• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.117-128
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• 2018

Purpose : To evaluate the usability of plan transfer between TOMO HD and Radixact, we compared the differences of dose in transferred plans by evaluating the dose of normal organ and target. TOMO HDA and Radixact. The completed plans were transferred each other and we compared the differences of dose by evaluating the DVH of each plans. Materials and Methods : We planned 4 different plans assuming the treatment of 2 cases in Head and Neck Cancer and 2 cases Prostate cancer. Each plan was designed so that 95 % of the prescription dose was irradiated over 99 % of the target volume, and the normal organ constraints dose was based on the SMC tolerance dose protocol. Each plan was transferred to each equipment and DVH(dose volume histogram) analysis of the transferred plans was compared and evaluated. Results : The Mean dose of CTV and GTV was increased and decreased in the transferred plans, but there was no significant differences. The target coverage of CTV and GTV was decreased in all cases of transferred plans from TOMO HAD to Radixact, and the change of CI and HI in CTV was within 0.1. Normal organ dose was increased in most cases when transferring from HAD to Radixact in both treatment plans. Conclusion : According to the results of this experiment, the target coverage was above the standard and the normal organ dose was almost same or decreased when transferring the plans from Radixact to HDA equipment. However the target coverage was reduced when transferring the plans from HDA to Radixact and there was an increase in dose in normal organs that could cause sever side effects such as Optic Chiasm ($D_{max}$1.38 Gy), Bladder ($D_{max}$3.07 Gy), Penile Bulb ($D_{max}$1.14 Gy). Therefore, it is necessary to pay attention to the dose change when transferring the plan and one-time transfer due to equipment inspection will be useful for efficient radiation therapy, but if the transferred treatment plans continue for several consecutive days, the treatment plan should be resumed.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.41-52
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• 2020

Purpose: To find out the dosimetric usefulness, setup reproducibility and efficiency of applying 3D Bolus by comparing two treatment plans in which Commercial Bolus and 3D Bolus produced by 3D Printing Technology were applied to the neck during VMAT treatment of Hypopahrynx Cancer to evaluate the clinical applicability. Materials and Methods: Based on the CT image of the RANDO phantom to which CB was applied, 3D Bolus were fabricated in the same form. 3D Bolus was printed with a polyurethane acrylate resin with a density of 1.2g/㎤ through the SLA technique using OMG SLA 660 Printer and MaterializeMagics software. Based on two CT images using CB and 3D Bolus, a treatment plan was established assuming VMAT treatment of Hypopharynx Cancer. CBCT images were obtained for each of the two established treatment plans 18 times, and the treatment efficiency was evaluated by measuring the setup time each time. Based on the obtained CBCT image, the adaptive plan was performed through Pinnacle, a computerized treatment planning system, to evaluate target, normal organ dose evaluation, and changes in bolus volume. Results: The setup time for each treatment plan was reduced by an average of 28 sec in the 3D Bolus treatment plan compared to the CB treatment plan. The Bolus Volume change during the pretreatment period was 86.1±2.70㎤ in 83.9㎤ of CB Initial Plan and 99.8±0.46㎤ in 92.2㎤ of 3D Bolus Initial Plan. The change in CTV Min Value was 167.4±19.38cGy in CB Initial Plan 191.6cGy and 149.5±18.27cGy in 3D Bolus Initial Plan 167.3cGy. The change in CTV Mean Value was 228.3±0.38cGy in CB Initial Plan 227.1cGy and 227.7±0.30cGy in 3D Bolus Initial Plan 225.9cGy. The change in PTV Min Value was 74.9±19.47cGy in CB Initial Plan 128.5cGy and 83.2±12.92cGy in 3D Bolus Initial Plan 139.9cGy. The change in PTV Mean Value was 226.2±0.83cGy in CB Initial Plan 225.4cGy and 225.8±0.33cGy in 3D Bolus Initial Plan 224.1cGy. The maximum value for the normal organ spinal cord was the same as 135.6cGy on average each time. Conclusion: From the experimental results of this paper, it was found that the application of 3D Bolus to the irregular body surface is more dosimetrically useful than the application of Commercial Bolus, and the setup reproducibility and efficiency are excellent. If further case studies along with research on the diversity of 3D printing materials are conducted in the future, the application of 3D Bolus in the field of radiation therapy is expected to proceed more actively.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.199-206
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• 2014

Purpose : According to the rapid increase recently in image-guided radiation therapy, It is necessary to control of the image guidance system completely. In particular for the main subject to the accuracy of image guided radiation therapy device to be done essentially the quality assurance. We made efficient phantom in AMC for the management of the accurate and efficient. Materials and Methods : By setting up of five very important as a quality assurance inventory of the Image guidance system, we made (AMC G-Box) phantom for quality assurance efficient and accurate. Quality assurance list were the Iso-center align, the real measurement, the center align of four direction, the accuracy of table movement and the reproducibility of Hounsfield Unit. The rectangular phantom; acrylic with a thickness of 1 cm to $10cm{\time}10cm{\time}10cm$ was inserted the three materials with different densities respectively for measure the CBCT HU. The phantom was to perform a check of consistency centered by creating a marker that indicates the position of the center fixed. By performing the quality assurance using the phantom of existing, comparing the resulting value to the different resulting value using the AMC G-Box, experiment was analyzed time and problems. Therapy equipment was used Varian device. It was measured twice at 1-week intervals. Results : When implemented quality assurance of an image guidance system using AMC G-Box and a phantom existing has been completed, the quality assurance result is similar in $0.2mm{\pm}0.1$. In the case of the conventional method, it was 45 minutes at 30 minutes. When using AMC G-Box, it takes 20 minutes 15 minutes, and declined to 50% of the time. Conclusion : The consistency and accurate of image guidance system tend to decline using device. Therefore, We need to perform thoroughly on the quality assurance related. It needs to be checked daily to consistency check especially. When using the AMC G-Box, It is possible to enhance the accuracy of the patient care and equipment efficiently performing accurate quality assurance.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.51-60
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• 2022

Objectives: The purpose is to evaluate dosimetric performance and delivery efficiency of VMAT with Halcyon LINAC for double target spine SBRT Materials and Methods: 12 patients with spine oligometastases were retrospectively studied. Single-isocenter spine SBRT plans was established using Halcyon® with Dual Layer MLC and Truebeam® with High Definition MLC. All patients' plans were created in Eclipse TPS through the identical conditions and optimization. C.I, H.I, G.I (Gradient Index), maximal and volumetric doses to spinal cord and low dose area were evaluated for comparison of both plans. Also, total MU and BOT(Beam On Time) were evaluated. Results: Halcyon plans was no Statistical differences in C.I and H.I. However, the average of G.I was 4.64 for Halcyon, which decreased to 5.5% compared to Truebeam (P<0.001). Halcyon plans demonstrated statistically significant reduced G.I. The average of 50% and 25% isodose volume was 487.56 cc (-3.82%, P<0.001), 1859.45 cc (-4.75%, P<0.001) in Halcyon, respectively. Significantly reduced low dose spill were observed in Halcyon plans. In the evaluation of the spinal cord, the average of Dmean and V10 of Halcyon plans in the sample group with an overlap volume of less than 1 cc was 6.802 Gy (-3.504%, P=0.067), 5.766±1.683 cc (-8.199%, P=0.002), respectively. Halcyon plans demonstrated statistically significant reduced D_mean and V10. For delivery efficiency, MU and BOT(maximum dose rate for each machine), on average, increased in Halcyon plans. However, the average of BOT(800MU/min for each machine) was 648.33 sec for Halcyon (-1.74%, P<0.001). Conclusion: Halcyon plan for double-target spine SBRT demonstrated advantages in the low dose area with a steep dose gradient, while having dosimetrically equivalent target dose distribution and spinal cord protective effect. As a result, Halcyon LINAC produced a dosimetrically improved plan for double-target spine SBRT.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.449-457
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• 2023

Shielding for reducing exposure dose can make the diagnosis limited. The purpose of this study is to increase the efficiency of radiation protection and minimize the loss of image information by producing the shielding made of the water and the contrast medium which has different proportion and finding out the ideal proportion of them. Each shielding materials were made of water and water-soluble iodine contrast medium with the different proportion. The attenuation rate of absorbed dose was evaluated by the shielding materials in the plastic contents for measuring the efficiency of the radiation protection. As a result, the higher ratio of the contrast medium, the more efficient it is for radiation attenuation. The anatomical structure was observed most properly in case of the solution with 20 ml of the contrast medium and most difficultly in case of more than 60 ml of the contrast medium. In case of the signal intensity between skeleton and gas, the difference of average value had a significant as p < 0.001. Shielding with contrast medium attenuates less than the conventional shielding but in the examination for the sensitive part to radiation, it can be used to minimize the loss of the image information and reduce the exposure dose.

• Proceedings of the Korean Vacuum Society Conference
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• 2010.02a
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• pp.289-289
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• 2010

정상 세포로부터 암과 같은 종양세포를 제거하는 방법으로 암세포가 사멸되는 임계온도 보다 높게 악성조직에 열을 가하는 방법이 연구되어지고 있다 [1]. 전류가 흐를 수 있는 4개의 전기탐침을 종양조직에 삽입하여 국부적으로 열을 발생시키는 발열요법으로 암을 치료하는 연구가 고려되고 있다. 발열요법은 1960년대에 시작하여 우리나라에서는 1985년 연세 암센터에서 capacitive type의 RF heating 또는 전자파에 의한 국소가온법과 방사선치료와 병용으로 이용되고 있다. 주로 이용되는 방법은 Radio frequency heating, Microwave heating, ultrasound heating을 들수 있다. 라디오주파수는 보통 300 MHz 이하의 주파수를 가리킨다. 본 연구에서는 교류파 대신에 직류전원에 의해 열을 발생하는 경우에 관한 연구이다. 전극에 의해 형성되는 전기장에 대한 방정식은 전도매질에서의 DC 응용모드이고, 조직 내에서의 직류 전류에 의해 발생되는 온도 분포를 모델링하는 bioheat 방정식과 연계된 문제이다. 전기장에 의해 발생되는 열의 근원은 resistive heat 또는 Joule 열이다. 본 연구에서는 교류 전류에 의한 RF heating 대신 단순한 모델의 경우로 직류 전류에 의한 열 발생에 관한 이론적 연구를 수행하였다. 종양 조직 내에 삽입된 전극에 22V를 인가하면 60초 이내에 $80^{\circ}C$까지 급속히 증가 된 후, 서서히 $90^{\circ}C$에 까지 도달한다. 4 개의 전극에 대칭적인 전위가 인가 된 경우 $50^{\circ}C$ 이상의 온도 분포를 암 조직의 모양과 유사하게 분포하게 하여 효과적인 치료를 수행 할 수 있는 조건을 제시한다.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.91-97
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• 2007

Purpose: To evaluate the feasibility of a commercial ion chamber array for intensity modulated radiation therapy (IMRT) quality assurance (QA) was performed IMRT patient-specific QA Materials and Methods: A use of IMRT patient-specific QA was examined for nasopharyngeal patient by using 6MV photon beams. The MatriXX (Wellhofer Dosimetrie, Germany) was used for IMRT QA. The case of nasopharyngeal cancer was performed inverse treatment planning. A hybrid dose distribution made on the CT data of MatriXX and solid phantom all of the same gantry angle (0$^\circ$). The measurement was acquired with geometrical condition that equal to hybrid treatment planning. The $\gamma$-index (dose difference 3%, DTA 3 mm) histogram was used for quantitative analysis of dose discrepancies. An absolute dose was compared at the high dose low gradient region. Results: The dose distribution was shown a good agreement by gamma evaluation. A proportion of acceptance criteria was 95.8%, 97.52%, 96.28%, 98.20%, 97.78%, 96.64% and 92.70% for gantry angles were 0$^\circ$, 55$^\circ$, 110$^\circ$, 140$^\circ$, 220$^\circ$, 250$^\circ$ and 305$^\circ$, respectively. The absolute dose in high dose low gradient region was shown reasonable agreement with the RTP calculation within $\pm$3%. Conclusion: The MatriXX offers the dosimetric characteristics required for performing both relative and absolute measurements. If MatriXX use in the clinic, it could be simplified and reduced the IMRT patient-specific QA workload. Therefore, the MatriXX is evaluated as a reliable and convenient dosimeter for IMRT patient-specific QA.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.96-99
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• 2005

본 연구에서는 식품의약품안전청의 도움을 받아 1998년부터 2003년까지 장기간에 걸친 교정정수의 분석을 통한 원통형이온함의 모델별 안정성을 확인하여 보다 효율적인 이온함의 선택으로 방사선치료기관의 선량측정체계의 정확도 향상에 기여하고자 한다. 방사선치료기관에서 사용하고 있는 Farmer형의 원통형이온함에 대한 에어커마 교정정수(NK)를 분석한 결과 Wellhofer FC65G (IC70)와 PTW 30001, 30013 (30006) 그리고 NE 2571 이온함 모델에 대한 교정정수는 모두 0.3%이내에서 잘 일치하였다. 또한 에어커마 교정정수를 이용하여 계산된 물 흡수선량 교정정수(Cal. ND,W)와 실제 측정에 의해 결정된 물 흡수선량 교정정수(Mea. ND,W)를 비교한 결과는 약 1.0% 정도 측정에 의한 교정정수가 높게 나타났으며 에어커마 교정정수를 분석한 결과와 마찬가지로 위 동일한 모델의 이온함에 대해서 측정의 표준편차가 0.14～0.17%로 나타나 장기적인 안정성이 입증되었다.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.343-349
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• 2018

Dose rate regulated tracking is known to be an efficient method which adaptively delivers tracking treatments when patient breathing is irregular. The Motion Management Interface (MMI, Varian Medical System, CA), which provides beam on/off switching during treatment is available for clinic. Study is to test if delivering the adaptive tumor tracking is feasible for irregular breathing using beam switching with MMI. 55 free breathing RPM traces acquired from lung cancer patients are used. The first day RPM traces of the patients are utilized to design preprogrammed tracking MLC patterns, of which periods are intentionally reduced by 20% in order to catch up the variation of patient breathing irregularity in the treatment day. Eligibility criteria for this technique are the variation of amplitude and period less than 20%. An algorithm which determines beam on/off every 100 ms by considering the preprogrammed (MLC) positions and current breathing positions is developed. Tracking error and delivery efficacy are calculated by simulating the beam-switching adaptive tracking from the RPM traces. Breathing patterns of 38 patients (70%) met the eligibility criteria. Tracking errors of all of the cases who meet the criteria are less than 2 mm (average 1.4 mm) and the average delivery efficacy was 71%. Those of rest of the cases are 1.9 mm and 48%. Adaptive tracking with beam switching is feasible if patient selection is based on the eligibility criteria.

• Journal of the Korean Society of Radiology
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• v.7 no.4
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• pp.285-291
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• 2013

In this study, compare and analyze the dose distribution and availability of radiation therapy when using a different devices to TNI(Total Lymphnodal Irradiation). Test subjects(patients) are 15 people(Male 7, Female 8). Acquire CT Simulation images of the 15 people using Somatom Sansation Open 16 channel and then acquired images was transferred to each treatment planning system Pinnacle Ver 8.0 and Tomotherapy Planning System and separate the tumor tissue and normal tissues(whole lung, spinal cord, Rt kidney, Lt kidney). Tumor prescription dose was set to 750 cGy. and then Compare the Dose Compatibility, Normal Tissue's Absorbed Dose, Dose Distribution and DVH. Statistical analysis was performed SPSS Ver. 18.0 by paired sample Assay. The absorbed dose in the tumor tissue was $751.0{\pm}4.7cGy$ in tomotherapy planning, $746.9{\pm}14.1cGy$ in linac. Tomotherapy's absorbed dose in the tumor was more appropriate than linac. and These values are not statistically significant(p>0.05). Tomotherapy plan's absorbed dose in the normal tissues were less than linac's plan. This value was statistically significant(p<0.05) excepted of whole lung. In DVH, appropriated on tumor and normal tissues in tomotherapy and linac but tomotherapy's TER was better than linac. Namely, a result of Absorbed dose in tumor and normal tissue, Dose distribution pattern, DVH, Both radiation therapy devices were appropriated in radiation therapy on TER. The Linac has a short treatment time(about 15-20 min) and open space on treatment time. It cause infant and pediatric patients to receiving uncomfortable treatment. So, In this case, it will be fine that Linac based therapy was restricted use. and if the patient was cooperative, it will be show a better prognosis that Tomotherapy using Radiation Therapy.