• Progress in Medical Physics
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• v.29 no.4
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• pp.123-136
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• 2018

The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.

• Radiation Oncology Journal
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• v.28 no.1
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• pp.50-56
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• 2010

Purpose: We report the results of an external audit on the absorbed dose of radiotherapy beams independently performed by third parties. For this effort, we developed a method to measure the absorbed dose to water in an easy and convenient setup of solid water phantom. Materials and Methods: In 2008, 12 radiotherapy centers voluntarily participated in the external auditing program and 47 beams of X-ray and electron were independently calibrated by the third party’s American Association of Physicists in Medicine (AAPM) task group (TG)-51 protocol. Even though the AAPM TG-51 protocol recommended the use of water, water as a phantom has a few disadvantages, especially in a busy clinic. Instead, we used solid water phantom due to its reproducibility and convenience in terms of setup and transport. Dose conversion factors between solid water and water were determined for photon and electron beams of various energies by using a scaling method and experimental measurements. Results: Most of the beams (74%) were within ${\pm}2%$ of the deviation from the third party's protocol. However, two of 20 X-ray beams and three of 27 electron beams were out of the tolerance (${\pm}3%$), including two beams with a >10% deviation. X-ray beams of higher than 6 MV had no conversion factors, while a 6 MV absorbed dose to a solid water phantom was 0.4% less than the dose to water. The electron dose conversion factors between the solid water phantom and water were determined: The higher the electron energy, the less is the conversion factor. The total uncertainty of the TG-51 protocol measurement using a solid water phantom was determined to be ${\pm}1.5%$. Conclusion: The developed method was successfully applied for the external auditing program, which could be evolved into a credential program of multi-institutional clinical trials. This dosimetry saved time for measuring doses as well as decreased the uncertainty of measurement possibly resulting from the reference setup in water.

• Progress in Medical Physics
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• v.28 no.2
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• pp.49-53
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• 2017

The energy distribution was calculated for an electron beam from an electron linear accelerator developed for medical applications using computational methods. The depth dose data for monoenergetic electrons from 0.1 MeV to 8.0 MeV were calculated by the DOSXYZ/nrc code. The calculated data were used to generate the energy distribution from the measured depth dose data by numerical iterations. The measured data in a previous work and an in-house computer program were used for the generation of energy distribution. As results, the mean energy and most probable energy of the energy distribution were 5.7 MeV and 6.2 MeV, respectively. These two values agreed with those determined by the IAEA dosimetry protocol using the measured depth dose.

• Progress in Medical Physics
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• v.22 no.2
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• pp.92-98
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• 2011

This study is to keep the accuracy and stability of the output dose evaluations for linear accelerator photon beams by using the air ionization chambers (TM31010, 0.125 cc, PTW) through the Task Group 51 protocol. The absorbed dose to water calibration factor $N_{dw}{^{Co-60}}$ was delivered from the air kerma calibration factor $N_k$ which was provided from manufacture through SSDL calibration for determination of output factor. The ionization chamber of TM31010 series was reviewed the calibration factor and other parameters for reduce the uncertainty within ${\pm}2%$ discrepancy and we found the supplied $N_{dw}{^{Co-60}}$ which was derived from Nk has shown a -2.8% uncertainty compare to that of PSDL. The authors provided the program to perform the output dosimetry with TG-51 protocol as it is composed same screen of TG-51 worksheets. The evaluated dose by determination of output factor delivered to postal TLD block for comparison the output dose to that of MDACC (RPC) in postal monitoring program. The results have shown the $1.001{\pm}0.013$ for 6 MV and $0.997{\pm}0.012$ discrepancy for 15 MV X rays for 5 years followed. This study shows the evaluated outputs for linear accelerate photon beams are very close to that of international output monitor with small discrepancy of ${\pm}1.3%$ with high reliability and showing the gradually stability after 2010.

• 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 the Korea Contents Association
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• v.8 no.11
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• pp.203-209
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• 2008

Nowadays the risk of radiation is getting more serious, so we must know the exact dose that was irradiated, Because very high radiation dose is used in radiation therapy field. We used the ionization chamber which measure the radiation dose in this study. We tried to know the incorrect result from the distortion of geometric structure of ionization chamber and we studied how to find the distortion of geometric structure of ionization chamber. We used a radio fluoroscopy to find the wound degree of electrode of ionization chamber and a reconstructed 3D CT image to analyze the wound degree of electrode quantitatively. we measured degree of distortion by comparing with absorbed dose of normal electrode and wound electrode. The comparative result is not absolute dosimetry at specific point but relative dosimetry between thats. We measured 4 MV, 10MV photon with same absorbed dose and dose rate. The degree of distortion of wound electrode was totally $5.5{\sim}7.2%$, and there was no difference between two energies. The variation induced from radiation dose to be irradiated and dose rate, and the degree of distortion from wound direction also was almost similar value. We could find that the geometric structure of ionization chamber that can influence a basic measurement of radiation dose can be changed by old usage and inattention of management in this study, especially winding of electrode can be happened, in radiation therapy field, It is very important to keep precise radiation dose quantitatively.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6133-6137
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• 2012

Purpose: To study the effect of bolus versus no bolus in the coverage of the nodal tumour volume with intensity-modulated radiotherapy (IMRT) for the treatment of nasopharyngeal carcinoma (NPC). Methods and Materials: This retrospective study used data from 5 consecutive patients with NPC who were treated with bolus for large neck nodes using IMRT from November 2011-January 2012 in our institute. All these patients were treated radically with IMRT according to our institution's protocol. Re-planning with IMRT without bolus for these patients with exactly the same target volumes were done for comparison. Comparison of the plans was done by comparing the V70 of PTV70-N, V66.5 of PTV70-N, V65.1 of PTV70-N and the surface dose of the PTV70-N. Results: The mean size of the largest diameter of the enlarged lymph nodes for the 5 patients was 3.9 cm. The mean distance of the GTV-N to the skin surface was 0.6 cm. The mean V70 of PTV70-N for the 5 patients showed an absolute advantage of 10.8% (92.4% vs. 81.6%) for the plan with bolus while the V66.5 of PTV70-N had an advantage of 8.1% (97.0% vs. 88.9%). The mean V65.1 also had an advantage of 7.1% (97.6% vs. 90.5%). The mean surface dose for the PTV70-N was also much higher at 61.1 Gy for the plans with bolus compared to only 23.5 Gy for the plans without bolus. Conclusion: Neck node bolus technique should be strongly considered in the treatment of NPC with enlarged lymph nodes treated with IMRT. It yields a superior dosimetry compared t o non-bolus plans with acceptable skin toxicity.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.307-312
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• 2009

The purpose of our study was to determine the eyeradiation dose when performing routine multi-detector computed tomography (MDCT). We also evaluated dose reduction and the effect on image quality of using a bismuth eye shield when performing head MDCT. Examinations were performed with a 64MDCT scanner. To compare the shielded/unshielded lens dose, the examination was performed with and without bismuth shielding in anthropomorphic phantom. To determine the average lens radiation dose, we imaged an anthropomorphic phantom into which calibrated photoluminescence glass dosimeter (PLD) were placed to measure the dose to lens. The phantom was imaged using the same protocol. Radiation doses to the lens with and without the lensshielding were measured and compared using the Student t test. In the qualitative evaluation of the MDCT scans, all were considered to be of diagnostic quality. We did not see any differences in quality between the shielded and unshielded brain. The mean radiation doses to the eyewith the shield and to those without the shield were 21.54 versus 10.46 mGy, respectively. The lens shield enabled a 51.3% decrease in radiation dose to the lens. Bismuth in-plane shielding for routine eye and head MDCT decreased radiation dose to the lenswithout qualitative changes in image quality. The other radiosensitive superficial organs specifically must be protected with shielding.

• Progress in Medical Physics
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• v.23 no.2
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• pp.114-122
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• 2012

For the determination of absorbed dose to water from a linear accelerator photon beams, it needs a exposure calibration factor $N_x$ or air kerma calibration factor $N_k$ of air ionization chamber. We used the exposure calibration factor $N_x$ to find the absorbed dose calibration factors of water in a reference source through the TG-21 and TRS-277 protocol. TG-21 used for determine the absorbed dose in accuracy, but it required complex calculations including the chamber dependent factors. The authors obtained the absorbed dose calibration factor $N_{dw}{^{Co-60}}$ for reduce the complex calculations with unknown $N_{dw}$ only with $N_x$ or $N_k$ calibration factor in a TM31010 (S/N 1055, 1057) ionization chambers. The results showed the uncertainty of calculated $N_{dw}$ of IC-15 which was known the $N_x$ and $N_{dw}$ is within -0.6% in TG-21, but 1.0% in TRS-277. and TM31010 was compared the $N_{dw}$ of SSDL to that of PSDL as shown the 0.4%, -2.8% uncertainty, respectively. The authors experimented with good agreement the calculated $N_{dw}$ is reliable for cross check the discrepancy of the calibration factor with unknown that of TM31010 and IC-15 chamber.

• Progress in Medical Physics
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• v.24 no.4
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• pp.315-322
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• 2013

The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.