• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7785-7788
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• 2015

Utilization of high energy photons (>10MV) with an optimal weight using a mixed energy technique is a practical way to generate a homogenous dose distribution while maintaining adequate target coverage in intact breast radiotherapy. This study represents a model for estimation of this optimal weight for day to day clinical usage. For this purpose, treatment planning computed tomography scans of thirty-three consecutive early stage breast cancer patients following breast conservation surgery were analyzed. After delineation of the breast clinical target volume (CTV) and placing opposed wedge paired isocenteric tangential portals, dosimeteric calculations were conducted and dose volume histograms (DVHs) were generated, first with pure 6MV photons and then these calculations were repeated ten times with incorporating 18MV photons (ten percent increase in weight per step) in each individual patient. For each calculation two indexes including maximum dose in the breast CTV ($D_{max}$) and the volume of CTV which covered with 95% Isodose line ($V_{CTV,95%IDL}$) were measured according to the DVH data and then normalized values were plotted in a graph. The optimal weight of 18MV photons was defined as the intersection point of $D_{max}$ and $V_{CTV,95%IDL}$ graphs. For creating a model to predict this optimal weight multiple linear regression analysis was used based on some of the breast and tangential field parameters. The best fitting model for prediction of 18MV photons optimal weight in breast radiotherapy using mixed energy technique, incorporated chest wall separation plus central lung distance (Adjusted R2=0.776). In conclusion, this study represents a model for the estimation of optimal beam weighting in breast radiotherapy using mixed photon energy technique for routine day to day clinical usage.

• Radiation Oncology Journal
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• v.6 no.1
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• pp.85-91
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• 1988

For the physical characterization of neutron beam, dosimetric measurements had been performed to obtain physical data of KCCH cyclotron-produced neutrons for clinical use. The results are presented and compared with the data of other institutions from the literatures. The central axis percent depth dose, build-up curves and open and wedge isodose curve values are intermediate between that of a 4 and 6 MV X-rays. The build-up level of maximum dose was at 1.35cm and entrance dose was approximately $40\%$. Flatness of the beam was $9\%$ at Dmax and less $than{\pm}3\%$ at the depth of $80\%$ isodose line. Penumbra begond the $20\%$ line is wider than corresponding photon beam. The output factors ranged 0.894 for $6\times6cm$ field to 1.187 for $30\times30cm$ field. Gamma contamination of neutron beam was $4.9\%$ at 2 cm depth in $10\times10cm$ field.

• Progress in Medical Physics
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• v.15 no.4
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• pp.186-191
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• 2004

The periodic Quality Assurance (QA) of each radiation treatment related equipments is important one, but quality assurance of the radiation treatment planning system (RTPS) is still not sufficient rather than other related equipments in clinics. Therefore, this study will present and test the periodic QA program to compare, evaluation the efficiency of the treatment planning systems. This QA program is divided to terms for the input, output devices and dosimetric data and categorized to the weekly, monthly, yearly and non-periodically with respect to the job time, frequency of error, priority of importance. CT images of the water equivalent solid phantom with a heterogeneity condition are input into the RTPS to proceed the test. The actual measurement data are obtained by using the ion chamber for the 6 MV, 10 MV photon beam, then compared a calculation data with a measurement data to evaluate the accuracy of the RTPS. Most of results for the accuracy of geometry and beam data are agreed within the error criteria which is recommended from the various advanced country and related societies. This result can be applied to the periodic QA program to improve the treatment outcome as a proper model in Korea and used to evaluate the accuracy of the RTPS.

• Progress in Medical Physics
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• v.12 no.1
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• pp.71-77
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• 2001

The region, near the edge of a radiation beam, where the dose changes rapidly according to the distance from the beam axis is known as the penumbra. There is a sharp dose gradient zone even in megavoltage photon beams due to source size, collimator, lead alloy block, other accessories, and internal scatter ray. We investigate dosimetric characteristics on penumbra regions of a standard collimator and compare to those of theoritical model for the optimal use of the system in radiotherapy. Peripheral dose distribution of 6 W Photon beams represents penumbral forming function as the depth. Also we have discussed that the peripheral dose distribution of clinical photon beams, differences between calculation dose use of emperical penumbral forming function and measurements in penumbral region. Predictions by emperical penumbral forming functions are compared with measurements in 3-dimensional water phantom and it is shown that the method is capable of reproduceing the measured peripheral dose values usually to within the statistical uncertainties of the data. The semiconductor detector and ion chamber were positioned at a dmax depth, 5cm depth, 10cm depth, and its specific ratio was determined using a scanning data. The effective penumbra, the distance from 80% to 20% isodose lines were analyzed as a function of the distance. The extent of penumbra will also expand with depth increase. Difference of measurement value and model functions value according to character of the detector show small error in dose distribution of the peripheral dose.

• Progress in Medical Physics
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• v.1 no.1
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• pp.31-42
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• 1990

The finding of long lived free radicals produced by ionizing radiation in organic crystals and the quantification of this effect by electron spin resonance(ESR) spactroscopy has proven excellent dosimetric applicability. The tissue equivalent alanine dosimeter also appear appropriate for radiation therapy level dosimetry. The dose measurement was performed in a Rando phantom using high energy photons as produced by high energy medical linear accelerator and cobalt-60 teletherapy unit. The absorbed dose range of the ESR/alanine dosimetry system could be extended down to 0.1 Gy. The response of the alanine dosimeters was determined for photons at different therapeutic dose levels from less than 0.1 Gy to 100 Gy and the depth dose measurements were carried out for photon energies of 1.25MeV, 6 and 10 MV with alanine dosimeters in Rando phantom. Comparisons between ESR/alanine in a Rando phantom and ion chamber in a water phantom were made performing depth dose measurements to examine the agreement of both methods under field conditions.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5019-5024
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• 2015

Background: The purpose of this study was to assess the dosimetric and clinical feasibility of volumetric modulated arc based hypofractionated stereotactic radiotherapy (RapidArc) treatment for large acoustic schwannoma (AS >10cc). Materials and Methods: Ten AS patients were immobilized using BrainLab mask. They were subject to multimodality imaging (magnetic resonance and computed tomography) to contour target and organs at risk (brainstem and cochlea). Volumetric modulated arc therapy (VMAT) based stereotactic plans were optimized in Eclipse (V11) treatment planning system (TPS) using progressive resolution optimizer-III and final dose calculations were performed using analytical anisotropic algorithm with 1.5 mm grid resolution. All AS presented in this study were treated with VMAT based HSRT to a total dose of 25Gy in 5 fractions (5fractions/week). VMAT plan contains 2-4 non-coplanar arcs. Treatment planning was performed to achieve at least 99% of PTV volume (D99) receives 100% of prescription dose (25Gy), while dose to OAR's were kept below the tolerance limits. Dose-volume histograms (DVH) were analyzed to assess plan quality. Treatments were delivered using upgraded 6 MV un-flattened photon beam (FFF) from Clinac-iX machine. Extensive pretreatment quality assurance measurements were carried out to report on quality of delivery. Point dosimetry was performed using three different detectors, which includes CC13 ion-chamber, Exradin A14 ion-chamber and Exradin W1 plastic scintillator detector (PSD) which have measuring volume of $0.13cm^3$, $0.009cm^3$ and $0.002cm^3$ respectively. Results: Average PTV volume of AS was 11.3cc (${\pm}4.8$), and located in eloquent areas. VMAT plans provided complete PTV coverage with average conformity index of 1.06 (${\pm}0.05$). OAR's dose were kept below tolerance limit recommend by American Association of Physicist in Medicine task group-101(brainstem $V_{0.5cc}$ < 23Gy, cochlea maximum < 25Gy and Optic pathway <25Gy). PSD resulted in superior dosimetric accuracy compared with other two detectors (p=0.021 for PSD.

• Journal of Biomedical Engineering Research
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• v.25 no.2
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• pp.89-95
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• 2004

Intensity-modulated radiation therapy (IMRT) often uses small beam segments. The heterogeneity effect is well known for relatively large field sizes used in the conventional radiation treatments. However, this effect is not known in small fields such as the beamlets used in IMRT. There are many factors that can cause errors in the small field i.e. electronic disequilibrium and multiple electron scattering. This study prepared geometrically regular heterogeneous phantoms, and compared the measurements with the calculations using the Convolution/Superposition algorithm and Monte Carlo method for small beams. This study used the BEAM00/EGS4 code to simulate the head of a Varian 2300C/D. The commissioning of a 6MV photon beam were performed from two points of view, the beam profiles and depth doses. The calculated voxel size was 1${\times}$1${\times}$2$\textrm{cm}^2$ with field sizes of 1${\times}$1$\textrm{cm}^2$, 2${\times}$2$\textrm{cm}^2$, and 5${\times}$5$\textrm{cm}^2$. The XiOTM TPS (Treatment Planning System) was used for the calculation using the Convolution/Superposition algorithm. The 6MV photon beam was irradiated to homogeneous (water equivalent) and heterogeneous phantoms (water equivalent ＋ air cavity, water equivalent ＋ bone equivalent). The beam profiles were well matched within :t1 mm and the depth doses were within ${\pm}$2%. In conclusion, the dose calculations of the Convolution/Superposition and Monte Carlo simulations showed good agreement with the film measurements in the small field.

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.41-54
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• 1996

The secondary electrons developed by interaction between primary beam and a tray mounted for blocks in Megavoltage irradiation result in excess soft radiation dose to the surface layer. To reduce this electron contamination, electron filters have been used to be attached under a tray. Various filters with Cu and Al plates in six different thickness and Cu/Al combined plates in 3 different thickness were tested to measure the reduction rate of secondary electron contamination to the surface layer. The measurement to find optimal filter was performed on 6MV linear accelerator in $10 cm{\times}10 cm$ field size and fixed 78.5cm source to measurement points distance from surface to maximum build up point in 2mm intervals. The result was analyzed as the ratio of measured doses with using filters, to standard doses of measured open beam. The result of this study was fellowing : 1. The contaminated low energy radiation were mainly produced by blocking tray. 2. The surface absorbed dose was slowly increased by increasing irradiation field size but rapidly increased at field size above $15cm{\times}15cm$. 3. Al plate upto 2.5mm thickness used as a filter was found to be inadequate due to the failure of reduction of the surface absorbed dose below doses of the under surface upto the maximal build up. Cu 0.5mm plate and Cu 0.28mm/A1 1.5mm compound plate were found to be optimal filters. 4. By using these 2 filters, the absorbed dose to the surface were effectively reduced $5.5\%$ in field size $4cm{\times}4cm,\;11.3\%$ in field size $10cm{\times}10cm,\;22.3\%$ in field size $25cm{\times}25cm$. 5. In field size $10cm{\times}10cm$, the absorbed dose to the surface of irradiation was reduced by setting TSD 20cm at least,. but effective and enough dose reduction could be achieved by setting TSD 30cm as 2 optimal filters used. 6. More surface dose absorbed at TSD less than 7.4cm with a tray and filters together indicated that soft radiation was also developed by filters. 7. The variation of PDD by the different size of irradiation field was minimal as 2 optimal filters used. There was also not different in variation of PDD according to using any of two different filters. 8. PDD was not effected either by various TSD or by using the different filter among two.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.95-100
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• 1995

Purpose : To evaluate the effect on surface dose due to Aquaplast used for immobilizing the patients with head and neck cancers in photon beam radiotherapy Materials and Methods: To assess surface and buildup region dose for 6MV X-ray from linear accelerator(Siemens Mevatron 6740), we measured percent ionization value with the Markus chamber model 30-329 manufactured by PTW Frieburg and Capintec electrometer, model WK92. For measurement of surface ionization value, the chamber was embedded in $25{\times}25{\times}3cm^3$ acrylic phantom and set on $25{\times}25{\times}5cm^3$ polystyrene phantom to allow adequate scattering. The measurements of percent depth ionization were made by placing the polystyrene layers of appropriate thickness over the chamber. The measurements were taken at 100cm SSD for $5{\times}5cm^2$, $10{\times}10cm^2$ and $15{\times}15cm^2$ field sizes, respectively. Placing the layer of Aquaplast over the chamber, the same procedures were repeated. We evaluated two types of Aquaplast: 1.6mm layer of original Aquaplast(manufactured by WFR Aquaplast Corp.) and transformed Aquaplast similar to moulded one for immobilizing the patients practically. We also measured surface ionization values with blocking tray in presence or absence of transformed Aquaplast. In calculating percent depth dose, we used the formula suggested by Gerbi and Khan to correct overresponse of the Markus chamber. Results : The surface doses for open fields of $5{\times}5cm^2$, $10{\times}10cm^2$, and $15{\times}15cm^2$ were $79\%$, $13.6\%$, and $18.7\%$, respectively. The original Aquaplast increased the surface doses upto $38.4\%$, $43.6\%$, and $47.4\%$, respectively. For transformed Aquaplast, they were $31.2\%$, $36.1\%$, and $40.5\%$, respectively. There were little differences in percent depth dose values beyond the depth of Dmax. Increasing field size, the blocking tray caused increase of the surface dose by $0.2\%$, $1.7\%$, $3.0\%$ without Aquaplast, $0.2\%$, $1.9\%$, $3.7\%$ with transformed Aquaplast, respectively. Conclusion: The original and transformed Aquaplast increased the surface dose moderately. The percent depth doses beyond Dmax, however, were not affected by Aquaplast. In conclusion, although the use of Aquaplast in practice may cause some increase of skin and buildup region dose, reductioin of skin-sparing effect will not be so significant clinically.

• Journal of radiological science and technology
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• v.30 no.2
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• pp.139-145
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• 2007

Dose evaluation for small field such as stereotactic radiosurgery was performed using $Gafchromic^{(R)}$ EBT film. Every film which irradiated 6MV photon beam was scanned and obtained the optical density(OD) by flat bed scanner after 24 hours of irradiation. This study compared dose from diode in water and Gafchromic $EBT^{(R)}$ film in acrylic phantom to verify the reliability of the film, and to evaluate the SRS in clinical dose distributions from calculation and measurement in the region of virtual target in humanoid and cylindrical phantoms were compared. The Gafchromic $EBT^{(R)}$ film was found to be linear up to 9Gy. The $D_{max}$ for 6 MV was measured at 1.5 cm from the surface by both of diode and the film. As the depth is deeper, the error was measured within $2{\sim}3%$ at $10{\sim}20\;cm$ depth. Comparing between distribution from calculation and measurement, we found that there is 5% error at 90% isodose line. We found that given dose could be measured accurately by using the phantoms. It was feasible to use the Gafchromic $EBT^{(R)}$ film in quality assurance of SRS.