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Quality Assurance for Intensity Modulated Radiation Therapy (세기조절방사선치료(Intensity Modulated Radiation Therapy; IMRT)의 정도보증(Quality Assurance))

  • Cho Byung Chul;Park Suk Won;Oh Do Hoon;Bae Hoonsik
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.275-286
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    • 2001
  • Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

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An Essay on the Change of Jinju Sword Dance after being designated as an Important Intangible Cultural Asset (<진주검무> 중요무형문화재 지정 이후의 변화에 관한 소고)

  • Lee, Jong Sook
    • Korean Journal of Heritage: History & Science
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    • v.49 no.1
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    • pp.4-21
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    • 2016
  • The purpose of this study is to investigate changes of Jinju Sword Dance, characteristics of the changes, and the current condition of its preservation and succession after the designation as the important intangible cultural property no. 12 in January 16th, 1967. In other words, this study understands the situation which has established the present state of after changes over generations. As of now. the year of 2015, the 3 generation holders have been approved since 1967. In 1967, 8 members of $1^{st}$ generation holders were selected from gisaengs of Gwonbeon. However, the succession training was incomplete due to conflicts among the holders, the deaths of some holders, and economic activities of the individuals. As the need of a pivot for succession training and activities was rising, Seong, Gye-Ok was additionally approved as the $2^{nd}$ generation holder on June $21^{st}$, 1978. Seong, Gye-Ok who had never been a gisaeng had dramatically changed with a lot of new attempts. After the death of Seong, Gye-Ok in 2009, Kim, Tae-Yeon and Yu, Yeong-Hee were approved as the $3^{rd}$ generation holders in February, 2010. Based on the resources including the "Cultural Research Reports of Important Intangible Cultural Properties" in 1966 and videos up to 2014, the changes of the dance and surroundings are as follow. 1. The formation of musical accompaniment has been changed during the 3 generations. In the video of the $1^{st}$ generation(in 1970), the performance lasted about 15 minutes, whereas the performance lasted 25 minutes in the video of the $2^{nd}$ generation. Yumbuldoduri rhythm was considered as Ginyumbul(Sangryeongsan) and played more slowly. The original dance requiring only 15 rhythms was extended to 39 rhythms to provide longer performance time. In the $3^{rd}$ generation, the dance recovered 15 rhythms using the term Ginyumbul. The facts that Yumbul was played for 3 minutes in the $1^{st}$ generation but for 5 minutes in the 3rd generation shows that there was tendency pursuing the slowness from the $2^{nd}$ generation. 2. For the composition of the Dance, the performance included additional 20 rhythms of Ginyumbul and Ah(亞)-shaped formation from the $2^{nd}$ generation. From the $3^{rd}$ generation, the performance excluded the formation which had no traditional base. For the movement of the Dance, the bridge poses of Ggakjittegi and Bangsukdoli have been visibly inflexible. Also, the extention of time value in 1 beat led the Dance less vibrant. 3. At the designation as an important intangible cultural property (in 1967), the swords with rotatable necks were used, whereas the dancers had been using the swords with non-rotatable necks since late 1970s when the $2^{nd}$ generation holder began to used them. The swords in the "Research Reports" (in 1966) was pointy and semilunar, whereas the straight swords are being used currently. The use of the straight swords can be confirmed from the videos after 1970. 4. There is no change in wearing Jeonlib, Jeonbok, and Hansam, whereas the arrangement of Saekdong of Hansam was different from the arrangement shown in the "Research Reports". Also, dancers were considered to begin wearing the navy skirts when the swords with non-rotatable necks began to be used. Those results showed that has been actively changed for 50 years after the designation. The $2^{nd}$ generation holder, Seong, Gye-Ok, was the pivot of the changes. However, , which was already designated as an important intangible cultural property, is considered to be only a victim of the change experiment from the project to restore Gyobang culture in Jinju, and it is a priority to conduct studies with historical legitimacy. First of all, the slowing beat should be emphasized as the main fact to reduce both the liveliness and dynamic beauty of the Dance.