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研究生:蔡旻家
研究生(外文):Min-Jia Tsai
論文名稱:NIPAM三維凝膠劑量計應用於體外放射治療與近接治療劑量驗證與比較
論文名稱(外文):NIPAM三維凝膠劑量計應用於體外放射治療與近接治療劑量驗證與比較
指導教授:姚俊旭姚俊旭引用關係
指導教授(外文):Chun-Hsu Yao
學位類別:碩士
校院名稱:中國醫藥大學
系所名稱:生物醫學影像暨放射科學學系碩士班
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:2016
畢業學年度:104
語文別:中文
論文頁數:68
中文關鍵詞:NIPAM凝膠劑量計光學電腦斷層掃描儀強度調控放射治療體積弧形調控放射治療近接治療伽瑪評估法體外放射治療
外文關鍵詞:NIPAM gel dosimeterOptical-CTIMRTVMATbrachytherapygamma evaluationEBRT
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本篇研究目的為探討NIPAM凝膠劑量計配合光學電腦斷層掃描儀,使用於體外放射治療與近接治療進行劑量驗證之特性與比較。
實驗方法使用NIPAM(N-isopropylacrylamide)凝膠劑量計來記錄其三維劑量分布,並使用自製平行光(parallel-beam)光學電腦斷層掃描儀(optical-CT scanner)量測劑量分布,結果使用伽瑪評估法比較量測值與TPS進行通過率計算。所使用的門檻值為3%劑量差異(DD)與3mm計量吻合距離(DTA)。
在體外放射治療的部分,使用兩個不同複雜程度的治療計畫,並分別使用兩種不同的治療技術,也就是強度調控放射治療(Intensity modulated radiotherapy, IMRT)與體積弧形調控放射治療(Volumetric modulated arc therapy, VMAT),使用Elekta的直線加速器進行輻射照射。實驗結果顯示,在複雜的Larynx cancer RT治療計畫下,VMAT治療技術雖能給予目標更順形的治療劑量,但計量分布較複雜,配合高劑量變化率及邊緣增強效應,使高劑量梯度區產生更多不通過區域,故於VMAT治療計畫通過率略低。
而近接治療是將水平塑管穿入假體做為射源導管(source catheter),使用micro-Selectron進行劑量給予。其結果顯示,距射源1.5cm處的伽瑪通過率皆高於95%,但射源導管造成雷射光折射與散射確實會對凝膠劑量分布帶來影響,此外影像重組時產生的條狀假影未來也是需要改善的地方。


In current study, dose characteristics and verification of both brachytherapy and external beam radiotherapy was compared by using N-isopropylacrylamide (NIPAM) gel dosimeter and optical computed tomography (optical-CT).
NIPAM polymer gel dosimeter was adopted to record three-dimensional (3D) dose distribution. A CCD-based parallel-beam optical-CT scanner developed by ourselves to perform dose measurement. The gamma evaluation technique was used to calculate the pass rate by comparing the measured data and TPS point by point. The criteria is 3% dose-difference (DD) and 3 mm dose-to-agreement (DTA).
For external beam radiotherapy, two different kinds of cancer cases were chosen including a simple lung cancer and a more complex larynx cancer. In addition, two radiation techniques were used to generate the TPS including intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) with Elekta accelerator (Elekta Axesse™, Sweden).
The result show that NIPAM polymer gel dosimeter showed good agreement for simple lung cancer TPS and for complex larynx cancer TPS. For a complex larynx cancer TPS, although VMAT can provides more conformal dose irradiation than IMRT, the gel dosimeter seems show disagreement in high dose gradient region where high dose rate irradiation was issued.
For high dose rate brachytherapy, the NIPAM gel phantom with horizontal plastic source catheter was irradiated by using Nucletron micro-Selectron with radiation source Ir-192. The results showed that the dose measured at 2 cm from seed center showed good agreement for HDR brachytherapy. However, the refraction and scattering caused by source catheter affected the dose distribution measured by gel dosimeter. Therefore, the measured dose distribution showed disagreement near the seed center. Besides, streak artifact was observed during image reconstruction and it needed to improve in the future study.


第一章 緒論 1
1.1前言 1
1.2劑量量測工具 2
1.3研究目的 3
第二章 文獻回顧 4
2.1 聚合物凝膠劑量計發展史 4
2.2 NIPAM聚合物凝膠反應機轉 9
2.3凝膠量測工具 11
2.3.1磁振造影 11
2.3.2 超音波 12
2.3.3 X光電腦斷層掃描儀 13
2.3.4光學電腦斷層掃描儀 14
第三章 研究方法 23
3.1 實驗設計 23
3.2 實驗流程 25
3.3 凝膠製備流程 26
3.4 治療計畫與輻射系統 28
3.5 實驗設備 31
3.5.1 計讀設備 31
3.5.2 冷卻系統 32
3.5.3 折射率計 32
3.5.4匹配液 32
3.6 分析方法 33
第四章 結果與討論 35
4.1體外放射治療 35
4.1.1 凝膠假體重組影像 35
4.1.2 未照射凝膠均勻度 37
4.1.3等劑量曲線與伽瑪評估法 39
4.1.3.1 Lung cancer SBRT 39
4.1.3.2 Larynx cancer RT 43
4.1.4凝膠劑量劑的時間穩定性 46
4.2 近接治療 47
4.2.1 凝膠假體重組影像 47
4.2.2 等劑量曲線與伽瑪評估法 49
4.2.2.1 水平切面 49
4.2.2.2 冠狀切面 53
4.2.3 中央縱斷圖 57
第五章 結論 58
參考文獻 60


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