• Progress in Medical Physics
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• v.14 no.1
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• pp.28-33
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• 2003

The aim of the study was to assess the isocenter deviation between multiple arcs and conformal beams in frameless FSRT. Forty seven patients received single isocenter radiosurgery or therapy (SRS/T) using available framelss FSRT system from Aug. 1997 to Dec. 2m. In choosing multiple arc FSRT or conformal FSRT, we had considered one of two techniques with respect to tumor size and tumor shape. In multiple arc FSRT, the average and standard deviation (SD) of the isocenter deviation was 0.2 mm (SD 0.2 mm), 0.2 mm (SD 0.2) and 0.3 mm (SD 0.2 mm)in the lateral (x), anterior-posterior (y) and cranio-caudal directions (z). In conformal FSRT, the average deviation and SD of the isocenter deviation was 0.2 mm (SD 0.2 mm), 0.3 mm(0.2 mm) and 0.4 mm (SD 0.2 mm) in the x, y and z directions. The average spacial deviation ($\Delta$r) was 0.41 mm and 0.54 mm in multiple arcs and conformal beams, respectively. The isocenter deviation using frameless FSRT system was similar value between multiple arcs and conformal beams. In practice, we believed we can select the appropriate treatment technique according to tumor shape and size.

• Progress in Medical Physics
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• v.25 no.4
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• pp.288-297
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• 2014

Dynamic conformal arc therapy (DCAT) and flattening-filter-free (FFF) beams are commonly adopted for efficient conformal dose delivery in stereotactic body radiation therapy (SBRT). Off-axis geometry (OAG) may be necessary to obtain full gantry rotation without collision, which has been shown to be beneficial for peripheral targets using flattened beams. In this study dose distributions in OAG using FFF were evaluated and the effect of mechanical rotation induced uncertainty was investigated. For the lateral target, OAG evaluation, sphere targets (2, 4, and 6 cm diameter) were placed at three locations (central axis, 3 cm off-axis, and 6 cm off-axis) in a representative patient CT set. For each target, DCAT plans under the same objective were obtained for 6X, 6FFF, 10X, and 10FFF. The parameters used to evaluate the quality of the plans were homogeneity index (HI), conformality indices (CI), and beam on time (BOT). Next, the mechanical rotation induced uncertainty was evaluated using five SBRT patient plans that were randomly selected from a group of patients with laterally located tumors. For each of the five cases, a plan was generated using OAG and CAG with the same prescription and coverage. Each was replanned to account for one degree collimator/couch rotation errors during delivery. Prescription isodose coverage, CI, and lung dose were evaluated. HI and CI values for the lateral target, OAG evaluation were similar for flattened and unflattened beams; however, 6FFF provided slightly better values than 10FFF in OAG. For all plans the HI and CI were acceptable with the maximum difference between flattened and unflattend beams being 0.1. FFF beams showed better conformality than flattened beams for low doses and small targets. Variation due to rotational error for isodose coverage, CI, and lung dose was generally smaller for CAG compared to OAG, with some of these comparisons reaching statistical significance. However, the variations in dose distributions for either treatment technique were small and may not be clinically significant. FFF beams showed acceptable dose distributions in OAG. Although 10FFF provides more dramatic BOT reduction, it generally provides less favorable dosimetric indices compared to 6FFF in OAG. Mechanical uncertainty in collimator and couch rotation had an increased effect for OAG compared to CAG; however, the variations in dose distributions for either treatment technique were minimal.

• Korean Journal of Optics and Photonics
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• v.10 no.2
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• pp.120-127
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• 1999

We discussed two main types-conformal and non-conformal (powered) - of holographic combiner. A theoretical model based on the Kogelnik's coupled wave theory was used to illustrate bandwidth and efficiency properties. Also we showed numerical values for the aberrations that are induced by a wavelength shift from construction to reconstruction and found optimum coordinates to reduce the chrolatic aberation of construction beams using aberration balancing techniques. The holographic combiner manufactured in conformal type with 60$^{\circ}$ incidence angle at 514.5 nm had narrow angular bandwidth (FWHM) of 4.1" and spectral bandwidth of 11.4 nm, while non-conformal one with 50$^{\circ}$, 30$^{\circ}$ incidence angle at 514.5 nm showed spectral and angular bandwidth of 10.7 nm and 5.5$^{\circ}$, respectively.vely.

• The Journal of the Acoustical Society of Korea
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• v.40 no.4
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• pp.347-358
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• 2021

The objective of this study is to optimize the shape of doubly curved surface where a conformal array is equipped. That surface is modeled with a double-ellipsoid solid controlled by four parameters. By analyzing the performance of the conformal array beams with the beam pattern synthesis, two design parameters are determined. Then, we define the weighted object function which is formulated as the sum of sharp indexes for directivity index, the elevation resolution, and the bearing resolution. The direct calculation on all grids is used to evaluate the weighted object function and seek the optimal value of two design parameters when the weightings are given. In the simulation, four kinds of weighting cases are respectively applied to evaluate the weighted object function. The optimal shapes of double-ellipsoid solid are shown in each case. Especially, when the uniform weightings are used, the double-ellipsoid solid with more smooth surface is obtained.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.241-247
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• 2018

Purpose: A hybrid-dynamic conformal arc therapy (HDCAT) technique consisting of a single half-rotated dynamic conformal arc beam and static field-in-field beams in two directions was designed and evaluated in terms of dosimetric benefits for radiotherapy of lung cancer. Materials and Methods: This planning study was performed in 20 lung cancer cases treated with the VERO system (BrainLAB AG, Feldkirchen, Germany). Dosimetric parameters of HDCAT plans were compared with those of three-dimensional conformal radiotherapy (3D-CRT) plans in terms of target volume coverage, dose conformity, and sparing of organs at risk. Results: HDCAT showed better dose conformity compared with 3D-CRT (conformity index: 0.74 ± 0.06 vs. 0.62 ± 0.06, p < 0.001). HDCAT significantly reduced the lung volume receiving more than 20 Gy (V₂₀: 21.4% ± 8.2% vs. 24.5% ± 8.8%, p < 0.001; V₃₀: 14.2% ± 6.1% vs. 15.1% ± 6.4%, p = 0.02; V₄₀: 8.8% ± 3.9% vs. 10.3% ± 4.5%, p < 0.001; and V₅₀: 5.7% ± 2.7% vs. 7.1% ± 3.2%, p < 0.001), V₄₀ and V₅₀ of the heart (V₄₀: 5.2 ± 3.9 Gy vs. 7.6 ± 5.5 Gy, p < 0.001; V₅₀: 1.8 ± 1.6 Gy vs. 3.1 ± 2.8 Gy, p = 0.001), and the maximum spinal cord dose (34.8 ± 9.4 Gy vs. 42.5 ± 7.8 Gy, p < 0.001) compared with 3D-CRT. Conclusions: HDCAT could achieve highly conformal target coverage and reduce the doses to critical organs such as the lung, heart, and spinal cord compared to 3D-CRT for the treatment of lung cancer patients.

• Radiation Oncology Journal
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• v.18 no.1
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• pp.1-10
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• 2000

Purpose : Although using the high energy Photon beam with conventional Parallel-opposed beams radiotherapy for nasopharyngeal carcinoma, radiation-induced xerostomia is a troublesome problem for patients. We conducted this study to explore a new parotid gland sparing technique in 3-D conformal radiotherapy (3-D CRT) in an effort to prevent the radiation-induced xerostomia. Materials and Methods : We peformed three different planning for four clinically node-negative nasopharyngeal cancer patients with different location of tumor(intracranial extension, nasal cavity extension, oropharyngeal extension, parapharyngeal extension), and intercompared the plans. Total prescription dose was 70.2 Gy to the isocenter. For plan-A, 2-D parallel opposing fields, a conventional radiotherapy technique, were employed. For plan-B, 2-D parallel opposing fields were used up until 54 Gy and afterwards 3-D non-coplanar beams were used. For plan-C, the new technique, 54 Gy was delivered by 3-D conformal 3-port beams (AP and both lateral ports with wedge compensator; shielding both superficial lobes of parotid glands at the AP beam using BEV) from the beginning of the treatment and early spinal cord block (at 36 Gy) was peformed. And bilateral posterior necks were treated with electron after 36 Gy. After 54 Gy, non-coplanar beams were used for cone-down plan. We intercompared dose statistics (Dmax, Dmin, Dmean, D95, DO5, V95, VOS, Volume receiving 46 Gy) and dose volume histograms (DVH) of tumor and normal tissues and NTCP values of parotid glands for the above three plans. Results : For all patients, the new technique (plan-C) was comparable or superior to the other plans in target volume isodose distribution and dose statistics and it has more homogenous target volume coverage. The new technique was most superior to the other plans in parotid glands sparing (volume receiving 46 Gy: 100, 98, 69$\%$ for each plan-A, B and C). And it showed the lowest NTCP value of parotid glands in all patients (range of NTCP; 96$\~$100$\%$, 79$\~$99$\%$, 51$\~$72$\%$ for each plan-A, B and C). Conclusion : We conclude that the new technique employing 3-D conformal radiotherapy at the beginning of radiotherapy and cone down using non-coplanar beams with early spinal cord block is highly recommended to spare parotid glands for node-negative nasopharygeal cancer patients.

• Nuclear Engineering and Technology
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• v.54 no.3
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• pp.1016-1023
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• 2022

In proton therapy, a highly conformal proton dose can be delivered to the tumor by means of the steep distal dose penumbra at the end of the beam range. The proton beam range, however, is highly sensitive to range uncertainty, which makes accurately locating the proton range in the patient difficult. In-vivo range verification is a method to manage range uncertainty, one of the promising techniques being prompt gamma imaging (PGI). In earlier studies, we proposed gamma electron vertex imaging (GEVI), and constructed a proof-of-principle system. The system successfully demonstrated the GEVI imaging principle for therapeutic proton pencil beams without scanning, but showed some limitations under clinical conditions, particularly for pencil beam scanning proton therapy. In the present study, we upgraded the GEVI system in several aspects and tested the performance improvements such as for range-shift verification in the context of line scanning proton treatment. Specifically, the system showed better performance in obtaining accurate prompt gamma (PG) distributions in the clinical environment. Furthermore, high shift-detection sensitivity and accuracy were shown under various range-shift conditions using line scanning proton beams.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.78-89
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• 2017

Purpose: To determine the optimal radiotherapy technique for gastric mucosa-associated lymphoid tissue lymphoma (MALToma), we compared the dosimetric parameters and the risk of solid secondary cancer from scattered doses among anterior-posterior/ posterior-anterior parallel-opposed fields (AP/PA), anterior, posterior, right, and left lateral fields (4_field), 3-dimensional conformal radiotherapy (3D-CRT) using noncoplanar beams, and intensity-modulated radiotherapy composed of 7 coplanar beams (IMRT_co) and 7 coplanar and noncoplanar beams (IMRT_non). Materials and Methods: We retrospectively generated 5 planning techniques for 5 patients with gastric MALToma. Homogeneity index (HI), conformity index (CI), and mean doses of the kidney and liver were calculated from the dose-volume histograms. Applied the Biological Effects of Ionizing Radiation VII report to scattered doses, the lifetime attributable risk (LAR) was calculated to estimate the risk of solid secondary cancer. Results: The best value of CI was obtained with IMRT, although the HI varied among patients. The mean kidney dose was the highest with AP/PA, followed by 4_field, 3D-CRT, IMRT_co, and IMRT_non. On the other hand, the mean liver dose was the highest with 4_field and the lowest with AP/PA. Compared with 4_field, the LAR for 3D-CRT decreased except the lungs, and the LAR for IMRT_co and IMRT_non increased except the lungs. However, the absolute differences were much lower than <1%. Conclusion: Tailored RT techniques seem to be beneficial because it could achieve adjacent organ sparing with very small and clinically irrelevant increase of secondary solid cancer risk compared to the conventional techniques.

• Nuclear Engineering and Technology
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• v.55 no.9
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• pp.3140-3149
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• 2023

In theory, the sharp dose falloff at the distal end of a proton beam allows for high conformal dose to the target. However, conformity has not been fully achieved in practice, primarily due to beam range uncertainty, which is approximately 4% and varies slightly across institutions. To address this issue, we developed a new range verification system prototype: a multi-slit prompt-gamma camera (MSPGC). This system features high prompt-gamma detection sensitivity, an advanced range estimation algorithm, and a precise camera positioning system. We evaluated the range measurement precision of the prototype for single spot beams with varying energies, proton quantities, and positions, as well as for spot-scanning proton beams in a simulated SSPT treatment using a phantom. Our results demonstrated high accuracy (<0.4 mm) in range measurement for the tested beam energies and positions. Measurement precision increased significantly with the number of protons, achieving 1% precision with 5 × 10⁸ protons. For spot-scanning proton beams, the prototype ensured more than 5 × 10⁸ protons per spot with a 7 mm or larger spot aggregation, achieving 1% range measurement precision. Based on these findings, we anticipate that the clinical application of the new prototype will reduce range uncertainty (currently approximately 4%) to 1% or less.

• Radiation Oncology Journal
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• v.37 no.4
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• pp.232-248
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• 2019

Proton beams have been used for cancer treatment for more than 28 years, and several technological advancements have been made to achieve improved clinical outcomes by delivering more accurate and conformal doses to the target cancer cells while minimizing the dose to normal tissues. The state-of-the-art intensity modulated proton therapy is now prevailing as a major treatment technique in proton facilities worldwide, but still faces many challenges in being applied to the lung. Thus, in this article, the current status of proton therapy technique is reviewed and issues regarding the relevant uncertainty in proton therapy in the lung are summarized.