目的 : 針對質子治療輻射安全與品質保證作業項目分析並開發輔助系統，提供國內質子治療中心品質保證項目之建議。
材料與方法 : 本研究收集國內外指標性質子治療中心機器品質保證資料，根據目前合作單位高雄長庚質子治療中心使用的筆尖射束掃描(Proton Pencil Beam scaning, PPBS)技術規劃出每日、每週、每月及每年的品質保證作業項目，區分為系統劑量性、機械性及安全性驗證，長庚質子治療中心採用MOSAIQ醫療資訊系統記錄品質保證之結果，該系統無法提供圖像化報表數據。故本研究欲開發筆尖射束掃描品質保證驗證系統，透過輔助系統將數據彙整成資料庫，並依照項目的資料進行數據化分析與圖像化報表建立。
結果 : 使用筆尖射束掃描品質保證驗證系統分析品質保證項目結果，質子治療品質保證(Proton Machine Quality Assurance, PMQA)每日品質保證結果在射束劑量輸出為0.12%±0.5%；百分深度劑量穩定度(D80%)為-0.098mm±0.153、(D90% - P90%)為 -0.069mm±0.048 ；線段式掃描在速度準確性分別為0.01%(1mm/ms, 150MeV)、0.05%(2mm/ms, 150MeV)、-0.09%(5mm/ms, 150MeV)、0.21%(10mm/ms, 150MeV)、0.26%(15mm/ms, 150MeV)及0.55%(20mm/ms, 150MeV)。每週品質保證結果在射束劑量輸出 0.44%±0.45(70至230MeV 最大誤差)，百分深度劑量穩定度(D80%)為-0.104mm±0.273、(Distal90% - Proximal 90%)為-0.002mm±0.87，線段式掃描在速度準確性分別為0.05%(1mm/ms, 100MeV)、0.06%(2mm/ms, 90MeV)、-0.09%(5mm/ms, 100MeV)、0.23%(10mm/ms, 150MeV)、0.45%(15mm/ms, 230MeV)及0.76%(20mm/ms, 200MeV)。每月品質保證結果在機頭旋轉角度準確性0.184±0.138(Gantry 0)、0.004±0.228(Gantry 90)、0.117±0.187(Gantry 180)、-0.129±0.229(Gantry 270)，X-ray DR 系統幾何準確度驗證0.294±0.481(X方向)、0.222±0.259(Y方向)。每年品質保證質子射束旋轉中心0.90mm、監控游離腔線性度-0.37%、監控游離腔再現性0.09%、監控游離腔劑量率依存性0.98%、劑量輸出機頭角度依存性-0.88%、百分深度劑量穩定度(D80%)為0.34mm、(D90% - P90%)為0.20mm、射束大小機頭角度依存性0.57mm、掃描位置控制機頭角度1.44mm、掃描速度控制機頭角度0.88mm、機頭旋轉角度-0.2、機頭旋轉中心1mm、射束錐口位置0mm、治療床移動線性程度0mm。
結論 : 筆尖射束掃描品質保證驗證系統分析出質子治療機器在系統劑量性、機械性及安全性品質保證結果皆符合規範的容許值，現階段質子治療機器系統相當穩定，此外本研究驗證分析系統能提供國內外治療中心未來開發之參考。

Purpose: Investigating proton therapy radiation safety and quality assurance operation, project analysis, and development of auxiliary systems to provide domestic proton therapy center quality assurance project recommendations.
Materials and methods: In this study, quality assurance data of the proton therapy center was collected at domestic and abroad. Based on the technology of the proton pencil beam scanning (PPBS) used by the current partner Kaohsiung Changgeng Proton Therapy Center, each year's quality assurance operations are divided into system dose and mechanical and safety verification. The Changgeng Proton Therapy Center uses the MOSAIQ medical information system to record the quality assurance results. The system cannot provide graphical report data. Therefore, this study intends to develop a quality assurance verification system for pencil beam scanning, which integrates data into a database through an auxiliary system, and performs data analysis and graphical report creation based on the project data.
Results: Using the pencil beam scanning quality assurance verification system to analyze the quality assurance project results, proton therapy quality assurance (Proton Machine Quality Assurance, PMQA) daily quality assurance recorded the following data: the beam dose output is 0.12% ± 0.5%; percent depth dose stability (D80%) is -0.098mm±0.153, (D90%-P90%) is -0.069mm±0.048; and the speed accuracy of line segment scanning is 0.01% (1mm/ms, 150MeV), 0.05% (2mm/ms, 150MeV), -0.09% (5mm/ms, 150MeV), 0.21% (10mm/ms, 150MeV), 0.26% (15mm/ms, 150MeV) and 0.55% (20mm/ms, 150MeV). Weekly quality assurance demonstrated that following results: a beam dose output of 0.44% ± 0.45 (70 to 230 MeV maximum error), a percent depth dose stability (D80%) is -0.104mm ± 0.273, (D90%-P90%) is -0.002mm ±0.87, and the speed accuracy of line segment scanning is 0.05% (1mm/ms, 100MeV), 0.06% (2mm/ms, 90MeV), -0.09% (5mm/ms, 100MeV), 0.23% (10mm/ms, 150MeV), 0.45% (15mm/ms, 230MeV) and 0.76% (20mm/ms, 200MeV). Monthly quality assurance showed that the head rotation angle accuracy was 0.184±0.138 (Gantry 0), 0.004±0.228 (Gantry 90), 0.117±0.187 (Gantry 180), -0.129±0.229 (Gantry 270) for the X-ray DR system. The geometric accuracy was verified to be 0.294±0.481 (X direction) and 0.222±0.259 (Y direction). Annual quality assurance data showed that the proton beam rotation center was 0.90mm, monitoring free cavity linearity was -0.37%, monitoring free cavity reproducibility was 0.09%, monitoring free cavity dose rate dependence was 0.98%, dose output head angle dependence was -0.88%, 100 Dose stability at depth (D80%) was 0.34mm, (D90%-P90%) was 0.20mm, beam size head angle dependence was 0.57mm, scanning position control head angle was 1.44mm, scanning speed control head angle was 0.88mm, head rotation angle was -0.2, head rotation center was 1mm, beam cone position was 0mm, and treatment bed movement linearity was 0mm.
Conclusions: The pencil beam scanning quality assurance verification system analyzes that the quality assurance results of the proton therapy machine to ensure that system dose and mechanical and safety values all meet the allowable values of the specifications. At this stage, the proton therapy machine system is quite stable. In addition, this research verification analysis system can provide a reference for future development of domestic and foreign treatment centers.

摘要
Abstract
致謝
目錄
表目錄
圖目錄
符號縮寫
第一章 緒論
1.1 動機
1.2 目的
1.3 相關文獻探討
第二章 材料與方法
2.1 前言
2.2 質子治療機器硬體設備
2.2.1迴旋加速器(Cyclotron)
2.2.2能源選擇系統(Energy Selection System)
2.2.3射束傳導系統(Beam Transport System)
2.2.4旋轉機架系統(Gantry System)
2.2.5射束噴嘴(Nozzle)
2.3質子治療機器品質保證作業蒐集原則
2.3.1品質保證作業驗證類別
2.3.2品質保證測量儀器
2.3.2.1每日射束劑量輸出穩定度
2.3.2.2每日射束百分深度與射束深度檢測
2.3.2.3每日射束掃描準確度
2.3.2.4每日射束大小穩定度
2.3.2.5每日射束掃描速度控制準確度
2.4品質保證程序執行目的
2.4.1每日品質保證程序
2.4.2每週品質保證程序
2.4.3每月品質保證程序
2.4.4每年品質保證程序
2.5 MATLAB程式環境介紹
2.5.1數據彙整
2.5.2 MATLAB GUI 圖像介面輔助分析資料
第三章 結果
3.1 前言
3.2 每日品質保證程序分析
3.2.1 射束劑量輸出穩定度
3.2.2 射束百分深度劑量穩定度
3.2.3 射束大小穩定度
3.2.4 射束掃描位置控制準確性
3.2.5 射束掃描速度控制準確度
3.3 每週品質保證程序分析
3.3.1 每週劑量性驗證結果
3.3.2 每週機械性驗證結果
3.4 每月品質保證程序分析
3.5 每年品質保證程序分析
3.6 MATLAB資料庫建立成果
3.6.1 MATLAB輔助分析介面成果
3.6.2 使用者介面設計
第四章 討論
4.1 前言
4.2 每日劑量射束更換量測游離腔之影響
4.3 筆尖式射束掃描每日射束速度項目評估
4.4 速度控制準確性誤差評估
第五章 結論
參考文獻
附錄
自傳

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