调强逆向治疗计划中使用简化剂量计算模型的影响及其改善方法

制定逆向放疗计划时往往使用计算效率较高的简化剂量计算模型来得到射束元剂量矩阵,但使用简化的剂量计算模型可能会对最终调强计划的质量产生一定的影响.我们研究了在制定调强计划时使用简化剂量计算模型得到射束元剂量分布对最终沉积剂量的影响及其改善方法.采用两个模拟实例,使用两种剂量计算模型:原射线剂量计算模型(不考虑散射线的影响)和微分卷积积分剂量计算模型(考虑散射线的影响).结果表明用原射线剂量计算模型得到射束元剂量矩阵作调强最优化,可能导致靶区边缘剂量欠缺的情况,采用给靶区加扩展区的方法和平移叠野法可以改善靶区边缘的剂量分布情况.

The Influence of Using Simplified Model for Beamlet Dose Calculations in IMRT Treatment Planning and the Approaches to Diminish the Influence

Simplified dose calculation model with high computation efficiency is often used to generate the dose matrices for beamlets in the inverse planning of the intensity modulate radiation therapy. It is likely that this simplification could degrade the quality of the final treatment plans. This paper is aimed at testing the influence of such simplification in dose calculations of beamlets and accordingly proposing methods to avoid severe degradation of the plans. Two simulation instances were adopted. The primary dose calculation model without involvment of scattering effect was used to generate the dose matrices of beamlets. The differential convolution superposition dose calculation model that well accounts for scattering effect was used to calculate the final dose distributions for given intensity profiles. It is found that the simplification in dose matrices of beamlets degrades the dose levels in the edge area of the targets, however, the degradation could be diminished or even avoided by adding a suitable margin around the targets or by using the multiple-shifted-beamlet-matrices (MSBM) method that was proposed in our previous paper.