- 學位論文
介入性血管攝影劑量評估系統之建立：應用於經動脈肝腫瘤栓塞
Establishing Dose Evaluation System for Interventional Angiography : Transcatheter Arterial Embolization
摘要
影像導引式手術利用透視導引執行醫療程序，因為容易達到病灶且相對風險小，越來越廣泛使用，成功地治療許多疾病，然而卻存在確定性效應和機率性效應的風險。國際組織也對於介入性的放射手術有閾值劑量上的建議，和皮膚劑量的限值。 本研究利用自顯色膠片和蒙地卡羅程式BEAMnrcMP建立一套評估劑量的方法，對此模型的射束品質、劑量特性進行驗證，並將完成膠片輻射劑量計量測病人表面劑量之結果放入蒙地卡羅模擬，進行決定劑量轉換，進而計算器官組織劑量。 本系統已成功建立，已可評估經動脈肝腫瘤栓塞手術時，個別病人的器官劑量和有效劑量，未來也可將此系統應用於其他介入性手術，這個系統的建立與運用極具意義，在臨床上的建議及學術上的研究具有相當的價值。
並列摘要
Minimally invasive imaging-guided vascular interventions with fluoroscopy and digital subtraction angiographic have recently become widespread and have been successfully in the treatment of various diseases. However, interventional fluoroscopy procedures may present deterministic and stochastic radiation risks. The International Commission on Radiological Protection (ICRP) and the Food and Drug Administration have requested identification of procedures that may involve patient doses greater than the recommended threshold. In this study, we used the gafchromic dosimetric media (self-developing “film”) and Measurement-based Monte Carlo simulation to establish the dose evaluation system for transcatheter arterial embolization of interventional radiology. We investigated the beam quality, characteristics of gafchromic films and further, and successfully inputed dose distribution of the measured films from clinical situation to Monte Carlo simulation. We calculated the organ doses and eventually get the effective doses. Establishing the dose evaluation system for transcatheter arterial embolization to investigate the organ and effective doses has provided the good experiences to other applications.