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dc.contributor.advisorHürmüz, Pervin
dc.contributor.authorŞahin, Meryem Cansu
dc.date.accessioned2017-02-21T11:44:58Z
dc.date.available2017-02-21T11:44:58Z
dc.date.issued2017-02-20
dc.date.submitted2016-11-06
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dc.identifier.urihttp://hdl.handle.net/11655/3200
dc.description.abstractŞAHİN, M. C. Three Dimensional Performance Analysis Of Cyberknife Synchrony® Respiratory Tracking System Using Polymer Gel Dosimeter. Hacettepe University Institute of Health Sciences, Thesis in Radiotherapy Physics Program, Ankara, 2017. Tumor movement is a challenging issue for the precise delivery of radiation for thoracic tumors. The Synchrony respiratory motion tracking system (RMTS) of Cyberknife® robotic radiosurgery unit synchronizes radiation beam delivery with the respiration induced tumor motion. This study aims to investigate the performance of Synchrony RMTS for different movement widths using polymer gel dosimetry. To the best of our knowledge this is the first study to make the three dimensional performance analysis of Synchrony RMTS. The MultiPlan® treatment planning system (TPS) of Cyberknife® was used to deliver 4 Gy to a tumor of 1X1X1 cm3. BrainLab Gating lung phantom was used to simulate lung movements with three different amplitudes (1 cm, 2 cm and 3 cm). Three fiducials were inserted to the phantom for tracking. Radiochromic film and polymer gel dosimetry were used and measurements were compared with the dose distributions acquired from the TPS. The dose information of irradiated gel were read out using 1.5 T magnetic resonance imaging. The gamma index values were analysed using the Ashland FilmQA Pro 3.0 software for film dosimeters and Polygevero software for gel dosimeters using the 3mm/3% criteria. PolyGevero gamma index value of ≤1 is accepted as a passing criteria according to the literature. The mean 3 mm 3% gamma index values of film dosimetry were 92.6±1.94%, 91.0±4.00%, 90.3±2.04% for tumor motions of 1 cm, 2 cm and 3 cm, respectively (p<0.001). For polymer gel dosimetry, the mean gamma index values calculated over almost three million points were 0.56±0.10, 0.60±0.24 and 0.65±0.30 for tumor motions of 1 cm, 2 cm and 3 cm, respectively (p<0.001). Although the difference was statistically significant for 3 different amplitudes, the performance of the system was within the acceptance limits. Three dimensional performance analysis showed that Cyberknife Synchrony® RMTS is successful in tumor tracking regardless of the amplitude of movement.en
dc.description.sponsorshipBu tez TÜBİTAK ARDEB 3001 projesi ile desteklenmiştir. Proje Kodu:115S446tr_TR
dc.description.tableofcontentsONAY iii YAYIMLAMA VE FİKRİ MÜLKİYET HAKLARI BEYANI iv ETİK BEYAN v TEŞEKKÜR vi ÖZET vii ABSTRACT viii İÇİNDEKİLER ix SİMGELER VE KISALTMALAR xii ŞEKİLLER DİZİNİ xiii TABLOLAR DİZİNİ xiv 1. GİRİŞ 1 2. GENEL BİLGİLER 2 2.1. Akciğer Kanserinde Tümör Hareketi 2 2.1.1. Görüntü Elde Edilmesindeki Sınırlamalar 3 2.1.2. Tedavi Planlama Sınırlamaları 3 2.1.3. Radyasyon Verilmesiyle İlgili Sınırlamalar 4 2.2. Radyoterapide Solunuma Bağlı Hareket İçin Kullanılan Yöntemler 4 2.2.1. Hareketi Kapsayan Yöntemler 5 2.2.2. Solunum Ayarlı Yöntemler 5 2.2.3. Abdominal Kompresyon “Forced Shallow Breathing” Yöntemi 6 2.2.4. Solunumla Senkronize “Real-Time Tumor Tracking” Yöntemi 6 2.2.5. Nefes Tutma Teknikleri 7 2.3. Stereotaktik Radyoterapi 9 2.4. Stereotaktik Radyoterapi Uygulamalarında Kullanılan Cihazlar 9 2.5. CyberKnife Robotik Radyocerrahi Ünitesi 11 2.6. Cyberknife Sistemi ve İzleme Algoritmaları 12 2.6.1. Akciğer Optimize Tedavisi 12 2.6.2. Synchrony Solunum Takip Algoritması 13 2.7. Jel Dozimetri 17 2.7.1. Fricke Jel Dozimetri 19 2.7.2. Polimer Jel Dozimetri 20 2.7.3. Jel Dozimetrinin Özellikleri 25 2.7.4. Jel Dozimetrinin Görüntülenme Yöntemleri 28 2.8. Film Dozimetri 29 2.8.1. Radyokromik Film Dozimetre 30 3. GEREÇ VE YÖNTEM 32 3.1. Accuray Marka CyberKnife® Robotik Radyocerrahi Sistemi 32 3.2. MultiPlan® Tedavi Planlama Sistemi 33 3.3. GE Healthcare Signa Hdxt 1.5 T Manyetik Rezonans Görüntüleme 34 3.4. Epson Marka 10000 XL Tarayıcı 35 3.5. MATLAB 7.10 Programı 35 3.6. Ashland FilmQA Pro 3.0 Yazılımı 35 3.7. PolyGeVero®Yazılımı 36 3.8. Brainlab Respiratory Gating Fantomu 38 3.9.Tedavi Planının Hazırlanması 39 3.10. Polimer Jel Dozimetrinin Hazırlanması 41 3.11. Parafin Wax’ın Hazırlanması 42 3.12. Gafkromik Film Dozimetre İçin Kalibrasyon Eğrisinin Oluşturulması 43 3.13. Polimer Jel Dozimetre İçin Kalibrasyon Eğrisinin Oluşturulması 45 4. BULGULAR 46 4.1. Gafkromik Film Bulguları 46 4.2. Polimer Jel Dozimetre Bulguları 51 4.2.1. Jel Dozimetre MR Görüntüleri 51 4.2.2. Bir cm Genlik ile Hareket Eden Tümör İçin Elde Edilen Polimer Jel Dozimetre Bulguları 52 4.2.3. İki cm Genlik ile Hareket Eden Tümör İçin Elde Edilen Polimer Jel Dozimetre Bulguları 56 4.2.4. Üç cm Genlik ile Hareket Eden Tümör İçin Elde Edilen Polimer Jel Dozimetre Bulguları 58 5. TARTIŞMA 62 6. SONUÇ VE ÖNERİLER 67 7. KAYNAKLAR 69 8. EKLER 76 EK - 1 Polimer Jel Dozimetrenin Hazırlanması 76 EK - 2 Parafin Wax’ın Hazırlanması 77 ÖZGEÇMİŞtr_TR
dc.language.isoturtr_TR
dc.publisherKanser Enstitüsütr_TR
dc.rightsinfo:eu-repo/semantics/closedAccesstr_TR
dc.subjectCyberknifetr_TR
dc.subjectSynchrony®
dc.subjectSolunum Takip Sistemi
dc.subjectPolimer Jel Dozimetre
dc.subjectGafkromik Film Dozimetre
dc.subjectPolyGeVero
dc.titleCyberknife Synchrony® Solunum Takip Sisteminin Polimer Jel Dozimetre ile Üç Boyutlu Performans Analizitr_TR
dc.typemasterThesistr_TR
dc.description.ozetŞAHİN, M.C. Cyberknife Synchrony® Solunum Takip Sisteminin Polimer Jel Dozimetre İle Üç Boyutlu Performans Analizi. Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü Radyoterapi Fiziği Programı Yüksek Lisans Tezi, Ankara, 2017. Tümör hareketi, torasik tümörlere radyasyon verilmesinde zorlayıcı bir konudur. CyberKnife robotik radyocerrahi ünitesinin Synchrony solunum takip sistemi, solunum ile radyasyon verilmesini senkronize ederek tümör hareketinin etkisini azaltmaktadır. Bu çalışmanın amacı, üç boyutlu polimer jel dozimetre kullanarak, farklı genliklerde hareket eden tümörler için Synchrony solunum takip sisteminin performansının araştırılmasıdır. Bilgilerimize göre bu çalışma, Synchrony solunum takip sisteminin üç boyutlu performans analizini yapan ilk çalışmadır. Boyutu 1x1x1 cm3 olan tümöre MultiPlan tedavi planlama sisteminde (TPS) fraksiyon dozu 4 Gy olacak şekilde tedavi planı hazırlanmıştır. BrainLab gating fantomu kullanılarak üç farklı genlik için tümör hereketi simüle edilmiştir. Takip için üç adet fidüsiyel fantom üzerine uygun pozisyonlarda yerleştirilmiştir. Rayokromik film dozimetre ve polimer jel dozimetre kullanılarak ölçümler alınmış ve bu sonuçlar MultiPlan TPS’nin doz dağılımı verileriyle karşılaştırılmıştır. Işınlanan jel dozimetrelerin doz bilgisini elde etmek için gerekli olan görüntüler 1,5 T manyetik rezonans görüntüleme cihazı ile elde edilmiştir. Radyokromik film dozimetrelerin analizi için Ashland FilmQA Pro 3.0 yazılımı kullanılmıştır. Polimer jel dozimetrelerin analizi için Gamma indeks kriteri 3 mm % 3 olarak belirlenmiş ve PolyGeVero yazılımı kullanılmıştır. Literatürde PolyGeVero ile yapılan çalışmalara göre Gamma indeks değerinin ≤1 olması geçer kriter olarak kabul edilmektedir. Radyokromik film dozimetre için 3 mm % 3 kriteri ile yapılan Gamma indeks değerleri, 1 cm, 2 cm ve 3 cm tümör hareketi için sırasıyla 92.6±1.94%, 91.0±4.00%, 90.3±2.04% olarak bulunmuştur (p<0.001). Polimer jel dozimetre için ortalama Gamma indeks değerleri yaklaşık üç milyon nokta kullanılarak hesaplanmıştır. Polimer jel dozimetre Gamma indeks değerleri 1 cm, 2 cm ve 3 cm tümör hareketi için sırasıyla 0.56±0.10, 0.60±0.24 ve 0.65±0.30 olarak bulunmuştur (p<0.001). Fark, üç ayrı hareket genliği için anlamlı olmasına rağmen, sistemin performansı kabul limitleri içindedir. Polimer jel dozimetre ile üç boyutlu performans analizi, CyberKnife Synchrony solunum takip sisteminin hareket genliğinden bağımsız olarak başarıyla tümör takibi yaptığını göstermiştir.tr_TR
dc.contributor.departmentRadyasyon Onkolojisitr_TR


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