• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.11-22
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• 1998

The absolute absorbed dose can be determined according to the measurement conditions ; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of $10{\times}10cm$ field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations on phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG2l and IAEA protocol. The differences between two protocols are within $1\%\;while\;the\;average\;value\;of\;IAEA\;protocol\;was\;0.5\%$ smaller than TG2l protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within $1\%,\;but\;individual\;discrepancies\;are\;in\;the\;range\;of\;-2.5\%\;to\;1.2\%$ depending upon the choice of measurement combination. The largest discrepancy of $-25\%$ was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coefficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, It shows that absorbed dose could be affected by phantom material other than water.

• 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.1
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• pp.27-32
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• 2017

We investigated the effect of a commercial iterative reconstruction technique (iDose, Philips) on the image quality and the dose calculation for the treatment plan. Using the electron density phantom, the 3D CT images with five different protocols (50, 100, 200, 350 and 400 mAs) were obtained. Additionally, the acquired data was reconstructed using the iDose with level 5. A lung phantom was used to acquire the 4D CT with the default protocol as a reference and the low dose (one third of the default protocol) 4D CT using the iDose for the spine and lung plans. When applying the iDose at the same mAs, the mean HU value was changed up to 85 HU. Although the 1 SD was increased with reducing the CT dose, it was decreased up to 4 HU due to the use of iDose. When using the low dose 4D CT with iDose, the dose change relative to the reference was less than 0.5% for the target and OARs in the spine plan. It was also less than 1.1% in the lung plan. Therefore, our results suggests that this dose reduction technique is applicable to the 4D CT image acquisition for the radiation treatment planning.

• Progress in Medical Physics
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• v.27 no.2
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• pp.64-71
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• 2016

We develop a manufacture procedure for the production of a patient specific customized bolus (PSCB) using a 3D printer (3DP). The dosimetric accuracy of the 3D-PSCB is evaluated for electron beam therapy. In order to cover the required planning target volume (PTV), we select the proper electron beam energy and the field size through initial dose calculation using a treatment planning system. The PSCB is delineated based on the initial dose distribution. The dose calculation is repeated after applying the PSCB. We iteratively fine-tune the PSCB shape until the plan quality is sufficient to meet the required clinical criteria. Then the contour data of the PSCB is transferred to an in-house conversion software through the DICOMRT protocol. This contour data is converted into the 3DP data format, STereoLithography data format and then printed using a 3DP. Two virtual patients, having concave and convex shapes, were generated with a virtual PTV and an organ at risk (OAR). Then, two corresponding electron treatment plans with and without a PSCB were generated to evaluate the dosimetric effect of the PSCB. The dosimetric characteristics and dose volume histograms for the PTV and OAR are compared in both plans. Film dosimetry is performed to verify the dosimetric accuracy of the 3D-PSCB. The calculated planar dose distribution is compared to that measured using film dosimetry taken from the beam central axis. We compare the percent depth dose curve and gamma analysis (the dose difference is 3%, and the distance to agreement is 3 mm) results. No significant difference in the PTV dose is observed in the plan with the PSCB compared to that without the PSCB. The maximum, minimum, and mean doses of the OAR in the plan with the PSCB were significantly reduced by 9.7%, 36.6%, and 28.3%, respectively, compared to those in the plan without the PSCB. By applying the PSCB, the OAR volumes receiving 90% and 80% of the prescribed dose were reduced from $14.40cm^3$ to $0.1cm^3$ and from $42.6cm^3$ to $3.7cm^3$, respectively, in comparison to that without using the PSCB. The gamma pass rates of the concave and convex plans were 95% and 98%, respectively. A new procedure of the fabrication of a PSCB is developed using a 3DP. We confirm the usefulness and dosimetric accuracy of the 3D-PSCB for the clinical use. Thus, rapidly advancing 3DP technology is able to ease and expand clinical implementation of the PSCB.

• Progress in Medical Physics
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• v.16 no.3
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• pp.116-124
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• 2005

Absorbed dose dosimetry protocols of high energy photon and electron beams, which are widely used and based on an air kerma calibration factors, have somewhat complex formalism and limitations for improving dosimetric accuracy due to uncertainty of the physical parameters used. Recently the IAEA and the AAPM published the absorbed dose to water-based dosimetry protocol. In this work web-based dose calibration program for IAEA TRS-398 and AAPM TG-51 protocols were developed. This program developed using the Visual C$\#$ language can be used in the internet. User selectable dosimetry protocol on the web allows the absorbed dose to water data of the two protocols at a reference point to be easily compared, and enables to conveniently manage and understand the current status of the dosimetry calibration performed at participating institutions in korea. This program and the resultant database from the web-based calibration can be useful in developing new dosimetry protocols in Korea.

• Progress in Medical Physics
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• v.14 no.3
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• pp.175-183
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• 2003

Absorbed dose dosimetry protocols of high energy photon and electron beams, which are widely used and based on an air kerma (or exposure) calibration factors, have somewhat complex formalism and limitations for improving dosimetric accuracy due to the uncertainty of the physical parameters used. Recently, the IAEA and the AAPM published the absorbed dose to water-based dosimetry protocols(IAEA TRS-398 and AAPM TG-51). The dose calibration programs for these two protocols were developed. This program for high energy photon and electron beams was also developed for users to use in a window environment using the Visual C++ language. The formalism and physical parameters of these two protocols were strictly applied to the program. The tables and graphs of the physical data, and the information of ion chambers were numericalized for their incorporation into a database. This program can be useful in developing new dosimetry protocols in Korea.

• Progress in Medical Physics
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• v.26 no.3
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• pp.178-184
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• 2015

The Markus ionization chamber(R) is a small plane parallel ionization chamber widely used in clinical electron beam dosimetry. Plane parallel chambers were recommended for low energy electron dosimetry with the beam quality at $R_{50}<4.0g/cm^2$ (${\bar{E}}{\approx}10MeV$) according to TRS-398 protocol. However, the quality correction factors ($k_{Q,Q_0}$) of the Markus chamber was not presented in TRS-398 protocol for electron beam quality at $R_{50}<2.0g/cm^2$ (${\bar{E}}{\approx}4MeV$). In this study, the $k_{Q,Q_0}$ factors of the Markus chambers (PTW-34045) for beam qualities at $R_{50}=1.0$, 1.4, 2.0, 2.5, 3.0, and $5.0g/cm^2$ were determined by Monte Carlo calculations (DOSRZnrc/EGSnrc) and the dosimetric formalism of quality correction factor. The derived $k_{Q,Q_0}$ values were evaluated using the produced data based on TRS-398 and TG-51 protocols and known values for the Markus chamber.

• Progress in Medical Physics
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• v.8 no.2
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• pp.87-102
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• 1997

The absolute absorbed dose can be determined according to the measurement conditions; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of 10cm $\times$ 10cm field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations of phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG21 and IAEA protocol. The differences between two protocols are within 1％ while the average value of IAEA protocol was 0.5％ smaller than TG21 protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within 1％, but individual discrepancies are in the range of - 2.5％ to 1.2％ depending upon the choice of measurement combination. The largest discrepancy of - 2.5％ was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coeficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, it shows that absorbed dose could be affected by phantom material other than water.

• Progress in Medical Physics
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• v.27 no.1
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• pp.25-30
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• 2016

The dosimetric characteristics were experimentally evaluated for electron beams from the prototype linac developed for radiotherapy units. This paper focuses on the electron beam output and energy variations as a function of electron gun heater current. The electron energy was derived from its mean and most probable energies measured by film dosimetry. The electron beam output at the maximum electron energy was measured with the plane parallel ionization chamber in water using TRS-398 dosimetry protocol. The mean energy and the most probable energy of the electron beam were 6.54~3.31 MeV and 5.94~2.80 MeV at electron gun current of 2.02~2.50 A respectively. The output dose rate for an electron beam of mean energy 6.54 MeV was 5.41 Gy/min ${\pm}1.5%$ at the reference depth in water.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.161-169
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• 2016

Purpose : To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. Materials and Methods : A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). Results : The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ${\pm}5%$ during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Conclusion : Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue.