International Spine Radiosurgery Consortium Consensus Guidelines에 따른Spine Stereotactic Radiosurgery에서 IMRT와 VMAT의 비교연구
- International Spine Radiosurgery Consortium Consensus Guidelines에 따른Spine Stereotactic Radiosurgery에서 IMRT와 VMAT의 비교연구
- Other Titles
- Comparison of IMRT and VMAT Techniques in Spine Stereotactic Radiosurgery with International Spine Radiosurgery Consortium Consensus Guidelines
- 강민규; 김성규; 오세안; 예지원
- 정위적 체부 방사선치료; International Spine Radiosurgery Consortium (ISRC); 세기조절방사선치료; 체적변조회전치료; Stereotactic body radiation therapy (SBRT); International Spine Radiosurgery Consortium (ISRC); Intensity-modulated radiation therapy (IMRT); Volumetric-modulated arc therapy (VMAT)
- Issue Date
- 의학물리, v.24, no.3, pp.145 - 153
- Stereotactic body radiation therapy (SBRT) is increasingly used to treat spinal metastases. To achieve the higheststeep dose gradients and conformal dose distributions of target tumors, intensity-modulated radiation therapy(IMRT) and volumetric-modulated arc therapy (VMAT) techniques are essential to spine radiosurgery. The purposeof the study was to qualitatively compare IMRT and VMAT techniques with International Spine RadiosurgeryConsortium (ISRC) contoured consensus guidelines for target volume definition. Planning target volume (PTV)was categorized as TB, TBPT and TST depending on sectors involved; TB (vertebral body only), TBPT (vertebral body+pedicle+transverse process), and TST (spinous process+transverse process). Three patients treated for spinaltumor in the cervical, thoracic, and lumbar region were selected. Eacg tumor was contoured by the definitionfrom the ISRC guideline. Maximum spinal cord dose were 12.46 Gy, 12.17 Gy and 11.36 Gy for TB, TBPT andTST sites, and 11.81 Gy, 12.19 Gy and 11.99 Gy for the IMRT, RA1 and RA2 techniques, respectively. Averagefall-off dose distance from 90% to 50% isodose line for TB, TBPT, and TST sites were 3.5 mm, 3.3 mm and3.9 mm and 3.7 mm, 3.7 mm and 3.3 mm for the IMRT, RA1 and RA2 techniques, respectively. For the mostcomplicated target TBPT sites in the cervical, thoracic and lumbar regions, the conformity index of the IMRT, RA1and RA2 is 0.621, 0.761 and 0.817 and 0.755, 0.796 and 0.824 for rDHI. Both IMRT and VMAT techniquesdelivered high conformal dose distributions in spine stereotactic radiosurgery. However, if the target volumeincludes the vertebral body, pedicle, and transverse process, IMRT planning resulted in insufficient conformityindex, compared to VMAT planning. Nevertheless, IMRT technique was more effective in reducing the maximumspinal cord dose compared to RA1 and RA2 techniques at most sites.
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