- 期刊
質子腦部立體定位放射手術治療，固定裝置及定位方式之研究
The Investigation of the Immobilization Devices and Localization Methods for Brain Cancer in Proton Stereotactic Radiosurgery (P-SRS)
摘要
針對質子腦部立體定位放射手術治療，評估使用不同固定裝置及不同標的物之定位方式，對於治療中心點之準確性的影響。一、分別用BoS^(TM) headframe（BoS）和BRW headring（headring）固定CIRS人頭假體，此假體嵌入1 mm的不透X光鋼珠（視為標準治療中心點），以骨骼執行影像導引對位，評估固定裝置的準確性；二、將四顆鈦珠嵌入假體後，使用headring固定假體，分別使用骨骼與鈦珠當標的物做影像導引定位，分析不同標的物之治療中心點差異。結果顯示，使用不同固定方式BoS與headring，治療中心點的平均誤差在三軸無顯著差異，而3D空間的誤差變化在統計上有顯著差異，分別為0.85±0.42 mm與0.60±0.32 mm（p = 0.017）。使用不同標的物骨骼與鈦珠，治療中心點之平均誤差在3D空間的誤差變化有顯著差異，分別為0.84±0.48 mm與0.41±0.23mm（p = 0.004），亦即使用鈦珠做標的物執行影像導引定位可以有效增加治療中心點的準確性。基於等待時間與病患舒適度的考量，本院目前臨床治療採用BoS固定方式及使用鈦珠作為標的物執行影像導引，避免病患因釘頭架而造成的不舒適性及有效增加治療中心的準確性。
並列摘要
There are two aims of this study: one is to assess the accuracy of the Base of Skull (BoS) immobilization cast and BRW headring for brain cancer in proton stereotactic radiosurgery (P-SRS); the other one is to investigate the accuracy of imaging-guided localization methods by using bony structure and fiducial markers as different landmarks. To assess the accuracy of the immobilization devices, the CIRS Radiosurgery Head Phantom with hidden target (as the isocenter) was immobilized by BoS and headring, respectively. After that, we implemented the imaging guidance by using bony structure. Compare to the localization methods, the CIRS Radiosurgery Head Phantom with hidden target was immobilized by headring and followed by implementation of the imaging guided process using bony structure and fiducial markers, respectively. For BoS and headring, translational deviations were not statistically significant, but there were significant differences in 3D vector, 0.85±0.42 mm and 0.60±0.32 mm (p = 0.017), respectively. For bony structure and fiducial markers, there were significant differences in 3D vector, 0.84±0.48 mm and 0.41±0.23 mm (p = 0.004), respectively. Based on waiting time and patient comfort considerations, we use BoS immobilization device with fiducial markers for brain cancer in proton stereotactic radiosurgery (P-SRS).
延伸閱讀
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