• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.65-73
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• 2017

Purpose: Machine Performance Check (MPC) is a self-checking software based on the Electronic Portal Imaging Device (EPID) to measure daily beam outputs without external installation. The purpose of this study is to verify the usefulness of MPC by comparing and correlating daily beam output of QA Beamchecker PLUS. Materials and Methods: Linear accelerator (Truebeam 2.5) was used to measure 10 energies which are composed of photon beams(6, 10, 15 MV and 6, 10 MV-FFF) and electron beams(6, 9, 12, 16 and 20 MeV). A total of 80 cycles of data was obtained by measuring beam output measurement before treatment over five months period. The Pearson correlation coefficient was used to evaluate the consistency of the beam output between the MPC and the QA Beamchecker PLUS. In this study, if the Pearson correlation coefficient is; (1) 0.8 or higher, the correlation is very strong (2) between 0.6 and 0.79, the correlation is strong (3) between 0.4 and 0.59, the correlation is moderate (4) between 0.2 and 0.39, the correlation is weak (5) lower than 0.2, the correlation is very weak. Results: Output variations observed between MPC and QA Beamchecker PLUS were within 2 % for photons and electrons. The beam outputs variations of MPC were $0.29{\pm}0.26%$ and $0.30{\pm}0.26%$ for photon and electron beams, respectively. QA Beamchecker PLUS beam outputs were $0.31{\pm}0.24%$ and $0.33{\pm}0.24%$ for photon and electron beams, respectively. The Pearson correlation coefficient between MPC and QA Beamchecker PLUS indicated that photon beams were very strong at 15 MV, and strong at 6 MV, 10 MV, 6 MV-FFF and 10 MV-FFF. For electron beams, the Pearson correlation coefficient were strong at 16 MeV and 20 MeV, moderate at 9 MeV and 12 MeV, and very weak at 6 MeV. Conclusion: MPC showed significantly strong correlation with QA Beamchecker PLUS when testing with photon beams and high-energy electron beams in the evaluation of daily beam output, but the correlation when testing with low-energy electron beams (6 MeV) appeared to be low. However, MPC and QA Beamchecker PLUS are considered to be suitable for checking daily beam output, as they performed within 2 % of beam output consistency during the observation. MPC which can perform faster than the conventional daily beam output measurement tool, is considered to be an effective method for users.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.321-327
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• 2014

Purpose : To verify the accuracy of the Ecilpse's dose calculation algorithm(AAA:Analytic anisotropic algorithm) in case of a radiation treatment on Inhomogeneous tissues using FFF beam comparing dose distribution at TPS with actual distribution. Materials and Methods : After acquiring CT images for radiation treatment by the location of tumors and sizes using the solid water phantoms, cork and chest tumor phantom made of paraffin, we established the treatment plan for 6MV photon therapy using our radiation treatment planning system for chest SABR, Ecilpse's AAA(Analytic anisotropic algorithm). According to the completed plan, using our TrueBeam STx(Varian medical system, Palo Alto, CA), we irradiated radiation on the chest tumor phantom on which EBT2 films are inserted and evaluated the dose value of the treatment plan and that of the actual phantom on Inhomogeneous tissue. Results : The difference of the dose value between TPS and measurement at the medial target is 1.28~2.7%, and, at the side of target including inhomogeneous tissues, the difference is 2.02%~7.40% at Ant, 4.46%~14.84% at Post, 0.98%~7.12% at Rt, 1.36%~4.08% at Lt, 2.38%~4.98% at Sup, and 0.94%~3.54% at Inf. Conclusion : In this study, we discovered the possibility of dose calculation's errors caused by FFF beam's characteristics and the inhomogeneous tissues when we do SBRT for inhomogeneous tissues. SBRT which is most popular therapy method needs high accuracy because it irradiates high dose radiation in small fraction. So, it is supposed that ideal treatment is possible if we minimize the errors when planning for treatment through more study about organ's characteristics like Inhomogeneous tissues and FFF beam's characteristics.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.7-12
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• 2022

Purpose: When it is difficult to secure the skin dose when treating Irregularly Shaped Skin Surface such as the nose where it is difficult to apply a bolus, increase the skin dose with a treatment plan that combines the IMRT (Intensity Modulated Radiation Therapy) delivery technique and FFF (Flattening Filter Free), It was tried to find out whether or not through the phantom experiment. Materials & Methods: Based on the 6MV-FF (Flattening Filter) and VMAT (Volumetric-Modulated Arc Therapy) treatment plans, which are the most commonly used treatment plans for head and neck cancer, A comparison group was created by combining VMAT and IMRT, FF and FFF, and the presence or absence of 5 mm bolus application. A virtual target was created on the Rando Phantom's nose, and a virtual bolus of 5 mm was applied assuming full contact on the Rando Phantom's nose. Five measurement points were determined based on the phantom's nose, and the absorbed dose was measured by irradiating each treatment plan 3 times per treatment plan according to the treatment technique and whether or not the bolus was applied. Result: The difference in skin dose in FF vs FFF increased in the case of FFF in VMAT bolus off, and there was no difference in case of IMRT bolus off. In VMAT bolus 5 mm and IMRT bolus 5 mm, it was confirmed that the skin dose was rather decreased in FFF. The difference in skin dose between VMAT and IMRT increased only in the case of FFF bolus off, and there was no statistical difference in the rest. For the difference in skin dose between bolus off vs bolus 5 mm, it was confirmed that the skin dose increased at bolus 5 mm, except for the case of using IMRT FFF. The treatment plan combining IMRT and FFF did not find any statistically significant difference as a result of analyzing the measured values of the treatment plan skin dose applied with a 5 mm bolus using the commonly used VMAT and FF. Therefore, it is thought that by using IMRT_FFF, it is possible to deliver a skin dose similar to that of applying a 5 mm bolus to VMAT_FF, which can be useful for patients who need a high skin dose but have difficulty applying a bolus. Conclusion: For patients who find it difficult to apply bolus, an increase in skin dose can be expected with a treatment plan that properly combines IMRT and FFF compared to VMAT and FF.

• Journal of the Korean Society of Radiology
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• v.13 no.1
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• pp.119-124
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• 2019

Radiation therapy using flattening filter free beam can prevent beam attenuation caused by flattening filter and can improve treatment efficiency. However, accurate dose control is not established for nonuniform iso dose distributions. In this study, curved dosimeter based on photoconductive material $HgI_2$ was fabricated and its reproducibility and linearity were evaluated at 6 MV photon energy to verify its performance. In order to show the usefulness of the curved measurement, the signals measured on the flat substrate and the curved substrate were compared in the flattening filter free beam using the acrylic filter. As a result, the reproducibility of the unit cell dosimeter was evaluated as SE 0.613%, and the linearity was evaluated as R-sq 0.9999. The usability evaluation of the array curve dosimeter demonstrated its usefulness by indicating a curvature error rate of 11.073%p and a reduced error rate.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.115-121
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• 2013

Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.

• Progress in Medical Physics
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• v.25 no.4
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• pp.210-217
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• 2014

This study investigated the dosimetric effects of different dose calculation algorithm for lung stereotactic ablative radiotherapy (SABR) using flattening filter-free (FFF) beams. A total of 10 patients with lung cancer who were treated with SABR were evaluated. All treatment plans were created using an Acuros XB (AXB) of an Eclipse treatment planning system. An additional plans for comparison of different alagorithm recalcuated with anisotropic analytic algorithm (AAA) algorithm. To address both algorithms, the cumulative dose-volume histogram (DVH) was analyzed for the planning target volume (PTV) and organs at risk (OARs). Technical parameters, such as the computation times and total monitor units (MUs), were also evaluated. A comparison analysis of DVHs from these plans revealed the PTV for AXB estimated a higher maximum dose (5.2%) and lower minimum dose (4.2%) than that of the AAA. The highest dose difference observed 7.06% for the PTV $V_{105%}$. The maximum dose to the lung was also slightly larger in the AXB plans. The percentate volumes of the ipsilateral lung ($V_5$, $V_{10}$, $V_{20}$) receiving 5, 10, and 20 Gy were also larger in AXB plans than for AAA plans. However, these parameters were comparable between both AAA and AXB plans for the contralateral lung. The differences of the maximum dose for the spinal cord and heart were also small. The computation time of AXB plans was 13.7% shorter than that of AAA plans. The average MUs were 3.47% larger for AXB plans than for AAA plans. The results of this study suggest that AXB algorithm can provide advantages such as accurate dose calculations and reduced computation time in lung SABR plan using FFF beams, especially for volumetric modulated arc therapy technique.