• Progress in Medical Physics
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• v.24 no.1
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• pp.1-24
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• 2013

As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.323-332
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• 1996

Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.7-12
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• 2022

Purpose: When it is difficult to secure the skin dose when treating Irregularly Shaped Skin Surface such as the nose where it is difficult to apply a bolus, increase the skin dose with a treatment plan that combines the IMRT (Intensity Modulated Radiation Therapy) delivery technique and FFF (Flattening Filter Free), It was tried to find out whether or not through the phantom experiment. Materials & Methods: Based on the 6MV-FF (Flattening Filter) and VMAT (Volumetric-Modulated Arc Therapy) treatment plans, which are the most commonly used treatment plans for head and neck cancer, A comparison group was created by combining VMAT and IMRT, FF and FFF, and the presence or absence of 5 mm bolus application. A virtual target was created on the Rando Phantom's nose, and a virtual bolus of 5 mm was applied assuming full contact on the Rando Phantom's nose. Five measurement points were determined based on the phantom's nose, and the absorbed dose was measured by irradiating each treatment plan 3 times per treatment plan according to the treatment technique and whether or not the bolus was applied. Result: The difference in skin dose in FF vs FFF increased in the case of FFF in VMAT bolus off, and there was no difference in case of IMRT bolus off. In VMAT bolus 5 mm and IMRT bolus 5 mm, it was confirmed that the skin dose was rather decreased in FFF. The difference in skin dose between VMAT and IMRT increased only in the case of FFF bolus off, and there was no statistical difference in the rest. For the difference in skin dose between bolus off vs bolus 5 mm, it was confirmed that the skin dose increased at bolus 5 mm, except for the case of using IMRT FFF. The treatment plan combining IMRT and FFF did not find any statistically significant difference as a result of analyzing the measured values of the treatment plan skin dose applied with a 5 mm bolus using the commonly used VMAT and FF. Therefore, it is thought that by using IMRT_FFF, it is possible to deliver a skin dose similar to that of applying a 5 mm bolus to VMAT_FF, which can be useful for patients who need a high skin dose but have difficulty applying a bolus. Conclusion: For patients who find it difficult to apply bolus, an increase in skin dose can be expected with a treatment plan that properly combines IMRT and FFF compared to VMAT and FF.

• Journal of Biomedical Engineering Research
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• v.16 no.3
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• pp.337-344
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• 1995

Because of the high energy of the treatment beam, contrast of portal films is very poor. Many image processing techniques have been applied to the portal images but a significant drawback is the loss of definition on the edges of the treatment field. Analysis of this problem shows that it may be remedied by separating the treatment field from the background prior to enhancement and uslng only the pixels within the field boundary in the enhancement procedure. A new edge extraction algorithm for accurate extraction of the radiation field boundary from portal Images has been developed for contrast enhancement of portal images. In this paper, portal image segmentation algorithm based on Sobel filtration, labelling processes and morphological thinning has been presented. This algorithm could automatically search the optimal threshold value which is sensitive to the variation of the type and quality of portal images.

• Progress in Medical Physics
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• v.25 no.2
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• pp.79-88
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• 2014

The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array. Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Because the Gate-IMRT method also has disadvantages such as unsuspected dosimetric variations when applying the gating system and an increased treatment time, it is better to perform a prior analysis of the patient's respiratory condition and the importance and fulfillment of the IMRT plan dose constraints in order to select an optimal IMRT method with which to correct the respiratory organ motional effect.

• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.521-529
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• 2016

Since Gamma Knife(R) radiosurgery(GKRS) is based on a single-fraction high dose treatment strategy, independent verification for the results of Leksell GammaPlan(R) (LGP) is an important procedure in assuring patient safety and minimizing the risk of treatment errors. Several verification methods have been developed and reported previously. Thus these methods were tested statistically and tried on Leksell Gamma Knife(LGK) target treatments through the embodiment of the previously proposed algorithms(PPA). The purpose of this study was to apply and evaluate the accuracy of verification methods for LGK target treatments using PPA. In the study 10 patients with intracranial lesion treated by GKRS were included. We compared the data from PPA and LGP in terms of maximum dose, arbitrary point dose, and treatment time at the isocenter locations. All data were analyzed by Paired t-test, which is statistical method used to compare two different measurement techniques. No statistical significance in maximal dose at 10 cases was observed between PPA and LGP. Differences in average maximal dose ranged from -0.53 Gy to 3.71 Gy. The arbitrary point dose calculated by PPA and LGP was not statistically significant too. But we found out the statistical difference with p=0.021 between TMR and LGP for treatment time at the isocenter locations. PPA can be incorporated as part of a routine quality assurance(QA) procedure to minimize the chance of a wrong overdose. Statistical analyses demonstrated that PPA was in excellent agreement with LGP when considering the maximal dose and the arbitrary point dose for the best plan of GKRS. Due to the easy applicability we hope PPA can be widely used.

• Proceedings of the Korean Information Science Society Conference
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• 1999.10c
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• pp.466-468
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• 1999

현재 인터넷 프로토콜인 IPv4의 주소 부족 등의 문제를 해결하기 위해 차세대 인터넷 프로토콜 IPv6에 대한 연구가 활발히 진행되고 있다. 그러나 새로운 프로토콜 IPv6 상에서 기존의 다른 상위 프로토콜 및 응용이 어떠한 영향을 받게 될지는 의문이다. 한편, IPv6 상에서 새로운 프로토콜 및 응용을 개발할 때에 많은 시험이 요구된다. 이와 같은 이유로 인해 새로운 통신 프로토콜에 있어서 모니터링은 필수적이다. 그러나 지금까지의 많은 모니터링 라이브러리들은 텍스트에 기반하고 있으며, 그래픽 데이터를 제공하는 도구들도 대부분 통계정보의 제공에 초점을 두고 있다. 이를 두고 프로토콜이 그 표준에 따라 정확한 원리에 맞게 동작하는 지를 파악하는 데는 큰 도움이 되지 않고 있다. 이에 본 연구에서는 대상 프로토콜의 실제적인 동작 과정이나 원리를 알 수 있도록 그래픽 기반의 사용자 친화적 모니터링 도구를 제작한다. 이를 위해, 먼저 IPv6가 다른 프로토콜에 영향을 미칠 수 있는 사항들을 분석한다. 다음으로 본 교에 구축되어 있는 IPv6 호스트에 모니터링에 필요한 환경을 구축하고, Java Applet을 이용한 모니터 프로그램을 제작한다. 현재 개발하는 모니터 프로그램은 TCP의 슬라이딩 윈도우(Sliding Window) 기법에 관련된 사항을 모니터링 해주는 것으로 그 범위를 한정한다. 개발된 도구를 이용하여 IPv6 상에서 FTP가 TCP를 이용하여 파일을 전송하는 경우의 모니터링을 실시하고, 그 결과를 분석 제시한다. 이로써, 개발된사용자 친화적 모니터링 도구가 얼마나 쉽게 슬라이딩 윈도우 기법을 이해시켜 주고, 내포된 의미를 파악할 수 있게 해주는지를 알 수 있다.한 것으로 연구되었다. 정상조 직에 비해 산소가 부족하여 염기성대사(anaerobic metabolism)를 많이 함으로 그 부산물인 유산 (lactic acid)이 많이 생성됨으로 정상조직보다 pH가 낮아 암 조직이 정상조직에 비해 고온온열치료에 더 잘 듣는 원인이 된다. 3) 영양이 부족한 상태의 세포는 고온온열치료에 훨씬 예민하다. 4) 암조직은 혈관상태가 정상조직에 비해 좋지 않음으로 정상조직보다 쉽게 가온이 되며, 일단 가온된 온도는 잘 식지 않음으로 정상조직에 비해 훨씬 효율적이다. 5)고 온온열치료는 4$0^{\circ}C$~43.5 $^{\circ}C$정도에서만 이 작용이 일어남으로 정상인체에서 43$^{\circ}C$이상의 가온 은 쉽지 않음으로 이 효과는 암조직에서 주고 일어나게 된다. 6)고온온열치료는 방사선치료 후에 생기는 손상의 재생을 억제함으로 방사선의 치료효과를 높인다. 7)38.5$^{\circ}C$~41.5$^{\circ}C$의 낮 은 온도에서도 암조직의 산소 상태를 호전시켜 방사선 치료효과를 증대시키는 역할을 한다.alization)가 나타난다. 그러나 무의식에 대칭화만 있는 것은 아니며, 의식의 사고양식인 비대칭도 어느 정도 나타나며, 대칭화의 정도에 따라, 대상들이 잘 구분되어 있는 단계, 의식수준의 감정단계, 집단 내에서의 대칭화 단계, 집단간에서의 대칭화 단계, 구분이 없어지는 단계로 구분하였다.systems. We believe that this taxonomy is a significant contribution because it ad

• Radiation Oncology Journal
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• v.19 no.3
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• pp.287-292
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• 2001

Prupose : We analyzed setup errors induced by using air-vacuum cushion as immobilization device in patients with rectal cancer. Materials and methods : We had treated the twenty patients with rectal cancer by 6 MV, 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at prone position. They were separated to two groups, control group, 10 patients using styrofoam, and test group, 10 patients using styrofoam and air-vacuum cushion. We measured errors of posterior field for x, y axis and lateral field for z, y axis with simulation film and EPID image using a matching technique. Results : In control group, the mean displacement values of pelvic bone landmark for x axis and y axis were 0.02 mm. 0.78 mm, respectively and the standard deviations of systematic error were 2.13 mm, 2.40 mm, respectively and the standard deviation of random error were 1.46 mm. 1.51 mm, respectively. In test group, the mean displacement values of x axis and y axis were -0.33 mm. 0.81 mm, respectively and the standard deviations of systematic error were 1.71 mm, 3.08 mm, respectively and the standard deviations of random errors were 1.40 mm. 1.88 mm, respectively. The mean displacement values of z axis and y axis were 2.98 mm. 0.74 mm, respectively and the standard deviations of systematic error were 4.75 mm, 2.65 mm, respectively and standard deviations of random error were 2.69 mm. 1.86 mm, respectively. The statistical difference of field size by using air vacuum cushion between two groups in posterior direction and lateral direction was not shown. Conclusion : We think that use of air-vacuum cushion may not be an advantage for improving setup accuracy in rectal cancer patients.

• The Journal of Korean Society for Radiation Therapy
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• v.35
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• pp.7-13
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• 2023

Purpose: In this study, we evaluated the effect of using a customized bolus on dose delivery in the treatment plan when cervical cancer protruded out of the body along with the uterus and evaluated reproducibility in patient set-up. Materials & Methods: The treatment plan used the Eclipse Treatment Planning System (Version 15.5.0, Varian, USA) and the treatment machine was VitalBeam (Varian Medical Systems, USA). The radiotherapy technique used 6 MV energy in the AP/PA direction with 3D-CRT. The prescribed dose is 1.8 Gy/fx and the total dose is 50.4 Gy/28 fx. Semiflex TM31010 (PTW, Germany) was used as the ion chamber, and the dose distribution was analyzed and evaluated by comparing the planned and measured dose according to each position movement and the tumor center dose. The first measurement was performed at the center by applying a customized bolus to the phantom, and the measurement was performed while moving in the range of -2 cm to +2 cm in the X, Y, and Z directions from the center assuming a positional error. It was measured at intervals of 0.5 cm, the Y-axis direction was measured up to ±3 cm, and the situation in which Bolus was set-up incorrectly was also measured. The measured doses were compared based on doses corrected to CT Hounsfield Unit (HU) 240 of silicon instead of the phantom's air cavity. Result: The treatment dose distribution was uniform when the customized bolus was used, and there was no significant difference between the prescribed dose and the actual measured value even when positional errors occurred. It was confirmed that the existing sheet-type bolus is difficult to compensate for irregularly shaped tumors protruding outside the body, but customized Bolus is found to be useful in delivering treatment doses uniformly.

• Journal of the Korean Society of Radiology
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• v.9 no.4
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• pp.249-255
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• 2015

In this study, through the additional information of the PET / CT images by utilizing the basic data of TPS clinical application on the basis of the image re-forming synthetic function, the True-D technology and MIM software for continued research and development in combination, based on the combination-work between the respective images, reducing the time and cost of useful reading in clinical wide use of image width, efficient, effective tool for tumor targeting at diagnosis and radiation therapy by use as, by using the precise therapeutic effect determination, the time taken to read in the clinical, unnecessary and expect to a can reduce the additional examination by the creation of tumor patients read reports and PACS such asWe expect to be utilized for compatibility development with other software to evaluate the performance of PET / CT equipment.