基于GPU加速的质子调强放疗鲁棒优化器

开发一种基于图形处理器（GPU）加速的质子调强放疗鲁棒优化器,用于减小质子束射程不确定性和靶区定位偏差对质子放疗的影响。建立的鲁棒优化模型使用的目标函数包括9种边界剂量目标,分别是:无偏差情况、2种射程偏差（偏长与偏短）、6种摆位不确定性（前后、侧向、上下入射方向各2种正负偏差）。首先靶区和危及器官的剂量贡献矩阵使用笔形束算法计算得到,然后使用共轭梯度法优化目标函数让其满足约束条件,这两部分均采用GPU加速。头颈部、肺部和前列腺三个临床病例被用来检测本优化器的性能表现。与传统基于计划靶区（PTV）的质子调强放疗计划相比,鲁棒优化器能够优化出对射程不确定性和摆位误差更加不敏感的治疗计划,让靶区实现了高剂量均匀性的同时危及器官（OARs）也得到了更好的保护。经过100次迭代,三个病例的优化时间均在10 s左右。该结果证明了基于GPU加速的质子调强放疗鲁棒优化器能够在短时间内设计出高鲁棒性的质子治疗计划,从而提高质子放射治疗的可靠性。This paper describes the development of a fast robust optimization tool that takes advantage of the GPU technologies. The objective function of the robust optimization model considered nine boundary dose distributions--two for ±range uncertainties, six for ±set-up uncertainties along anteroposterior (A-P), lateral (R-L) and superior{inferior (S-I) directions, and one for nominal situation. The nine boundary influence matrices were calculated using an in-house dose engine for proton pencil beams of a finite size, while the conjugate gradient method was applied to minimize the objective function. The GPU platform was adopted to accelerate both the proton dose calculation algorithm and the conjugate gradient method. Three clinical cases-one head and neck cancer case, one lung cancer case and one prostate cancer case-were investigated to demonstrate the clinical significance of the proposed robust optimizer. Compared with conventional planning target volume (PTV) based IMPT plans, the proposed method was found to be conducive in designing robust treatment plans that were less sensitive to range and setup uncertainties. The three cases showed that targets could achieve high dose uniformity while organs at risks (OARs) were under better protection against setup and range errors. The run times for the three cases were around 10 s for 100 iterations. The GPU-based fast robust optimizer developed in this study can serve to improve the reliability of traditional proton treatment planning by achieving a high level of robustness in a much shorter time.     

发散型准直器限束孔应用于被动散射质子放疗可行性研究

被动散射质子放疗（Passive Scattering Proton Therapy,PSPT）是质子治疗的主要技术之一,束流通过准直器限束孔（Aperture）时因边缘散射效应导致患者体内剂量分布偏离理想状态。使用蒙特卡洛软件TOPAS（TOol for PArticle Simulation）对质子束流经过发散型与传统型准直器限束孔后进入水模体中的过程建模,分析两种准直器的边缘散射效应对剂量及中子能谱分布的影响,分别测试70,110,160,200,230,250 MeV能量下的质子束流,发现传统Aperture在70 MeV的质子束下边缘散射效应最明显,在距水箱表面0.5 cm深度处横向剂量曲线平坦度、均匀度分别达到4.63%,108.05%,随着深度增加边缘散射效应逐渐减弱,在布拉格峰位置处接近消失。使用发散型准直器限束孔后,在70 MeV下平坦度、均匀度分别降至1.28%,101.31%,对于100,160,200 MeV质子束均有不同程度改善。对于能量接近250 MeV的质子束,发散型准直器限束孔设置下横向剂量曲线并无优势。边缘散射效应导致的剂量不均随水深增加而减弱,对于各个能量质子,使用发散型准直器限束孔后次级中子减少。研究结果表明,发散型准直器限束孔应用于PSPT效果显著,为进一步应用于临床提供数据支撑。Passive Scattering Proton Therapy (PSPT) is one of the main technologies for proton radiation therapy. The dose distribution in the patient deviates from the ideal state due to the edge scattering effect when the beam passes through the aperture. In this paper, TOPAS, a Monte Carlo software, was used to simulate the passive scattering treatment head. The influence of the edge scattering effect of the two aperture sets on the dose distribution was compared. The proton beam at 70, 110, 160, 200, 230 and 250 MeV was tested respectively. We found that the scattering effect of the conventional aperture is most obvious at 70 MeV, and the flatness and hetergeneity of the lateral dose curve at the inlet of 0.5 cm of the tank reach 4.63%, 108.05%, respectively. The dose shift caused by the edge scattering effect decreases with increasing water depth and disappears at the Bragg peak. After using the divergent aperture, the flatness and uniformity at 70 MeV are reduced to 1.28% and 101.31%, respectively, and the 100, 160, and 200 MeV proton beams are improved in different extents. For a proton beam with an energy close to 250 MeV, there is no advantage in the lateral dose curve of the divergent aperture. For all energy protons, the secondary neutrons are reduced with divergent aperture. The results show that the divergent aperture is effective for PSPT and this study provides data support for further application in clinical practice.