A polystyrene phantom was developed following the guidance of the International Atomic Energy Association (IAEA) for gamma knife (GK) quality assurance. Its performance was assessed by measuring the absorbed dose rate to water and dose distributions. The phantom was made of polystyrene, which has an electron density (1.0156) similar to that of water. The phantom included one outer phantom and four inner phantoms. Two inner phantoms held PTW T31010 and Exradin A16 ion chambers. One inner phantom held a film in the XY plane of the Leksell coordinate system, and another inner phantom held a film in the YZ or ZX planes. The absorbed dose rate to water and beam profiles of the machine-specific reference (msr) field, namely, the 16 mm collimator field of a GK PerfexionTM or IconTM, were measured at seven GK sites. The measured results were compared to those of an IAEA-recommended solid water (SW) phantom. The radius of the polystyrene phantom was determined to be 7.88 cm by converting the electron density of the plastic, considering a water depth of 8 g/cm2. The absorbed dose rates to water measured in both phantoms differed from the treatment planning program by less than 1.1%. Before msr correction, the PTW T31010 dose rates (PTW Freiberg GmbH, New York, NY, USA) in the polystyrene phantom were 0.70 (0.29)% higher on average than those in the SW phantom. The Exradin A16 (Standard Imaging, Middleton, WI, USA) dose rates were 0.76 (0.32)% higher in the polystyrene phantom. After msr correction factors were applied, there were no statistically significant differences in the A16 dose rates measured in the two phantoms; however, the T31010 dose rates were 0.72 (0.29)% higher in the polystyrene phantom. When the full widths at half maximum and penumbras of the msr field were compared, no significant differences between the two phantoms were observed, except for the penumbra in the Y-axis. However, the difference in the penumbra was smaller than variations among different sites. A polystyrene phantom developed for gamma knife dosimetry showed dosimetric performance comparable to that of a commercial SW phantom. In addition to its cost effectiveness, the polystyrene phantom removes air space around the detector. Additional simulations of the msr correction factors of the polystyrene phantom should be performed.
The Journal of Korean Institute of Electromagnetic Engineering and Science
/
v.29
no.6
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pp.407-410
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2018
As the operating frequency of an electromagnetic wave increases, the maximum output and wavelength of the wave decreases, so that the size of the circuit cannot be reduced. As a result, the fabrication of a circuit with high power (of the order of or greater than kW range) and terahertz wave frequency band is limited, due to the problem of circuit size, to the order of ${\mu}m$ to mm. In order to overcome these limitations, we propose a source design technique for 0.1 THz~0.3 GW level with cylindrical shape (diameter ~2.4 cm). Modeling and computational simulations were performed to optimize the design of the high-power electromagnetic sources based on Cherenkov radiation generation technology using the principle of plasma wakefield acceleration with ponderomotive force and artificial dielectrics. An effective design guideline has been proposed to facilitate the fabrication of high-power terahertz wave vacuum devices of large diameter that are less restricted in circuit size through objective verification.
Purpose: This study was designed to evaluate the effectiveness of postoperative radiotherapy for patients with low-grade astrocytomas and to define an optimal radiotherapeutic regimen and prognostic factors. Materials and Methods: A total of 69 patients with low-grade astrocytomas underwent surgery and postoperative radiotherapy immediately following surgery at our institution between October 1989 and September 2006. The median patient age was 36 years. Forty-one patients were 40 years or younger and 28 patients were 41 years or older. Fourteen patients underwent a biopsy alone and the remaining 55 patients underwent a subtotal resection. Thirty-nine patients had a Karnofsky performance status of less than 80% and 30 patients had a Karnofsky performance status greater than 80%. Two patients were treated with whole brain irradiation followed by a coned down boost field to the localized area. The remaining 67 patients were treated with a localized field with an appropriate margin. Most of the patients received a dose of $50\sim55$ Gy and majority of the patients were treated with a dose of 54 Gy. Results: The overall 5-year and 7-year survival rates for all of the 69 patients were 49% and 44%, respectively. Corresponding disease free survival rates were 45% and 40%, respectively. Patients who underwent a subtotal resection showed better survival than patients who underwent a biopsy alone. The overall 5-year survival rates for patients who underwent a subtotal resection and patients who underwent a biopsy alone were 57% and 38%, respectively (p<0.05). Forty-one patients who were 40 years or younger showed a better overall 5-year survival rate as compared with 28 patients who were 41 years or older (56% versus 40%, p<0.05). The overall 5-year survival rates for 30 patients with a Karnofsky performance status greater than 80% and 39 patients with a Karnofsky performance status less than 80% were 51% and 47%, respectively. This finding was not statistically significant. Although one patient was not able to complete the treatment because of neurological deterioration, there were no significant treatment related toxicities. Conclusion: Postoperative radiotherapy following surgery is a safe and effective treatment for patients with low-grade astrocytomas. The extent of surgery and age were noted as significant prognostic factors in this study. However, further effective treatment might be necessary in the future to improve long-term survival rates.
Circular metal electrodes were vacuum-deposited with chromium on the both sides of Teflon-FEP and PET film characteristic of electret and the physical properties of the two polymers were observed during an irradiation by gamma-ray from $\^$60/Co. With the onset of irradiation of output 25.0 cGy/min the induced current increased rapidly for 2 sec, reached a maximum, and subsequently decreased. A steady-state induced current was reached about in 60 second. The dielectric constant and conductivity of Teflon-FEP were changed from 2.15 to 18.0 and from l${\times}$l0$\^$-17/ to 1.57${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/, respectively. For PET the dielectric constant was changed from 3 to 18.3 and the conductivity from 10$\^$-17/ to 1.65${\times}$10$\^$-13/ $\Omega$-$\^$-1/cm$\^$-1/. The increase of the radiation-induced steady state current I$\^$c/, permittivity $\varepsilon$ and conductivity $\sigma$ with output(4.0 cGy/min, 8.5 cGy/min, 15.6 cGy/min, 19.3 cGy/min) was observed. A series of independent measurements were also performed to evaluate reproducibility and revealed less than 1% deviation in a day and 3% deviation in a long term. Charge and current showed the dependence on the interval between measurements, the smaller the interval was, the bigger the difference between initial reading and next reading was. At least in 20 minutes of next reading reached an initial value. It may indicate that the polymers were exhibiting an electret state for a while. These results can be explained by the internal polarization associated with the production of electron-hole pairs by secondary electrons, the change of conductivity and the equilibrium due to recombination etc. Heating to the sample made the reading value increase in a short time, it may be interpreted that the internal polarization was released due to heating and it contributed the number of charge carriers to increase when the samples was again irradiated. The linearity and reproducibility of the samples with the applied voltage and absorbed dose and a large amount of charge measured per unit volume compared with the other chambers give the feasibility of a radiation detector and make it possible to reduce the volume of a detector.
Background: CT based brachytherapy allows 3-dimensional (3D) assessment of organs at risk (OAR) doses with dose volume histograms (DVHs). The purpose of this study was to compare computed tomography (CT) based volumetric calculations and International Commission on Radiation Units and Measurements (ICRU) reference-point estimates of radiation doses to the bladder and rectum in patients with carcinoma of the cervix treated with high-dose-rate (HDR) intracavitary brachytherapy (ICBT). Materials and Methods: Between March 2011 and May 2012, 20 patients were treated with 55 fractions of brachytherapy using tandem and ovoids and underwent post-implant CT scans. The external beam radiotherapy (EBRT) dose was 48.6Gy in 27 fractions. HDR brachytherapy was delivered to a dose of 21 Gy in three fractions. The ICRU bladder and rectum point doses along with 4 additional rectal points were recorded. The maximum dose ($D_{Max}$) to rectum was the highest recorded dose at one of these five points. Using the HDRplus 2.6 brachyhtherapy treatment planning system, the bladder and rectum were retrospectively contoured on the 55 CT datasets. The DVHs for rectum and bladder were calculated and the minimum doses to the highest irradiated 2cc area of rectum and bladder were recorded ($D_{2cc}$) for all individual fractions. The mean $D_{2cc}$ of rectum was compared to the means of ICRU rectal point and rectal $D_{Max}$ using the Student's t-test. The mean $D_{2cc}$ of bladder was compared with the mean ICRU bladder point using the same statistical test. The total dose, combining EBRT and HDR brachytherapy, were biologically normalized to the conventional 2 Gy/fraction using the linear-quadratic model. (${\alpha}/{\beta}$ value of 10 Gy for target, 3 Gy for organs at risk). Results: The total prescribed dose was $77.5Gy{\alpha}/{\beta}10$. The mean dose to the rectum was $4.58{\pm}1.22Gy$ for $D_{2cc}$, $3.76{\pm}0.65Gy$ at $D_{ICRU}$ and $4.75{\pm}1.01Gy$ at $D_{Max}$. The mean rectal $D_{2cc}$ dose differed significantly from the mean dose calculated at the ICRU reference point (p<0.005); the mean difference was 0.82 Gy (0.48-1.19Gy). The mean EQD2 was $68.52{\pm}7.24Gy_{{\alpha}/{\beta}3}$ for $D_{2cc}$, $61.71{\pm}2.77Gy_{{\alpha}/{\beta}3}$ at $D_{ICRU}$ and $69.24{\pm}6.02Gy_{{\alpha}/{\beta}3}$ at $D_{Max}$. The mean ratio of $D_{2cc}$ rectum to $D_{ICRU}$ rectum was 1.25 and the mean ratio of $D_{2cc}$ rectum to $D_{Max}$ rectum was 0.98 for all individual fractions. The mean dose to the bladder was $6.00{\pm}1.90Gy$ for $D_{2cc}$ and $5.10{\pm}2.03Gy$ at $D_{ICRU}$. However, the mean $D_{2cc}$ dose did not differ significantly from the mean dose calculated at the ICRU reference point (p=0.307); the mean difference was 0.90 Gy (0.49-1.25Gy). The mean EQD2 was $81.85{\pm}13.03Gy_{{\alpha}/{\beta}3}$ for $D_{2cc}$ and $74.11{\pm}19.39Gy_{{\alpha}/{\beta}3}$ at $D_{ICRU}$. The mean ratio of $D_{2cc}$ bladder to $D_{ICRU}$ bladder was 1.24. In the majority of applications, the maximum dose point was not the ICRU point. On average, the rectum received 77% and bladder received 92% of the prescribed dose. Conclusions: OARs doses assessed by DVH criteria were higher than ICRU point doses. Our data suggest that the estimated dose to the ICRU bladder point may be a reasonable surrogate for the $D_{2cc}$ and rectal $D_{Max}$ for $D_{2cc}$. However, the dose to the ICRU rectal point does not appear to be a reasonable surrogate for the $D_{2cc}$.
Purpose : To evaluate the effectiveness and tolerance of postoperative e지ernai beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Materials and Methods : Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58$\%$), mixed oligodendrogliomas-19 patients (27$\%$), oiigodendrogliomas-11 patients (15$\%$). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. Ail of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000 $\~$ 5500 cGy. Results : The overall 5 and 7 year survival rates for entire group of 72 patients were 61$\~$ and 50$\~$. Corresponding disease free survival rates for entire patients were 53$\~$ and 45$\~$, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogiiomas, and oligodendrogiiorras were 48$\%$ and 45$\%$, 76$\%$ and 56$\%$, and 80$\%$ and 52$\%$, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for sub total resection patients and biopsy alone patients were 57$\%$ and 43$\%$, respectively. Forty six patients who were 40 years or younger survived batter than 26 patients who were 41 years or older (overall survival rate at 5 years, 69$\%$ vs 45$\%$). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Conclusion : Postoperative radiotherapy was safe and effective treatment for patients with low grade gliomas. However, we probably need prospective randomized trial to define optimal treatment timing and schedule for low grade gliomas and select patient group for different treatment philosophies.
Intensity-modulated radiotherapy(IMRT) has disadvantages such as increasing the low doses of irradiation to normal tissues and accumulated dose for the whole volume by leakage and transmission of the Multi Leaf Collimator (MLC). The accumulated dose and low dose may increase the occurrence of secondary malignant neoplasms. For this reasons, the jaw tracking function of the TrueBeam (Varian Medical Systems, Palo Alto, CA) was developed to reduce the leakage and transmission dose of the MLC with existing linear accelerators. But quantitative analysis of the dose reduction has not been verified. Therefore, in the present study, we intended to verify the clinical possibility of utilizing the jaw tracking function in brain tumor with comparison of treatment plans. To accomplish this, 3 types of original treatment plans were made using Eclipse11 (Varian Medical Systems, Palo Alto, CA): 1) beyond 2 cm distance from the Organs At Risk (OARs); 2) within 2 cm distance from the OARs; and 3) intersecting with the OARs. Jaw tracking treatment plans were also made with copies of the original treatment planning using Smart LMC Version 11.0.31 (Varian Medical Systems, Palo Alto, CA). A comparison between the 2 types of treatment planning methods was performed using the difference of the mean dose and maximum dose to the OARs in cumulative Dose Volume Histogram (DVH). In the DVH comparison, the maximum difference of 0.5 % was observed between the planning methods in the case of over 2 cm distance, and the maximum of 0.6 % was obtained for within the 2 cm distance. For the case intersecting with the OAR, the maximum difference of 2 % was achieved. According to these results, it could be realized that the differences of mean dose and maximum dose to the OARs was larger when the OARs and PTV were closer. Therefore, treatment plans with the jaw tracking function consistently affected the dose reduction and the clinical possibility could be verified.
Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.
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.
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.
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