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臺灣應用輻射與同位素雜誌

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篇名 小啞鈴式固定器針板應用於攝護腺插種治療之輔助工具
卷期 6:3
並列篇名 Special Design Dumbbells Template for Fixation in Prostate Needle Implant Procedure
作者 吳嘉明葉世安蕭光吟郭忠民陳清江趙敏吳敬次
頁次 899-905
關鍵字 攝護腺插種治療特殊針板模擬治療Prostate needle implantspecial design Dumbbell templatebrachytherapy
出刊日期 201009

中文摘要

使用銥-192(Ir-192)為射源做攝護腺插種近接治療時,通常會使用一塊讓針可以平行插入的針板,然而此針板除了可讓近接治療的近接器(空心針)平行插入外,對於針插入攝護腺到達定位後,除了鎖上一顆阻擋器阻止針往病人體內的內戳外,並不能阻止針往外滑,本實驗說明如何利用自行設計的特殊針板,以運用在攝護腺插種治療中達到可以讓針固定的效果,以便執行最佳的插種及進行治療。為了可讓針有效的固定在針板上,在固定性這方面初期的設計,所顯示的是每一根治療針都做一個小固定器,此固器有一圈向內凹的槽讓此小固定器鑲在壓克力板內,因為向內凹的槽只能讓此小固定器裝置做旋轉,而不能和針板垂直方向做前後滑動,而讓此小固定器旋轉的目的是要讓每一個小固器上固定治療針作用的螺絲可以被螺絲起子旋轉到,除此之外,可以輔助治療針在實際插入病人前於電腦治療計劃系統(Plato)上執行模擬計劃,以期讓治療針可在治療計劃系統先模擬好要插入的位置,以便實際插在病灶的治療針達最佳的分佈,讓最佳的等劑量曲線均勻的包覆病灶,而讓直腸和膀胱的劑量降到最低。使用此處自行設計的特殊針板可以讓針插入攝護腺後得到固定的效果,如果此裝置如再配合直腸超音波的使用,則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達到讓輻射劑量達到最佳的分佈,但是對於針尖必須插入膀胱才可讓輻射劑量到達跟膀胱緊貼著的病灶部位,針對此缺點,解決的方法必須從針的結構上改良才可以讓治療更具靈活性。

英文摘要

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 ofconventional templates, we developed a special template for guiding needles insertion and fixation when practice prostate needle implant.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.A dosimetric measurement with home-made phantom have been developed. The special designed acrylic board domed-cones combination provide needles up to 60o 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.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.

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