• Korean Journal of Digital Imaging in Medicine
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• v.12 no.1
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• pp.59-64
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• 2010

We examined the accuracy and efficiency of phantom by applying the designed phantom in order to check daily quality assurance easily by objective criteria and to confirm daily quality assurance of linear accelerator, simulator, and CT-simulator. The results of 10 weeks of linear accelerator output dose using American Association of Physicists in Medicine(AAPM) daily quality assurance guide were measured within ${\pm}1%$ of error. Mechanical check of laser alignment, optical distance indicator(ODI), CT scanner laser and alignment of gantry lasers with the center of imaging plane were measured within ${\pm}1mm$. Daily average working time for daily quality assurance of radiation therapy equipments was 38 minutes. The designed phantom was easy to install and daily quality assurance was possible with only one installation. The aspects reproducibility and efficiency as well as accuracy of quality assurance were excellent.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.2
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• pp.137-144
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• 2008

Positron emission tomography-computed tomography (PET/CT) provides both functional and anatomical images of high quality non-invasively with better precision in localization than PET alone. Increase in the use of PET/CT, coupled with increasing concerns about the quality of medical services accrued the demands for accurate evaluation of system performance and quality assurance. Thus, well designed programs for performance evaluation and quality assurance are needed. Widely used protocols for performance evaluation of PET are the methods proposed by National Electrical Manufacturers Association (NEMA) in 1994 and 2001. In addition, in order to maintain high quality of PET/CT images, quality assurance programs including periodic (daily, monthly, and yearly). Therefore, in this article, the methods and present state of performance evaluation and quality assurance of PET/CT are reviewed.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• Progress in Medical Physics
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• v.21 no.1
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• pp.99-112
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• 2010

In Republic of Korea, there are many Quality Assurance protocol for general radiation treatment machine such as linac. However, Quality Assurance protocol for radiosurgery treatment system is not ready perfectly. One of the radiation treatment machine for radiosurgery, novalis system needs to suitable Quality Assurance protocol for using it right way during radiation treatment and maintaining suitable accuracy for daily, weekly, monthly and annually periods. Therefore, in this article, we develop Quality Assurance protocol for novalis system. We collected and analysed domestic and foreign novalis Quality Assurance protocol. After that, we selected essential QA items and each tolerance range for developing proper QA protocol, and we made anatomical phantom for execution of selected QA items and evaluation of overall state of QA, and then, we use this measured value as a reference. Quality Assurance items are consisted of Mechanical accuracy QA part and Radiation delivery QA part. Mechanical accuracy QA part is comprised of radiation generation machine part, assistive devices part and multi-leaf collimator part. Radiation delivery QA part is divided into radiation isocenter accuracy and dosimetric evaluation. After that, developed novalis QA tables are made by using these QA items. These novalis QA tables would be used to good standard in order to maintain apt accuracy for radiosurgery in daily, weekly, monthly and annually periods.

• Progress in Medical Physics
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• v.28 no.4
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• pp.197-206
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• 2017

We develop guidelines for the quality assurance of radiation treatment planning systems (TPS) by comparing and reviewing recommendations from major countries and organizations, as well as by analyzing the AAPM, ESTRO, and IAEA TPS quality assurance guidelines. We establish quality assurance items for acceptance testing, commissioning, periodic testing, system management, and security, and propose methods to perform each item within acceptable standards. Acceptance includes tests of hardware and network environments, data transmission, software, and benchmarking as specified by the system supplier, and apply the IAEA classification criteria. Commissioning includes dosimetric and non-dosimetric items for assessing TPS performance by applying the AAPM classification criteria and the latest technical items from the IAEA. Periodic quality assurance tests include daily, weekly, monthly, yearly, and occasional items by applying the AAPM classification criteria. System management and security items include the state and network connectivity of TPS, periodic data backup, and data access security. The guidelines for TPS quality assurance proposed in this study will help to improve the safety and quality of radiotherapy by preventing incidents related to radiotherapy.

• Progress in Medical Physics
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• v.23 no.2
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• pp.123-126
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• 2012

For the purpose of quality assurance (QA) of the blood irradiator, QA programs for daily, monthly, and yearly were developed. For daily tests, simple items for basically operating the machine are recommended. For monthly and yearly tests, the measurement of dose to assure the dose delivery system are performed by a dosimetry devices (Glass dosimeter jig) developed in this study. The QA program is practical for clinical environment.

• Journal of Radiation Protection and Research
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• v.44 no.1
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• pp.43-52
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• 2019

Background: The mid-term performance of clinical linear accelerator (LINAC) during volumetric modulated arc therapy (VMAT) treatment period is not performed in clinical practice and usually replaced with one-time plan quality assurance (QA). In this research we aim to monitor daily reproducibility of VMAT delivery from tracking individual leaf movement error and dosimetric error to evaluate the mid-term quality of the machine used. Materials and Methods: First, multileaf collimator (MLC) information was imported into MATLAB program to determine which of the MLC leaves in the leaf bank had the maximum RMS position error (maxRMS). We estimated where the maximum positional errors (maxPE) of the chosen leaf occur along its path length and tracked its daily variations over the entire treatment period. Secondly, picture information of dosimetric error from portal dosimetry was imported into MATLAB where representative high gamma index region (HGR) was determined as HGR with length of > 1 cm and their centers were daily tracked. Results and Discussion: The maxPEs in the brain and tongue cases were distributed broader than in other cases, but all data were found located within ${\pm}0.5mm$. From first day to last day all of five cases show the similar visual pattern of HGRs and Centers of the longest HGRs remained within ${\pm}1mm$ of that in first day. These findings prove excellent mid-term performance of the LINAC used in VMAT treatments over a full course of treatment. Conclusion: Tracking the daily location changes of leaf movement and dosimetric error can be a good indicator of predicting the daily quality like stability and reproducibility of beam delivering in VMAT treatment.

• Journal of Radiation Protection and Research
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• v.44 no.1
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• pp.32-42
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• 2019

Background: There have been much efforts to develop the proper and realistic machine Quality Assurance (QA) reflecting on real Volumetric Modulated Arc Therapy (VMAT) plan. In this work we propose and test a special VMAT plan of plan-class specific (pcsr) QA, as a machine QA so that it might be a good solution to supplement weak point of present machine QA to make it more realistic for VMAT treatment. Materials and Methods: We divided human body into 5 treatment sites: brain, head and neck, chest, abdomen, and pelvis. One plan for each treatment site was selected from real VMAT cases and contours were mapped into the computational human phantom where the same plan as real VMAT plan was created and called plan-class specific reference (pcsr) QA plan. We delivered this pcsr QA plan on a daily basis over the full research period and tracked how much MLC movement and dosimetric error occurred in regular delivery. Several real patients under treatments were also tracked to test the usefulness of pcsr QA through comparisons between them. We used dynalog file viewer (DFV) and Dynalog file to analyze position and speed of individual MLC leaf. The gamma pass rate from portal dosimetry for different gamma criteria was analyzed to evaluate analyze dosimetric accuracy. Results and Discussion: The maxRMS of MLC position error for all plans were all within the tolerance limit of < 0.35 cm and the positional variation of maxPEs for both pcsr and real plans were observed very stable over the research session. Daily variations of maxRMS of MLC speed error and gamma pass rate for real VMAT plans were observed very comparable to those in their pcsr plans in good acceptable fluctuation. Conclusion: We believe that the newly proposed pcsr QA would be useful and helpful to predict the mid-term quality of real VMAT treatment delivery.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.29-33
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• 2017

Purpose In this study, we evaluated image by applying normalization factor during 30 days to the PET images. Materials and Methods Normalization factor was acquired during 30 days. We compared with 30 normalization factors. We selected 3 clinical case (PNS study). We applied for normalization factor to PET raw data and evaluated SUV and count (kBq/ml) by drawing ROI to liver and lesion. Results There is no significant difference normalization factor. SUV and count are not different for PET image according to normalization factor. Conclusion We can get a lot of information doing the quality assurance such as performance of sinogram and detector. That's why we need to do quality assurance daily.

• Progress in Medical Physics
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• v.14 no.3
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• pp.151-160
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• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.