摘要Radiation oncology is one of the three major treatment modalities to manage cancer patient cares, and is a discipline mainly driven by technology and medical devices. Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s) while maximizing the sparing of normal organ structures. Recently, different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options. Besides linear accelerators (Linac) that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns, imaging systems, computer information and calculation systems have been more and more integrated into radiotherapy processes. To bring radiotherapy to a potentially higher level, many institutions have either acquired or started to consider particle therapy, especially proton therapy. The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems. This paper is intended to provide an introductory description of radiation oncology and related procedures, and to provide an overview of the current status of medical devices in radiotherapy in the United States of America. This paper covers the radiation delivery systems, imaging systems, treatment planning systems, record and verify systems, and QA systems.
Abstract：Radiation oncology is one of the three major treatment modalities to manage cancer patient cares, and is a discipline mainly driven by technology and medical devices. Modern radiation treatments have become fairly complex and involve in utilizing a variety of medical devices to achieve the goal of providing conformal radiation dose coverage to the tumor target(s) while maximizing the sparing of normal organ structures. Recently, different forms of linear accelerators/radioactive source based machines have been invented and developed with the aim of providing improved treatments and more treatment options. Besides linear accelerators (Linac) that have been undergoing constant improvement and advancement and can deliver fairly complicated dose distribution patterns, imaging systems, computer information and calculation systems have been more and more integrated into radiotherapy processes. To bring radiotherapy to a potentially higher level, many institutions have either acquired or started to consider particle therapy, especially proton therapy. The complexity of modern radiotherapy demands in-depth understanding of radiation physics and machine engineering as well as computer information systems. This paper is intended to provide an introductory description of radiation oncology and related procedures, and to provide an overview of the current status of medical devices in radiotherapy in the United States of America. This paper covers the radiation delivery systems, imaging systems, treatment planning systems, record and verify systems, and QA systems.
Ning J. Yue, Ph.D., Professor,
Ting Chen, Ph.D., Assistant Professor
Wei Zou, Ph.D., Assistant Professor. Radiation Oncology and Medical Devices ( Part 2)[J]. 中国医疗设备, 2014, 29(2): 1-10.
Ning J. Yue, Ph.D., Professor,
Ting Chen, Ph.D., Assistant Professor
Wei Zou, Ph.D., Assistant Professor. Radiation Oncology and Medical Devices ( Part 2). China Medical Devices, 2014, 29(2): 1-10.
Beaulieu L,Carlsson Tedgren A,Carrier JF,et al.Report of the Task Group 186 on model-based dose calculation methods in brachytherapy beyond the TG-43 formalism: current status and recommendations for clinical implementation[J/OL].Med Phys.2012,39(10):6208-36.
[15]
Kutcher GJ,Coia L,Gillin M,et al.Comprehensive QA for radiation oncology:report of AAPM Radiation Therapy Committee Task Group 40[J].Med Phys.1994,21(4):581-618.
[19]
Dieterich S,Cavedon C,Chuang CF,et al.Report of AAPM TG 135:quality assurance for robotic radiosurgery[J].Med Phys.2011,38(6):2914-36.
[17]
Mutic S,Palta JR,Butker EK,et al.Quality assurance for computed-tomography simulators and the computed-tomography-simulation process: report of the AAPM Radiation Therapy Committee Task Group No.66[J].Med Phys.2003,30(10):2762-92.
[16]
Fraass B,Doppke K,Hunt M,et al.American Association of Physicists in Medicine Radiation Therapy Committee Task Group 53:quality assurance for clinical radiotherapy treatment planning[J].Med Phys.1998,25(10):1773-829.
[18]
Pfeiffer D,Sutlief S,Feng W,et al.AAPM Task Group 128: quality assurance tests for prostate brachytherapy ultrasound systems[J].Med Phys.2008,35(12):5471-89.
[24]
Bissonnette JP,Balter PA,Dong L,et al.Quality assurance for image-guided radiation therapy utilizing CT-based technologies:a report of the AAPM TG-179[J].Med Phys. 2012,39(4):1946-63.
[9]
Rivard MJ,Coursey BM,DeWerd LA,et al.Update of AAPM Task Group No.43 Report:A revised AAPM protocol for brachytherapy dose calculations[J/OL].Med Phys.2004,31(3):633-74.
[11]
Rivard MJ,Davis SD,DeWerd LA,et al.Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-ray Source:an electronic brachytherapy source[J/DB].Med Phys.2006,33(11):4020-32.
[20]
Klein EE,Hanley J,Bayouth J,et al.Task Group 142,American Association of Physicists in Medicine.Task Group 142 report: quality assurance of medical accelerators[J].Med Phys.2009,36(9):4197- 212.
[23]
Molloy JA,Chan G,Markovic A,et al.Quality assurance of U.S.-guided external beam radiotherapy for prostate cancer: report of AAPM Task Group 154[J].Med Phys.2011,38(2):857-71.
[21]
Willoughby T,Lehmann J,Bencomo JA,et al.Quality assurance for nonradiographic radiotherapy localization and positioning systems:report of Task Group 147[J].Med Phys.2012,39(4):1728-47.
[8]
Perez-Calatyaud J,Ballester F,Das RK,et al.Dose calculation for photon-emitting brachytherapy sources with average energy higher than 50 keV:report of the AAPM and ESTRO[J/DB]. Med Phys.2012,39(5):2904-29.
[10]
Nath R,Anderson LL,Luxton G,et al.Dosimetry of interstitial brachytherapy sources:recommendations of the AAPM Radiation Therapy Committee Task Group No.43.American Association of Physicists in Medicine[J/OL].Med Phys.1995,22(2):209-34.
[13]
AAPM.AAPM report no.96:The measurement, reporting, and management of radiation dose in CT[R].Report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. College Park,MD:AAPM, 2008.
[14]
AAPM.AAPM report no.111:Comprehensive methodology for the evaluation of radiation dose in X-ray computed tomography[R]//Report of AAPM Task Group 111:The future of CT dosimetry.College Park,MD:AAPM,2010.
[22]
Langen KM,Papanikolaou N,Balog J,et al.QA for helical tomotherapy:report of the AAPM Task Group 148[J].Med Phys. 2010,37(9):4817-53.
