• Progress in Medical Physics
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• v.14 no.2
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• pp.99-107
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• 2003

This study was performed to prepare the verification film for localizing beam-target position with the Photon Knife radiosurgery system (PKRS) using linear accelerator(Mitsubishi, Model ML-15MDX). We developed a laser calibration system using a reticle of transparent lucite to detect Inlet and outlet beams. We verified fixation of the second collimator with film mounted on a holder in the shape of an octagon block 5cm apart from the isocenter. The film was exposed to photon beams of linear accelerator at an interval of 45 degrees during the gantry movement. There were no shifts in the beam of the second collimator during gantry movement. We used a position marker which is designed a head-shaped small lead block and a 10 mm in diameter of steel bead in the plastic tube. The position marker helped to verify the beam directions with patient position in multi-arc and trans-multi-arc of PKRS The verification of beam alignments showed an average 0.8$\pm$0.26 mm discrepancy in LINAC-gram images of PKRS. In our study, the couch movement was $\pm$5 mm laterally, while it shook $\pm$ 2 mm toward the couch axis. The couch, however, was immediately returned to the initial site after shaking. Thus, we postulate that the beam-target position(s) should be verified with LINAC-gram in a stereotactic radiosurgery system to achieve the accuracy of beam-target alignment.

• The Journal of Korean Society for Radiation Therapy
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• v.9 no.1
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• pp.25-28
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• 1997

With the advances in radiation therapy technology and equipment, the need for more accurate and safer radiation delivery to the target region has been continuously growing. Stereotactic Radiosurgery(SRS) is a good example of $^{\ast}Accuracy^{\ast}$ but has a substantial risk of causing severe late neurological damages. Fractionated Stereotactic Radiation Therapy(FSRT) is a modification of SRS enabling conventional fractionation with maintaining accuracy using noninvasive and relocatable frame. Verification of mechanical accuracy in FSRT has been done according to the manufacture's recommendations using RLPP, LTLF, and Depth-helmet. In order to reinforce this, we have developed additional novel verification procedure using Linac-grams with the Angiolocalizer attached on the GTC frame, which are then digitized into the planning software(X-Knife) to generate the three dimensional coordinates for cmoparison. This method has been successful in such ways that the anatomical landmarks are identifiable on the Linac-gram films and that the serial comparisons of the stereotactic coordinates of the isocenter are possible with more certainty a along the FSRT course than before.

• The Journal of Korean Society for Radiation Therapy
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• v.5 no.1
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• pp.83-87
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• 1992

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.131-133
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• 1996

• Journal of The Korean Radiological Technologist Association
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• v.29 no.1
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• pp.123-123
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• 2003

• Journal of the Korean Graphic Arts Communication Society
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• v.19 no.2
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• pp.12-21
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• 2001

For the purpose of determining characteristics of widely used commercial medical x-ray films, which are used for obtaining the Linac-grams for radiational treatment of cancers, we placed several commercial x-ray films at a fixed distance form the linear accelerator. After varying the exposed amount of radiation step by step, we could obtain a continually increasing density image for each film whose densities were determined by microdensitometer readings. The characteristic curves of the films were obtained by plotting the densities vs. the exposed radiation amounts, and their ${\gamma}$ values were determined. These values can be used to suggest a minimum necessary amount of exposed radiation to get a useful Linac-gram. The measured ${\gamma}$ values of the characteristic curves of the Kodak-DVP/RA-1 film were 1.73 when used 6MV x-ray, 1.70 when used 15MV of intensity. For the Konica-AX film, ${\gamma}$ values were 1.29 and 1.18 respectively. The result suggests that the effective conditions for high resolution of a L-gram be 6 MV of x-ray intensity and about 3 rad of exposed dose on a Kodak-DVP/RA-1 film.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.1-9
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• 2008

Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

• Radiation Oncology Journal
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• v.27 no.1
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• pp.42-48
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• 2009

Purpose: The introduction of image guided radiation therapy/four-dimensional radiation therapy (IGRT/4DRT) potentially increases the accumulated dose to patients from imaging and verification processes as compared to conventional practice. It is therefore essential to investigate the level of the imaging dose to patients when IGRT/4DRT devices are installed. The imaging dose level was monitored and was compared with the use of pre-IGRT practice. Materials and Methods: A four-dimensional CT (4DCT) unit (GE, Ultra Light Speed 16), a simulator (Varian Acuity) and Varian IX unit with an on-board imager (OBI) and cone beam CT (CBCT) were installed. The surface doses to a RANDO phantom (The Phantom Laboratory, Salem, NY USA) were measured with the newly installed devices and with pre-existing devices including a single slice CT scanner (GE, Light Speed), a simulator (Varian Ximatron) and L-gram linear accelerator (Varian, 2100C Linac). The surface doses were measured using thermo luminescent dosimeters (TLDs) at eight sites-the brain, eye, thyroid, chest, abdomen, ovary, prostate and pelvis. Results: Compared to imaging with the use of single slice non-gated CT, the use of 4DCT imaging increased the dose to the chest and abdomen approximately ten-fold ($1.74{\pm}0.34$ cGy versus $23.23{\pm}3.67$cGy). Imaging doses with the use of the Acuity simulator were smaller than doses with the use of the Ximatron simulator, which were $0.91{\pm}0.89$ cGy versus $6.77{\pm}3.56$ cGy, respectively. The dose with the use of the electronic portal imaging device (EPID; Varian IX unit) was approximately 50% of the dose with the use of the L-gram linear accelerator ($1.83{\pm}0.36$ cGy versus $3.80{\pm}1.67$ cGy). The dose from the OBI for fluoroscopy and low-dose mode CBCT were $0.97{\pm}0.34$ cGy and $2.3{\pm}0.67$ cGy, respectively. Conclusion: The use of 4DCT is the major source of an increase of the radiation (imaging) dose to patients. OBI and CBCT doses were small, but the accumulated dose associated with everyday verification need to be considered.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.143-149
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• 2012

Today each hospital is trend that change rapidly by up to date, digitization and introducing newest medical treatment equipment. So, we introduce new CR system and supplement film system's shortcoming and PACS, EMR, RTP system's network that is using in hospital harmoniously and accomplish quality improvement of medical treatment and service elevation about business efficiency enlargement and patient Accordingly, we wish to introduce our case that integrate reflex that happen with radiation oncology here upon to PACS using CR system and estimate the availability. We measured that is Gantry, Collimator Star Shot, Light vs. Radiation, HDR QA(Dwell position accuracy) with Medical LINAC(MEVATRON-MX) Then, PACS was implemented on the digital images on the monitor that can be confirmed through the QA. Also, for cooperation with OCS system that is using from present source and impose code that need in treatment in each treatment, did so that Order that connect to network, input to CR may appear, did so that can solve support data mistake (active Pinacle's case supports DICOM3 file from present source but PACS does not support DICOM3 files.) of Pinacle and PACS that is Planning System and look at Planning premier in PACS. All image and data constructed integration to PACS as can refer and conduct premier in Hospital anywhere using CR system. Use Dosimetry IP in Filmless environment and QA's trial such as Light/Radition field size correspondence, gantry rotation axis' accuracy, collimator rotation axis' accuracy, brachy therapy's Dwell position check is available. Business efficiency by decrease and so on of unnecessary human strength consumption was augmented accordingly with session shortening as that integrate premier that is neted with radiation oncology using CR system to PACS. and for the future patient information security is essential.