• Journal of Radiation Protection and Research
• /
• v.14 no.1
• /
• pp.24-33
• /
• 1989

The peripheral dose, defined as the dose outside therapeutic photon fields, was estimated for 6MV X-ray linear accelerator. The measurements were performed using silicon diode detectors controlled by automatic controlled water phantom. The effects of field size, collimator position, presence or absence of wedge filter, and wedge angle were analyzed. The results were as follows 1. The peripheral dose decreases as the distance from field margin increases and it is more than 2.4% of central axis maximum dose even at 15cm distance from field margin. 2. Maximum build-up of peripheral dose is at 2-3 mm from the water surface and drops to a minimum at 1.5cm depth and then the dose increase again. 3. The peripheral dose increases as the field size. increases. At the short distance from field margin, the difference of peripheral dose between 5 $\times\;5cm^2$ and 20 $\times\;20cm^2$ field size reaches more than 2 fold. 4. The peripheral dose is higher along the upper collimator than along the lower collimator. The differences is less than 1%. 5. The presence of wedge filter increases peripheral dose. And the peripheral dose is higher along the blade side of wedge filter than along the ridge side. The difference is about 3% at 5cm distance from the field margin for 15 $\times\;15cm^2$ field size and 60$^{\circ}$ wedge filter. 6. The Peripheral dose of wedge filter increases as the wedge filter angle increases and the increasing ratio is about 2 fold in 60$^{\circ}$wedge filter compared with open field.

• Progress in Medical Physics
• /
• v.3 no.2
• /
• pp.1-12
• /
• 1992

For intraoperative radiation therapy using electron beams, a cone system to deliver a large dose to the tumor during surgical operation and to save the surrounding normal tissue should be developed and dosimetry for the cone system is necessary to find proper X-ray collimator setting as well as to get useful data for clinical use. We developed a docking type of a cone system consisting of two parts made of aluminum: holder and cone. The cones which range from 4cm to 9cm with 1cm step at 100cm SSD of photon beam are 28cm long circular tubular cylinders. The system has two 26cm long holders: one for the cones larger than or equal to 7cm diamter and another for the smaller ones than 7cm. On the side of the holder is an aperture for insertion of a lamp and mirror to observe treatment field. Depth dose curve. dose profile and output factor at dept of dose maximum. and dose distribution in water for each cone size were measured with a p-type silicone detector controlled by a linear scanner for several extra opening of X-ray collimators. For a combination of electron energy and cone size, the opening of the X-ray collimator was caused to the surface dose, depths of dose maximum and 80%, dose profile and output factor. The variation of the output factor was the most remarkable. The output factors of 9MeV electron, as an example, range from 0.637 to 1.549. The opening of X-ray collimators would cause the quantity of scattered electrons coming to the IORT cone system. which in turn would change the dose distribution as well as the output factor. Dosimetry for an IORT cone system is inevitable to minimize uncertainty in the clinical use.

• Journal of Radiation Protection and Research
• /
• v.23 no.3
• /
• pp.139-147
• /
• 1998

Purpose: Tissue inhomogeneity such as lung affects tumor dose as well as transmission dose in new concept of on-line dosimetry which estimates tumor dose from transmission dose using the new algorithm. This study was carried out to confirm accuracy of correction by tissue density in tumor dose estimation utilizing transmission dose. Methods: Cork phantom (CP, density $0.202\;gm/cm^3$) having similar density with lung parenchyme and polystyrene phantom (PP, density $1.040\;gm/cm^3$) having similar density with soft tissue were used. Dose measurement was carried out under condition simulating human chest. On simulating AP-PA irradiation, PPs with 3 cm thickness were placed above and below CP, which had thickness of 5, 10, and 20 cm. On simulating lateral irradiation, 6 cm thickness of PP was placed between two 10 cm thickness CPs additional 3 cm thick PP was placed to both lateral sides. 4, 6, and 10 MV x-ray were used. Field size was in the range of $3{\times}3$ cm through $20{\times}20$ cm, and phantom-chamber distance (PCD) was 10 to 50 cm. Above result was compared with another sets of data with equivalent thickness of PP which was corrected by density. Result: When transmission dose of PP was compared with equivalent thickness of CP which was corrected with density, the average error was 0.18 (${\pm}0.27$) % for 4 MV, 0.10 (${\pm}0.43$) % for 6 MV, and 0.33 (${\pm}0.30$) % for 10 MV with CP having thickness of 5 cm. When CP was 10 cm thick, the error was 0.23 (${\pm}0.73$) %, 0.05 (${\pm}0.57$) %, and 0.04 (${\pm}0.40$) %, while for 20 cm, error was 0.55 (${\pm}0.36$) %, 0.34 (${\pm}0.27$) %, and 0.34 (${\pm}0.18$) % for corresponding energy. With lateral irradiation model, difference was 1.15 (${\pm}1.86$) %, 0.90 (${\pm}1.43$) %, and 0.86 (${\pm}1.01$) % for corresponding energy. Relatively large difference was found in case of PCD having value of 10 cm. Omitting PCD with 10 cm, the difference was reduced to 0.47 (${\pm}$1.17) %, 0.42 (${\pm}$0.96) %, and 0.55 (${\pm}$0.77) % for corresponding energy. Conclusion When tissue inhomogeneity such as lung is in tract of x-ray beam, tumor dose could be calculated from transmission dose after correction utilizing tissue density.

• Journal of radiological science and technology
• /
• v.33 no.2
• /
• pp.109-120
• /
• 2010

The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.

• Progress in Medical Physics
• /
• v.25 no.3
• /
• pp.151-156
• /
• 2014

The purpose of this study was to confirm the feasibility of imaging of therapy region from the boron neutron capture therapy (BNCT) using the measurement of the prompt gamma ray depending on the neutron flux. Through the Monte Carlo simulation, we performed the verification of physical phenomena from the BNCT; (1) the effects of neutron according to the existence of boron uptake region (BUR), (2) the internal and external measurement of prompt gamma ray dose, (3) the energy spectrum by the prompt gamma ray. All simulation results were deducted using the Monte Carlo n-particle extended (MCNPX, Ver.2.6.0, Los Alamos National Laboratory, Los Alamos, NM, USA) simulation tool. The virtual water phantom, thermal neutron source, and BURs were simulated using the MCNPX. The energy of the thermal neutron source was defined as below 1 eV with 2,000,000 n/sec flux. The prompt gamma ray was measured with the direction of beam path in the water phantom. The detector material was defined as the lutetium-yttrium oxyorthosilicate (Lu0,6Y1,4Si0,5:Ce; LYSO) scintillator with lead shielding for the collimation. The BUR's height was 5 cm with the 28 frames (bin: 0.18 cm) for the dose calculation. The neutron flux was decreased dramatically at the shallow region of BUR. In addition, the dose of prompt gamma ray was confirmed at the 9 cm depth from water surface, which is the start point of the BUR. In the energy spectrum, the prompt gamma ray peak of the 478 keV was appeared clearly with full width at half maximum (FWHM) of the 41 keV (energy resolution: 8.5%). In conclusion, the therapy region can be monitored by the gamma camera and single photon emission computed tomography (SPECT) using the measurement of the prompt gamma ray during the BNCT.

• Journal of the Korean Society of Radiology
• /
• v.11 no.5
• /
• pp.303-312
• /
• 2017

The central goal of Gamma Knife radiosurgery(GKRS) is to maximize the conformity of the prescription isodose surface, and to minimize the radiation effect of the normal tissue surrounding the target volume. There are the various kinds of indices related with the quality of treatment plans such as conformity index, coverage, selectivity, beam-on time, gradient index(GI), and conformity/gradient index(CGI). As the best treatment plan evaluation tool, we must check by all means conformity index, GI, and CGI among them. Specially, GI and CGI related with complication of healthy normal tissue is more indispensible than conformity index. Then author calculated and statistically analysed CGI, the newly defined conformity/gradient index as well as GI being applied widely using the treatment planning system Leksell GammaPlan(LGP) and the verification method Variable Ellipsoid Modeling Technique(VEMT). In the study 10 patients with intracranial lesion treated by GKRS were included. Author computed the indices from LGP and VEMT requiring only four parameters: the prescribed isodose volume, the volume with dose > 30%, the target volume, and the volume of half the prescription isodose. All data were analyzed by paired t-test, which is statistical method used to compare two different measurement techniques. No statistical significance in GI at 10 cases was observed between LGP and VEMT. Differences in GI ranged from -0.14 to 0.01. The newly defined gradient index calculated by two methods LGP and VEMT was not statistically significant either. Author did not find out the statistical difference for the prescribed isodose volume between LGP and VEMT. CGI as the evaluation index for determining the best treatment plan is not significant statistically also. Differences in CGI ranged from -4 to 3. Similarly newly defined Conformity/Gradient index for GKRS was also estimated as the metric for the evaluation of the treatment plans through statistical analysis. Statistical analyses demonstrated that VEMT was in excellent agreement with LGP when considering GI, new gradient index, CGI, and new CGI for evaluating the best plans of GKRS. Due to the application of the fast and easy evaluation tool through LGP and VEMT author hopes CGI and newly defined CGI as well as gradient indices will be widely used.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.16 no.1
• /
• pp.44-49
• /
• 2012

Purpose: In the whole body PET/CT scan, it is natural to lift the patient's arm for its quality improvement. However, when the lesion is located in head and neck, the arms should be located lower. This study was designed to compare the CT effective dose for each arm position applying Automatic Exposure Control (AEC). Materials and Methods: 45 patients who had $^{18}F$-FDG whole body PET/CT scan were studied with Biograph Truepoint 40 (SIEMENS, GERMANY), Biograph Sensation 16 (SIEMENS, GERMANY), Discovery STe 8 (GE healthcare, USA). The CT effective dose of 15 patients for each equipment was measured and comparatively analyzed in both arm-lifted position and lower-arm position. ImPACT v1.0 program was used as the method of measurement for CT effective dose. For the statistics analysis, Paired t-test which paired with SPSS 18.0 statistic program was applied. Results: In the case of arm-lifted, it was measured as $6.33{\pm}0.93mSv$ for Biograph Sensation 16, $8.01{\pm}1.34mSv$ for Biograph Truepoint 40, and $9.69{\pm}2.32mSv$ for Discovery STe 8. When arms are located lower position, it was measure as $6.97{\pm}0.76mSv$, $8.95{\pm}1.85mSv$, $13.07{\pm}2.87mSv$ for each. CT effective dose according to the arm position was 9.2% for Biograph Truepoint 40, 10.5% for Biograph Sensation 16, and 25.9% for Discovery Ste 8. The statistics analysis showed the meaningful difference ($p$<0.05). Conclusion: For the whole body PET/CT case, CT effective dose applying AEC was decreased the radiation exposure of the patients when the arm was lifted for 15.2% of average value. The patient who has no lesion in head and neck would decrease the artifact occurrence in objective part and lower the CT effective dose. Also, for the patient who had lesion in head and neck, the artifact in objective part can be lower by putting the arms down, the fact that CT effective dose increases should be concerned in its whole body PET/CT scan.

• Journal of the Korean Society of Radiology
• /
• v.7 no.3
• /
• pp.213-219
• /
• 2013

Currently, about 35 cyclotrons have been operating in South Korea. Most of them are mainly used for the synthesis of radiopharmaceuticals such as $^{18}FDG$, which is a cancer tracer for nuclear medicine. Highly enriched $H_2{^{18}}O$ containing up to 98% of $^{18}O/O$ isotope ratio is used as the target for $^{18}F$ production. The price of the highly enriched $H_2{^{18}}O$ ranges 60~70 USD/g, and all of them have been imported from foreign country in spite of the very expensive price. The target (enriched $H_2{^{18}}O$) is non-radioactive before the proton beam irradiation. But, the post-irradiation target (used $H_2{^{18}}O$) must be managed following the National Radiation Safety Regulations, because it turns into radioactive by the radioactivation of the impurities within the target. Recently, nevertheless of the fast increasing amount of used $H_2{^{18}}O$ in accordance with the increasing number of nuclear medicine cases, any activation analysis on the used $H_2{^{18}}O$ have been conducted yet in Korea. In this research, activation analysis have been conducted to confirm the specific radioactivity(Bq/g) of each radioisotopes within the used $H_2{^{18}}O$. The analysis have been done on the 3 of 20g samples collected from the used $H_2{^{18}}O$ storages at different cyclotron centers. Based on the results, it was confirmed that the "used $H_2{^{18}}O$" contains gamma emitters such as $^{56}Co$, $^{57}Co$, $^{58}Co$, and $^{54}Mn$ as well as the considerable amount of beta emitter $^3H$. It was also confirmed that the only one sample contained over exemption level of gamma emitters while the specific activity of tritium was lower than the exemption level in all samples. The specific activity of radioisotopes were measured different levels in the samples depending on the elapsed time after irradiation. Further study on the activation of the "used $H_2{^{18}}O$" is definitely necessary, nevertheless the as-is results of this research must be useful in establishing a rational "used $H_2{^{18}}O$" management protocol.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.1
• /
• pp.77-89
• /
• 1999

Background: High-dose chemotherapy is increasingly employed in many refractory malignant diseases. This therapy has been reported to increase response rate and survival benefits but it is also associated with higher treatment-related morbidity and mortality. We evaluated clinical characteristics and course of the pulmonary toxicity following high-dose chemotherapy with peripheral blood stem cell transplantation. Methods: Ninety-seven patients who had received high-dose chemotherapy with peripheral blood stem cell transplantation were evaluated. Five patients who developed lung lesions which were not related to infection nor primary malignant disease underwent transbronchial lung biopsy. The patients' clinical characteristics, treatments, and prognosis were reviewed retrospectively. Results: Five patients(5.1%) developed idiopathic pneumonia syndrome. The high dose chemotherapy regimens employed were cyclophosphamide, BCNU, and cisplatin in 3 cases, one case of BCNU, etoposide, Ara-C, and cyclophosphamide combination, and a regimen consisting of BCNU, etoposide, Ara-C, and melphalan. The total dose of BCNU used was 300-400 mg/$m^2$ and that of cyclophosphsmide was 6,000 mg/$m^2$. All of 5 patients received radiation therapy before this treatment. After an average duration of 14 weeks (4-26 weeks) of high-dose chemotherapy, patients developed cough, dyspnea and fever. The chest X-rays showed bilateral diffuse infiltration in 3 cases and the focal infiltration in the other 2 cases. All the patients received corticosteroid therapy as a treatment for the lung lesions. Two of them progressed to acute respiratory distress syndrome and died. Three patients recovered without residual lung lesion but one of them died of dilated cardiomyopathy. Conclusion: High-dose chemotherapy with peripheral blood stem cell transplantation especially which containing BCNU regimen may develop idiopathic pneumonia syndrome related to pulmonary toxicity and corticosteroid therapy may be bel1eficial in some cases.

• Clinical and Experimental Pediatrics
• /
• v.52 no.6
• /
• pp.674-679
• /
• 2009

Purpose : The authors aimed to analyze the long-term effects of treatments, especially external beam radiotherapy (EBRT), in bilateral retinoblastoma patients. Methods : This retrospective study analyzed the medical records of 22 bilateral retinoblastoma patients who were registered between October, 1987 and October, 1998 and followed-up for more than 10 years. They were treated by enucleation, EBRT, and systemic chemotherapy. Age at diagnosis, sex, delay prior to treatment, Reese-Ellsworth (RE) classification, and the local treatment modalities were analyzed in relation to recurrence-free survival (RFS) and complications. Results : Median age at diagnosis was 7.0 months (range 1.7-31.6 months). Leukocoria was the most common presenting feature. Two patients had a familial history. The RE classifications of the 44 eyes were group II in 4, III in 14, IV in 4, and V in 22. At the end of a median follow-up period of 141 months (range 55-218 months), 20 patients were alive. The 10-year ocular survival rate of the 44 eyes was $56.8{\pm}7.5%$. The 10-year RFS and ocular survival rate of the 29 eyes treated by combined EBRT and chemotherapy were 75.9% and 86.2%, respectively. Treatment delay (>3 months) was found to be related to higher risk of recurrence. Complications after EBRT were cataract, retinal detachment, phthisis bulbi, and facial asymmetry. No patient developed a second malignancy during the follow-up period. Conclusion : Early detection and prompt treatment can increase ocular survival rates. In addition, careful attention should be paid to possible long-term sequelae in these patients.