設計一套特殊針板及平行定位量角器做為攝護腺插種治療輔助工具的研究

A Special Designed Domed-Cones Template and Parallel Shift Protractor for Fixation and Pre-Plan in Prostate Needle Implant Procedure

吳嘉明(Jia-Ming Wu) ； 葉世安(Shyh-An Yeh) ； 蕭光吟(Kuan-Yin Hsiao) ； 郭忠民(Chung-Ming Kuo) ； 陳清江(Ching-Jiang Chen) ； 趙敏(Max Min Chao) ； 吳敬次(Jin-Tze Wu)

《放射治療與腫瘤學》 18卷2期 (2011/06) Pp. 137-147

https://doi.org/10.6316/TRO/201118(2)137

摘要

目的：本篇說明如何利用自行設計的特殊針板及平行定位量角器，以期在攝護腺的插種過程中，達到既可以讓針固定及斜插的效果、且可以預先模擬針置入人體的角度及針置入的深度，以便執行最佳的插種治療。材料與方法：我們結合兩片長寬均是7.5公分，厚度為0.5公分，內側有“碗結構”形狀的壓克力板，而在每個“碗結構”形狀的壓克力板外側各有60º角的火山錐合成特殊的針板；而在此兩個“碗結構”所合成的空心球體內包含兩瓣有孔洞的半球體；結果顯示，在攝護腺的插種過程中，當使用此種特殊針板時，可以達到防止針往內戳，又可避免針往外滑，且可以讓針以傾斜的角度插入病患體內的功能。結果與討論：使用此篇自行設計的特殊針板的同時，如果再加上平行定位量角器的輔助及針板固定器的運用，足以讓攝護腺插種治療達到最佳的插種效果；如果以此裝置再配合直腸超音波的使用，不但在攝護腺插種治療上，甚至在永久性的插種治療上都可以讓輻射劑量達到最佳的分佈。

關鍵字

攝護腺插種治療 ； 特殊針板 ； 平行定位量角器 ； 模擬治療

並列摘要

Purpose: Normally, the conventional acrylic board with parallel holes template in prostate needle implant lead disadvantages to be able to tile or rotate when needles need to approach seminal vesicle or to avoid the obstruction of symphysis pubis. In order to overcome the disadvantages of conventional templates, we developed a special template for guiding needles insertion and fixation when practice prostate needle implant.Materials and Methods: Two acrylic board, each with 7.5 cm by 7.5 cm of width, length and 0.5 cm thickness, were drilled a set of domed holes and cones combination placed split balls inside this combination to provide firmly grip and fixation of needles both in tilting and rotation movement. Thirety nine domed-cones combination concentric circles array provide at most thirety nine needles insertion and eight nylon screws screwed tight to compress those thirety nine glass fiber reinforced plastic split balls inside domed-cones combination to support needles fixation. All these materials have been considered the tolerance not to be spoiled under normal sterillizaton condition.Results: A dosimetric measurement with home-made phantom have been developed. The special designed acrylic board domed-cones combination provide needles up to 60° rotation flexibility application. Some area that isodose curves couldn't cover in conventional parallel template could be covered now by using this new designed template.Conclusion: This special designed acrylic board domed-cones combination not only provide a reliable way for needles fixation and rotational function, but also provide a superior dose distribution in anterior portion of prostate and well coverage of seminal vesicle.

並列關鍵字

Prostate needle implant ； Domed-Cones template ； Parallel shift protractor ； Brachy therapy pre-simulation