• Journal of the Korean Society of Radiology
• /
• v.7 no.4
• /
• pp.285-291
• /
• 2013

In this study, compare and analyze the dose distribution and availability of radiation therapy when using a different devices to TNI(Total Lymphnodal Irradiation). Test subjects(patients) are 15 people(Male 7, Female 8). Acquire CT Simulation images of the 15 people using Somatom Sansation Open 16 channel and then acquired images was transferred to each treatment planning system Pinnacle Ver 8.0 and Tomotherapy Planning System and separate the tumor tissue and normal tissues(whole lung, spinal cord, Rt kidney, Lt kidney). Tumor prescription dose was set to 750 cGy. and then Compare the Dose Compatibility, Normal Tissue's Absorbed Dose, Dose Distribution and DVH. Statistical analysis was performed SPSS Ver. 18.0 by paired sample Assay. The absorbed dose in the tumor tissue was $751.0{\pm}4.7cGy$ in tomotherapy planning, $746.9{\pm}14.1cGy$ in linac. Tomotherapy's absorbed dose in the tumor was more appropriate than linac. and These values are not statistically significant(p>0.05). Tomotherapy plan's absorbed dose in the normal tissues were less than linac's plan. This value was statistically significant(p<0.05) excepted of whole lung. In DVH, appropriated on tumor and normal tissues in tomotherapy and linac but tomotherapy's TER was better than linac. Namely, a result of Absorbed dose in tumor and normal tissue, Dose distribution pattern, DVH, Both radiation therapy devices were appropriated in radiation therapy on TER. The Linac has a short treatment time(about 15-20 min) and open space on treatment time. It cause infant and pediatric patients to receiving uncomfortable treatment. So, In this case, it will be fine that Linac based therapy was restricted use. and if the patient was cooperative, it will be show a better prognosis that Tomotherapy using Radiation Therapy.

• The Journal of Korean Society for Radiation Therapy
• /
• v.7 no.1
• /
• pp.15-31
• /
• 1995

The radiosurgery treatment is one time, non surgical approach to the treatment of patients with intracranial disorders whose conditions would be difficult or dangerous to treat with conventional sugical procedures. The LINAC based radiosurgery is based on the combination of multiple isocentric arc irradiation with small fields centered in the stereotactic target. The absorption of the beam in a tissue equivalent medium, such as water, as well as the uniformity, or profile, of the beam must be precisely documented. The beam characteristics and dosimetric measurememts of the 6MV X-ray beam from a ML-6M linear accelerator are examined. The percent depth dose (PDD) and beam profile (including flatness, symmetry and penumbra) is calibrated with the radiosurgery cone in water phantom. The cone is made of lead which size is from $10{\times}10mm{\phi}$ to $30{\times}30mm{\phi}$ All of these dosimetric measurements sufficiently characterized the beam to permit safe clinical use.

• Progress in Medical Physics
• /
• v.26 no.2
• /
• pp.99-105
• /
• 2015

The monitor chamber is a real time dosimetry device for the measurement and the control of radiation beam intensity of the linac system. The monitor chamber prototype was developed for monitoring and controlling radiation beam from the linac based radiation generator. The thin flexible printed circuit boards were used for electrodes of the two independent plane-parallel ionization chambers to minimize the attenuation of radiation beam. The dosimetric characteristics, saturation and linearity of the measured charge, were experimentally evaluated with the Co-60 gamma rays. The performance of the developed monitor chamber prototype was in an acceptable range and this study shows the possibility of the further development of the chamber with additional functions.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2003.09a
• /
• pp.56-56
• /
• 2003

For the treatment of superficial tumors like squamous cell carcinoma of the head and neck, 6 MV photon beam is not appropriate and a spoiler is widely used to increase dose in the buildup region, while preserving the skin sparing effect. However, commercially available treatment planning systems assume a normal unspoiled beam, thereby cannot predict the buildup dose with spoiler accurately. We aimed to implement a Monte Carlo (MC) based planning system to apply it to the radiation treatment of head and neck. Lucite with thickness of 10-mm was used for the beam spoiler with Siemens Primus 6 MV photon beam. BEAM/DOSXYZ MC system was employed to model the linac and the spoiler. To verify the calculation accuracy of MC simulations, the percent depth doses (PDDs) and profiles with and without spoiler were measured using a parallel-plate chamber. For the MC based planning, we adopted a hybrid interface system between Pinnacle (Philips, USA) and BEAM/DOSXYZ to support treatment parameters of Siemens linac and the spoiler. The measurements of PDDs and profiles agreed with the corresponding MC simulations within 2% (lSD), which demonstrate the reliability of our MC simulations. The spoiler generated electrons make a contribution to the absorbed dose up to depth of 2cm, which shows that the dominant source of increased dose from spoiler system is the contaminating electrons created by the spoiler. The whole procedures necessary for MC based treatment planning were performed seamlessly between Pinnacle and BEAM/DOSXYZ system. This ability helps to increase the clinical efficiency of the spoiler technique. In conclusion, we implemented a MC based treatment planning system for a 6 MV photon beam with a spoiler. We demonstrate sophisticated MC technique makes it possible to predict dose distributions around buildup region accurately.

• Progress in Medical Physics
• /
• v.23 no.3
• /
• pp.127-137
• /
• 2012

A conversing beam is firstly designed for radiosurgery by a neurosugern Lars Leksell in 1949 with orthogonal x-rays tube moving through horizontal moving arc to focusing the beam at target center. After 2 decades he composits 201 source of the Co-60 for gamma knife which beams focused at locus. Sveral linac-based stereotactic radiosurgery using the circular collimated beam which size range for 0.4~4.0 cm in a diameter by non-coplanar multiarc have been developed over the decades. The irregular lesions can be treated by superimposing with several spherical shots of radiation over the tumour volume. Linac based techniques include the use of between 4 and 11 non-co-planar arcs and a dynamic rotation technique and use photon beam energies in the range of 6~10 MV. Reviews of the characteristics of several treatment techniques can be found in the literature (Podgorsak 1989, Schell 1991). More in recent, static conformal beams defined by custom shaped collimators or a mini- or micro-multileaf collimator (mMLC) have been used in SRS. Finally, in the last few years, intensity-modulated mMLC SRS has also been introduced. Today, many commercial and in-house SRS programs have also introduced non-invasive immobilization systems include the cyberknife and tomotherapy and proton beam. This document will be compared the characteristics of dose distribution of radiosurgery as introduced gamma knife, BrainLab include photon knife in-house SRS program and cyberknife in currently wide used for a cranial SRS.

• Radiation Oncology Journal
• /
• v.19 no.2
• /
• pp.81-86
• /
• 2001

Prupose : To evaluate the role of linac based radiosurgery (RS) in the treatment of meningiomas, we retrospectively analyzed the results of clinical and follow up CT/MRI studies. Methods and Materials : From the 1988 July to 1998 April, twenty patients of meningioma had been treated with 6 MV linear accelerator based radiosurgery. Of the 20 patients, four $(20\%)$ were male and 16 $(80\%)$ were female. Mean age was 51 years old ($22\~78$ years old). Majority of intracranial location of tumor for RS were parasagittal and sphenoid wing area. RS was done for primary treatment in 6 $(30\%)$, postoperative residual lesions in 11 $(55\%)$ and regrowth after surgery in 3 $(15\%)$. Mean tumor volume was $5.72\;cm^3\;(0.78\~15.1\;cm^3)$ and secondary collimator size was 2.04 cm $(1\~3\;cm)$. The periphery of tumor margin was prescribed with the mean dose of 19.6 Gy $(9\~30\;Gy)$ which was $40\~90\%$ of the tumor center dose. The follow up duration ranged from 2.5 to 109 months (median 53 months). Annual CT/MRI scan was checked. Results : By the follow up imaging studies, the tumor volume was reduced in 5 cases $(25\%)$, arrested growth in 14 cases $(70\%)$, and increased size in 1 case $(15\%)$. Among these responsive and stable 19 patients by imaging studies, there showed loss of contrast enhancement after CT/MRI in four patients. In clinical response, nine $(45\%)$ patients were considered improved condition, 10 $(50\%)$ patients were stable and one $(5\%)$ was worsened to be operated. This partly resulted in necrosis after surgery. Conclusion : The overall control rate of meningiomas with linac based RS was $95\%$ by both imaging follow-up and clinical evaluation. With this results, linac based RS is considered safe and effective treatment method for meningioma.

• Journal of the Korean Society of Radiology
• /
• v.6 no.5
• /
• pp.365-371
• /
• 2012

The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.

• Journal of Radiation Protection and Research
• /
• v.43 no.3
• /
• pp.107-113
• /
• 2018

Background: The purpose of our study was to compare the dosimetric advantages of Flattening filter free (FFF) beams for trigeminal neuralgia patients using 4 mm conical collimators over previously treated patients with 6 MV SRS beam. Materials and Methods: A retrospective study was conducted for 5 TN patients who had been previously treated at our institution using frame-based, LINAC-based stereotactic radiosurgery (SRS) on Novalis Tx using 6 MV SRS beam were replanned on 6X FFF beams on Edge Linear accelerator with same beam angles and dose constraints using 4 mm conical collimator. The total number of monitor units along with the beam on time was compared for both Edge and Novalis Tx by redelivering the plans in QA mode of LINAC to compare the delivery efficiency. Plan quality was evaluated by homogeneity index (HI) and Paddick gradient index (GI) for each plan. We also analyzed the doses to brainstem and organ at risks (OARs). Results and Discussion: A 28% beam-on time reduction was achieved using 6X FFF when compared with 6X SRS beam of Novalis Tx. A sharp dose fall off with gradient index value of $3.4{\pm}0.27$ for 4 mm Varian conical collimator while $4.17{\pm}0.20$ with BrainLab cone. Among the 5 patients treated with a 4 mm cone, average maximum brainstem dose was 10.24 Gy for Edge using 6X FFF and 14.28 Gy for Novalis Tx using 6X SRS beam. Conclusion: The use of FFF beams improves delivery efficiency and conical collimator reduces dose to OAR's for TN radiosurgery. Further investigation is warranted with larger sample patient data.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.167-174
• /
• 1993

Recently, stereotactic radiosurgery plan is required with the information of 3-D image and dose distribution. A project has been doing if developing LINAC based stereotactic radiosurgery since April 1991. The purpose of this research is to develop 3-D radiosurgery planning system using personal computer. The procedure of this research is based on two steps. The first step is to develop 3-D localization system, which input the image information of the patient, coordinate transformation, the position and shape of target, and patient contour into computer system using CT image and stereotactic frame. The second step is to develop 3-D dose planning system, which compute dose distribution on image plane, display on high resolution monitor both isodose distribution and patient image simultaneously and develop menu-driven planning system. This prototype of radiosurgery planning system was applied recently for several clinical cases. It was shown that our planning system is fast, accurate and efficient while making it possible to handle various kinds of image modalities such as angiography, CT and MRI. It makes it possible to develop general 3-D planning system using beam's eye view or CT simulation in radiation therapy in future.

• Progress in Medical Physics
• /
• v.31 no.4
• /
• pp.145-152
• /
• 2020

Purpose: In ionization-chamber dosimetry for high-dose-rate electron beams-above 20 mGy/pulse-the ion-recombination correction methods recommended by the International Atomic Energy Agency (IAEA) and the American Association of Physicists in Medicine (AAPM) are not appropriate, because they overestimate the correction factor. In this study, we suggest a practical ion-recombination correction method, based on Boag's improved model, and apply it to reference dosimetry for electron beams of about 100 mGy/pulse generated from an electron linear accelerator (LINAC). Methods: This study employed a theoretical model of the ion-collection efficiency developed by Boag and physical parameters used by Laitano et al. We recalculated the ion-recombination correction factors using two-voltage analysis and obtained an empirical fitting formula to represent the results. Next, we compared the calculated correction factors with published results for the same calculation conditions. Additionally, we performed dosimetry for electron beams from a 6 MeV electron LINAC using an Advanced Markus^® ionization chamber to determine the reference dose in water at the source-to-surface distance (SSD)=100 cm, using the correction factors obtained in this study. Results: The values of the correction factors obtained in this work are in good agreement with the published data. The measured dose-per-pulse for electron beams at the depth of maximum dose for SSD=100 cm was 115 mGy/pulse, with a standard uncertainty of 2.4%. In contrast, the k_s values determined using the IAEA and AAPM methods are, respectively, 8.9% and 8.2% higher than our results. Conclusions: The new method based on Boag's improved model provides a practical method of determining the ion-recombination correction factors for high dose-per-pulse radiation beams up to about 120 mGy/pulse. This method can be applied to electron beams with even higher dose-per-pulse, subject to independent verification.