调强适形放射治疗的QA(QC)

QA(QC)CT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)CT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)CT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)CT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)3-DVirtualPatientExample:NPCcaseIMRTCT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)QA(QC)•---•IMRTQAQCQA(QC)•---•IMRTQAQCCT•CT•IMRTQAQCQA(QC)•---•IMRTQAQCVerificationinPhantom•PositioningCo-ordinatesVerification•Dose&DoseDistributionsVerificationIMRTTransferPlaninVirtualPatientHybridPlaninPhantomVerificationPhantomAbsoluteDoseMeasurementinPhantomIMRTVerificationPhantomDoseDistributionsMeasurementIMRTGelDosimetryDoseVerificationIMRTDoseDiscrepanciesCaseNo.DoseDiscrepanciesbetweenmeasuredandCalculatedinphantomforIMRTCasesTreatedUptoJune2003,totalpatients101withaveragedeviation2.49%±SD2.73%12over101casesoverpassthelimitM.U.CheckIMRTQAQCCT(3D)(2D)(2D,3D)(X,CT)()(DRR)(X,EDIP)QA(QC)•MLCCTQAQC•GTVCTVITV•ABC••EPID•QA(QC)•MLCCTQAQC•GTVCTVITV•ABC••EPID•MLCCTQAQC•••()••()•M.U.~cGyIMRTQAQCMLCCTQAQC•••()••()•M.U.~cGyIMRTQAQCMLCQA(QC)•MLC–MLC–MLC–MLC–MLCGA(0°90°270°180°)•Scp(Sc)M.U.•M.U.IMRTQAQCMLCQA(QC)•MLC–MLC–MLC–MLC–MLCGA(0°90°270°180°)•Scp(Sc)M.U.•M.U.IMRTQAQCMLCMLCIMRTQAQCMLCMLCIMRTQAQCMLCQA(QC)•MLC–MLC–MLC–MLC–MLCGA(0°90°270°180°)•Scp(Sc)M.U.•M.U.IMRTQAQCScp(Sc)M.U.MLCQA(QC)•MLC–MLC–MLC–MLC–MLCGA(0°,90°270°180°)•Scp(Sc)M.U.•M.U.IMRTQAQCM.U.M.U.M.U.M.U.M.U.•IMRT•–X––(NomosMimic)•––IMRTQA&QC•••QA&QC••••••IMRT•––•––•IMRT,IMRT•IMRT•–––•:()••••••1:•–––•––––MLC2:••••CRT–AAPM55–NCSRadiotherOncol60:203-213,2001•IMRT–:XY:XY:XY:::NOMOS•••3:•IMRT≤3mm•4:••5:••6:()CRT*IMRT#A()1.()2%/2.3%3-4%3.(30%/cm)3mm3-4mm4.3%3-4%30%35%()CRT*IMRT#B1D1.3%/C1.4%5%2.(30%/cm)4mm4-5mm3.3%4%40%45-50%•,•MLCMLCElekta20-12.50.5Siemens20-10Varian20-16:•IMRT1-2•–1-2–2-4–MLC3-5••TPS•QA(QC)******1/4•IMRTQA&QCQA&QC•–––QA&QC•••TPSQA(QC)