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題名:電腦刀呼吸同步追蹤系統應用於放射治療之評估     (30點)
EVALUATION OF THE APPLICATION OF SYNCHRONY RESPIRATORY TRACKING SYSTEM OF CYBERKNIFE RADIOTHERAPY
著者:郭駿騵(Chun-Yuan Kuo) ;林家瑋(Jia-Wei Lin) ;蕭安成(An-Cheng Shiau) ;余孝緯(Hsiao-Wei Yu) ;陳尚文(Shang-Wen Chen) ;鍾道生(Tao-Sang Chung) ;陳秋萍(Chiu-Ping Chen) ;林招膨(Jao-Perng Lin) ;蔡若婷(Jo-Ting Tsai)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:電腦刀 ; 呼吸同步追蹤系統 ; 影像導引系統 ; 移動假體 ; CyberKnife ; Synchrony respiratory tracking system ; Image guide system ; Motion phantom
刊名:放射治療與腫瘤學
頁碼:1-15
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

旦且:驗誼與探討電腦刀呼吸同步追蹤系統,在腫瘤因呼吸而造成週期性移動下,治療位置準確 度與治療範圍的變化情形,評估該系統於臨床治療上之貢獻及其相關影響。 姐姐盟主這:本研究使用具有呼吸同步追蹤功能的電腦刀立體定位放射手術系統。使用移動假體 (Motion phantom) 模擬病患治療位置因呼吸而移動情形。此假體配置一個自旋轉軸帶動之平台, 可作前後方向運動,平台上可供放置內含驗證片的全系統測試用球型立方體。臘語片使用MD-55 膠片,掃描鞍誼片使用Epson expression 1680 穿透式平版掃描器。空間位置準確度買賣誼之分析 敕體為End to End test 。臨床病患劑量分佈駿誼之分析軟體則為Film QA 。空間位置準確度分析 分靜態、運動不補償及運動自動補償等三種條件進行,自假體靜止狀態到假體移動同時做動治療 設備作動態自動補償,評估電腦刀在各種情況下執行治療計鐘時的空閑位重準確度情形。在治療 位軍運動誤差及動態自動補償誤差的評估方面,設計了兩個臨床狀況實驗:一、呼吸週期中不同 位置,二、變化呼吸頻率取定位影像之治療準確度評估。臨床劑量驗證則針對肺部、肝臟與攝誰 腺三個部位,各選擇一位病患之電腦治療計盒,以MD-55 劑量驗誼膠片, γ 數值評估方法(3 % , 3 mm)' 比對在腫瘤中心點所在的軸狀切面( ax ial ) 及矢狀切面(sag i ttal) 劑量量測結果與電腦治 療計畫計算結果之差異。 益基:假體靜態條件, 平均誤差為0 .42 :t 0.06 mm 。假體過期運動時,在呼吸週期不同時間點取 f擎的情況下,運動不校正補償與運動校正橘償條件下之平均誤差分別為7.59 :t 5.14 mm 與0 . 35 :t 0.10 mm ' p 值小於0.0001 。在變化呼吸頻率的情況下,每分鐘20 次與每分鐘15;欠之平均該差 差距僅有0 . 12 mm ' p 值為0 . 11 。臨床病患劑量驗詣,自市部、肝臟與攝護膜三組臨床病患之軸狀切 面與失狀切面之2 維劑量驗誼, γ 數值評估方法的通過率皆高於99 % 。 鐘益:在本研究的分析中,電腦刀呼吸同步追蹤系統之空間位置準確度誤差小於0 . 5 mm ' 符合立 體定位敘射手術治療對於空間位重準確度之要求。在處理治療位置會囡呼吸而移動的病患時, 執 行此系統,將可大幅減少照射的範圈,有效降低正常組織的傷害。在鷗床病患劑量驗證寶島章中, 劑量分佈之準確性亦可充分滿足臨床治療的要求。然而使用本系統的治療時間常須1 . 5-2 . 5 小時, 易使病患因久躺不耐而躁動,影響治療位置的準確性。臨床應用時, 應斟酌病患的穩定度適當使 用即時影像導引的功能,確保治療的晶質。
星星單單至: To verify the accuracy of CyberKnife@ Respiratory Tracking System (SRTS) in tracking the tumor motion during the respiratory cycle and the influence on treatment fie1d; and to evaluate the clinical application of the system. Materials and Method~ : The SRTS was a subsystem of the CyberKnife@ stereotactic radiosurgery system for respiratory tracking. The motion phantom was used in the respiratory motion experiments, which can imitate regular breathing pattern. The motion phantom contained a motion table and a ball-cube phantom which can hold verification films. We performed the E2E CyberKnife@ dose calibration procedure and used MD-55 verification film, flatbed scanner (Epson Expression 1680) and dose ana1ysis software (Film QA)ωevaluate the clinical dosimetry and treatment accuracy. The mechanical a∞uracy of the SRTS was tested and confirmed by three stages of studies including the static phantom, motion phantom and the motion 仕acking compensation 位periments . We also designed two experiments with phantom moved in different phases and frequency of the respiratory cycle to test for the accuracy of the image guide system on motion compensation. The clinical dosimetry verification studies included the lung, liver and prostate cancer patients. The two dimensional dose distribution (sagittal and axial) measured by the MD-55 film was compared with the treatment planning result by a gamma comparison with pass criteria of 3%/3 mm. 車旦旦11. : The average positional error for the static stage study was 0 .42 士0.06 mm. The average targeting error with and without the SRTS tracking compensation in the respiratοry cycle was 0.35 士0 .1 0 mm and 7.59 ::1:: 5.14 mm, respectively (p < 0.0001). The difference of average targeting error between two respiratory cycles (l5/min and 20/min) was 0.12 mm (p = 0.11). In the verification ofthe axial and sagitta12-D dose distribution ofthe three clinical cases, they were 99% compatible C'onclusio!! : The spatial positional error of SRTS was less than 0.5 mm which matched the accuracy requirement of stereotatic radiosurgery. By using the SRTS to track and compensate for the motion of lesions during respiratory cycle, we can significantly minimize the volume of the treatment field ançl the dose of the surrounding critical structures. The accuracy of dosimetry was also proven by our clinical cases experiments. However, additional positional error wiU be caused by patient w




本卷期目次
放射治療與腫瘤學
電腦刀呼吸同步追蹤系統應用於放射治療之評估/ 郭駿騵林家瑋蕭安成余孝緯陳尚文鍾道生陳秋萍林招膨蔡若婷
RETROSPECTlVE ANALYSIS OF OUTCOMES FOR PATIENTS WITH INVASIVE THYMOMA RECEIVING SURGERY WITH OR WITHOUT ADJUVANT RADIOTHERAPY/ Wan-yu ChenJason Chia-Hsien ChengYung-Chie LeeFeng-Ming Hsu
THE CLINICAL OUTCOME OF NEOADJUVANT CHEMORADIOTHERAPY IN LOCALLY ADVANCED RECTAL CANCER/ Chien-Chih ChenHui-Ling YehJin-Ching LinWei-Ming WangY.C. Jeffrey ChaoChen-Fa ChangJia-Fu Lin
COMPARISON OF TREATMENT RESULTS OF MALIGNANT ASTROCYTOMA AFTER POST-OP RADIOTHERAPY ALONE OR POST-OP CONCURRENT CHEMORADIOTHERAPY PLUS ADJUVANT EMOTHERAPY--EXPERIENCE IN TSGH/ Kuen-Tze LinChing-Jung WuYee-Min JenMeei-Shyuan, LeeWen-Yen HuangChang-Ming ChenHsing-Lung ChaoChun-Shu LinYu-Fu SuJang-Chun Lin
EVALUATION OF PROSTATE CANCER TREATED WITH TEMPORARY IDGH DOSE RATE INTERSTITIAL BRACHYTHERAPY AND FOLLOWED BY EBRT/ Li-Chu PaiShi-Long LianChih-Jen HuangChia-Chu LiuWen-Jeng WuHuan-Chun HsiehShu-Pin Huang
利用射束阻擋法修正三維正子造影之非真實事件貢獻/ 郭瓊蓮林信宏莊克士詹美玲羅素花王裕文
MAILGNANT LYMPHOMA INVOLVING THE PROSTATE: A CASE REPORT/ Li-Min SunEng-Yen HuangNai-Jen ChangLi-Min ChungChiao-Yi LuJi-An LiangMan-Gang Lee
PROSTATE CANCER OF A YOUNG MAN: A CASE REPORT AND REVIEW OF LITERATURE/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao ChangLi-Chung HungYung-Hsien Liu
BASAL CELLADENOCARCINOMA OF PAROTID GLAND: A CASE REPORT IN TAIWAN/ Ting-An ChangJyh-Der LeuChien-Ru Liu
 
   
 
   

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