• Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
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• 2003.11a
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• pp.380-383
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• 2003

The purpose of this study is to develope prototype EPID system and improve image quality of radiation therapy field imaging system using CCD camera. For this research we used Linac(Clinac 4/100), Copper metal plate, $Gd_2O_2S_2$ phosphor and CCD camera(Photronic). In this study we find best thickness of buil-up metal plate and acquired projection image of humanoid head phantom. Also we enhanced raw image data using superposition and histogram stretching method. Through the thickness optimized of metal plate and image processing, we confirmed of an improved image quality of an EPID system using CCD camera. As result, highest quality image was acquired at 1mm thickness of Copper metal plate and improved image quality by image processing methods.

• Progress in Medical Physics
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• v.28 no.2
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• pp.54-60
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• 2017

This study was designed to measure transit dose with an electronic portal imaging device (EPID) in eight patients treated with intensity modulated radiotherapy (IMRT), and to verify the accuracy of dose delivery to patients. The calculated dose map of the treatment planning system (TPS) was compared with the EPID based dose measured on the same plane with a gamma index method. The plan for each patient was verified prior to treatment with a diode array (MapCHECK) and portal dose image prediction (PDIP). To simulate possible patient positioning errors during treatment, outcomes were evaluated after an anthropomorphic phantom was displaced 5 and 10 mm in various directions. Based on 3%/3 mm criteria, the $mean{\pm}SD$ passing rates of MapCHECK, PDIP (pre-treatment QA) for 47 IMRT were $99.8{\pm}0.1%$, $99.0{\pm}0.7%$, and, respectively. Besides, passing rates using transit dosimetry was $90.0{\pm}1.5%$ for the same condition. Setup errors of 5 and 10 mm reduced the mean passing rates by 1.3% and 3.0% (inferior to superior), 2.2% and 4.3% (superior to inferior), 5.9% and 10.9% (left to right), and 8.9% and 16.3% (right to left), respectively. These findings suggest that the transit dose-based IMRT verification method using EPID, in which the transit dose from patients is compared with the dose map calculated from the TPS, may be useful in verifying various errors including setup and/or patient positioning error, inhomogeneity and target motions.

• Radiation Oncology Journal
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• v.14 no.1
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• pp.69-76
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• 1996

Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.107-113
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• 2000

Purpose : The goal of this study 닌as to improve the accuracy of three-dimensional conformal radiotherapy (3-D CRT) by measuring the treatment setup error and physiological movement of liver based on the analysis of images which were obtained by electronic portal imaging device (EPID). Materials and Methods : For 10 patients with hepatocellular carcinoma, 4-7 portal images were obtained by using EPID during the radiotherapy from each patient daiiy. We analyzed the setup error and physiological movement of liver based on the verification data. We also determined the safety margin of the tumor in 3-D CRT through the analysis of physiological movement. Results : The setup errors were measured as 3mm with standard deviation 1.70 mm in x direction and 3.7 mm with standard deviation 1.88 mm in y direction respectively. Hence, deviation were smaller than 5mm from the center of each axis. The measured range of liver movement due to the physiological motion was 8.63 mm on the average. Considering the motion of liver and setup error, the safety margin of tumor was at least 15 mm. Conclusion : EPID is a very useful device for the determination of the optimal margin of the tumor, and thus enhance the accuracy and stability of the 3-D CRT in patients with hepatocellular carcinoma.

• The Journal of Korean Society for Radiation Therapy
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• v.11 no.1
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• pp.16-21
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• 1999

Purpose : The aim of this study is to conform the possibility of the liquid type EPID as a QC tools to clinical indication and of replacement of the film dosimetry. Aditional aim is to describe a procedure for the use of a EPID as a physics calibration tool in the measurements of radiation beam parameters which are typically carried out with film. Method & Materials : In this study we used the Clinac 2100c/d with EPID. This system contains 65536 liquid-filled ion chambers arranged in a $256{\times}256$ matrix and the imaging area is $32.5{\times}32.5cm$ with liquid layer thickness of 1mm. The EPID was tested for different field sizes under typical clinical conditions and pixel values were calibrated against dose by producing images using various thickness of lead attenuators(lead step wedge) using 6 & 10MV x-ray. We placed various thickness of lead on the table of linear accelerator and set the portal vision an SDD of 100cm. To acquire portal image we change the field size and energy, and we recorded the average pixel value in a $3{\times}3$ pixel region of interest(ROI) at field center was recorded. The pixel values were also measured for different field sizes in order to evaluate the dependence of pixel value on x-ray energy spectrum and various scatter components. Result : The EPID, as a whole, was useful as a QA tool and dosimetry device. In mechanical check, cross-hair centering was well matched and the error was less than ?2mm and light/radiation field coincidence was less than 1mm also. In portal dosimetry the wider the field size the the higher the pixel value and as the lead thickness increase, the pixel value was exponentially decreased. Conclusions : The EPID was very suitable for QA tools and it can be used to measure exit dose during patients treatment with reasonable accuracy. But when indicate the EPID to clincal study deep consideration required

• Progress in Medical Physics
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• v.25 no.4
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• pp.281-287
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• 2014

The Winston Lutz test, which checks the accuracy of the isocenter for stereotactic radiosurgery (SRS), was performed with the commercial electronic portal imaging device (EPID). The usual Winston Lutz test with film was also performed for comparison with the test with EPID. The maximum difference in isocenter between the two methods was 0.32 mm. The Winston Lutz test using EPID is practical as it can reduce time and avoid human errors compared to the test with film.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.67-67
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• 2003

It is crucial to minimize setup errors of a cancer treatment machine using a high energy and to perform precise radiation therapy. Usually, port film has been used for verifying errors. The Korea Cancer Center Hospital (KCCH) has manufactured digital electronic portal imaging device (EPID) system to verify treatment machine errors as a Quality Assurance (Q.A) tool. This EPID was consisted of a metal/fluorescent screen, 45$^{\circ}$ mirror, a camera and an image grabber and could display the portal image with near real time KIRAMS has also made the acrylic phantom that has lead line of 1mm width for ligh/radiation field congruence verification and reference points phantom for using as an isocenter on portal image. We acquired portal images of 10$\times$10cm field size with this phantom by EPID and portal film rotating treatment head by 0.3$^{\circ}$, 0.6$^{\circ}$ and 0.9$^{\circ}$. To check field size, we acquired portal images with 18$\times$18cm, 19$\times$19cm and 20$\times$20cm field size with collimator angle 0$^{\circ}$ and 0.5$^{\circ}$ individually. We have performed Flatness comparison by displaying the line intensity from EPID and film images. The 0.6$^{\circ}$ shift of collimator angle was easily observed by edge detection of irradiated field size on EPID image. To the extent of one pixel (0.76mm) difference could be detected. We also have measured field size by finding optimal threshold value, finding isocenter, finding field edge and gauging distance between isocenter and edge. This EPID system could be used as a Q.A tool for checking field size, light/radiation congruence and flatness with a developed video based EPID.

• Progress in Medical Physics
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• v.24 no.4
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• pp.253-258
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• 2013

The purpose of this study is to evaluate and analyze the relationship between the external radiation dose reconstruction which is transmitted from the patient who receives radiation treatment through electronic portal imaging device (EPID) and the internal dose derived from the Monte Carlo simulation. As a comparative analysis of the two cases, it is performed to provide a basic indicator for similar studies. The geometric information of the experiment and that of the radiation source were entered into Monte Carlo n-particle (MCNPX) which is the computer simulation tool and to derive the EPID images, a tally card in MCNPX was used for visualizing and the imaging of the dose information. We set to source to surface distance (SSD) 100 cm for internal measurement and EPID. And the water phantom was set to be 100 cm of the source to surface distance (SSD) for the internal measurement and EPID was set to 90 cm of SSD which is 10 cm below. The internal dose was collected from the water phantom by using mesh tally function in MCNPX, accumulated dose data was acquired by four-portal beam exposures. At the same time, after getting the dose which had been passed through water phantom, dose reconstruction was performed using back-projection method. In order to analyze about two cases, we compared the penetrated dose by calibration of itself with the absorbed one. We also evaluated the reconstructed dose using EPID and partially accumulated (overlapped) dose in water phantom by four-portal beam exposures. The sum dose data of two cases were calculated as each 3.4580 MeV/g (absorbed dose in water) and 3.4354 MeV/g (EPID reconstruction). The result of sum dose match from two cases shows good agreement with 0.6536% dose error.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.77-84
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• 2012

Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

• Progress in Medical Physics
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• v.14 no.3
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• pp.151-160
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• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.