• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.603-609
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• 2022

The dose distribution in the human body was evaluated and analyzed through dosimetry data using water phantom, ionization chamber and simulated by Monte Carlo simulation for ^99mTc and ¹⁸F sources, which are frequently used in the nuclear medicine in this study. As a result of this study, it was found that the dose decreased exponentially as the distance from the radioisotope increased, and it particularly showed a tendency to decrease sharply when the radioisotope was separated by 5 cm. It means that a large amount of dose is delivered to an organ located within 4 cm of source's movement path when a source uptake in the human body. Numerically, it was formed in the rage of 0.16 to 2.16 pC/min for ^99mTc and 0.49 to 9.29 pC/min for ¹⁸F. In addition, the energy transfer coefficient calculated using the result was found to be similar to the measured value and the simulation value in the range of 0.240 to 0.260. Especially, when the measured data and the simulation value were compared, there was a difference is within 2%, so the reliability of the data was secured. In this study, the distribution of radiation generated from a source was calculated to quantitatively evaluate the internal dose by radioisotopes. It presented reliable results through comparative analysis of the measurement value and simulation value. Above all, it has a great significance to the point that it was presented by directly measuring the distribution of radiation in the human body.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.123-131
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• 2009

Purpose: We tested a sample of nuclear medicine workers at Korean healthcare institutions for internal contamination with radioactive isotopes, measuring concentrations and evaluating doses of individual exposure. Materials and Methods: The detection and measurement was performed on urine samples collected from 25 nuclear medicine workers at three large hospitals located in Seoul. Urine samples were collected once a week, 100~200 mL samples were gathered up to 6~10 times weekly. A high-purity germanium detector was used to measure gamma radiations in urine samples for the presence of radioactive isotopes. Based on the detection results, we estimated the amounts of intake and committed effective doses using IMBA software. In cases where committed effective doses could not be adequately evaluated with IMBA software, we estimated individual committed effective doses for radionuclides with a very short half life such as $^{99m}Tc$ and $^{123}I$, using the methods recommended by International Atomic Energy Agency. Results: Radionuclides detected through the analysis of urine samples included $^{99m}Tc$, $^{123}I$, $^{131}I$ and $^{201}Tl$, as well as $^{18}F$, a nuclide used in Positron Emission Tomography examinations. The committed effective doses, calculated based on the radionuclide concentrations in urine samples, ranged from 0 to 5 mSv, but were, in the majority of cases, less than 1 mSv. The committed effective dose exceeded 1 mSv in three of the samples, and all three were workers directly handling radioactive sources. No nurses were found to have a committed effective dose in excess of 1 mSv. Conclusions: To improve the accuracy of results, it may be necessary to conduct a long-term study, performed over a time span wide enough to allow the clear determination of the influence of seasonal factors. A larger sample should also help increase the reliability of results. However, as most Korean nuclear medicine workers are currently not necessary to monitored routinely for internal contamination with radionuclides. Notwithstanding, a continuous effort is recommended to reduce any unnecessary exposure to radioactive substances, even if in inconsequential amounts, by regularly surveying workplace environments and frequently monitoring atmospheric concentrations of radionuclides.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.20 no.2
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• pp.253-264
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• 1990

The purpose of this study was to estimate the distribution of absorbed doses of each important organs of head and neck region in panoramic radiography. Radiation dosimetry at internal anatomic sites and skin surfaces of phantom (RT-210 Humanoid Head & Neck Section/sup R/) was performed with lithium fluoride (TLD-100/sup R/) thermoluminescent dosimeters according to change of kilovoltage (65kVp, 75kVp and 85kVp) with 4 miliamperage and 20 second exposure time. The results obtained were as follows; Radiation absorbed doses of internal anatomic sites were presented the highest doses of 1.04 mGy, 1.065 mGy and 2.09 mGy in nasopharynx, relatively high doses of 0.525 mGy, 0.59 mGy and 1.108 mGy in deep lobe of parotid gland, 0.481 mGy, 0.68 mGy and 1.191 mGy in submandibular gland. But there were comparatively low doses of 0.172 mGy and 0.128 mGy in eyes and thyroid gland that absorbed dose was estimated at 85kVp. Radiation absorbed doses of skin surfaces were presented the highest doses of 1. 263 mGy, 1.538 mGy and 2.952 mGy in back side of first cervical vertebra and relatively high doses of 0.267 mGy, 0.401 mGy and 0.481 mGy in parotid gland. But there were comparatively low doses of 0.057 mGy, 0.068 mGy and 0.081 mGy in philtrum and 0.059 mGy in middle portion of chin that absorbed dose was estimated at 85kVp. According to increase of kilovoltage, the radiation absorbed doses were increased 1.1 times when kilovolt age changes from 65kVp to 75kVp and 1.9 times when kilovolt age changes from 75kVp to 85kVp at internal anatomic sites. According to increase of kilovoltage, the radiation absorbed doses were increased 1.3 times when kilovolt age changes from 65kVp to 75kVp and 1.6 times when kilovoltage changes from 75kVp to 85kVp at skin surfaces.

• Progress in Medical Physics
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• v.26 no.4
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• pp.241-249
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• 2015

As radiation therapy is one of three major cancer treatment methods, many cancer patients get radiation therapy. To exposure as much radiation to cancer while normal tissues near tumor get little radiation, medical physicists make a radiotherapy plan treatment and perform quality assurance before patient treatment. Despite these efforts, unintended medical accidents can occur by some errors. In order to solve the problem, patient internal dose reconstruction methods by measuring transit dose are suggested. As feasibility study for development of patient dose verification system, inverse square law, percentage depth dose and scatter factor are used to calculate dose in the water-equivalent homogeneous phantom. As a calibration results of ionization chamber and glass dosimeter to transit radiation, signals of glass dosimeter are 0.824 times at 6 MV and 0.736 times at 10 MV compared to dose measured by ionization chamber. Average scatter factor is 1.4 and Mayneord F factor was used to apply percentage depth dose data. When we verified the algorithm using the water-equivalent homogeneous phantom, maximum error was 1.65%.

• Journal of Radiation Protection and Research
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• v.25 no.4
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• pp.191-195
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• 2000

This study was undertaken to estimate the exposed dose of the medical personnel during the intracoronary radiotherapy procedure as a part of ongoing SPARE (Seoul National University Hospital Post-Angioplasty Rhenium) trial. Data of thirty-four patients among forty-two irradiated patients participating in this trial due to coronary artery stenosis were retrospectively analyzed. Intracoronary radiotherapy was delivered to the patient immediately after angioplasty ballooning. Prescribed dose was 17 Gy to media of the diseased artery and was delivered with $^{188}Re$ filled balloon catheter. Dosimetry was carried out with GM counter at eight different points. Ten centimeter and forty centimeter from the patient's heart were selected to represent maximum and whole-body exposed dose of the operator, respectively. Median delivered dose was 111.6 mCi with average treatment time of 576 seconds. Average exposed dose rate at 10 cm and 40 cm from the patient's heart were 0.43 mSv/hr and 0.30 mSv/hr, respectively. Average exposed doses per treatment were 0.07 mSv and 0.05 mSv for 10 cm and 40 cm from the patient's heart, respectively. Exposed doses measured are much lower than recommended limit of 50 mSv for radiation workers or 1 mSv for general population in ICRP-60. This study proves that current method of intracoronary radiotherapy incorporated in this trial is very safe regarding radiation protection.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3257-3265
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• 2015

Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.

• Progress in Medical Physics
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• v.12 no.1
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• pp.71-77
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• 2001

The region, near the edge of a radiation beam, where the dose changes rapidly according to the distance from the beam axis is known as the penumbra. There is a sharp dose gradient zone even in megavoltage photon beams due to source size, collimator, lead alloy block, other accessories, and internal scatter ray. We investigate dosimetric characteristics on penumbra regions of a standard collimator and compare to those of theoritical model for the optimal use of the system in radiotherapy. Peripheral dose distribution of 6 W Photon beams represents penumbral forming function as the depth. Also we have discussed that the peripheral dose distribution of clinical photon beams, differences between calculation dose use of emperical penumbral forming function and measurements in penumbral region. Predictions by emperical penumbral forming functions are compared with measurements in 3-dimensional water phantom and it is shown that the method is capable of reproduceing the measured peripheral dose values usually to within the statistical uncertainties of the data. The semiconductor detector and ion chamber were positioned at a dmax depth, 5cm depth, 10cm depth, and its specific ratio was determined using a scanning data. The effective penumbra, the distance from 80% to 20% isodose lines were analyzed as a function of the distance. The extent of penumbra will also expand with depth increase. Difference of measurement value and model functions value according to character of the detector show small error in dose distribution of the peripheral dose.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.9-15
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• 2003

Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.422-429
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• 1999

Purpose: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. Materials and Methods: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. Results: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. Conclusion: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our results suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.

• Progress in Medical Physics
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• v.9 no.3
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• pp.155-162
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• 1998

Ho-l66 was produced by neutron reaction in a reactor at the Korea Atomic Energy Institute (Taejon, Korea). Ho-l66 emits a high energy beta particles with a maximum energy of 1.85 MeV and small proportion of gamma rays (80 keV). Therefore, the radiation absorbed dose estimation could be based on the in-vivo quantification of the activity in tumors from the gamma camera images. Approximately 1 mCi of Ho-l66 in solution was mixed into the flood phantom and planar scintigraphic images were acquired with and without patient interposed between the phantom and scintillation camera. Transmission factor over an area of interest was calculated from the ratio of counts in selected regions of the two images described above. A dual-head gamma camera(Multispect2, Siemens, Hoffman Estates, IL, USA) equipped with medium energy collimators was utilized for imaging(80 keV${\pm}$10%). Fifty-nine year old female patient with hepatoma was enrolled into the therapeutic protocol after the informed consent obtained. Thirty millicuries(110MBq) of Ho-166-CHICO was injected into the right hepatic arterial branch supplying hepatoma. When the injection was completed, anterior and posterior scintigraphic views of the chest and pelvic regions were obtained for 3 successive days. Regions of interest (ROIs) were drawn over the organs in both the anterior and posterior views. The activity in those ROIs was estimated from geometric mean, calibration factor and transmission factors. Absorbed dose was calculated using the Marinelli formula and Medical Internal Radiation Dose (MIRD) schema. Tumor dose of the patient treated with 1110 MBq(30 mCi) Ho-l66 was calculated to be 179.7 Gy. Dose distribution to normal liver, spleen, lung and bone was 9.1, 10.3, 3.9, 5.0 % of the tumor dose respectively. In conclusion, tumor dose and absorbed dose to surrounding structures were calculated by daily external imaging after the Ho-l66 therapy for hepatoma. In order to limit the thresholding dose to each surrounding organ, absorbed dose calculation provides useful information.