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Utilize in-vivo offline PET/CT imaging to evaluate range deviations of implanted metal-clips in whole-breast proton radiotherapy

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机构: [1]Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [2]Shanghai Key Laboratory of Radiation Oncology, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [3]Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [4]College of Physics, Sichuan University, No. 24 South Section 1, Yihuan Road, Wuhou District, Chengdu 610065, China. [5]Key Laboratory of Radiation Physics and Technology, Ministry of Education (Institute of Nuclear Science and Technology), Sichuan University, No. 24 South Section 1, Yihuan Road, Wuhou District, Chengdu 610065, China. [6]Department of Radiotherapy, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai 201321, China. [7]Department of Radiotherapy, Shanghai Proton and Heavy Ion Center, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [8]Department of Medical Physics, Shanghai Proton and Heavy Ion Center, 333 Huiyuan Road, Pudong District, Shanghai 201321, China.
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关键词: PET verification proton radiotherapy offline PET surgical clips

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This study presented a quantitative analysis of the differences in the depths of the distal 50% of acquired and estimated positron emission tomography (PET) images for 18 patients who had a total of 109 titanium (Ti) metal-surgical clips implanted after breast-conserving surgery. Offline PET/computed tomography (PET/CT) images were acquired after proton irradiation. Hounsfield Unit modifications were applied to correct for metal artifacts induced by the Ti clips in the planning CT scans of the soft tissues surrounding the clips. The positron-emitting-isotope PET distribution was calculated through Range-Verification scripting. Quantitative analysis was conducted on the depth differences at the distal 50% R50 of the PET and the calculated PET distribution. Using the R50 method, the depth verification results of the clips and the normal tissues were compared. The R50 method calculates the positional difference at the half-maximum value 2 cm from the skin, with clips beyond this position not affecting the results. Analyses of the regions around the Ti clips were conducted. The depth difference for Ti < 2 cm (where the depth of the clips from the skin was <2 cm) was -1.63 ± 1.08 mm, while the corresponding normal tissue (Ticont) showed a depth difference of -1.79 ± 1.15 mm. There was no statistically significant difference in the depth differences between Ti < 2 cm and the corresponding Ticont. This study utilized offline PET verification to demonstrate that applying tissue corrections based on surgical clips and surrounding muscle tissues in clinical practice ensures that the presence of surgical clips does not compromise the precision of proton dose delivery at the surgical site.© The Author(s) 2025. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.

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出版当年[2025]版:
大类 | 4 区 医学
小类 | 3 区 生物学 4 区 肿瘤学 4 区 核医学
最新[2025]版:
大类 | 4 区 医学
小类 | 3 区 生物学 4 区 肿瘤学 4 区 核医学
第一作者:
第一作者机构: [1]Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [2]Shanghai Key Laboratory of Radiation Oncology, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [3]Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [4]College of Physics, Sichuan University, No. 24 South Section 1, Yihuan Road, Wuhou District, Chengdu 610065, China. [5]Key Laboratory of Radiation Physics and Technology, Ministry of Education (Institute of Nuclear Science and Technology), Sichuan University, No. 24 South Section 1, Yihuan Road, Wuhou District, Chengdu 610065, China. [6]Department of Radiotherapy, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai 201321, China.
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通讯机构: [1]Department of Nuclear Medicine, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [2]Shanghai Key Laboratory of Radiation Oncology, 333 Huiyuan Road, Pudong District, Shanghai 201321, China. [3]Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 333 Huiyuan Road, Pudong District, Shanghai 201321, China.
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