Research on the Uncertain Liver Position with Active Breathing Coordinator for
the Treatment of Liver Cancer Particles Therapy
XIE Wenbo1,2,3
1. Department of Medical Physics, Shanghai Proton and Heavy Ion Center, Shanghai 201321, China丨
2. Shanghai Key Laboratory of Radiation Oncology, Shanghai 201321, China丨
3. Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201321, China
Abstract:Objective Active breathing coordinator (ABC) is an effective method to reduce organ movement induced by respiration, At
present, ABC has been used in photon radiation therapy, but there is no relevant report in particle therapy. In this study, when ABC was
used for particle therapy of hepatocellular carcinoma, the lipiodol location in liver was measured and analyzed. Methods Ten patients
with hepatocellular carcinoma were enrolled in this study. All 10 patients had good lipiodol deposition and successfully completed the
treatment. 100 sets of orthogonal verification portal images were taken. Before each fraction of treatment, position verification portal
images were taken near the target region to compare with the fused DRR images in the particle therapy system (Iontris Siemens). In
this study, lipiodol was used as a surrogate for liver tumors since lipiodol was implanted in all patients and the location of lipiodol
was relatively fixed with liver tumors. After the good image registration based on vertebral body, the deviation between lipiodol in
the verification portal image and that in the DRR was measured, and the data were recorded and analyzed in three directions: Lateral
(X-direction), Longitudinal (Y-direction) and Vertical (Z-direction). Results All 10 patients cooperated well, and no air leakage was
observed during the fluoroscopy of the inhale and breath holding stage. The mean errors of lipiodol position in three directions of Lat,
Long and Vert were (0.19±0.20) cm,(0.23±0.21) cm,and (0.18±0.19) cm respectively丨 the mean negative values of Lat, Long
and Vert were (-0.17±0.14) cm,(-0.22±0.21) cm,and (-0.19±0.16) cm respectively丨 the mean positive values of Lat, Long and
Vert were (0.22±0.24) cm,(0.25±0.21) cm,(0.19±0.22) cm, respectively. Conclusion By analyzing the data obtained, it can be
concluded that in liver particle therapy with lipiodol implanted, ABC can effectively control the liver position caused by respiration,
with good reproducibility and small uncertainty, which meets the clinical treatment standard of our hospital, and the data also can be
used as reference by physician when customized margin needed.
谢文波1,2,3. 主动呼吸控制用于肝癌粒子治疗肝脏位置不确定性研究[J]. 中国医疗设备, 2021, 36(7): 81-84.
XIE Wenbo1,2,3. Research on the Uncertain Liver Position with Active Breathing Coordinator for
the Treatment of Liver Cancer Particles Therapy. China Medical Devices, 2021, 36(7): 81-84.