肺癌放疗中的运动管理.ppt

Special ways for intrafraction movement. 1. curving the total movement: Advantages 1. curving the total movement: Defects 1)dont observe where tumor is. 2)working procedure and equipment are easy 1)involve more organs 2)increase dose exposed on organ 3)working procedure of registering CT image is multifarious Special ways for intrafraction movement. 2.curving the part movement:How to know tumor position. External position sensor Internal fiducial Special ways for intrafraction movement. 2.curving the part movement:How to treat tumor. Special ways for intrafraction movement. 2.curving the part movement:Advantages. 2.curving the part movement:Defects. 1) reduce PTV 2)decrease dose exposed on organ 1)working procedure and equipment are complex. 2)establish and exchange relationship between external mark and tumor in vivo. 3)working procedure of registering CT image is multifarious. Special ways for intrafraction movement. 3.point:How to extend the residence time of tumor at this point. Special ways for intrafraction movement. 3.point:equipment. ABC techology Advantages of ABC techology 2)Decrease normal lung tissue density, therefore less healthy tissue in path of irradiation 1)reduce PTV at the most large. Defects of ABC techology ? Initial patient set up ? Detecting patient movement during treatment ? Patient training ? Patient compliance ? Repeatability of breath holding ? Margins added to compensate for all the above Special ways for intrafraction movement. 4.real-time tracking:equipment. Special ways for intrafraction movement. 4.real-time tracking:Advantages. 4.real-time tracking:Defects. 1)initiative pathway. 2)quality assurance and quality control is uncertain. 3)algorithm is very complex. 1)dont observe where tumor is. Average position 1)dont observe where tumor is. 2)working procedure and equipment are easy. 3) reduce PTV to a certain degree. 4)decrease dose exposed on organ. 3 phases 4 phases IMRT plan1 parameters： Lung V20=30%，V5=60%， M