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研究生:黃勝賢
研究生(外文):Sheng -Shien Huang
論文名稱:全身照射放射治療劑量之評估
論文名稱(外文):Evaluation of the Dose for Total Body Irradiation
指導教授:游澄清
指導教授(外文):Cheng-Ching Yu
學位類別:碩士
校院名稱:元培科學技術學院
系所名稱:影像醫學研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:63
中文關鍵詞:全身照射放射治療熱發光劑量計二極體偵檢器
外文關鍵詞:Total body radiationthermoluminescent dosimetersdiode detector
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摘要
骨髓移植前之全身放射治療是一般血癌治療之通則,為了評估全身放射治療之輻射劑量,本研究使用固態水假體及人形假體模擬病人全身放射治療條件,以二極體偵檢器(Diode)及熱發光劑量計(thermoluminescent dosimeter ,TLD)量測全身放射治療病人之肺部及其他重要器官劑量,以作為臨床醫師評估病人治療劑量的依據。
本研究分為四部份:(1)應用二極體偵檢器與游離腔在特定距離及深度下進行校正,取得二極體偵檢器之劑量校正因子;(2)利用軟木模擬人體肺部組織,經電腦斷層掃瞄、分析,比較兩者密度之差異,以此模擬肺部組織進行肺部與縱隔腔劑量之測量與評估;(3)利用游離腔及固態水假體量測輸出劑量及中心軸與離軸百分深度劑量(percent depth dose,PDD),並比較中心軸與離軸之百分深度劑量的差異;(4)應用熱發光劑量計在人形假體內佈點,量測假體縱中心軸之劑量分佈及各重要器官之劑量,並建立全身重要器官與入射表面之間的劑量轉換因子。當治療時,只要使用二極體偵檢器量測射束中心軸人體表面劑量,即可快速評估肺部與其他重要器官之劑量。
實驗結果顯示,軟木墊與人體肺組織密度相似,可以軟木墊取代固態水假體模擬人體肺部組織。根據二極體偵檢器量測結果,評估假體中軸上肺部縱膈腔之最高劑量較照野中心點增加20.67 %,此與TLD全身佈點實驗之測量值(同區域增加20.42 %) 相當接近。甲狀腺、性腺、眼球等重要器官之劑量較指定點為低,故在臨床應用上,應特別考慮肺部劑量增加之影響。本研究證實二極體偵檢器之計讀較熱發光劑量計快速,能夠即時獲取劑量資訊,且具準確性高(誤差+ 1 % 以內)、體積小、受外在因數影響少等優點,使用二極體偵檢器來評估全身照射放射治療病人之劑量為準確、方便可行。
Abstract
Total body irradiation before bone marrow transplant is a general protocol for curing leukemia. This study used plastic water phantoms and an Rando phantom to simulate the situation of real total body irradiation. The diode detector and thermoluminescent dosimeter (TLD) were used to measure the lung and other critical organ doses. The results of dose measurement and evaluation can be used as the important references for doctors in clinical treatments.
This study consists of four parts. (1) To get dose calibration factors of the diode detector using an ion chamber at a specific distance and depth. (2) To analyze the density differences between corks and human lung tissues by computer tomography (CT). (3) Use the ion chamber and plastic phantoms to measure the output factors, PDDs (percent depth doses) and off-axis ratio, to compare the differences of PDDs which are measured on the central axis and off-axis. (4) Placed TLDs inside the Rando phantom to get the dose distributions along the longitude of the phantom and the other critical organs. Also, the doses measured were used to establish the dose conversion factors for the critical organs to the entrance surface dose. During the clinical irradiation the surface central axis dose measured by diode detector can conveniently be used to evaluate the doses of lung and other critical organs.
The results show that the density of corks is similar to the lung tissues. The plastic water phantoms can be replaced by the corks in simulation the human lung tissues. The doses of upper mediastinum lung in the Rando phantom are 20.67 % higher than that of the center in field. The doses of TLDs at the same part increase by 20.42 %. The doses of thyroids, gonad glands and eyes are lower than prescribed doses. The increased doses of lung should be considered in clinical practice. The advantages of diode detector than the TLDs: the reading of diode detectors is faster than TLDs, the dose information is real-time and high
目 錄
致 謝 ...........................................................Ⅰ
中文摘要 ...........................................................Ⅱ
英文摘要 ...........................................................Ⅲ
目 錄 ...........................................................Ⅴ
表 目 錄............................................................Ⅷ
圖 目 錄 ...........................................................Ⅸ

第一章 緒論 ......................................................... 1
1.1 前言 ..................................................... 1
1.2 文獻探討 ................................................. 2
1.3 研究目的 ................................................. 4
1.4 實驗流程規劃 ............................................. 4
第二章 實驗原理 ..................................................... 6
2.1 醫用直線加速器原理 ........................................ 6
2.1.1 直線加速器治療輔助配件 ............................... 7
2.1.2 直線加速器特性應用 .................................. 8
2.2 百分深度劑量(PDD)定義及特性............................... 8
2.2.1 百分深度劑量與輻射線能量之關係........................ 9
2.2.2 百分深度劑量與射束照野面積之關係....................... 9
2.2.3 百分深度劑量與射源距離之關係 ......................... 9
2.2.4 梅納因子參數 ....................................... 10
2.3 熱發光劑量計原理 ......................................... 11
2.4 二極體偵測器原理 ......................................... 11
第三章 實驗設備結構與材料介紹 ....................................... 13
3.1 醫用直線加速器 ........................................... 13
3.2 二極體偵檢器 (Sun Nuclear QED Diode) 計讀設備 ............. 16
3.2.1 二極體偵檢器計讀儀 ................................. 16
3.2.2 二極體偵檢器之規格 ................................. 17
3.2.3 二極體偵檢器前置處理器 .............................. 18
3.3 固態水假體 (Solid Water Phantom) ........................ 19
3.3.1 固態水假體之特性 ................................... 20
3.3.2 固態水假體之應用 ................................... 20
3.4 人形假體 (Rando phantom) .................................20
3.5 輻射劑量儀 (PTW Unidos Dosimeter) ....................... 22
3.6 農夫型游離腔 (Farmer type) ............................... 22
3.7 熱發光劑量計 (TLD-100) ................................... 24
3.8 全自動熱發光計讀儀 ....................................... 24
3.8.1 熱發光計讀儀原理 ................................... 24
3.8.2 熱發光計讀儀之特點 ................................. 25
3.8.3 自動回火爐 ........................................ 25
3.9 壓克力箱 ................................................ 26
3.10 軟木墊材料 ............................................. 27
第四章 實驗步驟與方法 ............................................... 28
4.1 TLD的篩選與校正 .......................................... 28
4.1.1 TLD之篩選 ......................................... 29
4.1.2 TLD之校正 ......................................... 29
4.2 利用熱發光劑量計量测假體內之劑量分怖佈 ..................... 30
4.2.1 人型形假體縱中心軸剖面圖怖佈點量测 ................... 30
4.2.2 人形假體全身重要器官佈點量測 ........................ 31
4.3 計算農夫型游離腔在TG-21號議定書的各項轉換參數 .............. 32
4.4 農夫型(0.6 cc)游離腔輸出劑量因子校正 ...................... 33
4.5 百分深度劑量測量 ......................................... 35
4.5.1 射束中心軸百分深度劑量測量 .......................... 35
4.5.2 離軸百分深度劑量測量 ............................... 36
4.6 二極體偵檢器與農夫型游離腔比對校正 ......................... 36
4.7 二極體偵檢器之線性校正 .................................... 37
4.8 比較軟木墊與肺組織之CT值 .................................. 37
4.8.1 軟木墊模擬肺組織之劑量量測 .......................... 38
4.9 射束平坦度量測 ........................................... 39
4.9.1 醫用直線加速器射束輸出平坦特性量測 ................... 40
4.9.2 量測均勻假體之縱中心軸劑量分佈 ...................... 40
4.10 直線加速器照射劑量參數計算 ............................... 40
4.11 全身照射肺部劑量評估及各重要器官之劑量轉換因子計算.......... 41
第五章 結果與討論 .................................................. 43
5.1 熱發光劑量計的篩選與校正 .................................. 43
5.1.1 TLD篩選 ........................................... 43
5.1.2 TLD校正 ........................................... 44
5.2 利用熱發光劑量計量測假體內之劑量分佈 ....................... 45
5.2.1 人形假體縱中心軸劑量量測 ............................ 45
5.2.2 人形假體全身重要器官劑量分佈 ........................ 46
5.3 TG-21號議定書之應用 ...................................... 47
5.4 農夫型游離腔(0.6 cc)輸出劑量因子校正 ...................... 47
5.5 百分深度劑量的測量 ....................................... 51
5.5.1 射束中心軸百分深度劑量 .............................. 51
5.5.2 離軸百分深度劑量 ................................... 51
5.6 二極體偵檢器與農夫型游離腔比對校正 ......................... 52
5.7 二極體偵檢器之線性校正 .................................... 52
5.8 軟木墊與肺組織之CT值比較 .................................. 53
5.8.1 軟木墊模擬肺組織之劑量量測 .......................... 54
5.9 射束平坦度量測 ........................................... 55
5.10 直線加速器照射劑量參數計算................................ 56
5.11 全身照射肺部劑量評估及各重要器官之劑量轉換因子計算.......... 56
5.11.1 病人全身照射肺部劑量評估 .......................... 56
5.11.2 入射表面與重要器官之劑量轉換因數 ................... 58
第六章 結論 ........................................................ 60
參考文獻 .......................................................... 61
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