• Radiation Oncology Journal
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• v.25 no.1
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• pp.54-61
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• 2007

[ $\underline{Purpose}$ ]: The purpose of this study is to develop a practical method for determining accurate marker positions for prostate cancer radiotherapy using CT images and kV x-ray images obtained from the use of the on- board imager (OBI). $\underline{Materials\;and\;Methods}$: Three gold seed markers were implanted into the reference position inside a prostate gland by a urologist. Multiple digital image processing techniques were used to determine seed marker position and the center-of-mass (COM) technique was employed to determine a representative reference seed marker position. A setup discrepancy can be estimated by comparing a computed $COM_{OBI}$ with the reference $COM_{CT}$. A proposed algorithm was applied to a seed phantom and to four prostate cancer patients with seed implants treated in our clinic. $\underline{Results}$: In the phantom study, the calculated $COM_{CT}$ and $COM_{OBI}$ agreed with $COM_{actual}$ within a millimeter. The algorithm also could localize each seed marker correctly and calculated $COM_{CT}$ and $COM_{OBI}$ for all CT and kV x-ray image sets, respectively. Discrepancies of setup errors between 2D-2D matching results using the OBI application and results using the proposed algorithm were less than one millimeter for each axis. The setup error of each patient was in the range of $0.1{\pm}2.7{\sim}1.8{\pm}6.6\;mm$ in the AP direction, $0.8{\pm}1.6{\sim}2.0{\pm}2.7\;mm$ in the SI direction and $-0.9{\pm}1.5{\sim}2.8{\pm}3.0\;mm$ in the lateral direction, even though the setup error was quite patient dependent. $\underline{Conclusion}$: As it took less than 10 seconds to evaluate a setup discrepancy, it can be helpful to reduce the setup correction time while minimizing subjective factors that may be user dependent. However, the on-line correction process should be integrated into the treatment machine control system for a more reliable procedure.

• Journal of Radiation Protection and Research
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• v.35 no.1
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• pp.34-42
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• 2010

With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.