股骨CT图像的边缘提取

为重建和测量股骨的解剖结构,需要大量地读取CT图像的信息,以获得股骨轮廓的坐标值.本研究采用直方图阈值图像分割、Kirsh边缘提取方法获得股骨的二值化轮廓图像.轮廓的提取应用了"迷宫"边缘跟踪算法.本方法可大量、快捷、正确地提取图像轮廓信息.     

链码跟踪算法在三维医学图像处理中的应用

针对链码跟踪八方向寻址提出了一种新的链码跟踪算法，并将此方法运用于医学图像的等剂量线绘制当中。该算法将链码分为四个象限，依据不同的跟踪顺序加以连接，并遵循整体方向一致的原则。在得到一个封闭的轮廓信息后，再转向下一个轮廓，直到所有轮廓跟踪完毕，解决了医学图像处理中同一剂量的等剂量线出现多次的情况。将排序后的链码进行插值拟合，把x、y的关系转化为距离分别与x和y的关系，得到封闭的平滑的等剂量线。在医学图像处理的三维重建中利用此方法，得到的等剂量线效果较好。     

SmartSequence与SlidingWnd两种子野分割算法的比较

目的:本研究试图比较Elekta Xio TPS(版本:4.62)计划设计中使用SmartSequence和SlidingWnd两种子野分割算法的特点。方法:对9例宫颈癌患者优化计划设计后的射野通量分布,分别用两种子野分割算法分别分割子野,将剂量归一到95%ptv=5000 cGy。然后利用剂量体积直方图(DVH)、靶区和危及器官的剂量分布、子野数、机器跳数(MU)以及治疗时间,对两组计划进行比较。结果:两种子野分割算法得到的计划均满足临床要求,剂量分布基本一致,DVH接近。相对于SlidingWnd子野分割算法,SmartSequence分割算法得到的子野数数目平均减少了28%,总MU数减少了20%,但是在治疗时间上没有明显优势。结论:在维持治疗计划方案质量相同的条件下,与SlidingWnd子野分割算法相比,SmartSequence分割算法可以显著减少子野数和总MU数。     

侧向电子失衡对肺部肿瘤放射治疗计划设计的影响

目的 :分析高能X射线通过低密度的肺组织时 ,侧向电子失衡对肺部肿瘤放射治疗计划的影响。方法 :用 6MV和 18MVX射线对一例肺癌进行三维适形治疗 (3D CRT)计划设计 ,并用Helax TMS计划系统提供的笔形束算法和筒串算法对两种能量下的布野方案相同的 3D CRT计划进行剂量计算 ,比较靶区及危及器官的剂量分布、DVH等指标。结果 :采用笔形束算法 6MV与 18MV计划的等剂量线和DVH相近 ,18MV计划的靶区剂量均匀性略优于 6MV计划 ;而当采用能进行电子侧向散射修正的筒串算法时 ,靶区的高剂量覆盖程度明显变差 ,18MV计划靶区剂量亏损更为显著 ,6MV计划高剂量覆盖靶区的程度优于 18MV计划 ;不同能量、算法下肺和脊髓的受量基本相同。结论 :对于肺部肿瘤 ,剂量计算应采用能够准确修正不均匀组织影响的算法 ,非调强放射治疗时最好使用 6MVX射线。     

脑室肿瘤放射治疗的剂量分布测量

放射治疗的根本目标在于给肿瘤区域足够的精确治疗剂量，而使周围正常组织和器官受照射量最小。提高肿瘤的局部控制率，减少正常组织的放射并发症，而实现这个目标的关键是取决于治疗剂量的精确实施和脑剂量分布的优劣。本工作根据临床常用的三种治疗方案，用ＴＬＤ剂量元件和剂量胶片，利用人体等效非均匀头模，检验治疗计划系统剂量分布理论计算结果     

髋臼CT图像轮廓跟踪方法

目的为重建和测量髋臼的解剖结构,需要大量地读取CT图像的信息,以获得髋臼轮廓的坐标值。方法本研究采用直方图阈值图像分割、kirsh边缘提取法获得髋臼的二值化轮廓图像。轮廓坐标的提取应用了“迷宫”边缘跟踪算法。结果本方法可大量、快捷、正确的提取图像轮廓信息。     

PBC算法与AAA算法在肺癌调强放疗中的剂量学比较

目的:分析、比较笔形束卷积算法(PBC)和各向异性解析算法(AAA)在非小细胞肺癌(NSCLC)调强放疗计划设计中的剂量学差异。方法:随机选择7例NSCLC患者,采用Eclipse version 7.3.10计划系统提供的PBC算法和AAA算法对每例NSCLC进行IMRT的计划设计,比较靶区及危及器官的剂量分布、DVH等指标。结果:两种算法获得治疗计划的靶区剂量均匀性和适形度均无明显差别,食管、心脏、脊髓等危及器官的受量也基本相同。结论:对于NSCLC,剂量计算应采用受呼吸时相影响更小的AAA算法。     

股骨CT图像轮廓跟踪方法

目的 为重建和测量股骨的解剖结构，需要大量地读取CT图像的信息，以获得股骨轮廓的坐标值。方法本研究采用直方图阈值图像分割、Kirsh边缘提取法获得股骨的二值化轮廓图像。结果轮廓坐标的提取应用了“迷宫”边缘跟踪算法。结论本方法可大量、快捷、正确地提取图像轮廓信息。     

用CUDA实现放射治疗中剂量的快速计算

剂量计算是放射治疗计划系统的关键技术之一,它既要有较高的计算精度又要有较快的计算速度。有限笔束(FSPB)算法是目前放射治疗计划系统大多采用的光子线剂量计算算法,其计算速度尚不能达到实时治疗计划程度。本文采用图形处理器(GPU),对FSPB算法中最耗时的部分实现了基于GPU并行化计算,与基于中央处理器(CPU)的计算相比,在中低端GPU(Geforce GT320)上,剂量计算速度提高可达25~35倍,在较高端GPU(TeslaC1060)上计算速度提高可达55~100倍,计算效率完全可用于实时治疗计划中的剂量计算。     

最佳适形野边距的决定因素和求取方法

目的：探讨最佳适形野边距(block aperture margin，BAM)的决定因素和求取方法。方法：采用三维治疗计划系统(three-dimensional treatment planning system,3-D TPS)，测算出头部和胸部常用放疗条件下“建议射野边距”(P90／50)；根据“建议射野边距”，计算出采用不同BAM时，6MeV X线三野照射头部靶区的剂量分布及15MeV X线四野照射胸部靶区的剂量分布。确定其中符合临床剂量要求，治疗体积在大小和形状上与计划靶区适形程度最好者所采用的BAM为最佳BAM。结果：头部靶区6MeV X线三野照射的最佳BAM为5-7mm，胸部靶区15MeV X线四野照射的最佳BAM为7-10mm。结论：最佳BAM的决定因素复杂，最终求取需三维剂量分布计算。     

A dosimetric leaf-setting strategy for shaping radiation fields using a multileaf collimator

A dosimetric leaf-setting strategy of using multileaf collimators (MLC) for shaping radiation fields has been developed. Existing MLC leaf-setting strategies are all based upon geometric criteria. This new approach, however, matches a prescribed field contour with a MLC using clinically consistent dosimetric criteria. The leaf positions are determined using an iterative optimization algorithm. An empirical dose model was developed to compare the dosimetric-based leaf-setting strategy with the geometric-based leaf-setting strategies. Differences up to half a centimeter in the leaf positions and isodose lines were found between setting the MLC geometrically and setting the MLC dosimetrically. The dosimetric leaf-setting strategy provides the ability to achieve better dose conformation for a clinically desired isodose line. Since the desired isodose line that covers a treatment volume is typically higher than 50% of the maximum dose, the scalloping effects due to the finite leaf width at the leaf edge or 50% isodose lines are much reduced. Another benefit of the dosimetric leaf-setting is that it separates the leaf-setting process from the treatment planning process, and this frees the treatment planning vendors from developing detailed dose models for various existing types and future upgrades of MLC systems.     

The effect of dose calculation uncertainty on the evaluation of radiotherapy plans

Monte Carlo dose calculations will potentially reduce systematic errors that may be present in currently used dose calculation algorithms. However, Monte Carlo calculations inherently contain random errors, or statistical uncertainty, the level of which decreases inversely with the square root of computation time. Our purpose in this study was to determine the level of uncertainty at which a lung treatment plan is clinically acceptable. The evaluation methods to decide acceptability were visual examination of both isodose lines on CT scans and dose volume histograms (DVHs), and reviewing calculated biological indices. To study the effect of systematic and/or random errors on treatment plan evaluation, a simulated "error-free" reference plan was used as a benchmark. The relationship between Monte Carlo statistical uncertainty and dose was found to be approximately proportional to the square root of the dose. Random and systematic errors were applied to a calculated lung plan, creating dose distributions with statistical uncertainties of between 0% and 16% (1 s.d.) at the maximum dose point and also distributions with systematic errors of -16% to 16% at the maximum dose point. Critical structure DVHs and biological indices are less sensitive to calculation uncertainty than those of the target. Systematic errors affect plan evaluation accuracy significantly more than random errors, suggesting that Monte Carlo dose calculation will improve outcomes in radiotherapy. A statistical uncertainty of 2% or less does not significantly affect isodose lines, DVHs, or biological indices.     

The reproducibility of polyacrylamide gel dosimetry applied to stereotactic conformal radiotherapy

The reproducibility of polyacrylamide gel (PAG) dosimetry has been evaluated when used to verify two radiotherapy treatment plans of increasing complexity. The plans investigated were a three-field coplanar arrangement, using the linac jaws for field shaping, and a four-field, conformal, non-coplanar plan using precision-cast lead alloy shielding blocks. Each treatment was performed three times using phantoms and calibration gels manufactured in-house. Two phantoms were specially designed for this work to aid accurate positioning of the gels for irradiation and imaging. All gels were imaged post-irradiation using a Siemens Vision 1.5T MR scanner. T2 relaxation images were calibrated to absorbed dose distributions using a number of smaller calibration vessels to produce distribution maps of relative dose. The relative dose distributions were found to be reproducible, with the standard deviation on the mean areas enclosed by the > or = 50% isodose lines measured in three orthogonal planes being 6.4% and 4.1% for the coplanar and non-coplanar plans respectively. The measured distributions were also consistent with those planned, with isodose lines generally agreeing to within a few millimetres. However, the measured absolute doses were on average 23.5% higher than those planned. Although the polyacrylamide gel dosimetry technique has some limitations, particularly when calibrating distributions to absolute dose, the ability to resolve sharp dose gradients in three dimensions with millimetre precision is invaluable when verifying complex conformal treatment plans, where avoidance of proximal, critical structures is a treatment criterion.     

Isodose plotting for pen plotters

A general algorithm for treatment plan isodose line plotting is described which is particularly useful for pen plotters. Unlike other methods of plotting isodose lines, this algorithm is designed specifically to reduce pen motion, thereby reducing plotting time and wear on the transport mechanism. Points with the desired dose value are extracted from the dose matrix and stored, sorted into continuous contours, and then plotted. This algorithm has been implemented on DEC PDP-11/60 and VAX-11/780 computers for use with two models of Houston Instrument pen plotters, two models of Tektronix vector graphics terminals, a DEC VT125 raster graphics terminal, and a DEC VS11 color raster graphics terminal. Its execution time is similar to simpler direct-plotting methods.     

Small computer algorithms for comparing therapeutic performances of single-plane iridium implants

We present a uniform method for selecting an optimum implant geometry by presenting techniques for evaluating the therapeutically significant maximum dose rate (herein referred to as the "maximum dose rate"), the reference isodose (85% of the maximum dose rate), and the area enclosed by the reference isodose contour. The therapeutic performances of planar iridium implants may be compared by evaluating their respective maximum dose rates, reference isodoses , and areas within the reference isodose contours. Because these parameters are mathematically defined, they reproducibly describe each implant geometry. We chose a small microcomputer to develop these comparison algorithms so that the radiotherapist need not have large, expensive computer facilities available to conduct his own studies. The development of these algorithms led to some significant conclusions and recommendations regarding the placement of interstitial implants. Using seeds that are centrally located in the array to evaluate the maximum dose contour avoids underestimating the array's maximum dose rate. This could occur if edge or corner seeds were used. Underestimating the maximum dose rate (and hence the reference isodose contour area) may have a serious therapeutic outcome, because the actual total treatment dosage may be excessive. As ribbon spacing is increased, there is a point beyond which the reference isodose contours become decoupled. At this point, a single relatively uniform reference isodose contour separates into several contours. This effect not only complicates the planimetry calculations, but it also adversely affects the therapeutic efficacy of the implant by producing therapeutically "cold" regions.     

Custom step wedge blocking using dynamic multileaf collimation for parametrial pelvic boost irradiation following brachytherapy for carcinoma of the cervix

Carcinoma of the cervix is typically treated with a combination of intracavitary brachytherapy and external beam radiation. The external beam dose is delivered with whole pelvis fields followed by split fields that protect midline organs at risk (bladder and rectum) while treating the parametria. Three approaches have been developed to shield midline structures: a simple rectangular block, a block customized to a single brachytherapy isodose line, and a step wedge filter constructed to conform to multiple brachytherapy isodose lines. A customized step wedge filter has the potential to produce a more homogeneous dose distribution but has not achieved widespread use due to labor intensive construction. We have developed a simple, novel method to produce a custom midline step wedge using dynamic multileaf collimation (dMLC). A comparison of film measurements in a phantom with the dose calculated by a commercial treatment planning system demonstrated agreement within 3% or 3 mm. The technique requires delivery times comparable to conventional techniques.     

伽玛刀治疗计划系统GAMMA—TPS的研制

伽玛刀治疗计划系统是伽玛刀的重要组成部分。ＧＡＭＭＡ－ＴＰＳ是专为瑞典ＬＥＫＳＥＬＬ伽玛刀而研制的高性能真三维治疗计划系统。它有两部分组成,基于４８６微机和多媒体卡的ＷＩＮＤＯＷＳ风格图象采集系统和基于ＳＧＩ ＩＮＤＩＧＯ２图形工作站主计划系统。ＧＡＭＭＡ－ＴＰＳ具有美观的图形界面;能自动或交互提取体表、病灶及敏感组织的轮廓线;具有逼真的基于体积和表面的三维结构重建和显示功能;可自动规划焦点数目的