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目的:探讨金属氧化物半导体场效应管(MOSFET)探测器在头、胸腹、盆腔、乳腺等部位以及调强验证中的实时剂量监测结果、临床使用范围及应用价值。方法:按照国际原子能委员会(IAEA)标准规程对MOSFET探测器进行刻度。选取全脑照射患者16例,盆腔照射患者12例,腹部照射患者10例,胸部照射患者4例,乳腺照射患者1例,调强放射治疗(IMRT)验证1例,进行临床实时剂量监测90次,实时监测剂量与计划系统计算剂量相比较,对偏差值进行分析研究。结果:头部、盆腔患者的剂量偏差为(1.47±2.17)%,最大偏差4.9%;腹部(含倾斜入射以及使用楔形板的患者)剂量偏差为(-0.23±2.93)%,最大偏差6.4%;胸部照射患者的剂量偏差为(6.14±2.2)%,最大偏差9.2%;乳腺组织(切线野照射)剂量偏差>14%;IMRT剂量验证偏差为-3.75%。结论:MOSFET探测器对头、盆腔部位的实时剂量监测准确、便捷,可做为临床质控的重要环节来确保患者最终接受剂量的准确性。对胸、腹和乳腺部位由于测量中不确定因素过多,偏差结果难于分析,因此不适合使用MOS-FET进行实时剂量的监测。
Objective: To investigate the real-time dose monitoring results, clinical application range and application value of metal oxide semiconductor field effect transistor (MOSFET) detectors in the head, chest and abdomen, pelvis, breast and other parts as well as the strength adjustment verification. Method: Scale the MOSFET detector according to International Atomic Energy Agency (IAEA) standards. Sixteen cases of whole brain irradiation, 12 cases of pelvic irradiation, 10 cases of abdominal irradiation, 4 cases of chest irradiation, 1 case of breast irradiation, 1 case of IMRT and 90 cases of real-time dose monitoring , Real-time monitoring dose compared with the calculated dose of the planning system, to analyze the deviation value. Results: The dose deviation in the head and pelvis patients was (1.47 ± 2.17)% and the maximum deviation was 4.9%. The dose deviation in the abdomen (patients with oblique incidence and using the wedge plate) was (-0.23 ± 2.93)% and the maximum deviation was 6.4% (6.14 ± 2.2)%, the maximum deviation of 9.2%; breast tissue (tangent field irradiation) dose deviation of> 14%; IMRT dose verification bias of -3.75%. Conclusion: Real-time dose monitoring of the head and pelvis of the MOSFET detector is accurate and convenient. It can be used as an important part of clinical quality control to ensure the final dose of the patient. For chest, abdomen and breast parts due to the measurement of uncertainties too much, the results of the deviation is difficult to analyze, it is not suitable for real-time dose monitoring using MOS-FET.