• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.59-67
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• 2014

Purpose : This study aims to evaluate 3D dosimetric impact for MIP image and each phase image in stereotactic body radiotherapy (SBRT) for lung cancer using volumetric modulated arc therapy (VMAT). Materials and Methods : For each of 5 patients with non-small-cell pulmonary tumors, a respiration-correlated four-dimensional computed tomography (4DCT) study was performed. We obtain ten 3D CT images corresponding to phases of a breathing cycle. Treatment plans were generated using MIP CT image and each phases 3D CT. We performed the dose verification of the TPS with use of the Ion chamber and COMPASS. The dose distribution that were 3D reconstructed using MIP CT image compared with dose distribution on the corresponding phase of the 4D CT data. Results : Gamma evaluation was performed to evaluate the accuracy of dose delivery for MIP CT data and 4D CT data of 5 patients. The average percentage of points passing the gamma criteria of 2 mm/2% about 99%. The average Homogeneity Index difference between MIP and each 3D data of patient dose was 0.03~0.04. The average difference between PTV maximum dose was 3.30 cGy, The average different Spinal Coad dose was 3.30 cGy, The average of difference with $V_{20}$, $V_{10}$, $V_5$ of Lung was -0.04%~2.32%. The average Homogeneity Index difference between MIP and each phase 3d data of all patient was -0.03~0.03. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : There is no tendency of dose difference between MIP with 3D CT data of each phase. But there are appreciable difference for specific phase. It is need to study about patient group which has similar tumor location and breathing motion. Then we compare with dose distribution for each phase 3D image data or MIP image data. we will determine appropriate image data for treatment plan.

• Journal of the Korea Safety Management & Science
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• v.17 no.3
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• pp.215-219
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• 2015

The purpose in this study is to investigate CT number difference between conventional CT and CT simulator. It shows good correlation in CT number on the muscle, bone, and air. However, in the liver, lungs and water, the low correlation was detected. This result can become the good index for the direction of the distribution of dose difference research between CT equipment for using the computerized radiation therapy planning system.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1031-1041
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• 2018

Objective: To compare image quality and radiation dose of high-pitch dual-source spiral cardiothoracic computed tomography (CT) between non-electrocardiography (ECG)-synchronized and prospectively ECG-triggered data acquisitions in young children with congenital heart disease. Materials and Methods: Eighty-six children (${\leq}3$ years) with congenital heart disease who underwent high-pitch dual-source spiral cardiothoracic CT were included in this retrospective study. They were divided into two groups (n = 43 for each; group 1 with non-ECG-synchronization and group 2 with prospective ECG triggering). Patient-related parameters, radiation dose, and image quality were compared between the two groups. Results: There were no significant differences in patient-related parameters including age, cross-sectional area, body density, and water-equivalent area between the two groups (p > 0.05). Regarding radiation dose parameters, only volume CT dose index values were significantly different between group 1 ($1.13{\pm}0.09mGy$) and group 2 ($1.07{\pm}0.12mGy$, p < 0.02). Among image quality parameters, significantly higher image noise ($3.8{\pm}0.7$ Hounsfield units [HU] vs. $3.3{\pm}0.6HU$, p < 0.001), significantly lower signal-to-noise ratio ($105.0{\pm}28.9$ vs. $134.1{\pm}44.4$, p = 0.001) and contrast-to-noise ratio ($84.5{\pm}27.2$ vs. $110.1{\pm}43.2$, p = 0.002), and significantly less diaphragm motion artifacts ($3.8{\pm}0.5$ vs. $3.7{\pm}0.4$, p < 0.04) were found in group 1 compared with group 2. Image quality grades of cardiac structures, coronary arteries, ascending aorta, pulmonary trunk, lung markings, and chest wall showed no significant difference between groups (p > 0.05). Conclusion: In high-pitch dual-source spiral pediatric cardiothoracic CT, additional ECG triggering does not substantially reduce motion artifacts in young children with congenital heart disease.

• Journal of Radiation Protection and Research
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• v.30 no.1
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• pp.9-15
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• 2005

This study was conducted to investigate the patient exposure dose during a CT examination and the present position in utilization of the CT equipments. To this end Questionnaire were sent out to 278 medical facilities registered at Korea Hospital Association and replies of 161 medical facilities were analyzed. The results were as follows ; 1) The distribution of CT examination was. Brain 40.7%, Abdomen 27.8%, Chest 15.7%, Spine 4.8%, Pelvis 4.1%, PNS 3.2%, Facial bone 2.5% and Extremity 1.1% respectively. 2) The statistics for dose index according to each part of examination were Brain 38.0mGy, Abdomen 12.0mGy for adults : Brain 13.6mGy, Abdomen 6.2mGy for infant. Our surveyed dose index appeared lower than the IAEA recommends. 3) Most medical facilities have selected the parameters for radiographic exposure in the range of $100{\sim}120kVp,\;100{\sim}250mA\;and\;1{\sim}2$ seconds.

• Journal of radiological science and technology
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• v.44 no.2
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• pp.101-107
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• 2021

The purpose of this study was to evaluate optimal CT scan parameters to minimize patient dose to the irradiation and maintain satisfactory image quality in low-dose chest computed tomography (CT) scans. In a chest anthropomorphic phantom, chest CT scans were performed at different kVp and mA within reference of 3.4mGy in volume CT Dose Index (CTDI_vol). The following quantitative parameters had been statistically evaluated: image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM). Nine radiographers conducted the blind test to select the optimal kVp-mA combination. Results indicated that the kVp-mA combination of 80kVp-90mA, 100kVp-50mA, 120kVp-30mA and 140kVp-30mA were obtained high SNR and CNR. The 120kVp-30mA combination offered good compromise in the FOM, which showed the quality and dose performance. In the blind test, an image of 80kVp-90mA obtained a high score with 4.7 points, and 120kVp-10mA or 140kVp-10mA with a low tube current were observed severe noise and poor image quality, thus resulting in decreased diagnostic accuracy. On the other hand, in the combination of high kVp and high mA(140kVp-90mA), the image quality was improved, but the radiation dose was also increased. the FOM value of 140kVp-90mA was lower than 120kVp-30mA. The application of appropriate scan parameters in low-dose chest CT scans produced satisfactory results in dose and image quality for the accuracy of the clinical diagnosis.

• Journal of radiological science and technology
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• v.38 no.3
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• pp.245-252
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• 2015

To obtain the best SNR (signal to noise ratio) due to changes in CTDI (computed tomography dose index) made for the purpose of setting the optimum image obtained by reducing the dose in abdominal CT. Abdominal CT scans of 59 patients a $400-499cm^2$ (n = 12), $500-599cm^2$ (n = 21), $600-699cm^2$ (n = 17), $700-799cm^2$ (n = 9) were separated by four groups and the effective dose was used in the Excel to get the area of the patient using the ImageJ program. Patients of CTDI, DLP, SNR, the effective dose were analyzed. Abdominal CT area was increased to 13 mGy in CTDI is 7.3 mGy, DLP to 732 in $394.4mGy{\cdot}cm$, also effective dose was 5.9 mSv increase in 11mSv. SNR is 15 dB was maintained at 12.7. CTDI according to the average of the abdominal area of 8.9 mGy, the average of the DLP was $481.54mGy{\cdot}cm$, the effective dose is calculated to be 7.2 mSV. Effective dose was calculated by multiplying the load factor of DLP in the abdomen showed no statistically significant difference of (p < .05), there was a significant difference in SNR (p > . 05). To improve image quality of abdominal CT scan image in consideration of the CTDI according to the volume of the patient it should be able to reduce the radiation exposure of the patients.

• Journal of radiological science and technology
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• v.41 no.3
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• pp.209-214
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• 2018

The results of CBCT was obtained using image guided radiation therapy for radiation therapy in 5 prostate cancer patients. Using these results, we compared and evaluated the dose changes according to the treatment plan depending on the volume and position of bladder, rectum, and prostate. The 28 images of CBCT were acquired using On-Board Imaging device before radiotherapy. After the outline of bladder, rectum, and PTV, pCT images and CBCT images for radiotherapy were treated respectively. The volume of the bladder was increased by 105.6% and decreased by 45.2%. The volume of the rectum was increased by 30.5% and decreased by 20.3%. Prostate volume was increased by 6.3% and decreased by 12.3%. The mean dose of the rectum was higher in the CBCT than in the pCT, and V40 (equivalent to 40 Gy) of the bladder showed a reduction in all treatment regimens in the CBCT than in the pCT. Conformity treatment and homogeneity index of PTV showed better results in all treatment regimens using pCT than CBCT. It was found that the dose distribution of the pelvic internal organs varied greatly according to the patient 's condition and pretreatment.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.25-28
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• 2012

Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.131-143
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• 2015

Purpose : By comparing a CT fusion plan based on MRI with a plan based on only MRI without CT, we intended to study usefulness of a plan based on only MRI. And furthermore, we intended to realize a realtime MR-IGRT by MRI image without CT scan during the course of simulation, treatment planning, and radiation treatment. Materials and Methods : BBB CT (Brilliance Big Bore CT, 16slice, Philips), Viewray MRIdian system (Viewray, USA) were used for CT & MR simulation and Treatment plan of 11 patients (1 Head and Neck, 5 Breast, 1 Lung, 3 Liver, 1 Prostate). When scanning for treatment, Free Breathing was enacted for Head&Neck, Breast, Prostate and Inhalation Breathing Holding for Lung and Liver. Considering the difference of size between CT and Viewray, the patient's position and devices were in the same condition. Using Viewray MRIdian system, two treatment plans were established. The one was CT fusion treatment plan based on MR image. Another was MR treatment plan including electron density that [ICRU 46] recommend for Lung, Air and Bone. For Head&Neck, Breast and Prostate, IMRT was established and for Lung and Liver, Gating treatment plan was established. PTV's Homogeneity Index(HI) and Conformity Index(CI) were use to estimate the treatment plan. And DVH and dose difference of each PTV and OAR were compared to estimate the treatment plan. Results : Between the two treatment plan, each difference of PTV's HI value is 0.089% (Head&Neck), 0.26% (Breast), 0.67% (Lung), 0.2% (Liver), 0.4% (Prostate) and in case of CI, 0.043% (Head&Neck), 0.84% (Breast), 0.68% (Lung), 0.46% (Liver), 0.3% (Prostate). As showed above, it is on Head&Neck that HI and CI's difference value is smallest. Each difference of average dose on PTV is 0.07 Gy (Head&Neck), 0.29 Gy (Breast), 0.18 Gy (Lung), 0.3 Gy (Liver), 0.18 Gy (Prostate). And by percentage, it is 0.06% (Head&Neck), 0.7% (Breast), 0.29% (Lung), 0.69% (Liver), 0.44% (Prostate). Likewise, All is under 1%. In Head&Neck, average dose difference of each OAR is 0.01~0.12 Gy, 0.04~0.06 Gy in Breast, 0.01~0.21 Gy in Lung, 0.06~0.27 Gy in Liver and 0.02~0.23 Gy in Prostate. Conclusion : PTV's HI, CI dose difference on the Treatment plan using MR image is under 1% and OAR's dose difference is maximum 0.89 Gy as heterogeneous tissue increases when comparing with that fused CT image. Besides, It characterizes excellent contrast in soft tissue. So, radiation therapy using only MR image without CT scan is useful in the part like Head&Neck, partial breast and prostate cancer which has a little difference of heterogeneity.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.341-349
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• 2011

This study was to measure the patient dose difference between 3D treatment planning CT and 4D respiratory gating CT. Study was performed with each 10 patients who have lung and liver cancer for measured patient exposure dose by using SOMATON SENSATION OPEN(SIMENS, GERMANY). CTDIvol and DLP value was used to analyze patient dose, and actual dose was measured in the location of liver and kidney for abdominal examination and lung, heart and spinal cord for chest examination. Rando phantom were used for the experiment. OSLD was used for in-vitro and in-vivo dosimetry. Increasing overall actual dose in 4D respiratory gated CT-simulation using OSLD increase the dose by 5.5 times for liver cancer patients and 6 times for lung cancer patients. In CT simulation of 10 lung cancer patients, CTDIvol value was increased by 5.7 times and DLP 2.4 times. For liver cancer patients, CTDIvol was risen by 3.8 times and DLP 1.6 times. The accuracy of treatment volume could be increased in 4D CT planning for position change due to the breaths of patient in the radiation therapy. However, patients dose was increased in 4D CT than 3D CT. In conclusion, constant efforts is required to reduce patients dose by reducing scan time and scan range.