• Journal of Radiation Protection and Research
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• v.27 no.1
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• pp.37-49
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• 2002

The accuracy of radiation dose delivery to target volume is one of the most important factors for good local control and less treatment complication. In vivo dosimetry is an essential QA procedure to confirm the radiation dose delivered to the patients. Transmission dose measurement is a useful method of in vivo dosimetry and it's advantages are non-invasiveness, simplicity and no additional efforts needed for dosimetry. In our department, in vivo dosimetry system using measurement of transmission dose was manufactured and algorithms for estimation of transmission dose were developed and tested with phantom in various conditions successfully. This system was applied in clinic to test stability, reproducibility and applicability to daily treatment and the accuracy of the algorithm. Transmission dose measurement was performed over three weeks. To test the reproducibility of this system, X-tay output was measured before daily treatment and then every hour during treatment time in reference condition(field size; $10 cm{\times} 10 cm$, 100 MU). Data of 11 patients whose pelvis were treated more than three times were analyzed. The reproducibility of the dosimetry system was acceptable with variations of measurement during each day and over 3 week period within ${\pm}2.0%$. On anterior- posterior and posterior fields, mean errors were between -5.20% and +2.20% without bone correction and between -0.62% and +3.32% with bone correction. On right and left lateral fields, mean errors were between -10.80% and +3.46% without bone correction and between -0.55% and +3.50% with bone correction. As the results, we could confirm the reproducibility and stability of our dosimetry system and its applicability in daily radiation treatment. We could also find that inhomogeneity correction for bone is essential and the estimated transmission doses are relatively accurate.

• Progress in Medical Physics
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• v.25 no.1
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• pp.23-30
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• 2014

The purpose of this study is to evaluate the developed dose verification program for in vivo dosimetry based on transit dose in radiotherapy. Five intensity modulated radiotherapy (IMRT) plans of lung cancer patients were used in the irradiation of a homogeneous solid water phantom and anthropomorphic phantom. Transit dose distribution was measured using electronic portal imaging device (EPID) and used for the calculation of in vivo dose in patient. The average passing rate compared with treatment planning system based on a gamma index with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit was 95% for the in vivo dose with the homogeneous phantom, but was reduced to 81.8% for the in vivo dose with the anthropomorphic phantom. This feasibility study suggested that transit dose-based in vivo dosimetry can provide information about the actual dose delivery to patients in the treatment room.

• Journal of Radiation Protection and Research
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• v.36 no.2
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• pp.86-92
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• 2011

This study used the optically stimulated luminescence dosimeters (OSLDs), recently, received the revaluation of usefulness in vivo dosimetry, and the diode detecters to measure the skin dose of patient with the rectal cancer. The measurements of dose delivered were compared with the planned dose from the treatment planning system (TPS). We evaluated the clinical application of OSDs in radiotherapy. We measured the calibration factor of OSLDs and used the percent depth dose to verified, also, we created the three point of surface by ten patients of rectal cancer to measured. The calibration factors of OSLD was 1.17 for 6 MV X-ray and 1.28 for 10 MV X-ray, demonstrating the energy dependency of X-ray beams. Comparison of surface dose measurement using the OSLDs and diode detectors with the planned dose from the TPS, The skin dose of patient was increased 1.16 ~ 2.83% for diode detectors, 1.36 ~ 2.17% for OSLDs. Especially, the difference between planned dose and the delivery dose was increased in the perineum, a skin of intense flexure region, and the OSLDs as a result of close spacing of measuring a variate showed a steady dose verification than the diode detecters. Therefore, on behalf of the ionization chamber and diode detecters, OSLDs could be applied clinically in the verification of radiation dose error and in vivo dosimety. The research on the dose verification of the rectal cancer in the around perineal, a surface of intense flexure region, suggest continue to be.

• Radiation Oncology Journal
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• v.20 no.4
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• pp.396-404
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• 2002

Purpose : Many papers support a correlation between rectal complications and rectal doses in uterine cervical cancer patients treated with radical radiotherapy. In vivo dosimetry in the rectum following the ICRU report 38 contributes to the quality assurance in HDR brachytherapy, especially in minimizing side effects. This study compares the rectal doses calculated in the radiation treatment planning system to that measured with a silicon diode the in vivo dosimetry system. Methods : Nine patients, with a uterine cervical carcinoma, treated with Iridium-192 high dose rate brachytherapy between June 2001 and Feb. 2002, were retrospectively analysed. Six to eight-fractions of high dose rate (HDR)-intracavitary radiotherapy (ICR) were delivered two times per week, with a total dose of $28\~32\;Gy$ to point A. In 44 applications, to the 9 patients, the measured rectal doses were analyzed and compared with the calculated rectal doses using the radiation treatment planning system. Using graphic approximation methods, in conjunction with localization radiographs, the expected dose values at the detector points of an intrarectal semiconductor dosimeter, were calculated. Results : There were significant differences between the calculated rectal doses, based on the simulation radiographs, and the calculated rectal doses, based on the radiographs in each fraction of the HDR ICR. Also, there were significant differences between the calculated and measured rectal doses based on the in-vivo diode dosimetry system. The rectal reference point on the anteroposterior line drawn through the lower end of the uterine sources, according to ICRU 38 report, received the maximum rectal doses in only 2 out of the nine patients $(22.2\%)$. Conclusion : In HDR ICR planning for conical cancer, optimization of the dose to the rectum by the computer-assisted planning system, using radiographs in simulation, is improper. This study showed that in vivo rectal dosimetry, using a diode detector during the HDR ICR, could have a useful role in quality control for HDR brachytherapy in cervical carcinomas. The importance of individual dosimeters for each HDR ICR is clear. In some departments that do not have the in vivo dosimetry system, the radiation oncologist has to find, from lateral fluoroscopic findings, the location of the rectal marker before each fractionated HDR brachytherapy, which is a necessary and important step of HDR brachytherapy for cervical cancer.

• Journal of Radiation Protection and Research
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• v.27 no.3
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• pp.147-154
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• 2002

Purpose : Measurement of transmission dose is useful for in vivo dosimetry of QA purpose. The objective of this study is to develope an algorithm for estimation of tumor dose using measured transmission dose for open radiation field. Materials and Methods : Transmission dose was measured with various field size (FS), phantom thickness (Tp), and phantom chamber distance (PCD) with a acrylic phantom for 6 MV and 10 MV X-ray. Source to chamber distance (SCD) was set to 150 cm. Measurement was conducted with a 0.6 co Farmer type ion chamber. Using measured data and regression analysis, an algorithm was developed lot estimation of expected reading of transmission dose. Accuracy of the algorithm was tested with flat solid phantom with various settings. Results : The algorithm consisted of quadratic function of log(A/P) (where A/P is area-perimeter ratio) and tertiary function of PCD. The algorithm could estimate dose with very high accuracy for open square field, with errors within ${\pm}0.5%$. For elongated radiation field, the errors were limited to ${\pm}1.0%$. Conclusion : The developed algorithm can accurately estimate the transmission dose in open radiation fields with various treatment settings.

• Journal of the Korean Society of Radiology
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• v.8 no.4
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• pp.171-180
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• 2014

In this study, the authors attempted to measure the skin dose by irradiating the actual dose on to the TLD(Thermo-Luminescence Dosimeter) and EBT3 Film used as the In-vivo dosimetry after planning the same treatment as the actual patient on a Phantom, because the erythema or dermatitis is frequently occurred on the patients' skin at the time of the proton therapy of medulloblastoma patient receiving the proton therapy. They intended to know whether there is the usefulness for the dosimetry of skin by the comparative analysis of the measured dose values with the treatment planned skin dose. The CT scan from the Brain to the Pelvis was done by placing a phantom on the CSI(Cranio-spinal irradiation) Set-up position of Medulloblastoma, and the treatment Isocenter point was aligned by using DIPS(Digital Image Positioning System) in the treatment room after planning a proton therapy. The treatment Isocenter point of 5 areas that the proton beam was entered into them, and Markers of 2 areas shown in the Phantom during CT scans, that is, in all 7 points, TLD and EBT3 Film pre-calibrated are alternatively attached, and the proton beam that the treatment was planned, was irradiated by 10 times, respectively. As a result of the comparative analysis of the average value calculated from the result values obtained by the repeated measurement of 10 times with the Skin Dose measured in the treatment planning system, the measured dose values of 6 points, except for one point that the accurate measurement was lacked due to the measurement position with a difficulty showed the distribution of the absolute dose value ${\pm}2%$ in both TLD and EBT Film. In conclusion, in this study, the clinical usefulness of the TLD and EBT3 Film for the Enterance skin dose measurement in the first proton therapy in Korea was confirmed.

• 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.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.155-163
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• 2004

Purpose : To confirm the reproducibility of in vivo transmission dosimetry system and the accuracy of the a1gorithms for the estimation of transmission dose in head and neck radiation therapy patients. Materials and Methods : From September 5 to 18, 2001, transmission dose measurements were peformed when radiotherapy was given to brain or head and neck cancer patients. The data of 35 patients who were treated more than three times and whose central axis of the beam was not blocked were analyzed in this study. To confirm the reproducibility of this system, transmission dose was measured before dally treatment and then repetitively every hour during the treatment time, with a field size of 10$\times$10 cm$^{2}$ and a delivery of 100 MU. The accuracy of the transmission dose calculation algorithms was confirmed by comparing estimated dose with measured dose. To accurately estimate transmission dose, tissue inhomogeneity correction was done. Results : The measurement variations during a day were within $\pm$0.5$\%$ and the dally variations in the checked period were within $\pm$ 1.0$\%$, which were acceptable for system reproducibility. The mean errors between estimated and measured doses were within $\pm$5.0$\%$ in Patients treated to the brain, $\pm$2.5$\%$ in head, and $\pm$ 5.0%$\%$in neck. Conclusion : The results of this study confirmed the reproducibility of our system and its usefulness and accuracy for dally treatment. We also found that tissue inhomogeneity correction was necessary for the accurate estimation of transmission dose in patients treated to the head and neck.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.53-60
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• 2015

Purpose : The purpose of this study is to evaluate the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. Materials and Methods : The phantom is produced to equally describe prostate and rectum based on a 3D volume contour of an actual prostate cancer patient who is treated in Asan Medical Center by using a 3D printer (3D EDISON+, Lokit, Korea). CT(Computed tomography) images of phantom are aquired by computed tomography (Lightspeed CT, GE, USA). By using treatment planning system (Eclipse version 10.0, Varian, USA), treatment planning is established after volume of a prostate cancer patient is compared with volume of the phantom. MOSFET(Metal OXIDE Silicon Field Effect Transistor) is estimated to identify precision and is located in 4 measuring points (bladder, prostate, rectal anterior wall and rectal posterior wall) to analyzed treatment planning and measured value. Results : Prostate volume and rectum volume of prostate cancer patient represent 30.61 cc and 51.19 cc respectively. In case of a phantom, prostate volume and rectum volume represent 31.12 cc and 53.52 cc respectively. A variation of volume between a prostate cancer patient and a phantom is less than 3%. Precision of MOSFET represents less than 3%. It indicates linearity and correlation coefficient indicates from 0.99 ~ 1.00 depending on dose variation. Each accuracy of bladder, prostate, rectal anterior wall and rectal posterior wall represent 1.4%, 2.6%, 3.7% and 1.5% respectively. In- vivo dosimetry represents entirely less than 5% considering precision of MOSFET. Conclusion : By using a 3D printer, possibility of phantom production based on prostate is verified precision within 3%. effectiveness of In-vivo dosimetry is confirmed from a phantom which is produced by a 3D printer. In-vivo dosimetry is evaluated entirely less than 5% considering precision of MOSFET. Therefore, This study is confirmed the usefulness of a 3D printed phantom for in-vivo dosimetry of a prostate cancer patient. It is necessary to additional phantom production by a 3D printer and In-vivo dosimetry for other organs of patient.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.43-51
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• 2017

Purpose: The purpose of this study is to evaluate the dosimetric effects of couch attenuation and air gaps using 3D phantom for prone breast radiation therapy. Materials and method: A 3D printer(Builder Extreme 1000) and computed tomography (CT) images of a breast cancer patient were used to manufacture the customized breast phantom. Eclipse External Beam Planning 13.6 (Varian Medical Systems Palo Alto, CA, USA) was used to create the treatment plan with a dose of 200 cGy per fraction with 6 MV energy. The Optically Stimulated Luminescence Detector(OSLD) was used to measure the skin dose at four points (Med 1, Med 2, Lat 1, Lat 2) on the 3D phantom and ion-chamber (FC65-G) were used to perform the in-vivo dosimetry at the two points (Anterior, Posterior). The Skin dose and in-vivo dosimetry were measured with reference air gap (3 cm) and increased air gaps (1, 2, 3, 4, 5, 6 cm) from reference distance between the couch and 3D phantom. Results: As a result, measurement for the skin dose at lateral point showed a similar value within ${\pm}4%$ compared to the plan. While the air gap increased, skin dose at medial 1 was reduced. And it was also reduced over 7 % when the air gap was more than 3 cm compared to radiation therapy plan. At medial 2 it was reduced over 4 % as well. The changes of dose from variety of the air gap showed similar value within ${\pm}1%$ at posterior. As the air gap was increased, the dose at anterior was also increased and it was increased by 1 % from the air gap distance more than 3 cm. Conclusion: Dosimetrical measurement using 3D phantom is very useful to evaluate the dosimetric effects of couch attenuation and air gaps for prone breast radiation therapy. And it is possible to reduce the skin dose and increase the accuracy of the radiation dose delivery by appling the optimized air gap.