU
1
;
Ya-zheng CHEN
;
Zu-wen YAO
;
Rui LIU
;
Yang LIU
;
Xiao-hua WANG
Author Information
1. 遂宁市中心医院肿瘤中心放射治疗科,四川 遂宁 629018
- Publication Type:Journal Article
- Keywords:
electronic portal imaging device;
fraction image;
breast cancer;
IMRT;
dosimetric verification
- From:
Chinese Medical Equipment Journal
2025;46(6):54-58
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the stability and reproducibility of the treatment fractions during the intensity-modulated radiotherapy(IMRT)for breast cancer and the effect of respiratory motion on the dose irradiation of breast cancer radiotherapy by comparing the results of breast cancer dosimetric verification based on fractionated images by an electronic portal imaging device(EPID).Methods A total of 28 IMRT patients admitted to some hospital from January to June 2023 were grouped according to the pathological results and effects of respiratory motion on the accuracy of radiotherapy during clinical treatment,including 14 cases in a breast group and 14 cases in a non-breast group with 8 ones of head and neck tumors,5 ones of esophageal cancer and 1 case of cervical cancer.All the patients underwent a scan with cone beam computed tomography(CBCT)before the first radiotherapy,and image registration was carried out with a positioning CT.An EPID was used to acquire transmission dose images of 10 fractions of radiotherapy,and γ analysis was performed using the RIT 113 QA software to compare the images of the subsequent 9 fractions with those of the first fraction,with the images of the first fraction of radiotherapy as the baseline values.Absolute maximum dose normalization was implemented under the condition of 10%dose assessment threshold,and the γ-pass rates under the 3 criteria of 2%/2 mm,3%/2 mm and 3%/3 mm were counted separately.The fraction dose verification results of the 28 patients were divided into 3 treatment phases of 2-4 times(T1),5-7 times(T2)and 8-10 times(T3)to analyze the stability of dose irradiation during the radiotherapy.SPSS 22.0 software was used for statistical analysis.Results Under the condition of 10%dose assessment threshold,the breast and non-breast groups had the γ-pass rates being(95.80±2.65)%and(94.60±6.59)%under the 2%/2 mm criterion and(98.46±1.31)%and(97.50±3.30)%under the 3%/2 mm criterion respectively,and the differences were statistically significant(all P<0.05).Under the assessment criteria of 2%/2 mm,3%/2 mm and 3%/3 mm,the breast group had the γ-pass rates of fractions of treatment significantly lower than those of the non-breast group(all P<0.05),while the γ-pass rates showed no significant differences at T1,T2 and T3 treatment phases(all P>0.05).Conclusion EPID fraction images contribute to evaluating IMRT accuracy effectively.IMRT has high stability and reproducibility during the treatment cycle,while respiration may result in dose deviation during the fraction radiotherapy for breast cancer,and optical surface tracking technology or active breathing control technology is suggested to be involved in to relieve dose deviation.[Chinese Medical Equipment Journal,2025,46(6):54-58]