• Journal of Radiation Protection and Research
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• v.36 no.1
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• pp.23-27
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• 2011

In order to confirm feasibility of MOSFET modality in use of in.vivo dosimetry, evaluation of gonad shielding in order to minimize gonadal dose of patients undergoing radiotherapy by using MOSFET modality was performed. Gonadal dose of patients undergoing radiotherapy for rectal cancer in the department of radiation oncology of Seoul National University Hospital since 2009 was measured. 6 MV and 15 MV photon beams emitted from Varian 21EX LINAC were used for radiotherapy. In order to minimize exposed dose caused by the scattered ray not only from collimator of LINAC but also from treatment region inside radiation field, we used box.shaped lead shielding material. The shielding material was made of the lead block and consists of $7.5\; cm\;{\times}\;9.5\;cm\;{\times}5.5\;cm$ sized case and $9\;cm\;{\times}\;9.5\;cm\;{\times}\;1\;cm$ sized cover. Dosimetry for evaluation of gonad shielding was done with MOSFET modality. By protecting with gonad shielding material, average gonadal dose of patients was decreased by 23.07% compared with reference dose outside of the shielding material. Average delivered gonadal dose inside the shielding material was 0.01 Gy. By the result of MOSFET dosimetry, we verified that gonadal dose was decreased by using gonad shielding material. In compare with TLD dosimetry, we could measure the exposed dose easily and precisely with MOSFET modality.

• Progress in Medical Physics
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• v.16 no.2
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• pp.82-88
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• 2005

In this study, the physical compensator made with the high density material, Cerrobend, and the electronic compensator realized by the movement of a dynamic multileaf collimator were analyzed in order to verify the properness of a design function in the commercial RTP (radiation treatment planning) system, Eclipse. The CT images of a phantom composed of the regions of five different thickness were acquired and the proper compensator which can make homogeneous dose distribution at the reference depth was designed in the RTP. The frame for the casting of Cerrobend compensator was made with a computerized automatic styrofoam cutting device and the Millennium MLC-120 was used for the electronic compensator. All the dose values and isodose distributions were measured with a radiographic EDR2 film. The deviation of a dose distribution was $\pm0.99 cGy\;and\;\pm1.82cGy$ in each case of a Cerrobend compensator and a electronic compensator compared with a $\pm13.93 cGy$ deviation in an open beam condition. Which showed the proper function of the designed compensators in the view point of a homogeneous dose distribution. When the absolute dose value was analyzed, the Cerrobend compensator showed a $+3.83\%$ error and the electronic compensator showed a $-4.37\%$ error in comparison with a dose value which was calculated in the RTP. These errors can be admtted as an reasonable results that approve the accuracy of the compensator design in the RTP considering the error in the process of the manufacturing of the Cerrobend compensator and the limitation of a film in the absolute dosimetry.

• Progress in Medical Physics
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• v.9 no.4
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• pp.227-245
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• 1998

A most appropriate model of 3-D conformal radiotherapy has been induced by clinical evaluation and animal study, and therapeutic gains were evaluated by numerical equation of tumor control probability(TCP) and normal tissue complication probability (NTCP). The radiation dose to the tumor and the adjacent normal organs was accurately evaluated and compared using the dose volume histogram(DVH). The TCP and NTCP was derived from the distribution of given dosage and irradiated volume, and these numbers were used as the biological index for the assessment of the treatment effects. Ten patients with liver disease have been evaluated and 3 dogs were sacrificed for this study. Based on the 3-D images of the tumor and adjacent organs, the optimum radiation dose and the projection direction which could maximize the radiation effect while minimizing the effects to the adjacent organs could be decided. 3). The most effective collimation for the normal adjacent organs was made through the beams eye view with the use of multileaf collimator. When the dose was increased from 50Gy to 70Gy, the TCP for the conventional 2-port radiation and the 5-port multidimensional therapy was 0.982 and 0.995 respectively, while the NTCP was 0.725 and 0.142 respectively, suggesting that the 3-D conformal radiotherapy might be the appropriate therapy to apply sufficient radiation dose to the tumor while minimizing the damages to the normal areas of the liver. Positive correlation was observed between the NTCP and the actual complication of the normal liver in the animal study. The present study suggest that the use of 3-D conformal radiotherapy and the application of the mathematical models of TCP and NTCP may provide the improvements in the treatment of hepatoma with enhanced results.

• Progress in Medical Physics
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• v.21 no.4
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• pp.332-339
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• 2010

We aimed to setup an adaptive radiation therapy platform using cone-beam CT (CBCT) and multileaf collimator (MLC) log data and also intended to analyze a trend of dose calculation errors during the procedure based on a phantom study. We took CT and CBCT images of Catphan-600 (The Phantom Laboratory, USA) phantom, and made a simple step-and-shoot intensity-modulated radiation therapy (IMRT) plan based on the CT. Original plan doses were recalculated based on the CT ($CT_{plan}$) and the CBCT ($CBCT_{plan}$). Delivered monitor unit weights and leaves-positions during beam delivery for each MLC segment were extracted from the MLC log data then we reconstructed delivered doses based on the CT ($CT_{recon}$) and CBCT ($CBCT_{recon}$) respectively using the extracted information. Dose calculation errors were evaluated by two-dimensional dose discrepancies ($CT_{plan}$ was the benchmark), gamma index and dose-volume histograms (DVHs). From the dose differences and DVHs, it was estimated that the delivered dose was slightly greater than the planned dose; however, it was insignificant. Gamma index result showed that dose calculation error on CBCT using planned or reconstructed data were relatively greater than CT based calculation. In addition, there were significant discrepancies on the edge of each beam while those were less than errors due to inconsistency of CT and CBCT. $CBCT_{recon}$ showed coupled effects of above two kinds of errors; however, total error was decreased even though overall uncertainty for the evaluation of delivered dose on the CBCT was increased. Therefore, it is necessary to evaluate dose calculation errors separately as a setup error, dose calculation error due to CBCT image quality and reconstructed dose error which is actually what we want to know.

• Progress in Medical Physics
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• v.16 no.1
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• pp.24-31
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• 2005

The stereotactic radiosurgery (SRS) describes a method of delivering a high dose of radiation to a small tar-get volume in the brain, generally in a single fraction, while the dose delivered to the surrounding normal tissue should be minimized. To perform automatic plan of the SRS, a new method of multi-isocenter/shot linear accelerator (linac) and gamma knife (GK) radiosurgery treatment plan was developed, based on a physical lattice structure in target. The optimal radiosurgical plan had been constructed by many beam parameters in a linear accelerator or gamma knife-based radiation therapy. In this work, an isocenter/shot was modeled as a sphere, which is equal to the circular collimator/helmet hole size because the dimension of the 50% isodose level in the dose profile is similar to its size. In a computer-aided system, it accomplished first an automatic arrangement of multi-isocenter/shot considering two parameters such as positions and collimator/helmet sizes for each isocenter/shot. Simultaneously, an irregularly shaped target was approximated by cubic structures through computation of voxel units. The treatment planning method by the technique was evaluated as a dose distribution by dose volume histograms, dose conformity, and dose homogeneity to targets. For irregularly shaped targets, the new method performed optimal multi-isocenter packing, and it only took a few seconds in a computer-aided system. The targets were included in a more than 50% isodose curve. The dose conformity was ordinarily acceptable levels and the dose homogeneity was always less than 2.0, satisfying for various targets referred to Radiation Therapy Oncology Group (RTOG) SRS criteria. In conclusion, this approach by physical lattice structure could be a useful radiosurgical plan without restrictions in the various tumor shapes and the different modality techniques such as linac and GK for SRS.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.1-9
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• 2003

I. Purpose The multileaf collimator(MLC) has many advantages, but use of the MLC increased effective penumbra and isodose undulation in dose distribution compared with that of an alloy block. In this work, we introduced the HD-270 MLC, which can improve the above disadvantages of MLC, and reported its feasibility study. II. Method and Materials The HD-270 MLC is a technique which combines the use of the existing Siemens multileaf collimator(3D MLC) with patient translation perpendicular to the leaf plane. The technique produces a smoothed isodose distribution with the reduced isodose undulation and effective penumbra. To assess the efficacy of the HD-270 technique and determine the appropriate resolution, a polygonal shaped MLC field was made to produce field edge angles from 0 degree to 75 degree with a step of 15 degree. Each HD-270 group was generated according to the allowed resolution, i. e., 5, 3, and 2mm. The experiment was carried out on Primus, a Siemens linear accelerator configured with HD-270 MLC. The total 60 MU of 6 MV photon beam was delivered to X-Omat film(Kodak, USA) at a SAD of 100 cm and 1.5 cm depth in solid water phantom. Exposed films were scanned by Lumiscan75(LUMISYS) and analyzed using RIT113 software(Radiological Imaging Technology Inc., USA). To test the mechanical accuracy of table movement, the transverse, longitudinal, and vertical positions were controlled by a consol with ${\pm}5\;mm,\;{\pm}4\;mm,\;{\pm}3\;mm,\;and\;{\pm}2\;mm$ steps, and then measured using a dial gauge with an accuracy of 0.001 inch. During the experiments, the table loaded with about 50Kg human phantom to simulate the real treatment situation. III. Results The effective penumbra and isodose undulation became larger with increase the resolution and field edge angle. The accuracy of the table movement on each direction is good within the ${\pm}1\;mm$. IV. Conclusion Clinical use of the MLC can be increased by using of the HD-270 MLC which complements to the disadvantages of the MLC.

• Journal of the Korean Society of Radiology
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• v.14 no.2
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• pp.105-109
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• 2020

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.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.104-109
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• 2014

Purpose: Conventional pinhole scintigraphy offers a high resolution and generally use for thyroid scan or bone scintigraphy. the aim of this study is to evaluate performance of each aperture according to the diameter size. Materials and Methods: In this study 2 mm, 4 mm, 6 mm, 8 mm diameter pinhole collimators were mounted on Siemens E.CAM systems. In order to evaluate performance evaluation of each aperture, we acquired projection image by using SPECT for evaluating FWHM, resolution test and static image for evaluating thyroid phantom test. Results: As a result of FWHM showed 2.2 mm FWHM, 3.2 mm FWHM, 5.4 mm FWHM, 7.5 mm FWHM per each aperture in the resolution test. SNR, uniformity, contrast were acquired result from thyroid phantom test comparing general image and delayed image. as a result of SNR showed 6.55, 8.47, 6.2, 5.23 in case of general image and 5.25, 5.01, 5.38, 5.82 in case of delayed image per each aperture. as a result of uniformity showed 0.152, 0.118, 0.161, 0.19 in case of general image and 0.19, 0.199, 0.185, 0.171 in case of delayed image per each aperture. as a result of contrast showed 1.31, 1.19, 1.15, 1.01 in case of general image and 1.09, 1.08, 1.04, 1 in case of delayed image per each aperture. Conclusion: Resolution and sensitivity were heavily influenced by aperture size. and also we found advantage of delayed image as a result of thyroid phantom test.

• Progress in Medical Physics
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• v.12 no.2
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• pp.161-169
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• 2001

For the head and neck radiotherapy, the technique of half beam using independent collimator is very useful to avoid overlapping of fields particularly when the lateral neck fields are placed adjacent to anterior supraclavicular field. Also abutting photon field with electron field is frequently used for the irradiation of posterior neck when tolerable dose on spinal cord has been reached. Using 6 MV X-ray and 9 MeV electron beams of Clinac1800(Varian, USA) linear accelerator, we performed film dosimetry by the X-OMAT V film of Kodak in solid water phantom and the dose distribution at beam center of 2 half beams further examined according to depths(0 cm, 1.5 cm, 3 cm, 5 cm) for single anterior half beam and anterior/posterior half beam. The dose distribution to the junction line between photon and electron fields was also measured. For the single anterior half beam, the absorption doses at 0.3 cm, 0.5 cm and 1 cm distances from beam center were 88%, 93% and 95% of open beam, respectively. In the anterior/posterior half beams, the absorption doses at 0.3 cm, 0.5 cm and 1 cm distances from beam center were 92%, 93% and 95% of open beam, respectively At the junction line between photon and electron fields, hot spot was developed on the side of the photon field and a cold spot was developed on that of the electron field. The hot spot in the photon side was developed at depth 1.5 cm with 7 mm width. The maximum dose of hot spot was increased to 6% of reference doses in the photon field. The cold spot in the electron side was developed at all measured depths(0.5 cm-3 cm) with 1-12.5 mm widths. The decreased dose in the cold spot was 4.5-30% of reference dose in the electron field. With above results, we concluded that when using electron beam or independent jaw for head and neck radiotherapy, the hot and cold dose area should be considered as critical point.

• Progress in Medical Physics
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• v.12 no.2
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• pp.103-112
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• 2001

Purpose: The purpose of this study was to investigate the current status of performing nuclear medicine quality control in korea and to test selected protocols of quality control of nuclear medicine counting system and gamma camera. Materials and Methods: Fifty three hospitals were included to investigate the current status of nuclear medicine quality control in korea. The precision of dose calibrator and thyroid uptake system was measured with Tc-99m 35.52 MBq for 2 minuets and Tc-99m 5.14 MBq for 10 sec every one minute, respectively. The sensitivity of CeraSPECT$^{TM}$ with low energy high resolution parallel hole collimator was measured using two cylindrical phantoms with 15 cm in diameter and 12 cm and 30 cm in heights containing Tc-99m. The correction factor for sensitivity of CeraSPECT$^{TM}$ was calculated using phantom data. The system planar sensitivity, uniformity, count rate and spatial resolution were measured for Varicam gamma camera with low energy high resolution parallel hole collimator using 140 keV centered 20% energy window, 256$\times$256 or 512$\times$512 matrix sizes. Results: The quality control of dose calibrator and well counter were showed poor performance status. On the other hand, The quality control of gamma camera and other systems were showed relatively good performance status. The results of precision of dose calibrator and thyroid uptake system was $\pm$1.4%(<$\pm$5%) and chi^2=29.7(>16.92), respectively. It showed that the sensitivity of CeraSPECT$^{TM}$ was higher in center slices compared with the edge slices. After correction of nonuniform sensitivities for patient data, it showed better results compare with prior to correction. System planar sensitivity of Varicam gamma camera was 4.39 CPM/MBq. The observed count rate at 20% loss was 102,407 counts/sec (head 1), 113,427 counts/sec (head 2), when input count rate was 81,926 counts/sec (head 1), 90,741 counts/sec (head 2). The spatial resolution without scatter medium were 8.16 mm of FWHM and 14.85 mm of FWTM. The spatial resolution with scatter medium were 8.87 mm of FWHM and 18.87 mm of FWTM. Conclusion: It is necessary to understand the importance of quality control and to perform quality control of nuclear medicine devices.vices.