MosaiQ系统验证摆位误差和治疗精度的临床应用

目的 探讨MosaiQ系统在图像引导放疗（IGRT）中验证摆位误差和治疗精度的效果和临床应用价值。方法 收集2014年1月8日至2017年5月30日行IGRT的510例恶性肿瘤患者。通过初审和终审的摆位误差，以及IGRT前MosaiQ系统记录的加速器治疗床值和校位完成后记录的治疗床值，统计分析各个部位肿瘤摆位误差的大小和治疗精度。结果头脚（Y）、左右（X）和前后（Z）3个方向上，头脚方向摆位误差最大（P＜005）；头部、头颈部、胸部、腹部、盆腔5个部位中，腹部肿瘤摆位误差最大（P＜0.05）；初审与终审间摆位误差的差异较小（P＞0.05），3个方向摆位误差的均值都小于2 mm。5个部位治疗精准率的差异无统计学意义（P＞0.05），且均超过了80.0％；头脚（Y）方向的精确率为84.7％，低于左右（X）和前后（Z）方向（P＜0.05）。结论 应用MosaiQ系统记录摆位误差和治疗精度可以对放疗技师在治疗摆位中起到规范作用，实现IGRT的全方位监控，为科室的放疗质量控制和质量保证提供理论及数据支持。

Study on setup errors and treatment accuracy in image guided radiotherapy based on MosaiQ

ObjectiveTo investigate the efficacy and the application value of MosaiQ system in image guided radiotherapy（IGRT）. MethodsFrom 8 Jan 2014 to 30 May 2017, 510 patients with malignancies receiving IGRT were enrolled. The setup errors required from the first trial and the final trial， and the accelerator treatment bed values before IGRT and after the calibration position were recorded. The tumor setup errors and the treatment accuracy of radiotherapy were analyzed statistically. ResultsThe setup errors of Y direction were the largest compared with X and Z directions（P＜0.05）. Abdominal tumor setup errors were the largest compared with head， head and neck， chest， abdomen and pelvis（P＜0.05）. The difference between the first trial and the final decision had no statistical significance （P＞0.05）， and the mean value of setup errors was less than 2 mm. The treatment accuracy for all parts had no differences （P＞0.05）， and the accuracy was more than 800％. The accuracy of Y direction was 84.7％， lower than X and Z directions （P＜0.05）. ConclusionMosaiQ system can achieve all round monitoring of IGRT， improve the accuracy of treatment， and provide theoretical and data support for quality control and assurance in the department of radiotherapy.