非侵入性腦立體放射治療定位架之技術與再現性研究

Techniques and Reproducibility of Noninvasive Frame

劉幕台(Mu-Tai Liu) ； 林招膨(Jao-Perng Lin) ； 張雅婷(Ya-Ting Chang) ； 林昇宏(Sheng-Hong Lin) ； 張東浩(Tung-Hao Chang) ； 許智捷(Chih-Chiech Hsu) ； 黃昭源(Chao-Yuan Huang)

《放射治療與腫瘤學》 6卷4期 (1999/12) Pp. 317-323

https://doi.org/10.6316/TRO/199906(4)317

摘要

目的：本文將研究新型，多功能非侵入性腦立體定位架操作流程之技術上的細節作介紹，以及此定位架重複固定後之臨床治療再現準確性。
材料與方法：此非侵入性立體定位架為stereoadaPter5000，由增強塑膠與不產生假影的鋁合金組成。定位架藉由兩側耳塞與鼻樑支援器固定於病患頭部‘定位架之緊度可由鼻樑支持器上的螺旋桿，鼻樑支持臂與三角物件相接的齒輪，以及連接金屬板與三角物件交接的齒輪所調整與控制，本文由七位健康的自願者進行測試，瞭解定位架固定於頭部的流程與花費的時間，以及試戴後的感覺。關於再現性的研究，是以自願者重複戴上定位架三次，每次相隔5分鐘，於同樣的參考點上標點，最後以毫米刻度尺量測差異值。
結果：將非侵入性定位架固定於自願者頭部所花費時問大約為3分鐘，自願者三次試戴結果，容忍度良好，無嚴重的不舒適感，其中的不舒適感包括鼻樑與外耳道受到壓迫，耳朵由於耳塞的掩蔽現象而有聽不太清楚的情況產生，關於再現性的研究，左右兩側各有一個參考點，右側平均差異0.74mm（標準差0.47mm，最大差異1.5mm)，左側平均差異0.89 mm（標準差0.24mm，最大差異1.25mm）。
結果：此腦立體定位架為一種非侵入性，可容易且快速的固定於病患的頭部，以及其重複的再現性高。因此對於此定位架不再侷限於單次的治療模式，而可應用於生物效應較好的分次治療技術。

關鍵字

非侵入性 ； 腦立體定位架 ； 再現性

並列摘要

Purpose: In this study, we will describe the technique details of mounting the new, versatile stereoadapter. In addition, we will research the reproducibility of repeated mounting of that.
Materials and Methods: The stereoadapter5000 is a non-invasive frame made of reinforced plastic and aluminum alloy. It is mounted to patient's head by means of two ear plugs and nasion support. The tight intensity of this frame is modify by a threaded screw at the nasion support, two cogwheel cases joined the lateral triangle components to the nasion support arm, and two ones joined the connector plate to the lateral triangle components. To achieve maximum accuracy and confidence with the stereoadapter, we should repeat the mounting procedure several times to become familiar with all the features of the frame. Besides, the reproducibility of repeat fixations of the frame to the head was tested in 7 healthy volunteers. The differences in location of the marking were measured.
Results: The mountings of the frame to the head took 3 mm. All subjects tolerated well the three mountings of the frame. Some complaints were unpleasant pressure on the bridge of the nose and on the external auditory canal and not hear well due to the occlusion of the canal by the ear plugs. About reproducibility of repeat fixation of this frame, the differences in the position of the blocks on the right side was 0.74 mm (SD 0.47 mm, range 1.5 mm), and on the left side was 0.89 mm (SD 0.24 mm, range 1.25).
Conclusion: This stereoadapter is easy and quick to mount on the patient's head, and reproducibility of repeated mountings is very 4gh. So not limited to single session, the stereotactic irradiation can be fractionated, according to radidbiological principles, in several sessions. In addition to combine with CT and MRI system, this frame is also suitable for open stereotactic surgery.

並列關鍵字

Non-invasive ； Stereoadapter ； Reproducibility