• Journal of the Korean Society of Radiology
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• v.6 no.6
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• pp.455-464
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• 2012

This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.82-88
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• 2014

Purpose: The purpose of study was to evaluate radiation dose for pediatric patients by changing tube voltage (kVp) and tube current (mA) at minimum conditions. By evaluating radiation dose, we want to provide dose reduction for pediatric patients and maintain good quality of SPECT/CT images. Materials and Methods: Discovery NM/CT 670 Scanne was used as SPECT/CT. Tube voltages are 80 and 100 kvP. Tube currents are 10, 15, 20, 25 mA. Using PMMA (Polymethyl methacrylate) Phantom, radiation dose which were calculated at center and peripheral dose and SNRD (Signal to Noise Ratio Dose) were evaluated. Using the CT performance phantom, spatial resolution was evaluated as the MTF (Modulation Transfer Function) graph. Jaszczak phantom was used for SPECT image evaluation by CNR (Contrast to Noise to Ratio). Results: Radiation dose using the PMMA phantom was higher peripheral dose than center dose about 7%. SNRD were 7.8, 8.2, 8.3, 8.8, 8.8, 9.9, 9.8, 9.6 for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. We can distinguish 35, 45, 70, 71, 52, 58, 90, 110 linepair for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA at resolution with MTF. CNR of SPECT images using CT attenuation map were 57.8, 57.7, 57.1, 56.7, 56.6, 56.7, 56.7, 56.7% for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. Conclusion: In this study, radiation dose for pediatric patients showed decreased low dose condition. And SNRD value was similar in all condition. Resolution showed higher value at 100kVp than 80kVp. for CNR, there was no significant difference. we should take additional study to prove better quality and dose reduction.

• Progress in Medical Physics
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• v.13 no.4
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• pp.209-217
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• 2002

There have been many studies on the application of the reciprocal advantages of multimodality image to define accurate target volume in the Process of radiation treatment planning. For the proper use of the multimodality images, the registration works between different modality images should be performed in advance. In this study, we selected chamfer matching method and mutual information method as most popular methods in recent image registration studies considering the registration accuracy and clinical practicality. And the two registration methods were analyzed to deduce the optimal registration method according to the characteristics of images. Lung phantom of which multimodality images could be acquired was fabricated and CT, MRI and SPECT images of the phantom were used in this study. We developed the registration program which can perform the two registration methods properly and analyzed the registration results which were produced by the developed program in many different images' conditions. Although the overall accuracy of the registration in both chamfer matching method and mutual information method was acceptable, the registration errors in SPECT images which had lower resolution and in degraded images of which data were removed in some part were increased when chamfer matching method was applied. Especially in the case of degraded reference image, chamfer matching methods produce relatively large errors compared with mutual information method. Mutual information method can be estimated as more robust registration method than chamfer matching method in this study because it did not need the prerequisite works, the extraction of accurate contour points, and it produced more accurate registration results consistently regardless of the images' characteristics. The analysis of the registration methods in this study can be expected to provide useful information to the utilization of multimodality images in delineating target volume for radiation treatment planning and in many other clinical applications.

• The Journal of Korean Society for Radiation Therapy
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• v.21 no.1
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• pp.33-39
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• 2009

Purpose: The aim of this study is to compare patient's body posture and its position at the time of simulation with one at the treatment room using On-board Imaging (OBI) and CT (CBCT). The detected offsets are compared with position errors of Rando Phantom that are practically applied. After that, Rando Phantom's position is selected by moving couch based on detected deviations. In addition, the errors between real measured values of Rando Phantom position and theoretical ones is compared. And we will evaluate target position's accuracy of KV X-ray imaging's 2D and CBCT's 3D one. Materials and Methods: Using the Rando Phantom (Alderson Research Laboratories Inc. Stanford. CT, USA) which simulated human body's internal structure, we will set up Rando Phantom on the treatment couch after implementing simulation and RTP according to the same ways as the real radioactive treatment. We tested Rando Phantom that are assumed to have accurate position with different 3 methods. We measured setup errors on the axis of X, Y and Z, and got mean standard deviation errors by repeating tests 10 times on each tests. Results: The difference between mean detection error and standard deviation are as follows; lateral 0.4+/-0.3 mm, longitudinal 0.6+/-0.5 mm, vertical 0.4+/-0.2 mm which all within 0~10 mm. The couch shift variable after positioning that are comparable to residual errors are 0.3+/-0.1, 0.5+/-0.1, and 0.3+/-0.1 mm. The mean detection errors by longitudinal shift between 20~40 mm are 0.4+/-0.3 in lateral, 0.6+/-0.5 in longitudinal, 0.5+/-0.3 in vertical direction. The detection errors are all within range of 0.3~0.5 mm. Residual errors are within 0.2~0.5 mm. Each values are mean values based on 3 tests. Conclusion: Phantom is based on treatment couch shift and error within the average 5mm can be gained by the diminution detected by image registration based on OBI and CBCT. Therefore, the selection of target position which depends on OBI and CBCT could be considered as useful.

• The Journal of Korean Society for Radiation Therapy
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• v.21 no.1
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• pp.1-7
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• 2009

Purpose: The purpose is to evaluate the accuracy of correcting the targeting error through the Target Location System (TLS) for the location change error of the reference point which arises from the movement or motion of patient during the treatment using the CyberKnife. Materials and Methods: In this test, Gafchromic MD-55 film was inserted into the head and neck phantom to analyze the accuracy of the targeting, and then the 6 MV X-ray of CyberKnife (CyberKnife Robotic Radiosurgery System G4, Accuray, US) was irradiated. End to End (E2E) program was used to analyze the accuracy of targeting, which is provided by Accuray Corporation. To compute the error of the targeting, the test was carried out with the films that were irradiated 12 times by maintaining the distance within the rage of $0{\pm}0.2\;mm$ toward x, y, z from the reference point and maintaining the angle within the rage of $0{\pm}0.2^{\circ}$ toward roll, pitch, yaw, and then with the films which were irradiated 6 times by applying intentional movement. And the correlation in the average value of the reference film and the test film were analyzed through independent samples t-test. In addition, the consistency of dose distribution through gamma-index method (dose difference: 3%) was quantified, compared, and analyzed by varying the distance to agreement (DTA) to 1 mm, 1.5 mm, 2 mm, respectively. Results: E2E test result indicated that the average error of the reference film was 0.405 mm and the standard deviation was 0.069 mm. The average error of the test film was 0.413 mm with the standard deviation of 0.121 mm. The result of independent sampling t-test for both averages showed that the significant probability was P=0.836 (confidence level: 95%). Besides, by comparing the consistency of dose distribution of DTA through 1 mm, 1.5 mm, 2 mm, it was found that the average dose distribution of axial film was 95.04%, 97.56%, 98.13%, respectively in 3,314 locations of the reference film, consistent with the average dose distribution of sagittal film that was 95.47%, 97.68%, 98.47%, respectively. By comparing with the test film, it was found that the average dose distribution of axial film was 96.38%, 97.57%, 98.04%, respectively, at 3,323 locations, consistent with the average dose distribution of sagittal film which was 95.50%, 97.87%, 98.36%, respectively. Conclusion: Robotic CyberKnife traces and complements in real time the error in the location change of the reference point caused by the motion or movement of patient during the treatment and provides the accuracy with the consistency of over 95% dose distribution and the targeting error below 1 mm.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.77-81
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• 2014

Purpose : In the current whole brain Radiation Therapy, Optimold was used to immobilize the head. However, skin dose was increased about 22% due to the scattering radiation by the Optimold. Since the minimum dose causing cataracts was 2 Gy, it could be seen that the effects were large especially on the lens. Therefore, in the whole brain Radiation Therapy, it was to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part. Materials and Methods : In order to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part, the Optimold mask was made ??up to 5mm bolus on the part of the eye lens in the human model phantom (Anderson Rando Phantom, USA). In the practice treatment, to measure the lens dose, the simulation therapy was processed by placing the GafChromic EBT3 film under bolus, and after the treatment plan was set up through the treatment planning system (Pinnacle, PHILIPS, USA), the treatments were measured repeatedly three times in the same way. After removing the Optimold mask in the eyeball part, it was measured in the same way as above. After scanning the film and measuring the dose by using the Digital Flatbed Scanner (Expression 10000XL, EPSON, USA), the doses were compared and evaluated according to the presence of Optimold mask in the eyeball part. Results : When there was the Optimold mask in the eyeball part, it was measured at $10.2cGy{\pm}1.5$ in the simulation therapy, and at $24.8cGy{\pm}2.7$ in the treatment, and when the Optimold mask was removed in the eye part, it was measured at $12.9cGy{\pm}2.2$ in the simulation therapy, and at $17.6cGy{\pm}1.5$ in the treatment. Conclusion : In case of removing the Optimold mask in the eyeball part, the dose was increased approximately 3 cGy in the simulation therapy and was reduced approximately 7 cGy in the treatment in comparison to the case that the Optimold mask was not removed. During the whole treatment, since the lens absorbed dose was reduced about 27%, the chance to cause cataracts and side effects was considered to be reduced due to decrease of the absorbed dose to the eye lens which had the high sensitivity on the radiation.

• Journal of the Institute of Electronics and Information Engineers
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• v.51 no.12
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• pp.180-188
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• 2014

It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

• Journal of Radiation Protection and Research
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• v.40 no.2
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• pp.118-123
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• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

• Progress in Medical Physics
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• v.9 no.2
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• pp.77-88
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• 1998

Wedge shaped isodoses are desired in a number of clinical situations. Hard wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths along with the practical consequendes of filter handling and placement problems. Dynamic wedging uses a combination of a moving collimator and changing monitor dose to achieve angled isodoses. The segmented treatment tables(STT) that monitor unit setting by every distance of moving collimator, was induced by numerical formular. The characteristics of dynamic wedge by STT compared with real dosimetry. Methods and Materials : The accelerator CLINAC 2100C/D at Yonsei Cancer Center has two photon energies (6MV and 10MV), currently with dynamic wedge angles of 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$. The segmented treatment tables(STT) that drive the collimator in concert with a changing monitor unit are unique for field sizes ranging from 4.0cm to 20.0cm in 0.5cm steps. Transmission wedge factors were measured for each STT with an standard ion chamber. Isodose profiles, isodose curves, percentage depth dose for dynamic wedge filters were measured with film dosimetry. Dynamic wedge angle by STT was well coincident with film dosimetry. Percent depth doses were found to be closer to open field but more shallow than hard wedge filter. The wedge transmission factor were decreased by increased the wedge angle and more higher than hard wedge filters. Dynamic wedging probided more consistent gradients across the field compared with hard wedge filters. Dynamic wedging has practical and dosimetric advantages over hard filters for rapid setup and keeping from table collisions. Dynamic wedge filters are positive replacement for hard filters and introduction of dynamic conformal radiotherapy and intensity modulation radiotherapy in a future.

• Progress in Medical Physics
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• v.26 no.2
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• pp.87-92
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• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.