• Title/Summary/Keyword: Head & Neck CT

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A Study on Superficial Dose of 6MV-FFF in HalcyonTM LINAC: Phantom Study (HalcyonTM 선형가속기 6MV-FFF 에너지의 표재 선량에 대한 고찰: Phantom Study)

  • Choi, Seong Hoon;Um, Ki Cheon;Yoo, Soon Mi;Park, Je Wan;Song, Heung Kwon;Yoon, In Ha
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.31-39
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    • 2020
  • Purpose: The aims of this study were to compare the superficial dose with Optically Stimulated Luminescence Dosimeter(OSLD) measurement and Treatment Planning System(TPS) calculation for 6MV-Flattening Filter Free(FFF) energy using HalcyonTM and TrueBeamTM. Materials and methods: Phantom study was performed using the CT images of human phantom. In the treatment planning system, the Planning Target Volume(PTV) was contoured which is similar to Glottic cancer. Furthermore, Point(M), Point(R), and Point(L) were contoured at the iso-center of head and neck region and 5mm bolus was applied to the body contour. Each treatment plans using 6MV-FFF energy from HalcyonTM and TrueBeamTM with static Intensity Modulated Radiation Therapy(IMRT) and Volumetric Modulated Arc Therapy(VMAT) were established with eclipse. To reproduce the same position as the TPS, OSLDs were placed at the iso-center point and 5mm bolus was applied to compare the error rate after the dose delivery. Result: The results of the study using human phantom are as follows. In case of HalcyonTM, the mean absolute error rates of the point dose using the treatment planning system and the dose measured by OSLD were 1.7%±1.2% for VMAT and 4.0±2.8% for IMRT. Also TrueBeamTM was identified as 2.4±0.4% and 8.6±1.8% respectively for VMAT and IMRT. Conclusion: Through the results of this study, TrueBeamTM confirmed that the average error rate was 2.4 times higher for VMAT and 3.6 times higher for IMRT than HalcyonTM. Therefore, based on the results of this study, If we need a more accurate dose assessment for the superficial dose, It is expected that using HalcyonTM would be better than TrueBeamTM.

Dose Planning of Forward Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer using Compensating Filters (보상여과판을 이용한 비인강암의 전방위 강도변조 방사선치료계획)

  • Chu Sung Sil;Lee Sang-wook;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.53-65
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    • 2001
  • Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

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Intensity Modulated Radiation Therapy Commissioning and Quality Assurance: Implementation of AAPM TG119 (세기조절방사선치료(IMRT)의 Commissioning 및 정도관리: AAPM TG119 적용)

  • Ahn, Woo-Sang;Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.99-105
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    • 2011
  • The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

Development of Video Image-Guided Setup (VIGS) System for Tomotherapy: Preliminary Study (단층치료용 비디오 영상기반 셋업 장치의 개발: 예비연구)

  • Kim, Jin Sung;Ju, Sang Gyu;Hong, Chae Seon;Jeong, Jaewon;Son, Kihong;Shin, Jung Suk;Shin, Eunheak;Ahn, Sung Hwan;Han, Youngyih;Choi, Doo Ho
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.85-91
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    • 2013
  • At present, megavoltage computed tomography (MVCT) is the only method used to correct the position of tomotherapy patients. MVCT produces extra radiation, in addition to the radiation used for treatment, and repositioning also takes up much of the total treatment time. To address these issues, we suggest the use of a video image-guided setup (VIGS) system for correcting the position of tomotherapy patients. We developed an in-house program to correct the exact position of patients using two orthogonal images obtained from two video cameras installed at $90^{\circ}$ and fastened inside the tomotherapy gantry. The system is programmed to make automatic registration possible with the use of edge detection of the user-defined region of interest (ROI). A head-and-neck patient is then simulated using a humanoid phantom. After taking the computed tomography (CT) image, tomotherapy planning is performed. To mimic a clinical treatment course, we used an immobilization device to position the phantom on the tomotherapy couch and, using MVCT, corrected its position to match the one captured when the treatment was planned. Video images of the corrected position were used as reference images for the VIGS system. First, the position was repeatedly corrected 10 times using MVCT, and based on the saved reference video image, the patient position was then corrected 10 times using the VIGS method. Thereafter, the results of the two correction methods were compared. The results demonstrated that patient positioning using a video-imaging method ($41.7{\pm}11.2$ seconds) significantly reduces the overall time of the MVCT method ($420{\pm}6$ seconds) (p<0.05). However, there was no meaningful difference in accuracy between the two methods (x=0.11 mm, y=0.27 mm, z=0.58 mm, p>0.05). Because VIGS provides a more accurate result and reduces the required time, compared with the MVCT method, it is expected to manage the overall tomotherapy treatment process more efficiently.

Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.