真空定位袋在放疗临床应用中的剂量学研究

目的探讨真空定位袋在放疗中的质量保证与质量控制。方法把真空定位袋抽成真空．并使其厚度分别为1cm．3cm,5cm,10cm不等,将其置放于加速器治疗床的固体水模上,固体水模内放置剂量测量仪探头,分别用6MV和15MV高能x线进行照射,得到一组剂量仪读数,然后拿掉真空定位袋,其它条件不变,再去照射。用两组数据进行比较可求出真空定位袋的穿透因子。结果对于不同型号,不同厚度的真空定位袋,穿透因子不同。结论相同能量x线照射下,穿透因子随着真空定位袋厚度的增加而减小;相同型号和厚度的真空定位袋,穿透因子随着x射线能量的增加而增加．因此有必要对真空定位袋进行质量保证和质量控制．确保放射治疗定位和剂量计算的精度。     

负压真空气垫的质量保证与质量控制探讨

目的：探讨放射治疗中负压真空气垫的质量保证和质量控制的内容和方法。方法：用真空泵把负压真空气垫抽成真空,分别使负压真空气垫厚度为1、2、3、…10cm不等。用能量为6MV的X线照射,然后拿掉负压真空气垫,同样条件下照射,计算出负压真空气垫的穿射因子。负压真空气垫对体表剂量的影响,首先测出一组不同厚度时的开放野的数值;将3种不同的负压真空气垫平放在有机玻璃模体上,再测出一组读数,求出体表剂量的增量。结果：负压真空气垫的厚度不同,穿射因子也不同;使用真空气垫提高了皮肤表面的剂量。结论：对负压真空气垫进行质量保证和质量控制,以保证放射治疗定位和剂量计算的精度;新买的负压真空气垫应由放疗科物理师及技术员检测后方可投入使用。     

不同模体材料对加速器绝对剂量校准的影响与分析

目的:探讨使用不同的模体材料如水、固体水校准加速器绝对剂量时对校准结果的影响程度,分析固体水模在不同能量挡时代替水模体的可行性。方法:分别采用水及PTW固体水测量Varian 21EX各个能量挡,测量探头板测量点深度为0.7 cm;6、9 MeV电子线测量深度为1 cm,需放置0.3 cm的固体水;12、16、20 MeV电子线测量深度为2 cm,需放置1.3 cm的固体水;6 MV X线测量深度为5 cm,需放置4.3 cm的固体水;15 MV X线测量深度为10 cm,需放置9.3 cm的固体水。结果:6、9、12、16、20 MeV电子线测量模体为固体水时比水分别小5.6%、2.8%、1.9%、0.7%、0.1%,6、15 MV X线测量模体为固体水时与水的差别分别为3.7%、3.6%。结论:校准12、16、20 MeV电子线及6、15 MV X线时固体水模可代替水模体,差别较小;6、9 MeV电子线因测量深度较浅,加之固体水是多个小单位固体水的叠加,测量差别较大,不易代替水测量。     

Varian直线加速器全碳纤维治疗床对放疗剂量的影响

目的:探讨Varian直线加速器全碳纤维治疗床对放疗剂量的影响。方法:将固体水模置于主床板、衔接处、延长板的中心处,改变机臂角度,从不同角度让不同能量的高能X射线穿透治疗床,通过对比测量计算出穿透因子。利用放射治疗计划系统设计加床和不加床的计划,测量绝对剂量的误差。结果:6、15 MV X线,主床板和延长板的穿透因子在机架角105～120°区间较低,主床板在115°时最小,穿透因子分别为0.954 4、0.968 5;延长板在110°时最小,穿透因子分别为0.914 7、0.924 7;衔接处的穿透因子远小于主床板和延长板,120°时最小,分别为0.484 8、0.586 0。利用TPS设计放射治疗计划加虚拟床后,实测剂量更接近计划中的计算值。结论:随着床板厚度的增加,穿透因子减小;主床板和延长板对剂量的衰减接近,衔接处衰减最大,摆位时应避免射野穿过;能量越高,穿透因子越大;在设计放射治疗计划时,加虚拟床是必要的。     

不同能量X线在中段食管癌三维适形放疗中的比较

目的：探讨中段食管癌三维适形放疗（3DCRT）X线能量的选择.方法：选择21例中段食管癌患者,对每例患者分别采用6 MV和15 MV X线进行3DCRT治疗计划设计,同一患者的2个计划均使用相同的布野方案和剂量体积约束.比较2组治疗计划的计划靶区、危及器官及正常组织的剂量分布.结果：能量6MVX线治疗计划计划靶区的剂量分布、均匀性、适形度与15 MV的结果近似相同,均数差异无统计学意义（P＞0.05）;能量6 MV治疗计划危及器官脊髓、心脏,正常组织肺的受照剂量与15 MV的结果一致,均数差异无统计学意义（P＞0.05）.结论：在中段食管癌3DCRT中,不同能量X线照射后,肿瘤组织、危及器官和正常组织剂量分布无明显差异,但高能X线使患者受到更多的低剂量照射.因此,中段食管癌3DCRT时X线能量一般选用6 MV.     

基于Eclipse研究不同人体替代组织的深度剂量特性

目的 研究放射治疗计划中不同人体组织深度剂量沉积特点。方法 在Eclipse计划系统中建立20 cm×20 cm×20 cm水模体，然后在水模体中心轴处，深度3cm下建立含不同人体替代组织的模体结构，并赋予组织密度值和CT值，射野10 cm×10 cm，使用6 MV X射线SSD=100 cm照射，提取射野中心轴深度剂量曲线数据与水模体中深度剂量曲线比较。结果 当给予6MV X射线照射时，含空气和肺组织模体均在组织和水材料下交界后出现二次剂量建成，且剂量值下降大大慢于单纯水模体；含骨骼肌和脂肪组织模体中的深度剂量线和单纯水模体相比相差较小，其中含骨骼肌模体中深度剂量线基本与水模体中相同，而含脂肪模体中数值略高于水模体的；含骨组织、铝模体和水材料的上交界后出现二次剂量建成现象，而和水材料下交界后剂量快速下降；含各种组织的模体在达到一定深度后剂量曲线均趋于平行。结论 当射线由低密度物质进入高密度物质后会产生二次剂量建成效应，且密度差异越大建成效应越明显；当射线由高密度物质进入低密度物质后，深度吸收剂量快速降低，且密度差越大降低速度越快。这种深度剂量特性对制定放射治疗计划可起到一定的指导作用。     

放射治疗对靶区外非邻近组织器官剂量的影响因素分析

目的 探讨加速器放射治疗时,X射线能量和照射野大小对靶区外非邻近组织器官剂量的影响,为改善患者的放射防护提供依据。方法 按照6 MV、15 MV X射线能量和5 cm×5 cm、10 cm×10 cm和15 cm×15 cm照射野进行分组,使用国产仿真人体模型,在靶区外非邻近组织器官使用TLD测量每组放射治疗条件下的体模器官剂量,对结果进行分析。结果 每100 cGy靶区剂量,靶区外非邻近组织器官剂量6 MV X射线组,5 cm×5 cm野为0.79 mSv,10cm×10 cm野为2.93 mSv,15 cm×15 cm野为8.71 mSv;15 MV X射线组,5 cm×5 cm野为9.05 mSv,10 cm×10 cm野为4.67 mSv,15 cm×15 cm野为8.61 mSv。照射野较小时,15 MV X射线组靶区外非邻近组织器官剂量大于6 MV X射线组,大野时小于6 MV X射线组。结论 从靶区外非邻近组织器官剂量而言,当靶区较小时,宜选择6 MV X射线能量进行治疗;当靶区较大时,使用15MV X射线能量具有优势。     

楔形因子对照射野大小和射线深度的影响分析

目的照射野大小和测量深度不同,将导致楔形因子发生改变,继而使楔形照射野下的剂量计算发生偏差。方法利用德国WELLHOFER公司DOSE-1剂量仪和FC65-G指型电离室、水模(40 cm×40 cm×30 cm)分别测量6MV条件下不同深度、不同面积的平野和楔形野的剂量率,计算其楔形因子。结果深度对楔形因子的影响较明显,随着测量深度的增加楔形因子也增加,楔形板角度越大,深度对楔形因子的影响越明显,从1.5cm到10cm时楔形因子最大有2.5%的偏差。照射野大小对楔形因子也有一定的影响,随着照射野的增加,楔形因子也增加,只是程度有所不同。射野较小而深度较浅时,实测的楔形因子比标准值要小,射野较大且深度较深时,实测的楔形因子比标准值要大。结论用传统方法计算楔形野剂量存在误差,根据质量控制要求,楔形因子的精确度不能超过2%,为保证剂量计算的准确,消除计算误差,应测量并使用不同楔形野的楔形因子,同时对楔形因子做深度修正,采用相对深度的楔形因子,以达到放射治疗质量保证和质量控制规定的标准。     

放疗体位固定面膜对体表剂量的影响研究

目的：研究在X线照射下放疗时用的固体面膜对患者体表剂量的影响.方法：采用IBA公司的MatriXX多通道剂量仪,32行32列矩阵电离室,半导体探测器,有机玻璃假体验证模,瓦里安CX直线加速器,测量不同形状和厚度的固定面膜对人体表皮剂量的影响.结果：6MV-X线照射下,戴热塑面膜比不戴热塑面膜,射野逐渐增大,其表面剂量增加范围在15.3％-27.5％之间,10MV-X线时在17.4％-36.8％之间.结论：通过两种能量的X线的比较,光子线能量越高对人体表面剂量的影响越大,面膜越薄且有网孔的,表面剂量影响越小,在临床使用中究竟该如何在计划系统中修正其影响还值得研究.     

DR摄影照射野与图像质量和辐射剂量的相关性研究

目的 探讨数字化X射线摄影中照射野的大小对辐射剂量和图像质量的影响。方法 对10cm、20cm厚度聚甲基丙烯酸甲酯(PMMA)和对比度细节体模(CDRAD2.0)组合用80kV自动曝光控制系统(AEC)摄影,记录相同曝光条件下不同照射野41cm×41cm,35cm×41cm,35cm×35cm,24cm×30cm,18cm×24cm的入射体表剂量(ESD)、剂量面积乘积(DAP)、管电流(mAs),计算图像质量因子(IQF)值,所得数据的差异比较用One-Way ANOVA分析和LSD-t检验。对3名医师阅片结果的一致性进行Kappa检验。结果 不同照射野,相同厚度组合的DAP、IQF值之间比较差异有统计学意义(F=12.52、14.23,21.38、19.82,均P < 0.05);ESD、mAs之间比较差异无显著性(F=0.329、0.347,0.029、0.535,均P > 0.05)。10cm、20cm厚度组合,照射野大小与DAP、IQF值呈正相关,与ESD、mAs无相关性。体模越厚,ESD、DAP、mAs增加越显著;体模增厚10cm,同一照射野的ESD、DAP、mAs分别增加约90%、74%、87%,IQF值增加约9%。结论 相同曝光条件下,照射野的大小与DAP、IQF值正相关,合理选择照射野,可减少受检者辐射剂量,提高影像质量。     

OSL剂量计能量响应特性的检测

目的:检测国内外目前常用的OSL剂量计的能量响应特性,评价剂量计的能响性能。方法:在标准剂量学实验室用60～250kV的窄谱束X射线及60Coγ标准辐射场,分别在空气中和板模体上照射两套OSL剂量计,测量后分别分析和评价其能量响应特性。结果:OSL剂量计在空气中和板模体上的能量响应在0.048～1.25MeV范围内,皆不>±20%。结论:正确选择灵敏度一致的OSL剂量计,其能量响应特性可满足辐射防护人员剂量监测要求。     

Investigation of photon beam models in heterogeneous media of modern radiotherapy

This study investigates the performance of photon beam models in dose calculations involving heterogeneous media in modern radiotherapy. Three dose calculation algorithms implemented in the CMS FOCUS treatment planning system have been assessed and validated using ionization chambers, thermoluminescent dosimeters (TLDs) and film. The algorithms include the multigrid superposition (MGS) algorithm, fast Fourier Transform Convolution (FFTC) algorithm and Clarkson algorithm. Heterogeneous phantoms used in the study consist of air cavities, lung analogue and an anthropomorphic phantom. Depth dose distributions along the central beam axis for 6 MV and 10 MV photon beams with field sizes of 5 cm x 5 cm and 10 cm x 10 cm were measured in the air cavity phantoms and lung analogue phantom. Point dose measurements were performed in the anthropomorphic phantom. Calculated results with three dose calculation algorithms were compared with measured results. In the air cavity phantoms, the maximum dose differences between the algorithms and the measurements were found at the distal surface of the air cavity with a 10 MV photon beam and a 5 cm x 5 cm field size. The differences were 3.8%. 24.9% and 27.7% for the MGS. FFTC and Clarkson algorithms. respectively. Experimental measurements of secondary electron build-up range beyond the air cavity showed an increase with decreasing field size, increasing energy and increasing air cavity thickness. The maximum dose differences in the lung analogue with 5 cm x 5 cm field size were found to be 0.3%. 4.9% and 6.9% for the MGS. FFTC and Clarkson algorithms with a 6 MV photon beam and 0.4%. 6.3% and 9.1% with a 10 MV photon beam, respectively. In the anthropomorphic phantom, the dose differences between calculations using the MGS algorithm and measurements with TLD rods were less than +/-4.5% for 6 MV and 10 MV photon beams with 10 cm x 10 cm field size and 6 MV photon beam with 5 cm x 5 cm field size, and within +/-7.5% for 10 MV with 5 cm x 5 cm field size, respectively. The FFTC and Clarkson algorithms overestimate doses at all dose points in the lung of the anthropomorphic phantom. In conclusion, the MGS is the most accurate dose calculation algorithm of investigated photon beam models. It is strongly recommended for implementation in modern radiotherapy with multiple small fields when heterogeneous media are in the treatment fields.     

Determination of percentage depth dose for 6 and 10 MV x-rays using Ge-doped optical fibre and TLD-100.

Percentage depth doses for 6 and 10 MV x-ray beams from a linear accelerator were measured using approximately 1 cm long (approximately 0.3 mg) Ge-doped optical fibre as a thermoluminescence dosimeter for two field sizes, 5 x 5 and 10 x 10 cm2. The results indicate that the Ge-doped optical fibre dosimeter is in good agreement with the results from a PTW 30001 cylindrical ionisation chamber and TLD-100. For 6 MV x-ray beams we observe that the depth of maximum dose d(max) is 1.5 and 2 cm for field sizes of 5 x 5 and 10 x 10 cm2 respectively. For 10 MV d(max) is 2 cm for a field size of 5 x 5 cm2 and 2.5 cm for a 10 x 10 cm2 field.     

Development of a high efficiency personal/environmental radon dosimeter using polycarbonate detectors.

Passive radon dosimeters, based on alpha particle etched track detectors, are widely used for the assessment of radon exposure. These methods are often applied in radon dosimetry for long periods of time. In this research work, we have developed a highly efficient method of personal/environmental radon dosimetry that is based upon the detection of alpha particles from radon daughters, (218)Po and (214)Po, using a polycarbonate detector (PC). The radon daughters are collected on the filter surface by passing a fixed flow of air through it and the PC detector, placed at a specified distance from the filter, is simultaneously exposed to alpha particles. After exposure, the latent tracks on the detector are made to appear by means of an electrochemical etching process; these are proportional to the radon dose. The air flow rate and the detector-filter distance are the major factors that can affect the performance of the dosimeter. The results obtained in our experimental investigations have shown that a distance of 1.5 cm between the detector and the filter, an absorber layer of Al with a thickness of 12 microm and an air flow rate of 4 l min(-1) offer the best design parameters for a high efficiency radon dosimeter. Then, the designed dosimeter was calibrated against different values of radon exposures and the obtained sensitivity was found to be 2.1 (tracks cm(-2)) (kBq h m(-3))(-1). The most important advantages of this method are that it is reliable, fast and convenient when used for radon dose assessment. In this paper, the optimized parameters of the dosimeter structure and its calibration procedure are presented and discussed.     

Radiation quality of a tomotherapy photon fan beam

Tomotherapy, a novel radiotherapy technique, uses narrow fan beams for cancer patient treatment. Photon energy spectra for a rectangular 10 x 1 cm2 photon beam were analyzed in central axis and penumbra regions at depths of 3 to 10 cm in a water phantom. A 6 MV beam of a Varian 2100C/D Linear Accelerator was modeled using BEAM99 Monte Carlo calculations to simulate energy transport in a water phantom. Arrays of 4 x 2 mm2 scoring regions were arranged to cover the central axis and penumbra areas. Radiation quality factors were calculated based on dose-mean linear energy transfer. Although there appears to be a trend towards higher quality factor values in the penumbra area, this change is fairly small, at most 3% in penumbra region. We conclude that change in radiation quality is not likely to be an issue in a tomotherapeutic approach when 6 MV x rays are used.     

Evaluation of MOSFETs for entrance dose dosimetry for 6 and 10 MV photons with a custom made build up cap

Commercially available MOSFETs, Thomson and Nielsen TN502-RD, were evaluated for suitability as an entrance dose in vivo dosimeter for 6MV and 10MV. Detector response was normally distributed around a mean (skewness = -0.01 +/- 0.24, kurtosis = -0.09 +/- 0.48) with a mean of 110.6 mV/Gy, with a standard deviation of 2.4% at 0.86 Gy. The standard deviation of readings increased with decreasing dose and increased at a rate greater than inverse square. The linearity coefficient was 0.9999. No significant dependence on angle, field size, dose rate, energy or time was observed. As such, they would be useful for entrance dose in vivo dosimetry. With a custom made build up cap corrections were required for field size, wedge, beam energy and tray factors, showing that build up cap design is an important consideration for entrance dose in vivo dosimetry using MOSFETs.