• Journal of Yeungnam Medical Science
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• v.6 no.1
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• pp.87-98
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• 1989

Clinical estimation of bladder and rectal doses from high dose rate intracavitary irradiation in carcinoma of the cervix uteri has been initiated on a routine basis in an effort to obtain the optimum radiotherapeutic dose. Simulation films with contrast media are used to image the bladder and rectum, and dose rates are estimated at various interesting points with the aid of treatment planning computer, NEC Therac-2300. Fifty-three patients have been reviewed in order to ascertain the correlation between radiation dose at interesting points in the bladder and rectum and the dose at Point A and B. The dose ratio between doses at Point A 'and interesting points is an important clinical factor in evaluating the treatment planning. This also serves as documentation of the dose to normal structures within the treatment volume. Authors conclude that obtained data are within acceptable ranges and routine simulation films of the bladder and rectum after administration of contrast media with dose calculations at interesting points provide important information for optimizing radiotherapy planning in the treatment of cervical carcinoma without increased time and effort or patient's discomfort.

• The Journal of Korean Society for Radiation Therapy
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• v.21 no.1
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• pp.17-23
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• 2009

Purpose: In treating head and neck cancer, it is very important to irradiate uniform dose on the junction of the bilateral irradiation field of the upper head and neck and the anterior irradiation field of the lower neck. In order to improve dose distribution on the junction, this study attempted to correct non uniform dose resulting from under dose and over dose using the field-in-field technique in treating the anterior irradiation field of the lower neck and to apply the technique to the treatment of head and neck cancer through comparison with conventional treatment. Materials and Methods: In order to examine dose difference between the entry point and the exit point where beam diffusion happens in bilateral irradiation on the upper head and neck, we used an anthropomorphic phantom. Computer Tomography was applied to the anthropomorphic phantom, the dose of interest points was compared in radiation treatment planning, and it was corrected by calculating the dose ratio at the junction of the lower neck. Dose distribution on the junction of the irradiated field was determined by placing low-sensitivity film on the junction of the lower neck and measuring dose distribution on the conventional bilateral irradiation of the upper head and neck and on the anterior irradiation of the lower neck. In addition, using the field-in-field technique, which takes into account beam diffusion resulting from the bilateral irradiation of the upper head and neck, we measured difference in dose distribution on the junction in the anterior irradiation of the lower neck. In order to examine the dose at interest points on the junction, we compared and analyzed the change of dose at the interest points on the anthropomorphic phantom using a thermoluminescence dosimeter. Results: In case of dose sum with the bilateral irradiation of the upper head and neck when the field-in-field technique is applied to the junction of the lower neck in radiation treatment planning, The dose of under dose areas increased by 4.7~8.65%. The dose of over dose areas also decreased by 2.75~10.45%. Moreover, in the measurement using low-sensitivity film, the dose of under dose areas increased by 11.3%, and that of over dose areas decreased by 5.3%. In the measurement of interest point dose using a thermoluminescence dosimeter, the application of the field-in-field technique corrected under dose by minimum 7.5% and maximum 17.6%. Thus, with the technique, we could improve non.uniform dose distribution. Conclusion: By applying the field-in-field technique, which takes into account beam divergence in radiation treatment planning, we could reduce cold spots and hot spots through the correction of dose on the junction and, in particular, we could correct under dose at the entry point resulting from beam divergence. This study suggests that the clinical application of the field-in-field technique may reduce the risk of lymph node metastasis caused by under dose on the cervical lymph node.

• Journal of radiological science and technology
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• v.33 no.3
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• pp.261-268
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• 2010

This study is compared that the dose distribution by experimentation and radiation therapy planning (RTP) when the air cavity region was treated high energy photon. The dose measurements were performed with a 6 MV photon beam of linear accelerator. The polystyrene and self made acyl phantom were similar to tissue density of the human body. A parallel plate chamber was connected to an electrometer. The measurement setup was SCD (Source Chamber Distance) 100 cm and the distance of surface from air cavity was 3 cm. Absorbed dose of interface were measured by area and height. The percent depth dose were measured presence and absence of air cavity, depth according to a ratio of field size and air cavity size. The dose distribution on planning was expressed to do the inhomogeneity correction. As the area of air cavity was increased, the absorbed dose were gradually reduced. It was slightly increased, when the height of air cavity was changed from 0 cm to 0.5 cm. After the point, dose was decreased. In case of presence of air cavity, dose after distal air cavity interface was more great than absence of air cavity. The rebuild up by field size and area of air cavity occurred for field size, $4{\times}4\;cm^2$, $5{\times}5\;cm^2$ and $6{\times}6\;cm^2$, with fixed on area of air cavity, $5{\times}5\;cm^2$. But it didn't occur at $10{\times}10\;cm^2$ field size. On the contrary, the field size was fixed on $5{\times}5\;cm^2$, rebuild up occurred in area of air cavity, $4{\times}4\;cm^2$, $5{\times}5\;cm^2$. but, it did not occur for air cavity, $2{\times}2\;cm^2$, $3{\times}3\;cm^2$. All of the radiation therapy planning were not occurred rebuild up. It was required to pay attention to treat tumor in air cavity because the dose distribution of planning was different from the dose distribution of patient.

• Journal of radiological science and technology
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• v.30 no.1
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• pp.33-38
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• 2007

The propose of this study is a verification of the correct calculation of the dose around source and the prescription dose of Ir-192 source in the plato treatment planning system. The source and orthogonal coordinates for lateral direction and those for the anterior posterior direction were drawn on a A4 paper and then input into the system. The prescription dose was prescribed to two points with radius 1 cm in the direction of polar angle $90^{\circ} and $270^{\circ} from the center of the source. The doses of prescription point and dose points acquired from the treatment planning system were compared with those from manual calculation using the geometry function formalism derived by Paul King et al. In this analysis, the doses of prescription point were exactly consistent with each other and those of dose points were obtained within the error point of 1.85%. And the system of accuracy was evaluated within 2% of tolerance error. Therefore, this manual dose calculation used for the geometry function formalism is considered to be useful in clinics due to its convenience and high quality assurance.

• Progress in Medical Physics
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• v.19 no.3
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• pp.191-199
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• 2008

PTV considered for the energy, dose distribution exposed to lung and spinal cord, and the characteristic of DVH(Dose Volume Histogram) were compared and investigated by planning the intensity modulated radiation therapy (IMRT) using the photon energies of 6 MV and 10 MV according to tumor location like as the anterior, middle, and posterior regions of lung, and the mediastinum region in lung cancer patients. Our institution installed the linear accelerator (Varian 21 EX-s, USA) equipped with 120 multileaf collimator for lung cancer patients, which is producing the photon energies of 6 MV and 10 MV, and radiation therapy planning was performed with ECLIPSE system (Varian, SomaVision 6.5, USA), which support inverse treatment planning. The tomographic images of 3 mm slice thickness for lung cancer patients were acquired using planning CT, and acquired tomographic images were sent to the Varis system, and then treatment planning was performed in the ECLIPSE system. The radiation treatment planning of the IMRT was processed from various angles according to the regions of the tumor, and using various beam lines according to the size and location of the tumor. The investigation of the characteristic of dose distributions for the energy of 6 MV and 10 MV according to tumor locations in lung cancer patients resulted that the maximum dose of 10 MV energy was 1.2% less than that of 6 MV energy without depending on the tumor location of lung cancer, and the reduction effects of MU were occurred from 10 to 25 MU. Radiation dose exposed to the lung satisfied the less 30% of V20, however radiation dose in 6 MV energy was from 0.1% to 0.5% less than that in 10 MV energy. Radiation dose exposed to the spinal cord for 6 MV energy was from 0.6% to 2.1% less than that for 6 MV energy.

• Journal of the Korea Safety Management & Science
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• v.17 no.4
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• pp.199-206
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• 2015

The purpose of this study was to investigate radiation dose sensitivity due to displacement of human extremities in the water bolus box on radiation therapy. Water bolus box and human thigh with femur bone were constructed in computerized radiation therapy planning system to verify the absorbed dose. Two 6MV X-ray beams were irradiated bilaterally into water bolus box and then radiation dose were calculated each situation at displacement of middle axis of thigh from the center in water bolus box to right and left direction. Absorbed dose of thigh and femur bone increased by the distance of displacement. The maximum dose of thigh even increased 20% over than prescribed dose. This is in contrast to conventional concept of dose distribution in water bolus box. Based on this result, displacement of body site in the water bolus box have to be averted during radiation therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.137-143
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• 2013

Purpose: We are to find out the difference of calculated dose of treatment planning system (TPS) and measured dose in case of inhomogeneous organ structure. Materials and Methods: Inhomogeneous phantom is made with solid water phantom and cork plate. CT image of inhomogeneous phantom is acquired. Treatment plan is made with TPS (Pinnacle3 9.2. Royal Philips Electronics, Netherlands) and calculated dose of point of interest is acquired. Treatment plan was delivered in the inhomogeneous phantom by ARTISTE (Siemens AG, Germany) measured dose of each point of interest is obtained with Gafchromic EBT2 film (International Specialty Products, US) in the gap between solid water phantom or cork plate. To simulate lung cancer radiation treatment, artificial tumor target of paraffin is inserted in the cork volume of inhomogeneous phantom. Calculated dose and measured dose are acquired as above. Results: In case of inhomogeneous phantom experiment, dose difference of calculated dose and measured dose is about -8.5% at solid water phantom-cork gap and about -7% lower in measured dose at cork-solid water phantom gap. In case of inhomogeneous phantom inserted paraffin target experiment, dose difference is about 5% lower in measured dose at cork-paraffin gap. There is no significant difference at same material gap in both experiments. Conclusion: Radiation dose at the gap between two organs with different electron density is significantly lower than calculated dose with TPS. Therefore, we must be aware of dose calculation error in TPS and great care is suggested in case of radiation treatment planning on inhomogeneous organ structure.

• Journal of Radiation Protection and Research
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• v.40 no.1
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• pp.55-64
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• 2015

Dose calculations which are a crucial requirement for radiotherapy treatment planning systems require accuracy and rapid calculations. The conventional radiotherapy treatment planning dose algorithms are rapid but lack precision. Monte Carlo methods are time consuming but the most accurate. The new combined system that Monte Carlo methods calculate part of interesting domain and the rest is calculated by neural can calculate the dose distribution rapidly and accurately. The preliminary study showed that neural networks can map functions which contain discontinuous points and inflection points which the dose distributions in inhomogeneous media also have. Performance results between scaled conjugated gradient algorithm and Levenberg-Marquardt algorithm which are used for training the neural network with a different number of neurons were compared. Finally, the dose distributions of homogeneous phantom calculated by a commercialized treatment planning system were used as training data of the neural network. In the case of homogeneous phantom;the mean squared error of percent depth dose was 0.00214. Further works are programmed to develop the neural network model for 3-dimensinal dose calculations in homogeneous phantoms and inhomogeneous phantoms.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.53-65
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• 2001

Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.31-39
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• 2020

Purpose: The aims of this study were to compare the superficial dose with Optically Stimulated Luminescence Dosimeter(OSLD) measurement and Treatment Planning System(TPS) calculation for 6MV-Flattening Filter Free(FFF) energy using HalcyonTM and TrueBeamTM. Materials and methods: Phantom study was performed using the CT images of human phantom. In the treatment planning system, the Planning Target Volume(PTV) was contoured which is similar to Glottic cancer. Furthermore, Point(M), Point(R), and Point(L) were contoured at the iso-center of head and neck region and 5mm bolus was applied to the body contour. Each treatment plans using 6MV-FFF energy from HalcyonTM and TrueBeamTM with static Intensity Modulated Radiation Therapy(IMRT) and Volumetric Modulated Arc Therapy(VMAT) were established with eclipse. To reproduce the same position as the TPS, OSLDs were placed at the iso-center point and 5mm bolus was applied to compare the error rate after the dose delivery. Result: The results of the study using human phantom are as follows. In case of HalcyonTM, the mean absolute error rates of the point dose using the treatment planning system and the dose measured by OSLD were 1.7%±1.2% for VMAT and 4.0±2.8% for IMRT. Also TrueBeamTM was identified as 2.4±0.4% and 8.6±1.8% respectively for VMAT and IMRT. Conclusion: Through the results of this study, TrueBeamTM confirmed that the average error rate was 2.4 times higher for VMAT and 3.6 times higher for IMRT than HalcyonTM. Therefore, based on the results of this study, If we need a more accurate dose assessment for the superficial dose, It is expected that using HalcyonTM would be better than TrueBeamTM.