• Progress in Medical Physics
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• v.25 no.3
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• pp.139-142
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• 2014

The purpose of this study was to develop a system of clinical application of reconstructed dose that includes dose reconstruction, reconstructed dose registration between fractions of treatment, and dose-volume-histogram generation and to demonstrate the system on a deformable prostate phantom. To achieve this purpose, a deformable prostate phantom was embedded into a 20 cm-deep and 40 cm-wide water phantom. The phantom was CT scanned and the anatomical models of prostate, seminal vesicles, and rectum were contoured. A coplanar 4-field intensity modulated radiation therapy (IMRT) plan was used for this study. Organ deformation was simulated by inserting a "transrectal" balloon containing 20 ml of water. A new CT scan was obtained and the deformed structures were contoured. Dose responses in phantoms and electronic portal imaging device (EPID) were calculated by using the XVMC Monte Carlo code. The IMRT plan was delivered to the two phantoms and integrated EPID images were respectively acquired. Dose reconstruction was performed on these images using the calculated responses. The deformed phantom was registered to the original phantom using an in-house developed software based on the Demons algorithm. The transfer matrix for each voxel was obtained and used to correlate the two sets of the reconstructed dose to generate a cumulative reconstructed dose on the original phantom. Forwardly calculated planning dose in the original phantom was compared to the cumulative reconstructed dose from EPID in the original phantom. The prescribed 200 cGy isodose lines showed little difference with respect to the "prostate" and "seminal vesicles", but appreciable difference (3%) was observed at the dose level greater than 210 cGy. In the rectum, the reconstructed dose showed lower volume coverage by a few percent than the plan dose in the dose range of 150 to 200 cGy. Through this study, the system of clinical application of reconstructed dose was successfully developed and demonstrated. The organ deformation simulated in this study resulted in small but observable dose changes in the target and critical structure.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.83-91
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• 2017

Objectives: The purpose of this study was to evaluate the error of the leaf position accuracy of the MLC due to the gravity effect according to the gantry angle by using picket fence test using EPID and GafChromic EBT3 film. Materials and Methods: A 5 cm solid phantom was placed on the table and the SAD was set to 100 cm. The EBT3 film was placed exactly over the solid phantom and covered a 1.5 cm solid phantom and the picket fence test was performed. The EPID was measured under the same conditions as the EBT3 film at SID 100 cm. The gantry angles were measured at $0^{\circ}$, $90^{\circ}$, $180^{\circ}$ and $270^{\circ}$ in order to evaluate the position of the MLC according to the gantry angle. For the geometric evaluation of the MLC, the leaf position accuracy of the MLC was analyzed using the analysis program. Results: In case of EPID, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.18 mm, 0.31 mm, 0.20 mm, 0.26 mm on the average and the maximum values of the errors were respectively 0.44 mm, 0.54 mm, 0.34 mm, 0.44 mm. In case of EBT3 film, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.19 mm, 0.21 mm, 0.19 mm, 0.31 mm on the average and the maximum values of the errors were respectively 0.35 mm, 0.45 mm, 0.36 mm, 0.48 mm. Conclusion: In this study, we analyzed the position error of the leaf of the MLC according to the gantry angle, and confirmed the position error of the leaf by gravity effect. As a result of comparing the leaf position accuracy using EPID and EBT3 film according to the variation of gantry angle, a larger error occurred in the error analysis method using EPID than that of EBT3 film. Therefore, in the case of IMRT based on MLC, as well as verification of accurate dosimetry should be conducted, it is considered that the quality control and verification for the precise operation of the MLC will be needed. and it is necessary to compare and verify the method of analysis.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.91-102
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• 2009

Purpose: To compare the accuracy and efficacy of EDR2 film, a 2D ionization chamber array (MatriXX) and an amorphous silicon electronic portal imaging device (EPID) in the pre-treatment QA of IMRT. Materials and Methods: Fluence patterns, shaped as a wedge with 10 steps (segments) by a multi-leaf collimator (MLC), of reference and test IMRT fields were measured using EDR2 film, the MatriXX, and EPID. Test fields were designed to simulate leaf positioning errors. The absolute dose at a point in each step of the reference fields was measured in a water phantom with an ionization chamber and was compared to the dose obtained with the use of EDR2 film, the MatriXX and EPID. For qualitative analysis, all measured fluence patterns of both reference and test fields were compared with calculated dose maps from a radiation treatment planning system (Pinnacle, Philips, USA) using profiles and $\gamma$ evaluation with 3%/3 mm and 2%/2 mm criteria. By measurement of the time to perform QA, we compared the workload of EDR2 film, the MatriXX and EPID. Results: The percent absolute dose difference between the measured and ionization chamber dose was within 1% for the EPID, 2% for the MatriXX and 3% for EDR2 film. The percentage of pixels with $\gamma$%>1 for the 3%/3 mm and 2%/2 mm criteria was within 2% for use of both EDR2 film and the EPID. However, differences for the use of the MatriXX were seen with a maximum difference as great as 5.94% with the 2%/2 mm criteria. For the test fields, EDR2 film and EPID could detect leaf-positioning errors on the order of -3 mm and -2 mm, respectively. However it was difficult to differentiate leaf-positioning errors with the MatriXX due to its poor resolution. The approximate time to perform QA was 110 minutes for the use of EDR2 film, 80 minutes for the use of the MatriXX and approximately 55 minutes for the use of the EPID. Conclusion: This study has evaluated the accuracy and efficacy of EDR2 film, the MatriXX and EPID in the pre-treatment verification of IMRT. EDR2 film and the EPID showed better performance for accuracy, while the use of the MatriXX significantly reduced measurement and analysis times. We propose practical and useful methods to establish an effective QA system in a clinical environment.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.1
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• pp.1-5
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• 2007

Purpose: The accuracy and advantages of OBI(On Board Imager) against the conventional method like film and EPID for the setup error correction were evaluated with the analysis of the accumulated data which were produced in the process of setup error correction using OBI. Materials and Methods: The results of setup error correction using OBI system were analyzed for the 130 patients who had been planned for 3 dimensional conformal radiation therapy during March 2006 and May 2006. Two kilo voltage images acquired in the orthogonal direction were fused and compared with reference setup images. The setup errors in the direction of vertical, lateral, longitudinal axis were recorded and calculated the distance from the isocenter. The corrected setup error were analyzed according to the lesion and the degree of shift variations. Results: There was no setup error in the 41.5% of total analyzed patients and setup errors between 1mm and 5mm were found in the 52.3%. 6.1% patients showed the more than 5mm shift and this error were verified as a difference of setup position and the movement of patient in a treatment room. Conclusion: The setup error analysis using OBI in this study verified that the conventional setup process in accordance with the laser and field light was not enough to get rid of the setup error. The KV images acquired using OBI provided good image quality for comparing with simulation images and much lower patients' exposure dose compared with conventional method of using EPID. These advantages of OBI system which were confirmed in this study proved the accuracy and priority of OBI system in the process of IGRT(Image Guided Radiation Therapy).