本研究藉由活體劑量驗證，來偵測照射條件的誤差。根據實驗的結果，可建立活體劑量驗證的協定，此外，對於系統的不準確度也加以分析，進而排除系統的不準確度。由病人體表入射及出射劑量，再經由穿透率曲線推導出中軸劑量。量測前，需建立校正因子與修正因子，校正因子是劑量對讀值的比值，修正因子是非參考狀況及參考狀況之間的比值，故包括射源到表面距離修正因子及照野修正因子。所使用的光子能量為 6 MV (Varian 2100C/D machine)，二極體型號是 VeriDose 30-472 (5-11 MV)，由於是量測兩測對照傳統照野的病人，故計算劑量時不包含不均質的修正。為找出系統不準確度的來源對二極體本身做量測（1）溫度依存性（2）面具造成劑量的擾動（3）離照野邊緣遠近散射的影響。假體的量測結果，其劑量誤差平均值為 0.184 %，標準差為 0.5 %。活體共量測 204 個照野，其劑量誤差平均值為 0.45 %，標準差為 3.12 %。若修正病人不對稱所造成的影響，標準差將降為 2.39 %；如果將手算劑量程式做不均質的評估，標準差將降為 1.51 %。系統不準確度由溫度而來的大約有 3 – 4 %；由面具而來的有 1 %；由面具和假體表面間隙造成的有 2 %；離照野邊緣四分之一邊長處將小於 2 %。只要經過不對稱修正及不均質評估，活體劑量驗證就可成為偵測劑量準確度的方法。

1. M. Essers and B. J. Mijnheer. “In vivo dosimetry during external photon beam radiotherapy.” Int J Radiat Oncol Biol Phys 43, 245–249 (1999).

2. G Leunens, J. Van Dam, A. Dutreix and E. van der Schueren “ Quality assurance in radiotherapy by in vivo dosimetry. 1. Entrance dose measurement, a reliable procedure” Radiother Oncol 17, 141–151 (1990).

3. G Leunens, J. Van Dam, A. Dutreix and E. van der Schueren “ Quality assurance in radiotherapy by in vivo dosimetry. 2. Determination of the target absorbed dose ” Radiother Oncol 17, 141–151 (1990).

4. J .H. Lanson, M. Essers, G. J. Meijer, A. W. H. Minken, G. J. Uiterwaal, B. J. Mijnheer. “In vivo dosimetry during conformal radiotherapy: Requirements for and findings of a routine procedure.” Radiother Oncol 52, 51–59 (1999).

5. Paul A. Jursinic “implementation of an in vivo diode dosimetry program and changes in diode characteristics over a 4-year clinical history” Med Phys 28, 1718-1728 (2001).

6. N. Jornet, M. Ribas, and Eudaldo “ In vivo dosimetry：intercomparison between p-type based and n-type based diodes for the 16-25 MV energy range” Med Phys 27, 1287-1293 (2000).

7. G. Leunens, J. Verstraete, A. Dutreix, E. van der Schueren. “Assessment of dose inhomogeneity at target level by in vivo dosimetry: Can the recommended 5% accuracy in the dose delivered to the target volume be fulfilled in daily practice?” Radiother Oncol 25, 242–250 (1992).

8. A. Feldman and F. M. Edwards. “The routine use of personal patient dosimeters is of little value in detecting therapeutic misadministrations; Point/Counterpoint.” Med Phys 28, 295–297 (2001).

9. Food and Drug Administration (FDA) “FDA Statement on Radiation Overexposures in Panama” http://www.fda.gov/cdrh/ocd/panamaradexp.html. (2001)

10. S. Vatnitsky, P. O. Lopez, J. Izewska, A. Meghzifene, V. Levin. “The radiation overexposure of radiotherapy patients in Panama 15 June 2001.” Radiother Oncol 60, 237–238 (2001).

11. “Investigation of an accidental exposure of radiotherapy patients in Panama, Report of a Team of Experts.” 26 May–1 June 2001. IAEA Report (2001).

12. G. J. Kutcher, L. Coia, M. Gillin, W. F. Hanson, S. Leibel, R. J. Morton, J. R. Palta, J. A. Purdy, L. E. Reinstein, G. K. Svensson, M. Weller, L. Wingfield. “Comprehensive QA for radiation oncology: Report of AAPM Radiation Therapy Committee Task Group 40.” Med Phys 21, 581–618 (1994). Also available as AAPM Report No. 46. 66

13. W. P. N. Mayles, S. Heisig, and H. M. O. Mayles. “Treatment Verification and in vivo Dosimetry” in Radiotherapy Physics by J. R. Williams and D. I. Thwaites. Oxford: Oxford University Press, pp. 227–251, (1993).

14. J. Van Dam and G. Marinello. “Methods for in vivo Dosimetry in External Radiotherapy. ESTRO Booklet on Physics for Clinical Radiotherapy No. 1. Garant (Leuven-Apeldoorn) ” (1994). (Check for PDF version at www.estroweb.org).

15. G. Rikner and E.Grusell. “Effect of radiation damage on p-type silicon detectors.” Phys Med Biol 28, 1261–1267 (1983).

16. G. Rikner and E. Grusell. “General specification for silicon semi-conductors for use in radiation dosimetry.” Phys Med Biol 32, 1109–1117 (1987).

17. G. Rikner. “Silicon diode as detectors in relative dosimetry of photon, electron and proton radiation fields.” Ph.D. Thesis, University of Uppsala, Sweden (1983).

18. Th. Loncol, J. L. Greffe, S. Vynckier, P. Scalliet. “Entrance and exit dose measurements with semiconductors and thermoluminescent dosimeters: A comparison of methods and in vivo results.” Radiother Oncol 41, 179–187 (1996).

19. P. C. Lee, J. M. Sawicka, and G. P. Glasgow. “Patient dosimetry quality assurance program with a commercial diode system.” Int J Radiat Oncol Biol Phys 29, 1175–1182 (1994).

20. S. Howlett, L. Duggan, S. Bazley, T. Kron. “Selective in vivo dosimetry in radiotherapy using p-type semiconductor diodes: A reliable quality assurance procedure.” Med Dosim 24, 53–56 (1999).

21. G. J. Meijer, A. W. H. Minken, K. M. van Ingen, B. Smulders, H. Uiterwaal, B. J. Mijnheer. “Accurate in vivo dosimetry of a randomized trial of prostate cancer irradiation.” Int J Radiat Oncol Biol Phys 49, 1409–1418 (2001).

22. J. R. Greig, R. W. Miller, P. Okunieff. “An approach to dose measurement for total body irradiation.” Int J Radiat Oncol Biol Phys 36, 463–468 (1996).

23. B. Planskoy, P. D. Tapper, A. M. Bedford, F. M. Davis. “Physical aspects of totalbody irradiation at the Middlesex Hospital (UCL group of hospitals), London 1988–1993, II. In vivo planning and dosimetry.” Phys Med Biol 41, 2327–2343 (1996).

24. N. Jornet, P. Carrasco, D. Jurado, A. Ruiz, T. Eudaldo, and M. Ribas. “Comparison study of MOSFET detectors and diodes for entrance in vivo dosimetry in 18 MV x-ray beams” Med. Phys. 31, 2534-2542 (2004)

25. P. D. Higgins, P. Alaei, B. J. Gerbi, and K. E. Dusenbery “In vivo diode dosimetry for routine quality assurance in IMRT” Med. Phys. 30, 3118-3123 (2003)

26. D. Marre and G. Marinello. “Comparison of p-type commercial electron diodes for in vivo dosimetry.” Med Phys 31, 50–56 (2004).

27. Cynthia F. Chuang, Lynn J. Verhey, and Ping Xia “ Investigation of the use of MOSFET for clinical IMRT dosimetric verification ” Med Phys 29, 1109-1115 (2002).

28. S Heukelom, J H Lanson and B J Mijnheer “ comparison of entrance and exit dose measurement using ionization chambers and silicon diodes ” Phys. Med. Biol., 36, 47-59 (1991)

29. A Noel, P. Aletti, P Bey, L. Malissard “detection of error in individual patient in radiotherapy by systematic in vivo dosimetry” Radiother Oncol 34, 144–151 (1995).

30. J T shakeshaft, H M Morgan, P D Simpson, “in vivo dosimetry using diodes as a quality control tool—experience of 2 years and 2000 patients” The British Journal of radiology, 72, 891-895 (1999)

31. S Broggi, C Fiorino and R Calandrino “In vivo estimation of midline dose maps by transit dosimetry in head and neck radiotherapy” The British Journal of radiology, 75, 974-981 (2005)

32. K. Huang, W. S. Bice, Jr., and O. H. Salvatierra, “Characterization of an in vivo diode dosimetry system for clinical use” Journal of applied clinical medical physics, volume 4, number 2, spring (2003)

33. A. S. Saini, T. C. Zhu, “Dose rate and SSD dependence of commercially available diode detectors” Med Phys 31, 914-924 (2004).

34. E. Yorke (Chair), R. Alecu, L. Ding, D. Fontenla, A. Kalend, D. Kaurin, M. E. M. McGary, G. Marinello, T. Matzen, A. Saini, J. Shi, W. Simon, T. C. Zhu, X. R. Zhu, G. Rikner, G. Nilsson, “diode in vivo dosimetry for patients receiving external beam radiation therapy” Task Group 62. Also available as AAPM REPORT NO. 87

35. Huyskens, D.P., Bogaerts R., Verstraete, J., Loof, M.,Nystrom, H., Fiorino, C., Broggi, S., Jornet, N., Ribas, M. and Thwaites, D.I. “Practical guidelines for the implementation of in vivo dosimetry with diodes in external radiotherapy with photon beams ( entrance dose ) ”. ESTRO Booklet No.5(Belgium: Garant)(2001)

36.G. F. Knoll “Radiation Detection and Measurement Third Edition” ISBN 0-471-07338-5

37.C.J. Tung, H.C. Wang, S.H. Lo, J.M. Wu and C.J. Wang “In vivo dosimetry for external photon treatments of head and neck cancers by diodes and TLD” Radiation Protection Dosimetry111, 1-6 (2004)

38.J. Malicki, M. Litoborski, J. Kierzkowski, G. Kosicka “how the implementation of an in vivo dosimetry protocol improved the dose delivery accuracy in head and neck radiotherapy” Neoplasma 51, 155~158 (2004)

39.Faiz M Khan, Ph.D. “The Physics of Radiation Therapy Third Edition” ISBN 0-7817-3065-1

40. C. Fiorino, D. Corletto, P Mangili, et al. “Quality assurance by systematic in vivo dosimetry: results on a large cohort of patients” Radiother Oncol 56, 85-95 (2000)

41.羅素花，活體劑量驗證方法在放射治療的應用，國立清華大學碩士論文，2000

42.王慧娟，頭頸部放射治療的活體劑量驗證，國立清華大學碩士論文，2001