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研究生:陳合興
研究生(外文):Ho-Hsing Chen
論文名稱:多葉式準直儀與呼吸運動同步的放射治療技術
論文名稱(外文):Multi-Leaf Collimator and Respiration Synchronized Radiation Therapy
指導教授:陳永忠陳永忠引用關係莊克士莊克士引用關係
指導教授(外文):Yung-Chung ChenKeh-shih Chuang
學位類別:碩士
校院名稱:東海大學
系所名稱:物理學系
學門:自然科學學門
學類:物理學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:144
中文關鍵詞:多葉式準直儀呼吸同步治療放射線治療強度調控
外文關鍵詞:Multi-Leaf CollimatorRespirationSynchronizedRadiation Therapygatingdeep-inspiration breath holdintensity modulated
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放射治療中的呼吸運動會導致腫瘤劑量及周圍組織器官的劑量的變化,使腫瘤劑量不足而正常組織或器官接受額外的劑量。傳統治療技術以增加安全範圍來使腫瘤接受足夠的劑量,但是卻增加了正常組織或器官的劑量。使用Gating技術可以降低安全範圍的大小,降低治療的副作用,但是治療時間會變長;深呼吸閉氣的技術可以降低安全範圍的大小又不增加治療時間,但是卻會使病人不舒適,未必適合多數病人。我們針對這個問題發展並設計了一套新方法。使用加速器多葉式準直儀的控制加上圖形介面的呼吸導引,可以讓照野跟著呼吸的起伏做同步的移動,使放射線能一直對準腫瘤的位置。這種方法在不增加治療時間,又可讓病人做合適的規律呼吸之下,有效的降低了外加安全範圍的大小。在不降低腫瘤劑量的前題下,減少正常組織器官接受到的劑量,降低放射治療的副作用。
By combining MLC(multi-leaf collimator) files modified technique and respiratory instruct technique, we made MLC motion and target motion synchronized. In phantom study the safe margins can be reduced.
In this study, organ motion simulation machine designed to simulate the organ motion. Kodak EDR-2 film were used to record the dose distribution. Profiles and isodose curves scanned from film were compared to verify the results of this study.
The profiles and isodose curves of synchronized fields coincide with those fields without target motion.
The synchronization technique reduced the penumbra regions which enlarged from respiration. Meanwhile, it enlarged the 95% field width, so that the safe margins around PTV reduced and lower the radiation complication.
第 1 章 緒論 1
1‧1 放射治療的目的 1
1‧2 放射治療中的不確定性 1
A‧ 擺位誤差(set up error) 2
B‧ 形變(deformation) 3
C‧ 器官移動(organ motion) 3
1‧3 治療中的呼吸運動 5
A‧ 加大安全範圍(safe margin) 5
B‧ DIBH(Deep Inspiration Breath-Hold) 8
C‧ Respiratory gating technique 11
D‧ ABC(Active Breath Control) 13
E‧ SMART(Synchronized Moving Aperture Radiation Therapy) 13
F‧ 其他方法 15
第 2 章 多葉式準直儀 (MULTI-LEAF COLLIMATOR) 18
2‧1 機頭幾何結構 18
2‧2 葉片結構 18
A‧ 葉片 18
B‧ 載台(carriage) 21
C‧ 控制系統 21
D‧ 傳輸界面 24
E‧ 強度調控治療IMRT(Intensity Modulated Radiation Therapy) 26
F‧ DMLC檔案結構 28
G‧ 劑量率(dose rate)與葉片速率的調控 30
H‧ DMLC(Dynamic Multi-Leaf collimator) 運作的限制 33
第 3 章 電腦治療計劃系統 35
第 4 章 RPM (REAL-TIME POSITION MANAGEMENT RESPIRATORY GATING SYSTEM)系統 38
4‧1 系統組成 38
A‧ 標誌方塊(Marker Block): 38
B‧ 追蹤攝影機(Tracking camera with illuminator ring): 39
C‧ 室內觀察視窗(In-room view finder): 39
D‧ 個人電腦: 39
E‧ gating 切換盒(gating switch box): 39
4‧2 作業流程 41
第 5 章 另一種技術-多葉式準直儀與呼吸同步放射治療(MULTI-LEAF COLLIMATOR AND RESPIRATION SYNCHRONIZED RADIATION THERAPY) 45
5‧1 概念 45
5‧2 呼吸模擬機的設計 47
5‧3 呼吸模擬機的運動波形導出 48
A‧ 運動軌跡紀錄 48
B‧ 波形分析 50
5‧4 多葉式準直儀葉片檔案結構修改 56
A‧ 結構與運作分析 56
B‧ 設計實際測試的葉片檔案 61
5‧5 在直線加速器上的測試 65
A‧ 直線加速器輸出劑量率的穩定度測試 65
B‧ 驗證片測量 68
5‧6 病人的呼吸控制 85
A‧ 視覺呼吸導引系統的設計 85
B‧ 由RPM系統監測並分析病人呼吸波形 85
5‧7 討論 91
A‧ 葉片控制系統 91
B‧ 呼吸的引導控制 92
C‧ 臨床問題的處理 92
D‧ 劑量剖面(dose profile)的分析 94
E‧ 影響同步的因素 101
F‧ 二維同步的問題 104
G‧ 影像掃描的問題 105
H‧ 同步之機制 106
I‧ 類似方法的比較 106
5‧8 結論 107
參考文獻 109
附錄 114
作者簡歷 132
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