• Progress in Medical Physics
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• v.14 no.2
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• pp.90-98
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• 2003

Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.85-86
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• 2005

• Radiation Oncology Journal
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• v.20 no.2
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• pp.165-171
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• 2002

Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.97-103
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• 2010

Purpose: Treating same region with different modalities there is a limit to evaluate the total absorbed dose of normal tissues. The reason is that it does not support to communication each modalities yet. In this article, it evaluates absorbed dose of the patients who had been treated same region by a tomotherapy and a linear accelerator. Materials and Methods: After reconstructing anatomic structure with a anthropomorphic phantom, administrate 45 Gy to a tumor in linac plan system as well as prescribe 15 Gy in tomotherapy plan system for make an ideal treatment plan. After the plan which made by tomoplan system transfers to the oncentra plan system for reproduce plan under the same condition and realize total treatment plan with summation 45 Gy linac treatment plan. To evaluate the absorbed dose of two different modalities, do a comparative study both a simple summation dose values and integration dose values. Then compare and analyze absorbed dose of normal tissues and a tumor with the patients who had been exposured radiation by above two differents modalities. Results: The result of compared data, in case of minimum dose, there are big different dose values in spleen (12.4%). On the other hand, in case of the maximum dose, it reports big different in a small bowel (10.2%) and a cord (5.8%) in head & neck cancer patients, there presents that oral (20.3%), right lens (7.7%) in minimum dose value. About maximum dose, it represents that spinal (22.5), brain stem (12%), optic chiasm (8.9%), Rt lens (11.5%), mandible (8.1%), pituitary gland (6.2%). In case of Rt abdominal cancer patients, there represents big different minimum dose as Lt kidney (20.3%), stomach (8.1%) about pelvic cancer patients, it reports there are big different in minimum dose as a bladder (15.2%) as well as big different value in maximum dose as a small bowel (5.6%), a bladder (5.5%) in addition, making treatment plan it is able us to get. Conclusion: In case of comparing both simple summation absorbed dose and integration absorbed dose, the minimum dose are represented higher as well as the maximum dose come out lower and the average dose are revealed similar with our expected values data. It is able to evaluate tumor & normal tissue absorbed dose which could had been not realized by treatment plan system. The DVH of interesting region are prescribed lower dose than expected. From now on, it needs to develop the new modality which are able to realize exact dose distribution as well as integration absorbed dose evaluation in same treatment region with different modalities.

• 대한방사선치료학회:학술대회논문집
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• 1999.05a
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• pp.20-21
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• 1999

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.57-65
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• 2004

Introduction : The phantom that includes high density materials such as steel was custom-made to fix lung and bone in order to evaluation inhomogeneity correction at the time of conducting radiation therapy to treat lung cancer. Using this, values resulting from the inhomogeneous correction algorithm are compared on the 2 and 3 dimensional radiation therapy planning systems. Moreover, change in dose calculation was evaluated according to inhomogeneous by comparing with the actual measurement. Materials and Methods : As for the image acquisition, inhomogeneous correction phantom(Pig's vertebra, steel(8.21g/cm3), cork(0.23 g/cm3)) that was custom-made and the CT(Volume zoom, Siemens, Germany) were used. As for the radiation therapy planning system, Marks Plan(2D) and XiO(CMS, USA, 3D) were used. To compare with the measurement value, linear accelerator(CL/1800, Varian, USA) and ion chamber were used. Image, obtained from the CT was used to obtain point dose and dose distribution from the region of interest (ROI) while on the radiation therapy planning device. After measurement was conducted under the same conditions, value on the treatment planning device and measured value were subjected to comparison and analysis. And difference between the resulting for the evaluation on the use (or non-use) of inhomogeneity correction algorithm, and diverse inhomogeneity correction algorithm that is included in the radiation therapy planning device was compared as well. Results : As result of comparing the results of measurement value on the region of interest within the inhomogeneity correction phantom and the value that resulted from the homogeneous and inhomogeneous correction, gained from the therapy planning device, margin of error of the measurement value and inhomogeneous correction value at the location 1 of the lung showed $0.8\%$ on 2D and $0.5\%$ on 3D. Margin of error of the measurement value and inhomogeneous correction value at the location 1 of the steel showed $12\%$ on 2D and $5\%$ on 3D, however, it is possible to see that the value that is not correction and the margin of error of the measurement value stand at $16\%$ and $14\%$, respectively. Moreover, values of the 3D showed lower margin of error compared to 2D. Conclusion : Revision according to the density of tissue must be executed during radiation therapy planning. To ensure a more accurate planning, use of 3D planning system is recommended more so than the 2D Planning system to ensure a more accurate revision on the therapy plan. Moreover, 3D Planning system needs to select and use the most accurate and appropriate inhomogeneous correction algorithm through actual measurement. In addition, comparison and analysis through TLD or film dosimetry are needed.

• Proceedings of the KSMRM Conference
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• 1996.10a
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• pp.11-11
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• 1996

• Radioisotope journal
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• v.10 no.1
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• pp.72-77
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• 1995

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.39-41
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• 2005

본 연구에서는 두경부암 환자에게 세기조절 방사선치료계획을 수립한 후 환자 위치의 정확한 재현성과 치료선량의 정확한 전달을 위한 정도관리를 본원에 설치되어 있는 21ex 선형가속기와 세기조절방사선치료계획 장치인 CORVUS 시스템을 사용하였다. 세기조절 방사선치료계획을 QA 아크릴 팬텀으로 옮겨 계산된 계산치가 1.50 Gy였으며, 같은 조건으로 QA 아크릴 팬텀을 설치하여 측정한 선량은 1.485 Gy였으며, TLD에서의 측정치는 1.483 Gy였다. 측정치의 비교에서 이온챔버와 TLD에서 각각 1.0%, 1.2%의 차이를 보여 세기조절방사선치료의 환자 적용에의 적합성을 확인하였다. 나아가 환자치료시 정확하게 치료되고 있는지에 대한 검정과정을 개발하였다.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.2
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• pp.75-80
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• 2006

Purpose: In radiation therapy, precise calculation of dose toward malignant tumors or normal tissue would be a critical factor in determining whether the treatment would be successful. The Radiation Treatment Planning (RTP) system is one of most effective methods to make it effective to the correction of dose due to CT number through converting linear attenuation coefficient to density of the inhomogeneous tissue by means of CT based reconstruction. Materials and Methods: In this study, we carried out the measurement of CT number and calculation of mass density by using RTP system and the homemade inhomogeneous tissue Phantom and the values were obtained with reference to water. Moreover, we intended to investigate the effectiveness and accuracy for the correction of inhomogeneous tissue by the CT number through comparing the measured dose (nC) and calculated dose (Percentage Depth Dose, PDD) used CT image during radiation exposure with RTP. Results: The difference in mass density between the calculated tissue equivalent material and the true value was ranged from $0.005g/cm^3\;to\;0.069g/cm^3$. A relative error between PDD of RTP and calculated dose obtained by radiation therapy of machine ranged from -2.8 to +1.06%(effective range within 3%). Conclusion: In conclusion, we confirmed the effectiveness of correction for the inhomogeneous tissues through CT images. These results would be one of good information on the basic outline of Quality Assurance (QA) in RTP system.