• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.169-176
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• 2018

Purpose : The purpose of this study is to evaluate clinical applicability of Co-60 ViewRay treatment plan to increase the skin dose in case of high skin dose is required such as Malignant Fungating Wound By measuring the presence / absence of Bolus application and skin dose by the treatment device and comparing it Materials and Methods : Nine inner measuring points of 2.5 cm lattice arrangement and all 13 measuring points including upper and lower left and right measuring points touching the chest and skin were marked. After CT was taken, each treatment plan was formulated through Eclipse and ViewRay-TPS, and a Fixed beam-IMRT treatment plan was formulated so that the left chest V2Gy=95 % is delivered. Before measurement QED detector was calibrated and the QED detector was positioned at the 13 measurement points displayed on Phantom and surface dose of each treatment planner was measured using 5 mm Bolus application using True-beam and View-ray before and after, measure three times and compare each before applying 5 mm Bolus. Results : The surface dose of the Co-60 ViewRay and the linear accelerator appeared at $76.8%{\pm}5.2%$ vs. $67.3{\pm}%7.5%$ and the surface dose after application of 5 mm Bolus was $87.6%{\pm}8.9%$ vs. $80.3%{\pm}10.2%$ It was measured at 10.2 % (p<0.001). Conclusion : As a result of the surface dose measurement of each treatment instrument, Co-60 ViewRay confirmed that the surface dose reached 95.6 % of 6 MV Linac with conventional 5 mm bolus, despite not using Bolus (p<0.001). Also, by utilizing magnetic resonance images for each treatment, it is possible to observe the change in the treatment site without the problem of exposure, it is easy to formulate an adaptive treatment plan and it is easy to secure the skin dose, so the size In the case of Malignant Fungating Wound patients who need fast skin changes and need high skin doses, Co-60 ViewRay is considered to be more useful than linear accelerators.

• Journal of radiological science and technology
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• v.38 no.2
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• pp.107-114
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• 2015

The purpose is reducing radiation dose while maintaining of image quality in liver dynamic CT(LDCT) scan, by protocols generally used and the tube voltage set at a low level protocol compared to the radiation dose and image quality. The target is body mass index, 18.5~24 patients out of 40 patients who underwent the ACT(abdominal CT). Group A(tube voltage : 120kVp, SAFIRE strength 1) of 20 people among 40 people, to apply the general abdominal CT scan protocol, group B(tube voltage : 100kVp, apply SAFIRE strength 0~5) was 20 people, set a lower tube voltage. Image quality evaluation was setting a region of interest(ROI) in the liver parenchyma, aorta, superior mesenteric artery (SMA), celiac trunk, visceral fat of arterial phase. In the ROI were compared by measuring the noise, signal to noise ratio(SNR), contrast to noise ratio(CNR), CT number. In addition, qualitative assessments to evaluate two people in the rich professional experience in Radiology by 0-3 points. We compared the total radiation dose, dose length product(DLP) and effective dose, volume computed tomography dose index(CTDIvol). The higher SAFIRE in the tube voltage 100 kVp, noise is reduced, CT number was increased. Thus, SNR and CNR was increased higher the SAFIRE step. Compared with the tube voltage 120kVp, noise, SNR, CNR was most similar in SAFIRE strength 2 and 3. Qualitative assessment SAFIRE strength 2 is the most common SAFIRE strength 2 the most common qualitative assessment, if the tube voltage of 100kVp when the quality of the images better evaluated was SAFIRE strength 1. Dose was reduced from 21.69%, in 100kVp than 120kVp. In the case of a relatively high BMI is not LDCT scan, When it is shipped from the factory tube voltage is set higher, unnecessary radiation exposure when considering the reality that is concerned, when according to the results of this study, set a lower tube voltage and adjust the SAFIRE strength to 1 or 2, the radiation without compromising image quality amount also is thought to be able to be reduced.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.73-81
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• 2018

Purpose : The aims of this study were to compare and assess the effectiveness of Volumetric Modulated Arc Therapy(VMAT) using jaw tracking(JT) and fixed jaw(FJ) in radiation therapy of multiple brain metastasis. Methode and material : Among the patients with Multiple Brain Metastasis treated with jaw tracking, 10 patients with more than 6 tumors and with the size of radiation field $14{\times}14cm^2$ or more were included. Each Treatment plans with jaw tracking(JT) and fixed jaw(FJ) was established with Eclipse (Ver. 13.6 Varian, USA). Gamma Index (3 mm, 3 % confidence interval - 95 %) and maximum dose difference were measured with an electronic portal imaging device(EPID). The $D_{max}$ and $D_{mean}$ of Organ At Risk(OAR) were assessed and compared, and the Conformity Index(CI) and Homogeneity Index(HI) were evaluated. Result : Evaluating jaw tracking(JT) and fixed jaw(FJ) outcomes, in all cases, Gamma Index met the permissible standard of 3 mm, 3 % confidence intervals of 95 %. The maximum dose difference value from the areas with leaf end transmission was measured at a maximum of 98.4 % and an average of 43.6 % in clockwise(CW), and 67.9 % and 41.0 % for each in Counter-Clockwise(CCW). With jaw tracking, the maximum value of $D_{max}$ for each normal organ in OAR decreased in 15.36 %~74.59 % with the average value decreasing in 2.84 %~39.80 %. The maximum value of $D_{mean}$ in OAR decreased in 27.90 %~65.23 %, with the average value decreasing in 7.70 %~41.71 %. No change has been found in Conformity Index and Homogeneity Index values. Conclusion : When Jaw tracking is used in treating patients with multiple brain metastasis with VMAT, the unnecessary exposure due to leakage and transmission of radiation in unspecified areas was reduced, without affecting the dose distribution of the planning target volume(PTV), and the availability of radiation therapy with lower doses in normal organs is expected.

• Journal of radiological science and technology
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• v.32 no.1
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• pp.25-32
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• 2009

To find out proper photographing conditions in the chest DR imaging, the evaluation of images using the C-D phantom was carried out on relationship of identification capability, graininess, and exposure ratio. The conclusions were obtained as follows. 1. The patient's entrance skin Exposure (ESE) was decreased as tube voltage was increased. 2. According to the tube voltage change, the C-D phantom's identification capability of the exposure conditions was most visible at 110 kVp. 3. The identification capability according to the exposure ratio (mAs) change was most visible at 90 kVp for 0.5 times of low exposure ratio and at 110 kVp for 1.5 times. Therefore, it is known that the images were able to be better identified at a high exposure than a low exposure. 4. The graininess according to the exposure ratio at tube voltage of 110 kVp resulted in the best thing at 1.5 times of ratio when the exposure ratio was 1.5 times increased and the tube voltage was changed, the graininess showed the best result at 110 kVp. Therefore, the patient's exposure dose was low when kVp was increased and the adequate kVp was found to be 110. The image was better identified when exposure ratio was 1.5 times compared to 1.0 times. The graininess was also good when the exposure ratio became 1.5 times. The tube voltage was good at 110 kVp. However, once the exposure ratio is increased, the amount of radiation dose that the patients received get increased, so that the exposure condition has to be thoroughly considered.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.765-771
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• 2019

Noise in skull X-ray imaging is inevitable, which reduces imaging quality and diagnostic accuracy and increases errors due to the nature of digital imaging devices. Increasing the dose can attenuate noise, but that could lead to big problems with higher exposure dose received by patients. Thus, noise reduction algorithms are actively being studied at low doses to solve dose problems and reduce noise at the same time. Wiener filter and median filter have been widely used, with the disadvantages of poor noise reduction efficiency and loss of much information about imaging boundary. The purpose of this study is to apply total variation (TV) algorithm to skull X-ray imaging that can compensate for the problems of previous noise reduction efficiency to assess quantitatively and compare them. For this study, skull X-ray imaging is obtained using various kVp and mAs using the skull phantom using the X-ray device of Siemens. In addition, contrast to noise ratio (CNR) and coefficient of variation (COV) are compared and measured when noisy image, median filter, Wiener filter and TV algorithm were applied to each phantom imaging. Experiments showed that when TV algorithms were applied, CNR and COV characteristics were excellent under all conditions. In conclusion, we've been able to see if we can use TV algorithm to improve image quality and CNR could be seen to increase due to the decrease in noise as the amount of increased mAs. On the other hand, COV decreased as the amount of increased mAs, and when kVp increased, noise was reduced and the transmittance was increased, so COV was reduced.

• Journal of the Korean Society of Radiology
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• v.7 no.6
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• pp.383-387
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• 2013

Diagnostic imaging systems play a critical role in obtaining anatomical images, which increases the frequency of inspection all over the world. However the likelihood that patients are exposed to relatively high radiation dose increases, which may lead to an increase of patient dose due to unnecessary radiation exposure unless appropriate management is accompanied. Thus the revised edition of IEC 60601-2-44 which is constancy tests for CT equipment which is designated as special medical equipment and is subject to safety management was studied. The results suggested the 3rd has been revised rationally in order to overcome the limitations in the 2nd by adopting clear and enhanced references, which implies the replacement of IEC 60601-2-44 2nd edition with IEC 60601-2-44 3rd will prevent the patients from the harm from improper medical equipment.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.73-82
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• 2022

Purpose: The purpose of this study is to evaluate the effectiveness of reducing the absorbed dose to the ovaries and the quality of the CBCT image when using the Halcyon^TM Fast kV CBCT of cervical cancer patients of child-bearing age who performed ovarian transposition Materials and Methods : Contouring of the cervix and ovaries required for measurement was performed on the computed tomography images of the human phantom (Alderson Rando Phantom, USA), and three Optically Stimulated Luminescence Dosimeter(OSLD) were attached to the selected organ cross-section, respectively. In order to measure the absorbed dose to the cervix and ovaries in the Truebeam^TM pelvis mode (Hereinafter referred to as TP), The Halcyon^TM Pelvis mode (Hereinafter referred to as HP) and The Halcyon^TM Pelvis Fast mode (Hereinafter referred to as HPF), An image was taken with a scan range of 17.5 cm and also taken an image that reduced the Scan range to 12.5cm. A total of 10 cumulative doses were summed, It was replaced with a value of 23 Fx, the number of cervical cancer treatments, and compared In additon, uniformity, low contrast visibility, spatial resolution, and geometric distortion were compared and analyzed using Catphan 504 phantom to compare CBCT image quality between equipment. Each factor was repeatedly measured three times, and the average value was obtained by analysing with the Doselab (Mobius Medical Systems, LP. Versions: 6.8) program. Results: As a result of measuring absorbed dose by CBCT with OSLD, TP and HP did not obtain significant results under the same conditions. The mode showing the greatest reduction value was HPF versus TP. In HPF, the absorbed dose was reduced by 39.8% in the cervix and 19.8% in the ovary compared to the TP in the scan range of 17.5 cm. the scan range was reduced to 12.5 cm, absorbed dose was reduced by 34.2% in the cervix and 50.5% in the ovary. In addition, result of evaluating the quality of the image used in the above experiment, it complied with the equipment manufacturer's standards with Geometric Distortion within 1mm (SBRT standard), Uniformity HU, LCV within 2.0%, Spatial Resolution more than 3 lp/mm. Conclusion: According to the results of this experiment, Halcyon^TM can select more various conditions than Truebeam^TM in treatment of fertility woman who have undergone ovarian Transposition , because it is important to reduce the radiation dose by CBCT during radiation therapy. So finally we recommend Halcyon^TM Fast kV CBCT which maintains image quality even at low mAs. However, it is consider that the additional exposure to low doses can be reduced by controlling the imaging range for patients who have undergone ovarian transposition in other treatment machines.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.549-556
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• 2017

This study compared the spatial scattered dose distribution according to whether the recently developed radiation shielding is used or not in order to understand the spatial scattered dose distribution of C-arm. The horizontal side distribution increased by $30^{\circ}$ in the interval of the radius 50 cm on the height of 95 cm based on the head of the patient, and it was measured by increasing $30^{\circ}$ with the interval of 50 cm in the vertical side of each horizontal side. In the same method, the radiation shielding was installed and measured. The result of measurement shows that the horizontal side of 50 cm distance was $0^{\circ}$, $90^{\circ}$ and $180^{\circ}$, was $1.77{\pm}0.12$, $1.90{\pm}0.13$, $2.12{\pm}0.14$, and $2.69{\pm}0.15mSv/h$ in the $270^{\circ}$ direction, and was $1.59{\pm}0.12$, $0.99{\pm}0.09$, $1.47{\pm}0.11$, and $1.37{\pm}0.11mSv/h$ after the use of the radiation shielding. In addition, the vertical distribution in horizontal direction $90^{\circ}$ with 50 cm distance was $30^{\circ}$, $60^{\circ}$, $120^{\circ}$, was $3.85{\pm}0.18$, $9.15{\pm}0.28$, $10.82{\pm}0.31$, and $5.40{\pm}0.22mSv/h$ in $150^{\circ}$, and was $2.03{\pm}0.13$, $4.32{\pm}0.19$, $2.76{\pm}0.16$, and $1.92{\pm}0.13mSv/h\;mR/h$ after the use of the radiation shielding. Both direction showed decrease according to the use of the radiation shielding. Therefore, radiation related workers who work in operating rooms should recognize the spatial scattered dose distribution exactly and need to try to prevent the risk of radiation exposure with proper protective measures.

• Korean Journal of Digital Imaging in Medicine
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• v.11 no.1
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• pp.15-20
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• 2009

Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

• Journal of Radiation Protection and Research
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• v.32 no.3
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• pp.123-133
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• 2007

Z-axis automatic tube current modulation technique automatically adjusts tube current based on size of body region scanned. The purpose of the current study was to compare noise, and radiation dose of multi-detector row CT (MDCT) of lower extremity performed with Z-axis modulation technique of automatic tube current modulation with manual selection fixed tube current. Fifty consecutive underwent MDCT venography of lower extremity with use of a MDCT scanner fixed tube current and Z-axis automatic tube current modulation technique (10, 11 and 12 HU noise index, $70{\sim}450\;mA$). Scanning parameters included 120 kVp, 0.5 second gantry rotation time, 1.35:1 beam pitch, and 1 mm reconstructed section thickness. For each subject, images obtained with Z-axis modulation were compared with previous images obtained with fixed tube current (200, 250, 300 mA) and with other parameters identical. Images were compared for noise at five levels: iliac, femoral, popliteal, tibial, and peroneal vein of lower extremity. Tube current and gantry rotation time used for acquisitions at these levels were recorded. All CT examinations of study and control groups were diagnostically acceptable, though objective noise was significantly more with Z-axis automatic tube current modulation. Compared with fixed tube current, 2-axis modulation resulted in reduction of CTDIvol (range, $-6.5%{\sim}-35.6%$) and DLP (range, $-0.2%{\sim}-20.2%$). Compared with manually selected fixed tube current, 2-axis automatic tube current modulation resulted in reduced radiation dose at MDCT of lower extremity venography.