• Asian Journal of Business Environment
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• v.4 no.3
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• pp.27-37
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• 2014

Purpose - In the past, designs for traditional products have usually focused on historic techniques. However, this tradition of using historic techniques has now been replaced by the trend of using the innovative design concept. Research design, data, and methodology - To measure future market trends and quality requirements, we apply the results of the questionnaires and analyze them with various experimental processes and a design methodology. In this way, we gauge the impact of the innovative product value chain on the promotion of new products. Results - Accompanied with an innovative product value chain, the product can stimulate the development of enterprise management, which has become the main issue in social and economic development in every developed country, and can facilitate the progress of enterprise management throughout the enterprise. Conclusions - Customer demand should be emphasized as the primary means to solve design problems, to design optimal solutions, to create differentiation with competitors, and to pursue optimal marketing strategies.

• Progress in Medical Physics
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• v.31 no.3
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• pp.63-70
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• 2020

Stereotactic radiosurgery is one of the most sophisticated forms of modern advanced radiation therapy. Unlike conventional fractionated radiotherapy, stereotactic radiosurgery uses a high dose of radiation with steep gradient precisely delivered to target lesions. Lars Leksell presented the principle of radiosurgery in 1951. Gamma Knife^® (GK) is the first radiosurgery device used in clinics, and the first patient was treated in the winter of 1967. The first GK unit had 179 cobalt 60 sources distributed on a hemispherical surface. A patient could move only in a single direction. Treatment planning was performed manually and took more than a day. The latest model, Gamma Knife^® Icon^TM, shares the same principle but has many new dazzling characteristics. In this article, first, a brief history of radiosurgery was described. Then, the physical properties of modern radiosurgery machines and physicists' endeavors to assure the quality of radiosurgery were described. Intrinsic characteristics of modern radiosurgery devices such as small fields, steep dose distribution producing sharp penumbra, and multi-directionality of the beam were reviewed together with the techniques to assess the accuracy of these devices. The reference conditions and principles of GK dosimetry given in the most recent international standard protocol, International Atomic Energy Agency TRS 483, were shortly reviewed, and several points needing careful revisions were highlighted. Understanding the principles and physics of radiosurgery will be helpful for modern medical physicists.

• Progress in Medical Physics
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• v.14 no.1
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• pp.8-14
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• 2003

The spinal cord dose is the one of the limiting factor for the radiation treatment of the head ＆ neck or the thorax region. It is not an easy task to maintain the spinal cord dose below tolerance and to keep the clinically acceptable dose to the PTV in this region. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. This technique is an extension of the conventional treatment planning. In the beginning the beam directions are selected as same as the conventional treatment planning to encompass the PTV, then the partial block are designed to shield the spinal cord. The plan comparisons between the conventional therapy plan and the PTB plan were performed to evaluate the validity of this technique. The mean dose and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan generated better results than the conventional treatment plan and it was proved to be useful for the H＆N region.

• Progress in Medical Physics
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• v.29 no.2
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• pp.66-72
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• 2018

The proper position of a multi-leaf collimator (MLC) is essential for the quality of intensity-modulated radiation therapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) dose delivery. Task Group (TG) 142 provides a quality assurance (QA) procedure for MLC position. Our study investigated the QA validation of the mechanical leaf gap measurement and the maintenance procedure. Two $VitalBeam^{TM}$ systems were evaluated to validate the acceptance of an MLC position. The dosimetric leaf gaps (DLGs) were measured for 6 MV, 6 MVFFF, 10 MV, and 15 MV photon beams. A solid water phantom was irradiated using $10{\times}10cm^2$ field size at source-to-surface distance (SSD) of 90 cm and depth of 10 cm. The portal dose image prediction (PDIP) calculation was implemented on a treatment planning system (TPS) called $Eclipse^{TM}$. A total of 20 VMAT plans were used to confirm the accuracy of dose distribution measured by an electronic portal imaging device (EPID) and those predicted by VMAT plans. The measured leaf gaps were 0.30 mm and 0.35 mm for VitalBeam 1 and 2, respectively. The DLG values decreased by an average of 6.9% and 5.9% after mechanical MLC adjustment. Although the passing rates increased slightly, by 1.5% (relative) and 1.2% (absolute) in arc 1, the average passing rates were still within the good dose delivery level (>95%). Our study shows the existence of a mechanical leaf gap error caused by a degenerated MLC motor. This can be recovered by reinitialization of MLC position on the machine control panel. Consequently, the QA procedure should be performed regularly to protect the MLC system.

• Progress in Medical Physics
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• v.13 no.4
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• pp.218-223
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• 2002

Stereotactic radiosurgery for intracranial lesion is well established since the Lars Leksell first introduced radiosurgery concept in 1951 Its use in the treatment of spinal lesion has been limited by the availability of effective immobilization devices. The first clinical experience of the spinal stereotactic radiosurgery technique was reported by Hamilton AJ. in 1995. Recently, Optic-guided patient positioning technique for extracranial stereotactic radiosurgery was developed and reported. This study is for assess the target positioning accuracy of the optic guided patient positioning system Exactrac (BrainLab., Inc, Germany). We have designed phantom for assess the accuracy of spinal stereotactic radiosurgery The infrared reflective body markers attached to the relatively immobile part of the body and a series of 2 mm CT images was taken. The image sets were transferred to the planning computer. During the radiosurgery treatment, we measure the real-time display showing the positioning values from Exactrac computer. And we compare the isocenter deviation from irradiated center point of the film which was mounted on the lesion site of the phantom and pin hole site of that film. The accuracy of the ExacTrac system in positioning a target point shows enough for the clinical applications.

• Progress in Medical Physics
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• v.17 no.4
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• pp.192-200
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• 2006

We evaluated the positional accuracy of the delivered beams to the target in a phantom by simulating the whole process of the radiation treatments Including CT scanning, planning and beam exposures with MLCs. For this purpose, a phantom was made to calibrate the alignment between the CT and the attached laser system. A new, convenient method was also devised to align the setup lasers in the treatment room. Film was used for the Identification of the delivered beam and analyzed with a homemade computer program. The positional differences between the target and the beam centers varied with the couch rotations. The accelerator we used showed a maximum discrepancy of 2.0 mm at the table angle of $295^{\circ}$. The same measurements based on the new isocenter from the Winston-Lutz test resulted in the maximum of 1.35 mm for all rotation angles. The evaluation of the differences between the target and the beam centers is useful for the treatment planning.

• Progress in Medical Physics
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• v.26 no.3
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• pp.168-177
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• 2015

For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

• Progress in Medical Physics
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• v.24 no.1
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• pp.35-40
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• 2013

Recently, the uses of Multi-Detector Computed Tomography (MDCT) for radiation treatment simulation and planning which is used for intensity modulated radiation therapy with high technique are increasing. Because of the increasing uses of MDCT, additional doses are also increasing. The objective of this study is to evaluate the absorbed dose of body and skin undergoing in MDCT scans. In this study, the exposed dose at the surface and the center of the cylindrical water phantom was measured using an pencil ionization chamber, 30 cc ionization chamber and TL Powder. The results of MDCT were 31.84 mGy, 33.58 mGy and 32.73 mGy respectively. The absorbed dose at the surface showed that the TL reading value was 33.92 mGy from MDCT. These results showed that the surface dose was about 3.5% from the MDCT exposure higher than a dose which is located at the center of the phantom. These results mean that the total exposed dose undergoing MDCT 4 times (diagnostic, radiation therapy planning, follow-up et al.), is about 14 cGy, and have to be considered significantly to reduce the exposed dose from CT scan.

• Progress in Medical Physics
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• v.29 no.2
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• pp.59-65
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• 2018

This paper describes the clinical use of the dose verification of multileaf collimator (MLC)-based CyberKnife plans by combining the Octavius 1000SRS detector and water-equivalent RW3 slab phantom. The slab phantom consists of 14 plates, each with a thickness of 10 mm. One plate was modified to support tracking by inserting 14 custom-made fiducials on surface holes positioned at the outer region of $10{\times}10cm^2$. The fiducial-inserted plate was placed on the 1000SRS detector and three plates were additionally stacked up to build the reference depth. Below the detector, 10 plates were placed to avoid longer delivery times caused by proximity detection program alerts. The cross-calibration factor prior to phantom delivery was obtained by performing with 200 monitor units (MU) on the field size of $95{\times}92.5mm^2$. After irradiation, the measured dose distribution of the coronal plane was compared with the dose distribution calculated by the MultiPlan treatment planning system. The results were assessed by comparing the absolute dose at the center point of 1000SRS and the 3-D Gamma (${\gamma}$) index using 220 patient-specific quality assurance (QA). The discrepancy between measured and calculated doses at the center point of 1000SRS detector ranged from -3.9% to 8.2%. In the dosimetric comparison using 3-D ${\gamma}$-function (3%/3 mm criteria), the mean passing rates with ${\gamma}$-parameter ${\leq}1$ were $97.4%{\pm}2.4%$. The combination of the 1000SRS detector and RW3 slab phantom can be utilized for dosimetry validation of patient-specific QA in the CyberKnife MLC system, which made it possible to measure absolute dose distributions regardless of tracking mode.

• Progress in Medical Physics
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• v.33 no.4
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• pp.150-157
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• 2022

Purpose: Elekta synergy^® was commissioned in the Seoul National University Veterinary Medical Teaching Hospital. Recently, Chung-Ang University Gwang Myeong Hospital commissioned Elekta Versa HD^TM. The beam characteristics of both machines are similar because of the same Agility^TM MLC Model. We compared measured beam data calculated using the Elekta treatment planning system, Monaco^®, for each institute. Methods: Beam of the commissioning Elekta linear accelerator were measured in two independent institutes. After installing the beam model based on the measured beam data into the Monaco^®, Monte Carlo (MC) simulation data were generated, mimicking the beam data in a virtual water phantom. Measured beam data were compared with the calculated data, and their similarity was quantitatively evaluated by the gamma analysis. Results: We compared the percent depth dose (PDD) and off-axis profiles of 6 MV photon and 6 MeV electron beams with MC calculation. With a 3%/3 mm gamma criterion, the photon PDD and profiles showed 100% gamma passing rates except for one inplane profile at 10 cm depth from VMTH. Gamma analysis of the measured photon beam off-axis profiles between the two institutes showed 100% agreement. The electron beams also indicated 100% agreement in PDD distributions. However, the gamma passing rates of the off-axis profiles were 91%-100% with a 3%/3 mm gamma criterion. Conclusions: The beam and their comparison with MC calculation for each institute showed good performance. Although the measuring tools were orthogonal, no significant difference was found.