Journal of the Korean Society of Radiology (한국방사선학회논문지)

The Korean Society of Radiology (한국방사선학회)
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A Study on Accuracy and Usefulness of In-vivo Dosimetry in Proton Therapy

양성자 치료에서 생체 내 선량측정 검출기(In-vivo dosimety)의 정확성과 유용성에 관한 연구

  • Kim, Sunyoung (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Choi, Jaehyock (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Won, Huisu (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Hong, Joowan (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Cho, Jaehwan (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Lee, Sunyeob (Department of International Radiological Science, Hallym University of Graduate Studies) ;
  • Park, Cheolsoo (Department of International Radiological Science, Hallym University of Graduate Studies)
  • 김선영 (한림국제대학원대학교 국제방사선학과) ;
  • 최재혁 (한림국제대학원대학교 국제방사선학과) ;
  • 원희수 (한림국제대학원대학교 국제방사선학과) ;
  • 홍주완 (한림국제대학원대학교 국제방사선학과) ;
  • 조재환 (한림국제대학원대학교 국제방사선학과) ;
  • 이선엽 (한림국제대학원대학교 국제방사선학과) ;
  • 박철수 (한림국제대학원대학교 국제방사선학과)
  • Received : 2014.04.22
  • Accepted : 2014.06.25
  • Published : 2014.06.30
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Abstract

In this study, the authors attempted to measure the skin dose by irradiating the actual dose on to the TLD(Thermo-Luminescence Dosimeter) and EBT3 Film used as the In-vivo dosimetry after planning the same treatment as the actual patient on a Phantom, because the erythema or dermatitis is frequently occurred on the patients' skin at the time of the proton therapy of medulloblastoma patient receiving the proton therapy. They intended to know whether there is the usefulness for the dosimetry of skin by the comparative analysis of the measured dose values with the treatment planned skin dose. The CT scan from the Brain to the Pelvis was done by placing a phantom on the CSI(Cranio-spinal irradiation) Set-up position of Medulloblastoma, and the treatment Isocenter point was aligned by using DIPS(Digital Image Positioning System) in the treatment room after planning a proton therapy. The treatment Isocenter point of 5 areas that the proton beam was entered into them, and Markers of 2 areas shown in the Phantom during CT scans, that is, in all 7 points, TLD and EBT3 Film pre-calibrated are alternatively attached, and the proton beam that the treatment was planned, was irradiated by 10 times, respectively. As a result of the comparative analysis of the average value calculated from the result values obtained by the repeated measurement of 10 times with the Skin Dose measured in the treatment planning system, the measured dose values of 6 points, except for one point that the accurate measurement was lacked due to the measurement position with a difficulty showed the distribution of the absolute dose value ${\pm}2%$ in both TLD and EBT Film. In conclusion, in this study, the clinical usefulness of the TLD and EBT3 Film for the Enterance skin dose measurement in the first proton therapy in Korea was confirmed.

본 연구는 양성자 치료를 시행하고 있는 수모세포종 환자의 양성자 치료 시 환자들의 Skin에서 홍반이나 피부염이 발생하는 경우가 빈번하여 Phantom에서 실제 환자와 동일한 치료계획 후 생체 내 선량측정 검출기(In-vivo dosimetry)로 사용되는 열 형광선량계(Thermo-luminescence Dosimeter, TLD)와 EBT3 Film으로 실제선량을 조사 측정한다. 측정된 선량값을 치료계획 된 피부선량과 비교 분석하여 양성자 치료 시 임상적으로 피부선량 측정 사용에 유용성이 있는지 알아보고자 한다. Phantom을 수모세포종의 전뇌척수치료(Cranio-spinal irradiation, CSI) Set-up position으로 위치하여 Brain에서 부터 Pelvis까지 CT촬영하고 양성자 치료계획 후 치료실에서 디지털 영상 포지셔닝 시스템(Digital Imaging Positioning System, DIPS)을 이용하여 정확하게 치료 Isocenter지점을 맞춘다. 양성자 빔이 들어가는 5부위의 치료 Isocenter 지점과 CT촬영 시 Phantom에 표시한 Marker 2부위, 모두 7지점에 미리 교정을 마친 열 형광선량계와 EBT3 Film을 교차해가면서 위치하여 붙이고 치료 계획된 양성자 빔을 각각 10회씩 조사한다. 10회 반복 측정하여 얻은 값을 평균산출하여 치료계획 시스템 에서 측정된 Skin Dose와 비교 분석한 결과, 측정위치의 어려움이 있는 정확한 측정이 결여된 한 지점을 제외한 나머지 6지점의 측정 선량값은 열 형광선량계와 EBT3 Film 모두 절대 선량값과 ${\pm}2%$이내의 분포를 보였다. 결론적으로, 본 연구에서는 국내 최초의 양성자 치료에서 Enterance skin dose 측정을 위한 In-vivo dosimetry로 열 형광선량계와 EBT3 Film의 임상적인 유용성을 확인하였다.

Keywords

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