• Progress in Medical Physics
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• v.16 no.2
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• pp.82-88
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• 2005

In this study, the physical compensator made with the high density material, Cerrobend, and the electronic compensator realized by the movement of a dynamic multileaf collimator were analyzed in order to verify the properness of a design function in the commercial RTP (radiation treatment planning) system, Eclipse. The CT images of a phantom composed of the regions of five different thickness were acquired and the proper compensator which can make homogeneous dose distribution at the reference depth was designed in the RTP. The frame for the casting of Cerrobend compensator was made with a computerized automatic styrofoam cutting device and the Millennium MLC-120 was used for the electronic compensator. All the dose values and isodose distributions were measured with a radiographic EDR2 film. The deviation of a dose distribution was $\pm0.99 cGy\;and\;\pm1.82cGy$ in each case of a Cerrobend compensator and a electronic compensator compared with a $\pm13.93 cGy$ deviation in an open beam condition. Which showed the proper function of the designed compensators in the view point of a homogeneous dose distribution. When the absolute dose value was analyzed, the Cerrobend compensator showed a $+3.83\%$ error and the electronic compensator showed a $-4.37\%$ error in comparison with a dose value which was calculated in the RTP. These errors can be admtted as an reasonable results that approve the accuracy of the compensator design in the RTP considering the error in the process of the manufacturing of the Cerrobend compensator and the limitation of a film in the absolute dosimetry.

• Progress in Medical Physics
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• v.12 no.2
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• pp.185-191
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• 2001

The virtual compensator which are realized using a multileaf collimator(MLC) and three-dimensional radiation therapy Planning(3D RTP) system was designed. And the feasibility study of the virtual compensator was done to verify that it can do the function of the conventional compensator properly. As a model for the design of compensator, styrofoam phantom and mini water phantom were prepared to simulate the missing tissue area and the calculated dose distribution was produced through the 3D RTP system. The fluence maps which are basic materials for the design of virtual compensator were produced based on the dose distribution and the MLC leaf sequence file was made for the realization of the produced fluence map. Ma's algorithm were applied to design the MLC leaf sequence and all the design tools were programmed with IDL5.4. To verify the feasibility of the designed virtual compensator, the results of irradiation with or without a virtual compensator were analyzed by comparing the irradiated films inserted into the mini water phantom. The higher dose area produced due to the missing tissue was removed and intended regular dose distribution was achieved when the virtual compensator was applied.

• Progress in Medical Physics
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• v.7 no.2
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• pp.3-17
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• 1996

Dose compensators have been widely used in radiotherapy fields. But, few reliable verification methods have been reported. We have developed the verification method for the evaluation of the effect of dose compensator using exit beam dose profile. The exit beam dose profiles were measured with and without dose compensator. For this purpose X-Omat V films and lead screened cassettes are used and dose distibutions are compared. Phantom data are collected using CT simulator(Picker, AcQ Sim) and compensator information can be obtained from Render Plan 3-D planning System. Aluminum Compensators are generated by computer controlled milling machine. The real dose distribution in the phantom and the exit beam dose profile can be obtained simultaneously with the films in the phantom and the opposite site of the beam. Dose compensations effects for oblique beam, parallel opposing beam and inhomogeneous human phantom can be obtained using above tools. And we could simate those effects with exit beam dose profile using the method that we have developed in this study.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.147-153
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• 1992

It is ideal thing to compensate tissue deficit without skin contamination in curvatured irradiation field of high energy photon beam. The 3-dimensional compensating technique utilizing tissue equivalent materials to ensure an adequate dose distribution and skin sparing effect was described. This compensator was made of paraffin ($70\%$) and stearin wax ($30\%$) compound. The parameters for evaluation of the effect on skin dose in application of compensator were considered in the size of the field, the thickness of the compensator and the source-to-axis distance. The results are as follows; the skin doses were not changed even though application of the compensator, but depended on the field size and the source-to-axis distance, and the skin doses were only slightly changed within $1\%$ relative errors as increasing the thickness of the compensator in these experiments.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.147-153
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• 2005

Purpose : We should use a computed tomography-simulator for the body measure and compensator manufacture process was practiced with TBI's positioning in process and to estimate the availability.,Materials and Methods : Patient took position that lied down. and got picture through computed tomography-simulator. This picture transmitted to Somavision and measured about body measure point on the picture. Measurement was done with skin, and used the image to use measure the image about lungs. We decided thickness of compensator through value that was measured by the image. Also, We decided and confirmed position of compensator through image. Finally, We measured dosage with TLD in the treatment department.,Results : About thickness at body measure point. we could find difference of $1{\sim}2$ cm relationship general measure and image measure. General measure and image measure of body length was seen difference of $3{\sim}4$ cm. Also, we could paint first drawing of compensator through the image. The value of dose measurement used TLD on head, neck, axilla, chest(lungs inclusion), knee region were measured by $92{\sim}98%$ and abdomen, pelvis, inquinal region, feet region were measured by $102{\sim}109%$.,Conclusion : It was useful for TBI's positioning to use an image of computed tomography-simulator in the process. There was not that is difference of body thickness measure point, but measure about length was achieved definitely. Like this, manufacture of various compensator that consider body density if use image is available. Positioning of compensator could be done exactly. and produce easily without shape of compensator is courted Positioning in the treatment department could shortened overall $15\{sim}20$ minute time. and reduce compensator manufacture time about 15 minutes.

• Progress in Medical Physics
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• v.19 no.1
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• pp.35-41
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• 2008

The main benefit of proton therapy over photon beam radiotherapy is the absence of exit dose, which offers the opportunity for highly conformal dose distributions to target volume while simultaneously irradiating less normal tissue. For proton beam therapy two patient specific beam modifying devices are used. The aperture is used to shape the transverse extension of the proton beam to the shape of the tumor target and a patient-specific compensator attached to the block aperture when required and used to modify the beam range as required by the treatment plan for the patient. A block of range shifting material, shaped on one face in such a way that the distal end of the proton field in the patient takes the shape of the distal end of the target volume. The mechanical quality assurance of range compensator is an essential procedure to confirm the 3 dimensional patient-specific dose distributions. We proposed a new quality assurance method for range compensator based on image processing using X-ray tube of proton therapy treatment room. The depth information, boundaries of each depth of plan compensatorfile and x-ray image of compensator were analyzed and presented over 80% matching results with proposed QA program.

• Progress in Medical Physics
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• v.16 no.3
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• pp.130-137
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• 2005

In total body irradiation (T81) for leukemia, we have a two methode. One is a AP (anterior-posterior) method and the other is a Lateral methode. Our hospital used lateral methode. T81 must consider about body contour, because of homogeneous dose distribution. For compensation about irregular body contour, we use compensator. For T81 treatment, we must be considered, accurate manufacture of compensator and accurate calculation of dose. We developed the automatic program for T81. This program accomplished for compensator design and dose calculation for irregular body. This program was developed for uses to use in a windows environment using the IDL language. In this program, it use energy data for each energy: TMR, output factor, inverse square law, spoiler, field size factor. This program reduces the error to happen due to the manual. As a development of program, we could decrease the time of treatment plan and care the patient accurately.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.233-241
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• 1994

Purpose : This study was performed to verify dose distribution with the tissue compensator which is used for uniform dose distribution in total body irradiation(TBI). Materials and methods : The compensators were made of lead(0.8mm thickness) and aluminum(1mm or 5mm thickness) plates. The humanoid phantom of adult size was made of paraffin as a real treatment position for bilateral total body technique. The humanoid phantom was set at 360cm of source-axis distance(SAD) and irradiated with geographical field size(FS) $144{\times}144cm^2(40{\times}40cm^2$ at SAD 100cm) which covered the entire phantom. Irradiation was done with 10MV X-ray(CLINAC 1800, Varian Co., USA) of linear accelerator set at Department of Therapeutic Radiology, Chonnam University Hospital. The midline absorbed dose was checked at the various regions such as head, mouth, mid-neck, sternal notch, mid-mediastinum, xiphoid, umbilicus, pelvis, knee and ankle with or without compensator, respectively. We used exposure/exposure rate meter(model 192, Capintec Inc., USA) with ionization chamber(PR 05) for dosimetry, For the dosimetry of thorax region TLD rods of $1x1x6mm^3$ in volume(LiF, Harshaw Co., Netherland) was used at the commercially available humanoid phantom. Results : The absorbed dose of each point without tissue compensator revealed significant difference(from $-11.8\%\;to\;21.1\%$) compared with the umbilicus dose which is a dose prescription point in TBI. The absorbed dose without compensator at sternal notch including shoulder was $11.8\%$ less than the dose of umbilicus. With lead compensator the absorbed doses ranged from $+1.3\%\;to\;-5.3\%$ except mid-neck which revealed over-compensation($-7.9\%$). In case of aluminum compensator the absorbed doses were measured with less difference(from $-2.6{\%}\;to\;5.3\%$) compared with umbilicus dose. Conclusion : Both of lead and aluminum compensators applied to the skull or lower leg revealed a good compensation effect. It was recognized that boost irradiation or choosing reference point of dose prescription at sternal notch according to the lateral thickness of patient in TBI should be considered.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.24-33
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• 2002

Purpose : In order to improve dose homogeneity and to reduce acute toxicity in tangential whole breast radiotherapy, we evaluated two treatment techniques using multiple static fields or universal compensators. Materials and Methods : 1) Multistatic field technique : Using a three dimensional radiation treatment planning system, Adac Pinnacle 4.0, we accomplished a conventional wedged tangential plan. Examining the isodose distributions, a third field which blocked overdose regions was designed and an opposing field was created by using an automatic function of RTPS. Weighting of the beams was tuned until an ideal dose distribution was obtained. Another pair of beams were added when the dose homogeneity was not satisfactory. 2) Universal compensator technique : The breast shapes and sizes were obtained from the CT images of 20 patients who received whole breast radiation therapy at our institution. The data obtained were averaged and a pair of universal physical compensators were designed for the averaged data. DII (Dose Inhomogeneity Index : percentage volume of PTV outside $95\~105\%$ of the prescribed dose) $D_{max}$ (the maximum point dose in the PTV) and isodose distributions for each technique were compared. Results : The multistatic field technique was found to be superior to the conventional technique, reducing the mean value of DII by $14.6\%$ (p value<0.000) and the $D_{max}$ by $4.7\%$ (p value<0.000). The universal compensator was not significantly superior to the conventional technique since it decreased $D_{max}$ by $0.3\%$ (p value=0.867) and reduced DII by $3.7\%$ (p value=0.260). However, it decreased the value of DII by maximum $18\%$ when patients' breast shapes fitted in with the compensator geometry. Conclusion : The multistatic field technique is effective for improving dose homogeneity for whole breast radiation therapy and is applicable to all patients, whereas the use of universal compensators is effective only in patients whose breast shapes fit inwith the universal compensator geometry, and thus has limited applicability.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.27-32
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• 2017

Objectives: Oncological hyperthermia is a treatment to selectively kill cancer cells by directly applying heat to cancer cells or indirectly demage cancer cells. One of the most side effects of treatment is burn that can appear on the skin. In areas with irregularities such as the umbilicus, the patient feels a sense of hot and treatment may be discontinued. Therefore, in order to eliminate the irregularities of these areas, compensators are manufactured and measured to decrease in temperature. Materials and Methods: The temperature of the four sites (umbilicus, near the umbilicus, 5 cm below the umbilicus, back) was measured five times around the umbilicus in patients who were treated at oncological hyperthermia treatment device(EHY-2000, Oncotherm Kft, Hungary). The temperature sensor (TM-100, Oncotherm Kft, Hungary) was attached to four sites and the changes were observed at 5, 15, 25, 35, and 50 minutes after treatment. Compensators of three materials were used(Vaseline, Bolus, Dental resin). The data measured five times were compared for each compensator. Results: The temperature change when the compensator was not used increase from 34.65 degrees to 42.9 degrees on average. The near umbilicus was changed from 32.20 degrees to 37.00 degrees, and the 5 cm below the umbilicus was changed from 31.90 to 34.41 degrees. When the compensator material was inserted into the umbilicus, the temperature change was measured as 5.42 degrees for bolus, 6.55 degrees for vaseline, and 6.83 degrees for resin. Conclusion: Using the compensator in the region where the irregularities such as the umbilicus, the heat sensation could be reduced. the use of a resin that can be customized not only lowers the temperature but also significantly reduces the feeling of the patient. It will be possible to reduce the heat sensation in the treatment and to treat it in a more comfortable condition.