透過您的圖書館登入
IP:18.206.160.129
  • 期刊

全國放射治療系統品質保證作業執行現況實測研究報告

A RECENT SURVEY OF QUALITY ASSURANCE FOR RADIATION THERAPY EQUIPMENT IN TAIWAN

摘要


目的:本研究依據自民國94年7月1日起訂定的「輻射醫療曝露品質保證標準」針對放射治療設備所規範的項目,藉由書面資料蒐集及現場實地訪查,建立全國放射治療劑量準確性與作業品質管控程度的資料庫,以檢視推行「輻射醫療曝露品質保證標準」的成效,同時作為精進此作業標準的重要參考,並協助臨床單位提昇放射治療品質及技術水平,強化輻射曝露品質保證規範的完 整性。材料與方法:本研究以書面審查及現場訪查的方式執行品保校驗查核工作,總計收集76家放射治療臨床單位,135台直線加速器,8台加馬刀,38台近接治療機,18台螺旋治療機,5台電腦刀的設備與品保校驗資料,同時完成所有設備的品保項目現場訪查。各設備品保作業的方法,劑量校驗的設備與流程等都請作業執行單位提供完整的資料作為書面審查及現場訪查的參考。現場 訪查則對所有品保作業的實際情形作詳盡的瞭解。綜合整理分析全國治療設備的品保校驗資料,建立包括治療設備特性數據、劑量量測儀器特性數據、劑量校驗方法與準確性分析資料、醫療單位及人員狀況與品保作業執行的分析資料等的資料庫,作為推行品保作業重要參考資料及未來精進醫療曝露品質保證政策之依據。結果:本計畫執行的所有品保項目,藉由資料收集與討論修改後,現場查核結果在依循臨床單位所制訂的程序書執行下,其結果皆符合「輻射醫療曝露品質保證標準」的規定。討論:基於精進品保作業品質的目的提出下列建議:1.設備使用單位應建立假體劑量轉換因子,進一步提昇劑量校驗的準確性。2.射束平坦性應建立適當基準值,以更有效的達到監控射束品 質的目的。3.射束平坦性及對稱性的計算應使用「輻射醫療曝露品質保證標準」程序書所載的公式。4.含放射性物質之遙控後荷式近接治療設備之輻射源強度校驗,建議應修改誤差容許值。5.放射治療設備劑量校驗使用的議定書,應依照內附的工作表(worksheet)建立完整的紙本表格 數據資料,避免直接或唯一使用excel應用程式工具。

並列摘要


Purpose : Based on the "medical radiation exposure quality assurance standards", with on-site visits to the radiation therapy departments, a national database for the accuracy and quality control of dosimetry in radiotherapy were established. This database can serve as a basis for reviewing the effects of the quality assurance standards for medical radiation exposure and improving quality assurance policies related to medical radiation exposure. In addition, the database can serve as a reference for clinical units seeking to enhance the quality of technologies used in radiotherapy and to strengthen the integrity of quality assurance measures related to medical radiation exposure. Materials and Methods : There are totally 204 radiotherapy equipments, including 135 linac, 8 gamma knife, 38 brachytherapy system, 18 Tomotherapy, and 5 Cyberknife, currently used in Taiwan. Methods of QA procedure, equipments of dose calibration will be ask to provide for on site inspection. Site visits will give a more detailed understanding of the actual situation of all quality assurance operations, and for dose output, beam energy and beam flatness and symmetry, actual measurement will be performed on site. Analyze the QA data from this study, including treatment equipment characteristics, characteristics of dose measurement instruments, the variations from the dose calibration methods, medical units and personnel statuses which will be an important reference for the improving of quality assurance in radiation therapy. Results : after data survey and parameter corrections, the results of on-site check for the QA items executed in this study are all fit the criteria of the "radiation exposure of medical quality assurance standards" Discussion : To improve the quality assurance procedures, we offer the following recommendations: 1. phantom dose conversion factor should be established, if the phantom is not used in the protocol, hence to further enhance the accuracy of dose calibration; 2. an appropriate reference level of beam flatness and symmetry should be established for monitoring the beam quality more effectively. 3. beam flatness and symmetry shall be calculated using the same formula list in the AEC published program of "radiation exposure of medical quality assurance standards". 4. the calibration criteria of brachytherapy source activity should be revised. 5. the data worksheet of dose calibration should be established fully according to the enclosed data worksheet in the protocol, should avoid direct or sole use of excel application tools.

延伸閱讀