• 한국의학물리학회지:의학물리
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• 제1권1호
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• pp.23-29
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• 1990

In order to explane the stereotactic procedure, the three steps of the procedure (target localization, dose planning, and radiation treatment) must be examined separately. The ultimate accuracy of the full procedure is dependent on each of these steps and on the consistancy of the approach The concern in this article was about dose planning, which is a important factor to the success of radiation treatment. The major factor in dose planning is a dosimetry system to evaluate the dose delivered to the target and normal tissues in the patient, while it generates an optimal dose distribution that will satisfy a set of clinical criteria for the patient. A three-dimensional treatment planning program is a prerequisite for treatment plan optimization. It must cover 3-D methods for representing the patient, the dose distributions, and beam settings. The major problems and possible modelings about 3-D factors and optimization technique were discussed to simplify and solve the problems associatied with 3-D optimization, with relative ease and efficiency. These modification can simplify the optimization problem while saving time, and can be used to develop reference dose planning system to prepare standard guideline for the selection of optimum beam parameters, such as the target position, collimator size, arc spacing, the variation in arc length and weight. The method yields good results which can then be simulated and tailored to the individual case. The procedure needed for dose planning in stereotactic radiosurgery is shown in figure 1.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1197-1199
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• 2016

Background: This study aimed to facilitate decision-making in cases of breast cancer radiotherapy shifts by simulating millimetric shifts and analyzing their effects on dose distribution. Methods: The study included 30 patients with left side breast cancer who were treated with three dimensional conformal radiotherapy (3D-CRT) in the Radiation Oncology Department in Hatay Public Hospital, between January 2013 and April 2015. A treatment plan shifting at three axes with six different measures was simulated. Results: The biggest difference in values was (+3mm shift) 476cGy, with a 7.7 % change for heart and 25.6% for spinal cord. The shifts in values respectively for CTV min, mean, max were -4.8%, 2.5%, 4%. The differences for lymphatic min, mean, max were 21.3%, 20.3%, -12.2%. Conclusion: The most important thing is not the treatment plan quality, but its practicality. The treatment plan must be practical and its practice must be controlled rigidly.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.248-251
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• 2002

The intensity modulated radiation therapy (IMRT) with a multileaf collimator (MLC) requires the conversion of a radiation fluence map into a leaf sequence file that controls the movement of the MLC during radiation treatment of patients. Patient dose verification is clinically one of the most important parts in the treatment delivery of the radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to the target helps to verify patient dose and to determine the physical characteristics of beams used in IMRT. A new method is presented for the pretreatment dosimetric verification of two dimensional distributions of photon intensity by means of Beam Intensity Scanner System (BISS) as a radiation detector with a custom-made software for dose calculation of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6MV photons on a Varian Clinac 21EX. The BISS reproduces 3D- relative dose distribution from the digitized fluoroscopic signals obtained by digital video camera-based scintillator(DVCS) device in the IMRT. For the intensity modulated beams (IMBs), the calculations of absorbed dose are performed in absolute beam fluence profiles which are used for calculation of the patient dose distribution. The 3D-dose profiles of the IMBs with the BISS were demonstrated by relative measurements of photon beams and shown good agreement with radiographic film. The mechanical and dosimetric properties of the collimating of dynamic and/or step MLC system alter the generated intensity. This is mostly due to leaf transmission, leaf penumbra and geometry of leaves. The variations of output according to the multileaf opening during the irradiation need to be accounted for as well. These phenomena result in a fluence distribution that can be substantially different from the initial and calculative intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT.

• 한국의학물리학회지:의학물리
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• 제28권1호
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• pp.33-38
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• 2017

Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

• Journal of Radiation Protection and Research
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• 제36권4호
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• pp.183-189
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• 2011

To quantitatively evaluate how setup errors in conjunction with dose gradients contribute to the error in IMRT dose quality assurance (DQA) measurements. The control group consisted of 5 DQA plans of which all individual field dose differences were less than ${\pm}5%$. On the contrary, the examination group was composed of 16 DQA plans where any individual field dose difference was larger than ${\pm}10%$ even though their total dose differences were less than ${\pm}5%$. The difference in 3D dose gradients between the two groups was estimated in a cube of $6{\times}6{\times}6\;mm^3$ centered at the verification point. Under the assumption that setup errors existed during the DQA measurements of the examination group, a three dimensional offset point inside the cube was sought out, where the individual field dose difference was minimized. The average dose gradients of the control group along the x, y, and z axes were 0.21, 0.20, and 0.15 $cGy{\cdot}mm^{-1}$, respectively, while those of the examination group were 0.64, 0.48, and 0.28 $cGy{\cdot}mm^{-1}$, respectively. All 16 plans of the examination group had their own 3D offset points in the cube. The individual field dose differences recalculated at the offset points were mostly diminished and thus the average values of total and individual field dose differences were reduced from 3.1% to 2.2% and 15.4% to 2.2%, respectively. The offset distribution turned out to be random in the 3D coordinate. This study provided the quantitative data that support the large individual field dose difference mainly stems from possible geometric errors (e.g., random setup errors) under the influence of steep dose gradients of IMRT field.

• 한국의학물리학회지:의학물리
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• 제7권2호
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• pp.3-17
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• 1996

방사선 치료분야에서 선량 보상체가 널리 이용되고 있으나, 그 보상효과에 대한 확실한 검증 방법은 알려진 바가 거의 없다. 본 연구에서는 Missing Tissue 뿐 아니라, Internal Tissue Inhomogeneity 까지 고려한 3차원 보상체를 제작하고, Exit Beam Dose Profile의 측정값과 본 연구에서 고안한 방법으로 기대값을 구해 비교함으로써 보상체의 성능을 평가하고자 하였다. 환자정보는 CT Simulator를 사용하여 얻었고, 보상체 정보는 Render Plan 3-D Planning System을 통해 얻었다. Computer Controlled Milling Machine으로 알루미늄 보상체를 제작해서 보상체가 있는 경우와 없는 경우의 선량 프로파일을 측정하여 비교하였다. 측정은 폴리스티렌 팬톰 사이에 필름을 삽입하여 팬톰 내에서의 실제 선량 분포를 구하고, 필름 카셋트를 이용해서 Exit Beam Dose Profile 을 동시에 얻었다. Oblique Beam, Parallel Opposing Beam, Inhomogeneus Human Phantom에 대해 제작된 보상체가 각각 선량보상 효과가 잘 나타남을 볼 수 있었고, 이 연구에서의 성능확인 방법을 통해 보상체의 성능을 확인할 수 있었다.

• 한국의학물리학회지:의학물리
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• 제9권2호
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• pp.65-71
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• 1998

1 cm 아크릴 판과 SSD 가 9MeV 전자선의 측방선량분포 및 깊이선량분포에 미치는 영향을 평가하여 아크릴 판을 전자선치료에서 에너지 저하체로 사용하는 타당성이 있는가를 분석하는 것이 목적이다 .Varian Clinac-2100C 에서 발생되는 9MeV 전자선을 7MeV로 저하시키기 위해 lcm 두께의 아크릴 판을 이용하였다. 아크릴 판은 엑스선 표적에서 65.4cm에 있는 전자선응용장치 상단에 두었으며, 조사면의 크기는 SSD 100cm 에서 l0$\times$10cm로 하였다. 100cm, 105cm, 110cm의 세 가지 SSD에 대해 선축상 깊이선량분포와 최대선량점깊이 (1.4cm) 에서 가로방향과 세로방향의 측방선량분포를 3D 물팬톰을 이용하여 측정하였다. 깊이선량분포에서는 최대선량점과 85% 선량점 ,50% 선량점 깊이와 표면에서 평균에너지, 실비정과 표면에서 최빈에너지를 비교하였다. 측방선량분포 측정으로부터 평탄도, 피넘브러폭, 실조사면크기를 비교하였다. 참조를 위한 목적에서 9MeV 전자선도 측정하였다. SSD가 l00cm 에서 l10cm로 증가함에 따라 7MeV 전자의 표면선량율이 85.5% 에서 82.2% 로 감소하였고, 선량증가영역을 제외하고는 깊이선량분포는 SSD에 영향을 받지 않았다. 평탄도는 7MeV가 4.7% 에서 10.4% 로 변하여 9MeV 의 1.4% 에서 3.5% 로 변한 것에 비하여 심하게 변하였다. 피넘브러폭은 7MeV 가 1.52cm 에서 3.03cm 로 증대하여 9MeV 의 1.14 cm에서 1.63cm로 증대된 것에 비해 심하게 변하였다. 7 MeV 전자선의 실조사면크기는 10.75cm에서 12.85 cm로 증대하여 9MeV 전자선의 10.32cm 에서 11.46cm 로 증대하는 것에 비해 심하게 변하였다. 가상선원표면거리는 7 MeV, 9MeV 각각에 대해 49.8cm,88.5cm였다. 에너지 저하체를 이용하는 경우에도 그렇지 않은 경우와 마찬가지로 SSD가 멀어져도 선량증가영역을 제외하고는 깊이선량분포는 변하지 않았다. 에너지 저하체를 사용하면 그렇지 않은 경우에 비해 SSD 가 증가하면 평탄도가 허용범위를 넘어 나빠지고, 피넘브러 폭은 넓어지며 조사면 크기가 더 심하게 커진다. 가상선원표면거리는 현저하게 짧아졌다. 결론적으로 전자선치료에서 특히 먼 SSD 에서 에너지 저하체를 이용하지 않는 것이 바람직하다고 생각된다.

• 대한방사선치료학회지
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• 제13권1호
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• pp.38-46
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• 2001

Purpose : The aim of this study is to investigate the effect of tissue inhomogeneities when appling to contrast medium among Homogeneous, Batho and ETAR dose calculation method in RTP system. Method and Material : We made customized heterogeneous phantom it filled with water or contrast medium slab. Phantom scan data have taken PQ 5000 (CT scanner, Marconi, USA) and then dose was calculated in 3D RTP (AcQ-Plan, Marconi, USA) depends on dose calculation algorithm (Homogeneous, Batho, ETAR). The dose comparisons were described in terms of 2D isodose distribution, percent depth dose data, effective path length and monitor unit. Also dose distributions were calculated with homogeneous and inhomogeneous correction algorithm, Batho and ETAR, in each patients with different clinical sites. Results : Result indicated that Batho and ETAR method gave rise to percent depth dose deviation $1.5{\sim}2.7\%,\;2.3{\sim}3.5\%$ (6MV, field size $10{\times}10cm^2$) in each status with and without contrast medium. Also show that effective path lengths were more increase in contrast status (23.14 cm) than Non-contrast (22.07 cm) about $4.9\%$ or 10.7 mm (In case Hounsfield Unit 270) and these results were similary showned in each patient with different clinical site that was lung. prostate, liver and brain region. Concliusion : In conclusion we shown that the use of inhomogeneity correction algorithm for dose calculation in status of injected contrast medium can not represent exact dose at GTV region. These results mean that patients will be more irradiated photon beam during radiation therapy.

• Journal of Radiation Protection and Research
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• 제1권1호
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• pp.22-30
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• 1976

The perturbation of dose distribution adjacent to cavities in high energy electron has shown that the percentage of dose increase varies markedly as a function of the build-up layer, the length and thickness of the cavities, and the electron energy. The dose distribution showed that cavities similar in size to those encountered in the head and neck measured by industrial film dosimetry and corrected by ionization chambers. The most increased doses by measuring are resulted in a localized dose of up to 130% of that measured at the depth of maximum dose within a homogeneous tissue equivalent phantom. The measured values and correction factors of dose perturbation due to air cavities showed in diagrams and would be summarized as follows. 1. In $8{\sim}12MeV$ electron beams, the most marked dose is observed when the build-up layer thickness is 0.5cm and cavity volume is $2{\times}2{\times}2cm^3$. 2. The highest dose point is located under cavity when the energy is increased and cavity length is longer. 3. The cavity length at which the maximum percentage dose occurs decreases with increasing energy. 4. The highest percentage cavity doses are obtained when the energy is high, the build-up layer is thin, the thickness of the cavity is large, and the length of the cavity is approximately 1 to 3cm. 5. The doses of upper portion of cavity are less than the standard dose distribution as 5 to 10%. 6. The maximum range of electron beam are extended as much as thickness of cavity. 7. A cavity having a length of 5cm closely approximates a cavity of infinite length.

• 한국방사선학회논문지
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• 제6권6호
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• pp.465-471
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• 2012

본 연구에서는 ALOKA PDM-117(X-ray 측정용 선량계)선량계를 이용하여 구내방사선 촬영기에서 발생하는 방사선에 대하여 거리의 변화에 따른 선량분포를 3차원으로 측정하였다. 구내 방사선촬영에 있어서 XCP 필름 유지기구(XCP-DS FIT)를 사용하여 영상을 얻는 경우 방사선의 선량 분포는 변할 수 있고 이것은 방사선영상과 환자피폭에 영향을 미치게 된다. 따라서 위치에 따른 선량을 표준화하여 XCP 필름 유지기구 사용 유무에 따른 선량과의 관계를 알아볼 필요성이 있다. 본 연구에서는 측정된 3차원 선량분포를 통하여 등각촬영시 얻을 수 있는 최적의 영상과 동일한 선량을 얻기 위한 조사시간과 거리와의 관계 및 선량분포의 모서리 퍼짐 현상에 대한 결과를 정량적으로 측정하였다. 거리가 증가함에 따라 중심 선량은 감소하였지만 조사통 가장자리 부분의 방사선 퍼짐은 증가하는 경향을 보였다. 이것은 XCP 필름 유지기구를 사용하는 경우에 선속 가장자리 부분에서 방사선의 선량이 퍼지는 경향을 보이기 때문이므로 환자의 병소이외의 부분에 대한 피폭에 주의를 기울여야 함을 정량적으로 확인 하였다. 본 연구의 결과는 품질 좋은 치아영상을 얻고, 환자의 피폭선량을 줄이는데 매우 유용하게 사용되어 질 수 있을 것으로 사료된다.