用切伦科夫成像监测乳腺放疗中组织变形，提升定位精度。
Cherenkov Imaged Bio-morphological Features Verify Patient Positioning with Deformable Tissue Translocation in Breast Radiotherapy
- 通过切伦科夫图像分析血流特征，追踪局部组织形变。
- 临床数据表明，患者间分数间定位偏差达3.7±2.4 mm，局部变形达3.3±1.9 mm。
- 适合关注放疗精准定位与形变监测的临床医生与物理师。
精确的患者定位对放疗剂量精准递送至关重要，定位误差会显著影响治疗效果。本研究提出一种基于切伦科夫成像分析的新方法，用于追踪分次乳腺癌放疗中的局域组织形变。主要目标是开发并验证一种基于切伦科夫图像的局域位置精度量化算法，尤其针对放疗中缺乏理想量化手段的局域形变。利用组织仿体在逐步移动下的切伦科夫图像，实现血管检测与分割，并应用于10例患者的分次全乳放疗数据。结合刚性与非刚性配准技术，检测分次间及分次内定位变化：刚性配准获得全局位移，非刚性配准生成二维局域形变图。该方法通过人体仿生胸腔模型实验验证，模拟了高达20 mm的治疗床位移和呼吸运动，平均定位精度达0.83 mm。临床切伦科夫数据分析显示，分次间设置偏差为3.7±2.4 mm（以首次分次为基准），局域形变（95百分位）最高达3.3±1.9 mm。本研究证明了基于切伦科夫成像的全局与局部定位变化量化方法可行性，可有效捕捉传统影像技术难以捕捉的局域形变。
原文摘要 · Abstract (English)
Accurate patient positioning is critical for precise radiotherapy dose delivery, as positioning errors can significantly affect treatment outcomes. This study introduces a novel method for tracking loco-regional tissue deformation through Cherenkov image analysis during fractionated breast cancer radiotherapy. The primary goal was to develop and test an algorithm for Cherenkov-based regional position accuracy quantification, specifically for loco-regional deformations, which lack ideal quantification methods in radiotherapy. Blood vessel detection and segmentation were developed in Cherenkov images using a tissue phantom with incremental movements, and later applied to images from fractionated whole breast radiotherapy in human patients (n=10). A combined rigid and non-rigid registration technique was used to detect inter- and intra-fractional positioning variations. This approach quantified positioning variations in two parts: a global shift from rigid registration and a two-dimensional variation map of loco-regional deformation from non-rigid registration. The methodology was validated using an anthropomorphic chest phantom experiment, where known treatment couch translations and respiratory motion were simulated to assess inter- and intra-fractional uncertainties, yielding an average accuracy of 0.83 mm for couch translations up to 20 mm. Analysis of clinical Cherenkov data from ten breast cancer patients showed an inter-fraction setup variation of 3.7 plus minus 2.4 mm relative to the first fraction and loco-regional deformations (95th percentile) of up to 3.3 plus minus 1.9 mm. This study presents a Cherenkov-based approach to quantify global and local positioning variations, demonstrating feasibility in addressing loco-regional deformations that conventional imaging techniques fail to capture.
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