Palacios Pérez, Eddie N. (2018) Implementación clínica de IGRT: estudio de la dosis impartida en diferentes modalidades de imágenes. / Clinical implementation of IGRT: study of the dose given in different imaging modalities. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
La radioterapia guiada por imagen (IGRT) aporta una manera eficiente de delimitación, planificación y posicionamiento del paciente. Sin embargo, debe contemplarse una relación costo-beneficio y la filosofía ALARA cuando se requiera del uso de radiación ionizante en imagenología medica. Se proponen protocolos IGRT de posicionamiento para las regiones de cabeza y cuello (C&C) y próstata a través del revelamiento del servicio, un análisis retrospectivo y mediciones dosimétricas en las modalidades de imagen disponibles. El análisis retrospectivo fue realizado sobre la población de pacientes tratados en CEMENER. Los protocolos se implementaron en cuatro pacientes de C&C y un paciente de próstata. Los resultados en los pacientes de C&C sugieren márgenes CTV-PTV de 4 mm como una cobertura segura en el posicionamiento. Fueron estimadas dosis efectivas de 0,43mSv, 0,90mSv y 48,9mSv; debidas a los protocolos C&C sin variación volumétrica, con variación volumétrica y próstata, respectivamente. Adicionalmente, son recomendadas estrategias de optimización para reducir las dosis debidas a exposiciones confines de IGRT sin comprometer la exactitud requerida por el tratamiento.
Resumen en inglés
Image-guided radiotherapy (IGRT) provides an efficient way of delimitation, planning and positioning the patient. However, a cost-benet relationship and the ALARA philosophy should be considered when the use of ionizing radiation in medical imaging is required. IGRT positioning protocols are proposed for the head and neck (H&N) and prostate regions through the service survey, a retrospective analysis and dosimetric measurements in the available image modalities. The retrospective analysis was performed on the population of patients treated at CEMENER. They have been implemented in four H&N patients and one prostate patient. The results in H&N patients suggest 4 mm CTV-PTV margins as a safe coverage in positioning. Effective doses of 0.43mSv, 0.90mSv and 48.9mSv were estimated; due to H&N protocols without volumetric variation, with volumetric and prostate variation, respectively. Additionally, optimization strategies are recommended to reduce the doses due to exposures for IGRT purposes without compromising the accuracy required by the treatment.
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Dosimetry; Dosimetría; [Imagen guided radiotherapy; Radioterapia guiada por imagen; IGRT protocols; Protocolo IGRT] |
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| Materias: | Medicina > Radioterapia |
| Divisiones: | Centro de Medicina Nuclear y Molecular de Entre Ríos (CEMENER) |
| Código ID: | 765 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 12 Feb 2021 08:19 |
| Última Modificación: | 12 Feb 2021 08:19 |
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