Razi Journal of Medical Sciences

fa نقش حسگرهای الکترونیکی در پرتودرمانی The Role of Electronic Sensors in Radiotherapy فیزیک‌پزشکی Biophysics مروري review article <div style="text-align: justify;">زمینه و هدف: هدف پرتودرمانی رساندن میزان دوز بالا به تومور و حداقل دوز، به بافت‌های سالم است. نتایج بالینی روش پرتودرمانی مورد استفاده بر اساس عوامل مختلفی مانند دوز جذبی مناسب در تومور است. علاوه بر این، تطبیق حجم هدف طراحی شده  با حجم هدف بالینی به عنوان عامل تاثیرگذاری دیگری است که باید در طول فرآیند پرتودرمانی در نظر گرفته شود. اخیراً استفاده از حسگرهای مختلف پرتودرمانی، غلبه بر این چالشها را ممکن ساخته است. هدف کار حاضر ارائه یک مطالعه مروری در مورد پیشرفت‌ها و الزامات اخیر حسگرهای پرتودرمانی در ردیابی تومور در زمان واقعی (حرکات تومور)، موقعیت مناسب بدن بیمار، نظارت بر پالس‌های پرتو، و وضعیت بیمار، حرکت در طول پرتودرمانی و تغییر شکل اندام است. روش کار: مطالعات مورد بررسی با انجام جستجو در پایگاه‌های اطلاعاتی MEDLINE، PubMed، PubMed Central و ISI از ژانویه 2008 تا ژانویه 2023 انتخاب شدند. حدود 100 مقاله جمع آوری شدند و در مجموع، حدود 40 مقاله از طریق غربالگری عنوان، چکیده و همچنین بررسی روش و قسمت نتیجه‌گیری هر مقاله، واجد شرایط بالقوه برای تحلیل شناخته شدند. یافته‌ها: با توجه به مطالعات بررسی شده می توان نتیجه گرفت که حسگرهای الکترونیکی از پتانسیل بسیار بالایی در زمینه رادیوتراپی برخوردار هستند، به طوری که معرفی حسگرهای مختلف در درمان سرطان بر چالش های موجود در این زمینه غلبه می کند. نتیجه گیری: با این حسگرهای الکترونیکی می‌توان از بافت سالم اطراف تومور به خوبی محافظت کرد و خطر ابتلا به سرطان ثانویه را کاهش داد. ورود حسگر های مختلف در پرتودرمانی سبب شد تا بتوان از این چالش‌ها عبور کرد و از کمترین حاشیه برای در نظر گرفتن حجم هدف بالینی استفاده کرد.</div> <div style="text-align: justify;">Background & Aims: Surgery, radiotherapy and chemotherapy are common methods in cancer treatment. Almost more than two thirds of cancer patients are treated by radiotherapy. Radiotherapy is an effective method for the treatment of many cancers, which is widely used to improve local tumor control and reduce the complications of normal tissue. External radiotherapy is usually performed after surgery, and this method has reduced local recurrence by two-thirds. One of the basic problems in radiotherapy is matching the planned target volume with the clinical target volume. Among the basic challenges of determining the planned target volume in modern radiotherapy, we can mention the movement of different organs, the positioning of the patient in each session, complete monitoring of dose delivery during radiation, and also the movement of the patient during radiotherapy. The presence of these factors causes additional margins to be added to the clinical target volume, which itself causes changes and uncertainties in measuring the clinical target volume. The use of different sensors in radiotherapy has made it possible to overcome these challenges and use the smallest margin to consider the volume of the clinical target. Recently, several studies have been carried out in the field of application of different sensors in radiotherapy in terms of examining the three-dimensional movement of the tumor, the accuracy of the patient's position, monitoring the radiation pulses and the deformation of the organ. Therefore, the purpose of this review is to express the basic applications of different sensors in the field of radiotherapy. Methods: Studies were selected by searching MEDLINE, PubMed, PubMed Central and ISI databases from January 2008 to January 2023. The search was performed using the keywords tumor motion, patient position, organ deformation and patient movement and radiotherapy sensors. The texts in the present study were clearly related to the investigated sensors in radiotherapy. Duplicate and unrelated studies, animal studies, and low-quality studies were excluded from the review. Following the aforementioned research method, about 100 articles were collected. All the selected studies were reviewed by the participating authors, and in total, about 40 articles were identified as potentially eligible for analysis through the screening of the title, abstract, as well as the review of the method and conclusion section of each article. Finally, the selected studies were independently summarized and coded data including study characteristics (first author name, study year, study type and publication journal), clinical outcomes from eligible studies were recorded. Results: Sensors are devices that detect events or changes in their environment and send information to other electronic devices. One of the basic users of sensors is in the field of radiotherapy. In the treatment design system, determining the clinical target volume is very important because one of the basic principles in radiotherapy is the closeness of the planned target volume to the clinical target volume. Among the basic challenges for determining the planned target volume in modern radiotherapy, we can mention the three-dimensional movement of the tumor, the accuracy of the patient's position, the monitoring of the radiation pulses, as well as the deformation of the organ during radiotherapy. The presence of these factors has caused physicists to consider additional margins in the clinical target volume, which itself causes changes and uncertainties in the measurement of the clinical target volume. The introduction of different sensors in this field has resulted in greater matching between planned and clinical target volumes. In this regard, in order to investigate the three-dimensional movement of the tumor, the movement of the tumor in the relevant organ should be observed because breathing and whether the organs around the tumor are full or empty can cause the movement of the tumor in the body. Therefore, the use of a respiratory sensor in radiotherapy improves both accuracy and comfort by considering respiratory states. The accuracy of the patient's position is very important in every session of radiotherapy. The current position of the patient in the treatment department is different from the position considered in the treatment design system by a registered reference level. For this reason, a three-dimensional optical sensor was used as an additional tool to verify the accuracy of the patient's position in the radiotherapy department. Real-time monitoring of dose delivery in radiotherapy is still considered as a fundamental challenge. Currently, there is no method to directly measure the treatment dose in the tumor itself. For this purpose, a sensor should be introduced in this field to provide the possibility of monitoring the dose delivery in real time to a certain extent and to detect individual X-ray pulses from linear accelerators. Therefore, the new optical fiber-based sensor is able to accurately measure the real-time dose for a wide range of operational conditions in clinical external beam radiotherapy. The deformation of the organ during radiotherapy has caused it to affect the design of the treatment and also provides the possibility of developing and applying adaptive treatment methods. For this reason, a passive infrared marker tracking system was introduced. Conclusion: In this review study, the basic applications of different sensors in the field of radiotherapy were briefly discussed. One of the basic problems in radiotherapy is to match the planned target volume with the clinical target volume. Therefore, to achieve this goal, the movement of different organs, the position of the patient in each session, and the complete monitoring of dose delivery during radiation should be considered. And also pay attention to the movement of the patient during radiotherapy. The presence of these factors has caused the physicists to add additional margins to the clinical target volume, which itself causes changes and uncertainties in the measurement of the clinical target volume. To solve these problems, the introduction of sensors into the field of radiotherapy has been proposed. These sensors can perform various measurements in a non-invasive and non-contact manner and also consider all tumor changes in different sessions. Therefore, these sensors have a very high application potential in the field of radiotherapy. It can also be mentioned that the introduction of different sensors in radiotherapy made it possible to overcome these challenges and use the smallest margin to consider the clinical target volume. Therefore, with these sensors, the healthy tissue surrounding the tumor can be well protected and the tumor can be harmed the most, as well as the risk of secondary cancers can be greatly reduced. </div> حرکت تومور, موقعیت بیمار, تغییر شکل اندام, حرکت بیمار, حسگرهای پرتودرمانی Tumor motion, Patient position, Organ deformation, Patient movement, Radiotherapy sensors 1 12 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5006-2&slc_lang=fa&sid=1 Seyed Ali Zoljalali Moghaddam سید علی ذوالجلالی مقدم 3900319475328460089962 0009-0008-0484-5824 No MSc Electronic Engineering, Department of Electrical Engineering, Faculty of Electrical and Computer Engineering, Tarbiat Modares University, Tehran, Iran کارشناسی ارشد برق الکترونیک، گروه مهندسی برق، دانشکده مهندسی برق و کامپیوتر، دانشگاه تربیت مدرس، تهران، ایران Seyed Hamid Zoljalali Moghaddam سید حمید ذوالجلالی مقدم hamid71712z@gmail.com 3900319475328460089963 3900319475328460089963 Yes MSc Medical Physics, Department of Medical Physics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran کارشناس ارشد فیزیک پزشکی، گروه فیزیک پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران