• Journal of the Korean Magnetics Society
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• v.25 no.6
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• pp.208-218
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• 2015

Recently, radiation therapy is used in the CT existing conventional two-dimensional radiation image, and set the size and location of the tumor in a manner that the image is going to change the treatment plan. After using the simulation using CT, radiation therapy it is four-dimensional or three-dimensional treatment made possible. and radiation therapy became the more effective ever before. High technology radiation therapy such as the treatment of SRS,IMRT, IGRT, SBRT, is a need to try contemplating the possibility to apply appropriate analysis and situation, so it has its own characteristics. and then it is believed that it is necessary to analyze and try it worries the proper applicability of the situation. The configuration of the various treatment that is applicable in many hospitals is necessary to try to determine how to practically apply the patients. Critical organs surrounding tumor give a small dose to avoid side effects and then the tumor has the therapeutic effect by providing a larger dose than before the radiation treatment.

• Progress in Medical Physics
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• v.20 no.2
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• pp.88-96
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• 2009

Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.285-293
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• 2006

$\underline{Purpose}$: This study was to search the optimal slice thickness of computed tomography (CT) in an intensity modulated radiation therapy plan through changing the slice thickness and comparing the change of the calculated absorbed dose with measured absorbed dose. $\underline{Materials\;and\;Methods}$: An intensity modulated radiation therapy plan for a head and neck cancer patient was done, first of all. Then CT with various ranges of slice thickness ($0.125{\sim}1.0\;cm$) for a head and neck anthropomorphic phantom was done and the images were reconstructed. The plan parameters obtained from the plan of the head and neck cancer patient was applied into the reconstructed images of the phantom and then absorbed doses were calculated. Films were inserted into the phantom, and irradiated with 6 MV X-ray with the same beam data obtained from the head and neck cancer patient. Films were then scanned and isodoses were measured with the use of film measurement software and were compared with the calculated isodeses. $\underline{Results}$: As the slice thickness of CT decreased, the volume of the phantom and the maximum absorbed dose increased. As the slice thickness of CT changed from 0.125 to 1.0 cm, the maximum absorbed dose changed ${\sim}5%$. The difference between the measured and calculated volume of the phantom was small ($3.7{\sim}3.8%$) when the slice thickness of CT was 0.25 cm or less. The difference between the measured and calculated dose was small ($0.35{\sim}1.40%$) when the slice thickness of CT was 0.25 cm or less. $\underline{Conclusion}$: Because the difference between the measured and calculated dose in a head and neck phantom was small and the difference between the measured and calculated volume was small when the slice thickness of CT was 0.25 cm or less, we suggest that the slice thickness of CT should be 0.25 cm or less for an optimal intensity modulated radiation therapy plan.

• Progress in Medical Physics
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• v.20 no.4
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• pp.324-330
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• 2009

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System ($Synchrony^{TM}$, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were $11.5{\pm}3.09\;mm$ for desynchronization and $0.14{\pm}0.08\;mm$ for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was $0.18{\pm}0.06\;mm$. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was $17.39{\pm}0.14\;mm$ for inactivity and $1.37{\pm}0.11\;mm$ for activity. The mean difference of absolute dose was $0.68{\pm}0.38%$ in static target and $1.31{\pm}0.81%$ in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.113-122
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• 2010

Purpose: To evaluate the accuracy of a target position at static and dynamic state by using Dynamic phantom for the difference between tumor's actual movement during respiratory gated radiation therapy and skin movement measured by RPM (Real-time Position Management). Materials and Methods: It self-produced Dynamic phantom that moves two-dimensionally to measure a tumor moved by breath. After putting marker block on dynamic phantom, it analyzed the amplitude and status change depending on respiratory time setup in advance by using RPM. It places marker block on dynamic phantom based on this result, inserts Gafchromic EBT film into the target, and investigates 5 Gy respectively at static and dynamic state. And it scanned investigated Gafchromic EBT film and analyzed dose distribution by using automatic calculation. Results: As a result of an analysis of Gafchromic EBT film's radiation amount at static and dynamic state, it could be known that dose distribution involving 90% is distributed within margin of error of 3 mm. Conclusion: As a result of an analysis of dose distribution's change depending on patient's respiratory cycle during respiratory gated radiation therapy, it is expected that the treatment would be possible within recommended margin of error at ICRP 60.

• Journal of radiological science and technology
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• v.34 no.1
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• pp.51-58
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• 2011

The aim of the study is to analyze the dose delivery error depending on the depth variation according to target positions and arc trajectories by comparing the simulated treatment planning with the actual dose delivery in conformal arc therapy. We simulated the conformal arc treatment planning with the three target positions (center, 2.5 cm, and 5 cm in the phantom). For the experiments, IMRT body phantom (I’mRT Phantom, Wellhofer Dosimetry, Germany) was used for treatment planning with CT (Computed Tomography, Light speed 16, GE, USA). The simulated treatment plans were established by three different target positions using treatment planning system (Eclipse, ver. 6.5, VMS, Palo Alto, USA). The radiochromic film (Gafchromic EBT2, ISP, Wayne, USA) and dose analysis software (OmniPro-IMRT, ver. 1.4, Wellhofer Dosimetry, Germany) were used for the measurement of the planned arc delivery using 6 MV photon beam from linear accelerator (CL21EX, VMS, Palo Alto, USA). Gamma index (DD: 3%, DTA: 2 mm) histogram and dose profile were evaluated for a quantitative analysis. The dose distributions surrounded by targets were also compared with each plans and measurements by conformity index (CI), and homogeneity index (HI). The area covered by 100% isodose line was compared to the whole target area. The results for the 5 cm-shifted target plan show that 23.8%, 35.6%, and 37% for multiple conformal arc therapy (MCAT), single conformal arc therapy (SCAT), and multiple static beam therapy, respectively. In the 2.5 cm-shifted target plan, it was shown that 61%, 21.5%, and 14.2%, while in case of center-located target, 70.5%, 14.1%, and 36.3% for MCAT, SCAT, and multiple static beam therapy, respectively. The values were resulted by most superior in the MCAT, except the case of the 5 cm-shifted target. In the analysis of gamma index histogram, it was resulted of 37.1, 27.3, 29.2 in the SCAT, while 9.2, 8.4, 10.3 in the MCAT, for the target positions of center, shifted 2.5 cm and 5 cm, respectively. The fail proportions of the SCAT were 2.8 to 4 times as compared to those of the MCAT. In conclusion, dose delivery error could be occurred depending on the target positions and arc trajectories. Hence, if the target were located in the biased position, the accurate dose delivery could be performed through the optimization of depth according to arc trajectory.

• Journal of Radiation Protection and Research
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• v.36 no.1
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• pp.28-34
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• 2011

The measurement-based verification for intensity modulated radiation therapy (IMRT) is a time-and labor-consuming procedure. Instead, this study aims to develop a MU fluence reconstruction method for IMRT QA. Total actual fluences from treatment planning system (TPS, Eclipse 8.6, Varian) were selected as a reference. Delivered leaf positions according to MU were extracted by the dynalog file generated after IMRT delivery. An in-house software was develop to reconstruct MU fluence from the acquired delivered leaf position data using MATLAB. We investigated five patient's plans delivered by both step-and-shoot IMRT and sliding window technologies. The total actual fluence was compared with the MU fluence reconstructed by using commercial software (Verisoft 3.1, PTW) and gamma analysis method (criteria: 3%/3 mm and 2%/1 mm). Gamma pass rates were $97.8{\pm}1.33$% and the reconstructed fluence was shown good agreement with RTP-based actual fluence. The fluence from step and shoot IMRT was shown slightly higher agreement with the actual fluence than that from sliding window IMRT. If moving from IMRT QA measurements toward independent computer calculations, the developed method can be used for IMRT QA. A point dose calculation method from reconstructed fluences is under development for the routine IMRT QA purpose.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.401-406
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• 2008

The aim of this study is to evaluate contra-lateral breast (CLB) surface dose in Field-in-Field (FIF) technique for breast conserving surgery patients. For evaluation of surface dose in FIF technique, we have compared with other techniques, which were open fields (Open), metal wedge (MW), and enhanced dynamic wedge (EDW) techniques under same geometrical condition and prescribed dose. The three dimensional treatment planning system was used for dose optimization. For the verification of dose calculation, measurements using MOSFET detectors with Anderson Rando phantom were performed. The measured points for four different techniques were at the depth of 0cm (epidermis) and 0.5cm bolus (dermis), and spacing toward 2cm, 4cm, 6cm, 8cm, 10cm apart from the edge of tangential medial beam. The dose calculations were done in 0.25cm grid resolution by modified Batho method for inhomogeneity correction. In the planning results, the surface doses were differentiated in the range of $19.6{\sim}36.9%$, $33.2{\sim}138.2%$ for MW, $1.0{\sim}7.9%$, $1.6{\sim}37.4%$ for EDW, and for FIF at the depth of epidermis and dermis as compared to Open respectively. In the measurements, the surface doses were differentiated in the range of $11.1{\sim}71%$, $22.9{\sim}161%$ for MW, $4.1{\sim}15.5%$, $8.2{\sim}37.9%$ for EDW, and 4.9% for FIF at the depth of epidermis and dermis as compared to Open respectively. The surface doses were considered as underestimating in the planning calculation as compared to the measurement with MOSFET detectors. Was concluded as the lowest one among the techniques, even if it was compared with Open method. Our conclusion could be stated that the FIF technique could make the optimum dose distribution in Breast target, while effectively reduce the probability of secondary carcinogenesis due to undesirable scattered radiation to contra-lateral breast.

• Progress in Medical Physics
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• v.20 no.3
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• pp.174-179
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• 2009

To track moving tumor in real time, CyberKnife system imports a technique of the synchrony respiratory tracking system. The fiducial marker which are detectable in X-ray images were demand in CyberKnife Robotic radiosurgery system. It issued as reference markers to locate and track tumor location during patient alignment and treatment delivery. Fiducial marker implantation is an invasive surgical operation that carries a relatively high risk of pneumothorax. Most recently, it was developed a direct lung tumor registration method that does not require the use of fiducials. The purpose of this study is to measure the accuracy of target applying X-sight lung tracking using the Gafchromic film in dynamic moving thorax phantom. The X-sight Lung Tracking quality assurance motion phantom simulates simple respiratory motion of a lung tumor and provides Gafchromic dosimetry film-based test capability at locations inside the phantom corresponding to a typical lung tumor. The total average error for the X-sight Lung Tracking System with a moving target was $0.85{\pm}0.22$ mm. The results were considered reliable and applicable for lung tumor treatment in CyberKnife radiosurgery system. Clinically, breathing patterns of patients may vary during radiation therapy. Therefore, additional studies with a set real patient data are necessary to evaluate the target accuracy for the X-sight Lung Tracking system.

• Progress in Medical Physics
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• v.17 no.3
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• pp.131-135
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• 2006

A commercial ion chamber matrix was examined the characteristics and its performance for radiotherapy qualify assurance. The device was the I'mRT 2D-MatriXX (Scanditronix-Wellhofer, Schwarzenbruck, Germany). The 2D-MatriXX device consists of a 1020 vented ion chamber array, arranged in $24{\times}24cm^2$ matrix. Each ion chamber has a volume of $0.08cm^3$, spacing of 0.762 cm and minimum sampling time of 20 ms. For the investigation of the characteristics, dose linearity, output factor, short-term reproducibility and dose rate dependency were tested. In the testing of dose linearity. It has shown a good signal linearity within 1% in the range of $1{\sim}800$cGy. Dose rate dependency was found to be lower than 0.4% (Range: 100-600 Mu/min) relative to a dose rate of 300 Mu/min as a reference. Output factors matched very well within 0.5% compared with commissioned beam data using a ionization chamber (CC01, Scanditronix-Wellhofer, Schwarzenbruck, Germany) in the range of field sizes $3{\times}3{\sim}24{\times}24cm^2$. Short-term reproducibility (6 times with a interval of 15 minute) was also shown a good agreement within 0.5%, when the temperature and the pressure were corrected by each time of measurement. in addition, we compared enhanced dynamic wedge (EDW, Varian, Palo Alto, USA) profiles from calculated values in the radiation planning system with those from measurements of the MatriXX. Furthermore, anon-uniform IMRT dose fluence was tested. All the comparison studies have shown good agreements. In this study, the MatriXX was evaluated as a reliable dosimeter, and it could be used as a simplistic and convenient tool for radiotherapy qualify assurance.