• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.57-67
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• 2013

Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

• Progress in Medical Physics
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• v.14 no.2
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• pp.74-80
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• 2003

The purpose of this study was to evaluate the performance of the teflon encapsulated TLD rod, which may be used in nuclear medicine for the direct in vivo measurements of radiation dose. We analyzed the influence of teflon encapsulation for measuring absorbed dose. An experiment was carried out to evaluate and observe the response of a LiF TLD-100 rod in a thin-wall teflon capsule at different depths in a solid phantom. An adult anthropomorphic phantom was used to measure the absorbed dose using thin teflon encapsulated TLD. The measurements of PDD-, and TMR in solid phantom and athe bsorbed dose in humanoid phantom performed with normal TLD were compared with values obtained by teflon encapsulated TLD. It was demonstrated that the difference of TL response of LiF in phantom with and without teflon thin-wall capsule was less than 3％ under the same conditions beyond the build-up region. However, significant differences were observed near the phantom surface because of the build-up effect caused by the thin-wall thickness of the teflon capsule. Thus, our study showed that the contribution of teflon thin-wall capsule to TLD response for the megavoltage photon beams was negligible and that it did not significantly effect dose measurement. The teflon encapsulated TLD described in this work has been proven to be appropriate for in vivo dosimetry in therapeutic environments.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.85-85
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• 2006

• Journal of the Korean Physical Society
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• v.73 no.10
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• pp.1571-1576
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• 2018

We developed and evaluated an algorithm to calculate the target radiation dose in cancer patients by measuring the transmitted dose during 3D conformal radiation treatment (3D-CRT) treatment. The patient target doses were calculated from the transit dose, which was measured using a glass dosimeter positioned 150 cm from the source. The accuracy of the transit dose algorithm was evaluated using a solid water phantom for five patient treatment plans. We performed transit dose-based patient dose verification during the actual treatment of 34 patients who underwent 3D-CRT. These included 17 patients with breast cancer, 11 with pelvic cancer, and 6 with other cancers. In the solid water phantom study, the difference between the transit dosimetry algorithm with the treatment planning system (TPS) and the measurement was $-0.10{\pm}1.93%$. In the clinical study, this difference was $0.94{\pm}4.13%$ for the patients with 17 breast cancers, $-0.11{\pm}3.50%$ for the eight with rectal cancer, $0.51{\pm}5.10%$ for the four with bone cancer, and $0.91{\pm}3.69%$ for the other five. These results suggest that transit-dosimetry-based in-room patient dose verification is a useful application for 3D-CRT. We expect that this technique will be widely applicable for patient safety in the treatment room through improvements in the transit dosimetry algorithm for complicated treatment techniques (including intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT).

• Progress in Medical Physics
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• v.24 no.2
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• pp.92-98
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• 2013

The experimental verification of treatment planning on the treatment spot is the ultimate method to assure quality of radiotherapy, so in-vivo skin dose measurement is the essential procedure to confirm treatment dose. In this study, glass rod dosimeter (GRD), which is a kind of photo-luminescent based dosimeters, was studied to produce a guideline to use GRDs in vivo dosimetry for quality assurance of radiotherapy. The pre-processing procedure is essential to use GRDs. This is a heating operation for stabilization. Two kinds of pre-processing methods are recommended by manufacturer: a heating method (70 degree, 30 minutes) and a waiting method (room temperature, 24 hours). We equally irradiated 1.0 Gy to 20 GRD elements, and then different preprocessing were performed to 10 GRDs each. In heating method, reading deviation of GRDs at same time were relatively high, but the deviation was very low as time went on. In waiting method, the deviation among GRDs was low, but the deviation was relatively high as time went on. The meaningful difference was found between mean reading values of two pre-processing methods. Both methods present mean dose deviation under 5%, but the relatively high effect by reading time was observed in waiting method. Finally, GRD is best to perform in-vivo dosimetry in the viewpoint of accuracy and efficiency, and the understanding of how pre-processing affect the accuracy is asked to perform most accurate in-vivo dosimetry. The further study is asked to acquire more stable accuracy in spite of different irradiation conditions for GRD usage.

• Journal of Radiation Protection and Research
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• v.36 no.1
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• pp.23-27
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• 2011

In order to confirm feasibility of MOSFET modality in use of in.vivo dosimetry, evaluation of gonad shielding in order to minimize gonadal dose of patients undergoing radiotherapy by using MOSFET modality was performed. Gonadal dose of patients undergoing radiotherapy for rectal cancer in the department of radiation oncology of Seoul National University Hospital since 2009 was measured. 6 MV and 15 MV photon beams emitted from Varian 21EX LINAC were used for radiotherapy. In order to minimize exposed dose caused by the scattered ray not only from collimator of LINAC but also from treatment region inside radiation field, we used box.shaped lead shielding material. The shielding material was made of the lead block and consists of $7.5\; cm\;{\times}\;9.5\;cm\;{\times}5.5\;cm$ sized case and $9\;cm\;{\times}\;9.5\;cm\;{\times}\;1\;cm$ sized cover. Dosimetry for evaluation of gonad shielding was done with MOSFET modality. By protecting with gonad shielding material, average gonadal dose of patients was decreased by 23.07% compared with reference dose outside of the shielding material. Average delivered gonadal dose inside the shielding material was 0.01 Gy. By the result of MOSFET dosimetry, we verified that gonadal dose was decreased by using gonad shielding material. In compare with TLD dosimetry, we could measure the exposed dose easily and precisely with MOSFET modality.

• Progress in Medical Physics
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• v.28 no.1
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• pp.33-38
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• 2017

Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.133-140
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• 2005

Purpose : This test is designed to identify the validity of treatment plan by implementing real-time dosimetry by means of dose that is absorbed into PTV and OAR when preparing doses of 3D and POP plans. Materials and Methods : In treatment. error can be calculated be comparing Exp. Dose with the actual dose, which has been converted from 'the reading value obtained by placing diode detector on the area to be measured'. Same test can be repeated using Alderson-Rando phantom. Results : Errors were found: A patient(POP plan): 197.6/199=-1.2%, B patient(3D-plan): 199.9/198.7=+0.6%, C patient: 196/200=-1.5%. In addition, considering the resulted value of measuring OAR besides target-dose for C patient showed 96/200, representing does of 47%, the purpose of protection was judged to be duly accomplished. Also it was acknowledged the resulted value of -3.7% met the targeted dose within the range of ${\pm}5%$. Conclusion : Aimed for identifying the usefulness of pre-treatment dose measurement using diode detector, this test was useful to evaluate the validity of curing because it resulted in the identification of category to be protected as well as t dose. Moreover, it is thought to have great advantage in ascertaining the dose of target, dose of which is not calculated yet. Similar to L-gram before treatment, this test is thought to be very effective so that it can bring great advantages in the aspects such as validity of curing method and post-treatment plan as well.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.74-81
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• 2000

Purpose: The purpose of this study was to develop in vivo dosimetries using both chromosomal aberrations and micronuclei in mice to assess biological effects of radiations. Materials and Methods: Five each mice were irradiated with 0, 1, 2, 3, 4, 5, 10 Gy of Cs-137 gamma-rays. We scored numbers of chromosomal aberrations in metaphase spreads and numbers of micronuclei in bone marrow smears under light microscope, and obtained the dose-response relationships. We also examined the relationship between the two dose-response curves. Results: The frequency of both chromosomal aberrations and micronuclei increased with dose, in a linear-quadratic manner The delta, beta, and alpha coefficients were 0.0176, 0.0324, and 0.0567 for metaphase analysis (r=1.0, p<0.001) and 0.0019, 0.0073, and 0.0506 for micronuclei assay (r=1.0, p<0.001). The frequency of chromosomal aberrations and micronuclei in different radiation doses was significantly correlated (r=0.99, p<0.01). Conclusion: In vivo dosimetry using either metaphase analysis or micronucleus assay was feasible in mice. These methods could be useful to evaluate biological effects of radiation.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.274-282
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• 2002

Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, the algorithm for estimating the transmission dose for open radiation fields was modified for application to partially blocked radiation fields. Materials and Methods : The beam data was measured with a flat solid phantom with various blocked fields. A new correction algorithm for partially blocked radiation field was developed from the measured data. This algorithm was tested in some settings simulating clinical treatment with an irregular field shape. Results : The correction algorithm for the beam block could accurately reflect the effect of the beam block, with an error within ${\pm}1.0\%$, with both square fields and irregularly shaped fields. Conclusion : This algorithm can accurately estimate the transmission dose in most radiation treatment settings, including irregularly shaped field.