• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.83-95
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• 2018

Purpose : After planning the Respiratory Gated Radiotherapy for Lung cancer, the movement and volume change of sparing normal structures nearby target are not often considered during dose evaluation. This study carried out 4-D dose evaluation which reflects the movement of normal structures at certain phase of Respiratory Gated Radiotherapy, by using Deformable Image Registration that is well used for Adaptive Radiotherapy. Moreover, the study discussed the need of analysis and established some recommendations, regarding the normal structures's movement and volume change due to Patient's breathing pattern during evaluation of treatment plans. Materials and methods : The subjects were taken from 10 lung cancer patients who received Respiratory Gated Radiotherapy. Using Eclipse(Ver 13.6 Varian, USA), the structures seen in the top phase of CT image was equally set via Propagation or Segmentation Wizard menu, and the structure's movement and volume were analyzed by Center-to Center method. Also, image from each phase and the dose distribution were deformed into top phase CT image, for 4-dimensional dose evaluation, via VELOCITY Program. Also, Using $QUASAR^{TM}$ Phantom(Modus Medical Devices) and $GAFCHROMIC^{TM}$ EBT3 Film(Ashland, USA), verification carried out 4-D dose distribution for 4-D gamma pass rate. Result : The movement of the Inspiration and expiration phase was the most significant in axial direction of right lung, as $0.989{\pm}0.34cm$, and was the least significant in lateral direction of spinal cord, as -0.001 cm. The volume of right lung showed the greatest rate of change as 33.5 %. The maximal and minimal difference in PTV Conformity Index and Homogeneity Index between 3-dimensional dose evaluation and 4-dimensional dose evaluation, was 0.076, 0.021 and 0.011, 0.0 respectfully. The difference of 0.0045~2.76 % was determined in normal structures, using 4-D dose evaluation. 4-D gamma pass rate of every patients passed reference of 95 % gamma pass rate. Conclusion : PTV Conformity Index was more significant in all patients using 4-D dose evaluation, but no significant difference was observed between two dose evaluations for Homogeneity Index. 4-D dose distribution was shown more homogeneous dose compared to 3D dose distribution, by considering the movement from breathing which helps to fill out the PTV margin area. There was difference of 0.004~2.76 % in 4D evaluation of normal structure, and there was significant difference between two evaluation methods in all normal structures, except spinal cord. This study shows that normal structures could be underestimated by 3-D dose evaluation. Therefore, 4-D dose evaluation with Deformable Image Registration will be considered when the dose change is expected in normal structures due to patient's breathing pattern. 4-D dose evaluation with Deformable Image Registration is considered to be a more realistic dose evaluation method by reflecting the movement of normal structures from patient's breathing pattern.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.607-614
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• 2016

The study investigates the necessity of 3 dimensional dose distribution evaluation instead of point dose and 2 dimensional dose distribution evaluation. Treatment plans were generated on the RANDO phantom to measure the precise dose distribution of the treatment site 0.5, 1, 1.5, 2, 2.5, 3 cm with the prescribed dose; 1,200 cGy, 5 fractions. Gamma analysis (3%/3 mm, 2%/2 mm) of dose distribution was evaluated with gafchromic EBT2 film and ArcCHECK phantom. The average error of absolute dose was measured at $0.76{\pm}0.59%$ and $1.37{\pm}0.76%$ in cheese phantom and ArcCHECK phantom respectively. The average passing ratio for 3%/3 mm were $97.72{\pm}0.02%$ and $99.26{\pm}0.01%$ in gafchromic EBT2 film and ArcCHECK phantom respectively. The average passing ratio for 2%/2 mm were $94.21{\pm}0.02%$ and $93.02{\pm}0.01%$ in gafchromic EBT2 film and ArcCHECK phantom respectively. There was a more accurate dose distribution of 3D volume phantom than cheese phantom in patients DQA using tomotherapy. Therefor it should be evaluated simultaneously 3 dimensional dose evaluation on target and peripheral area in rotational radiotherapy such as tomotherapy.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.303-309
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• 2017

To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to $2cm^3$ of bladder to less than 7.5 Gy, and $2cm^3$ of rectum to less than 5Gy. In one patient of 10 patients, $D_{2cm3}$ of rectal dose was over 5Gy and 6patients at $D_{2cm3}$ of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

• Journal of radiological science and technology
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• v.40 no.1
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• pp.87-92
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• 2017

The weight of small animal dosimetry has been continuously increased in pre-clinical studies using radiation in small animals. In this study, three-dimensional(3D) small animal phantom was fabricated using 3D printer which has been continuously used and studied in the various fields. The absorbed dose of 3D animal phantom was evaluated by film dosimetry. Previously, the response of film was obtained from the materials used for production of 3D small animal phantom and compared with the bolus used as the tissue equivalent material in the radiotherapy. When irradiated with gamma rays from 0.5 Gy to 6 Gy, it was confirmed that there was a small difference of less than 1% except 0.5 Gy dose. And when small animal phantom was irradiated with 5 Gy, the difference between the irradiated dose and calculated dose from film was within 2%. Based on this study, it would be possible to increase the reliability of dose in pre-clinical studies using irradiation in small animals by evaluating dose of 3D small animal phantom.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.33-33
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• 2003

목적 : 현재 국내에서 사용되고 있는 방사선치료계획 장비는 거의 모든 방사선종양학과에서 외국 회사의 제품을 사용하고 있는 실정이다. 본 연구는 국내 기술로 개발된 3 차원 조형 방사선치료계획 장비인 Core Plan의 선량계산 알고리즘의 정확성 및 방사선 치료계획 장비로서의 유용성에 관해 평가하고 본 장비의 특징에 대해 간략히 소개하고자 한다. 재료 및 방법 : 본 연구는 2002 년 11 월에 가톨릭대학교 성모병원 방사선종양학과와 서울씨앤제이의 연구계약에 의해 시행되었다. 본 장비에 대한 평가는 방사선분포 및 계산상의 정확성과 임상적용시의 유용성의 관점에서 시행되었다. 본 장비에서 이용된 광자선 선량계산은 Clarkson-Cunningham 모델이며 전자선 선량계산은 2.5D Hogstrom 알고리즘이다. 방사선분포 및 계산상의 정확성 평가를 위하여 방사선치료 장비는 본 병원이 보유한 Clinac 2100CD (Varian, USA)를 이용하였고 폴리스티렌 팬텀과 필름 및 이온 전리함을 이용하여 방사선분포 및 계산상의 정확성을 평가하였다. 방사선분포의 평가 방법은 필름을 이용한 방사선분포의 중심부단면 선량분포와 CorePlan 에서 재현된 방사선분포의 동일면 선량분포를 비교하였다. 임상적용은 2003 년 3 월부터 7 월까지 방사선치료를 받은 50 명의 환자를 대상으로 분석하였다. 본 시험에 적용된 환자는 본 병원이 보유한 3 차원 방사선치료계획 장비인 Prowess 3D (SSGI Inc., USA)를 이용하여 실제 치료된 환자들이며 이 환자를 대상으로 CorePlan에서 동일하게 재현하여 비교하였다. 결과 및 결론 : 방사선분포 및 계산상의 정확성 평가에서는 실제 측정된 결과와 CorePlan에서 재현된 결과가 모두 $\pm$3% 이내로 평가되었다. 50 명의 환자를 대상으로 시행한 임상시험 결과 Prowess 3D에서 나타낸 결과와 비교하여 두경부에서는 1.678%, 흉부 1.578%, 복부 1.271%의 선량값의 오차를 보였다. 본 연구를 진행하는 과정에서 많은 부분의 프로그램 수정이 있었으며 실제임상에 필요한 부분에 대한 추가 및 보완이 이루어졌다. 앞으로 진행될 과정은 실제임상의 사용에 필요한 부분의 계속적인 업그레이드와 전자선에 대한 방사선분포 및 계산정확성 평가, 임상적용에 있어서 Prowess3D 뿐만 아니라 다양한 방사선 치료계획 장비와의 비교를 할 예정이다.

• Progress in Medical Physics
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• v.10 no.2
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• pp.103-114
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• 1999

In this study, as a preliminary study for developing a full 3D photon dose calculation algorithm, We developed 2.5D photon dose calculation algorithm by extending 2D calculation algorithm to allow non-coplanar configurations of photon beams. For this purpose, we defined the 3d patient coordinate system and the 3d beam coordinate system, which are appropriate to 3d treatment planning and dose calculation. and then, calculate a transformation matrix between them. For dose calculation, we extended 2d "Clarkson-Cunningham" model to 3d one, which can calculate wedge fields as well as regular and irregular fields on arbitrary plane. The simple Batho's power-law method was implemented as an inhomogeneity correction. We evaluated the accuracy of our dose model following procedures of AAPM TG#23; radiation treatment planning dosimetry verifications for 4MV of Varian Clinac-4. As results, PDDs (percent depth dose) of cubic fields, the accuracy of calculation are within 1% except buildup region, and $\pm$3% for irregular fields and wedge fields. And for 45$^{\circ}$ oblique incident beam, the deviations between measurements and calculations are within $\pm$4%. In the case of inhomogeneity correction, the calculation underestimate 7% at the lung/water boundary and overestimate 3% at the bone/water boundary. At the conclusions, we found out our model can predict dose with 5% accuracy at the general condition. we expect our model can be used as a tool for educational and research purpose.. purpose..

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.857-862
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• 2022

The purpose of this study was to evaluate a three-dimensional conformal radiotherapy (3D-CRT) treatment plan with regard to head tilting in whole-brain radiotherapy (WBRT) using TomoDirect (TD) mode in Tomotherapy. WBRT 3D-CRT by TD was compared for a total of five head tilt angles (-20°, -10°, 0°. +10° and +20°). The dose homogeneity index (HI) and prescription dose index (CI) were calculated to confirm the target coverage. The maximum and average doses for critical organs such as the lens, eyeball and parotid glands were calculated for different angles of head tilting. The HI and CI were closet to the result value of 1 at the head tilted angle +10° and +20°. At a head tilted angle of +10°, the dose to the lens and eyeballs decreased by about 74% and about 30%, when compared with the reference angle (0°), respectively. The results of this study suggest that a head angle of +10 with chin-up would save adequate target coverage and reduce exposure dose to the lens.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.1
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• pp.7-17
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• 2007

Purpose: As increasing complexity of modern radiotherapy technique, more developing dosimetry is required. Polymer gel dosimeters offer a wide range of potential applications with high resolution and assured quality in the thee-dimensional verification of complex dose distribution such as intensity-modulated radiotherapy (IMRT). The purpose of this study is to find the most sensitive and suitable gel as a dosimeter by varying its composition ratio and its condition such as temperature during manufacturing. Materials and Methods: Each polymer gel with various ratio of composition was irradiated with the same amount of photon beam accordingly. Various polymer gels were analyzed and compared using a dedicated software written in visual C++ which converts TE images to R2 map images. Their sensitivities to the photon beam depending on their composition ratio were investigated. Results: There is no dependence on beam energy nor dose rate, and calibration curve is linear. Conclusion: The polymer gel dosimeter developed by using anti-oxidant in this study proved to be suitable for dosimetry.

• Progress in Medical Physics
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• v.25 no.4
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• pp.233-241
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• 2014

The aim of this study is to develop a new software tool for 3D dose verification using $PRESAGE^{REU}$ Gel dosimeter. The tool included following functions: importing 3D doses from treatment planning systems (TPS), importing 3D optical density (OD), converting ODs to doses, 3D registration between two volumetric data by translational and rotational transformations, and evaluation with 3D gamma index. To acquire correlation between ODs and doses, CT images of a $PRESAGE^{REU}$ Gel with cylindrical shape was acquired, and a volumetric modulated arc therapy (VMAT) plan was designed to give radiation doses from 1 Gy to 6 Gy to six disk-shaped virtual targets along z-axis. After the VMAT plan was delivered to the targets, 3D OD data were reconstructed from 512 projection data from $Vista^{TM}$ optical CT scanner (Modus Medical Devices Inc, Canada) per every 2 hours after irradiation. A curve for converting ODs to doses was derived by comparing TPS dose profile to OD profile along z-axis, and the 3D OD data were converted to the absorbed doses using the curve. Supra-linearity was observed between doses and ODs, and the ODs were decayed about 60% per 24 hours depending on their magnitudes. Measured doses from the $PRESAGE^{REU}$ Gel were well agreed with the TPS doses at central region, but large under-doses were observed at peripheral region at the cylindrical geometry. Gamma passing rate for 3D doses was 70.36% under the gamma criteria of 3% of dose difference and 3 mm of distance to agreement. The low passing rate was resulted from the mismatching of the refractive index between the PRESAGE gel and oil bath in the optical CT scanner. In conclusion, the developed software was useful for 3D dose verification from PRESAGE gel dosimetry, but further improvement of the Gel dosimetry system were required.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.264-273
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• 2002

Purpose : Three-dimensional radiation dosimetry using magnetic resonance imaging of polymer gel was recently introduced. This dosimetry system is based on radiation induced chain polymerization of acrylic monomers in a muscle equivalent gel and provide accurate 3 dimensional dose distribution. We planned this study to evaluate the clinical value of this 3-dimensional dosimetry. Materials and Methods: The polymer gel poured into a cylindrical glass flask and a spherical glass flask. The cylindrical test tubes were for dose response evaluation and the spherical flasks, which is comparable to the human head, were for isodose curves. T2 maps from MR images were calculated using software, IDL. Dose distributions have been displayed for dosimetry. The same spherical flask of gel and the same irradiation technique was used for film and TLD dosimetry and compared with each other. Results : The R2 of the gel respond linearly with radiation doses in the range of 2 to 15 Gy. The repeated dosimetry of spherical gel showed the same isodose curves. These isodose curves were identical to dose distributions from treatment planning system especially high dose range. In addition, the gel dosimetry system showed comparable or superior results with the film and TLD dosimetry. Conclusion : The 3-dimensional dosimetry for conformal radiation therapy using MRI of polymer gal showed stable and accurate results. Although more studies are needed for convenient clinical application, it appears to be a useful tool for conformal radiation therapy.