• Title/Summary/Keyword: Patient skin dose

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Analysis of Changes in Skin Dose During Weight Loss when Tomotherapyof Nasopharynx Cancer (비인두암 토모테라피 시 체중 감소에 따른 피부선량 변화 분석)

  • Jang, Joon-Young;Kim, Dae Hyun;Choi, Cheon Woong;Kim, Bo-Hui;Park, Cheol-Soo
    • Journal of the Korean Magnetics Society
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    • v.26 no.3
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    • pp.99-104
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    • 2016
  • For patients receiving chemotherapy and radiation therapy treatment progresses as vomiting, nausea, weight of the patient because of a loss of appetite it is reduced. The patient's weight and the distance from the skin and the treatment site is expected to be closer, thereby reducing the change in the skin because of this dose. This study tests using a loose see the difference between the volume change appears as the weight of the patient using the same phantom and the phantom body of the patient. To using the same as the position EBT film is attached to the skin of the treatment site and was adjusted to the thickness of the Bolus. And using a computerized treatment planning only tomotherapy equipment was passed under the conditions according to the thickness of the radiation dose. To baseline for accurate reproduction position using the MVCT was applied to treated with verification. By passing a total of three dose reduced the error, it was a measure of the film by using a dedicated scanner, EBT VIDAR scanner. Got an increase in the skin dose is displayed each time the thickness of the bolus reduced, in a bolus was completely removed with the highest value. If the changes appeared dose was greater weight loss patients to chemotherapy and therefore bolus thickness variation considering the weight loss of the patient when applying the tomotherapy of nasopharynx cancer was found that the increase in skin dose be increased. This large patient before treatment due to weight loss over the image verification is considered to be established should consider how to re-create your mask and treatment plan for fixing it.

Investigating the effects of a range shifter on skin dose in proton therapy

  • Ming Wang;Lei Zhang;Jinxing Zheng;Guodong Li;Wei Dai;Lang Dong
    • Nuclear Engineering and Technology
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    • v.55 no.1
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    • pp.215-221
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    • 2023
  • Proton treatment may deliver a larger dose to a patient's skin than traditional photon therapy, especially when a range shifter (RS) is inserted in the beam path. This study investigated the effects of an RS on skin dose while considering RS with different thicknesses, airgaps and materials. First, the physical model of the scanning nozzle with RS was established in the TOol for PArticle Simulation (TOPAS) code, and the effects of the RS on the skin dose were studied. Second, the variations in the skin dose and isocenter beam size were examined by reducing the air gap. Finally, the effects of different RS materials, such as polymethylmethacrylate (PMMA), Lexan, polyethylene and polystyrene, on the skin dose were analysed. The results demonstrated that the current RS design had a negligible effect on the skin dose, whereas the RS significantly impacted the isocenter beam size. The skin dose was increased considerably when the RS was placed close to the phantom. Moreover, the magnitude of the increase was related to the thickness of the inserted RS. Meanwhile, the results also revealed that the secondary proton primarily contributed to the increased skin dose.

The patient dose calculation model on the Exell program (촬영조건에 의한 환자 피폭선량의 자동계산 프로그램)

  • Kim, Jung-Min;Seok, Jin-Yong
    • Journal of radiological science and technology
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    • v.25 no.2
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    • pp.35-38
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    • 2002
  • Recently, They are usually recording the patient information on the Hospital Information System. In the department of Radiology, For the purpose of assuming patient exposed dose, Authors contrived the mathematical calculation model by use of x-ray out put data on the Excel program, if they in put the exposure factors (kVp, mAs, thickness), the program could automatically calculate the patient Skin dose. The assuming data by three dimensional equation has average errors within ${\pm}5%$, there for We could make good use of clinical field in department of radiology.

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The Study on Clinical Conditions and Skin Dose of Upper-Gastrointestinal X-ray Fluoroscopy (위장 X선 투시검사에 따른 실태 및 선량에 관한 연구)

  • Kim, Sung-Chul;Ahn, Sung-Min;Jang, Sang-Sup
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.7-12
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    • 2007
  • This study examined present conditions of upper-gastrointestinal X-ray fluoroscopy and patient skin dose. The authors elected 21 equipments to check the X-ray equipment and exposure factor of fluoroscopy & spot exposure in university hospitals, hospitals, and clinics where perform upper-gastrointestinal X-ray fluoroscopy more than five times every day in Incheon areas. The amount of patient's skin dose during upper-gastrointestinal X-ray fluoroscopy was measured by ionization chamber.

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In vivo dosimetry and acute toxicity in breast cancer patients undergoing intraoperative radiotherapy as boost

  • Lee, Jason Joon Bock;Choi, Jinhyun;Ahn, Sung Gwe;Jeong, Joon;Lee, Ik Jae;Park, Kwangwoo;Kim, Kangpyo;Kim, Jun Won
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.121-128
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    • 2017
  • Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusions: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.

Fundamental Study of nanoDot OSL Dosimeters for Entrance Skin Dose Measurement in Diagnostic X-ray Examinations

  • Okazaki, Tohru;Hayashi, Hiroaki;Takegami, Kazuki;Okino, Hiroki;Kimoto, Natsumi;Maehata, Itsumi;Kobayashi, Ikuo
    • Journal of Radiation Protection and Research
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    • v.41 no.3
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    • pp.229-236
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    • 2016
  • Background: In order to manage the patient exposure dose in X-ray diagnosis, it is preferred to evaluate the entrance skin dose; although there are some evaluations about entrance skin dose, a small number of report has been published for direct measurement of patient. We think that a small-type optically stimulated luminescence (OSL) dosimeter, named nanoDot, can achieve a direct measurement. For evaluations, the corrections of angular and energy dependences play an important role. In this study, we aimed to evaluate the angular and the energy dependences of nanoDot. Materials and Methods: We used commercially available X-ray diagnostic equipment. For angular dependence measurement, a relative response of every 15 degrees of nanoDot was measured in 40-140 kV X-ray. And for energy dependence measurement, mono-energetic characteristic X-rays were generated using several materials by irradiating the diagnostic X-rays, and the nanoDot was irradiated by the characteristic X-rays. We evaluated the measured response in an energy range of 8.1-75.5 keV. In addition, we performed Monte-Carlo simulation to compare experimental results. Results and Discussion: The experimental results were in good agreement with those of Monte-Carlo simulation. The angular dependence of nanoDot was almost steady with the response of 0 degrees except for 90 and 270 degrees. Furthermore, we found that difference of the response of nanoDot, where the nanoDot was irradiated from the randomly set directions, was estimated to be at most 5%. On the other hand, the response of nanoDot varies with the energy of incident X-rays; slightly increased to 20 keV and gradually decreased to 80 keV. These results are valuable to perform the precise evaluation of entrance skin dose with nanoDot in X-ray diagnosis. Conclusion: The influence of angular dependence and energy dependence in X-ray diagnosis is not so large, and the nanoDot OSL dosimeter is considered to be suitable dosimeter for direct measurement of entrance surface dose of patient.

Usability assessment of thermoplastic Bolus for skin VMAT radiotherapy (피부 병변에 대한 VMAT 치료 시 열가소성 bolus의 유용성 평가: case review)

  • Kim, Min Soo;Kim, Joo Ho;Shin, Hyun Kyung;Cho, Min Seok;Park, Ga Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.85-92
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    • 2020
  • Purpose: To find out the advantages of thermoplastic bolus compared to conventional bolus, which is mainly used in clinical practice, We evaluated Two cases in terms of dose and location reproducibility to assess Usability of thermoplastic Bolus for skin VMAT radiotherapy. Materials and Methods: Two patient's treated with left breast skin lesion were simulated using thermoplastic Bolus and planned with 2arc VMAT. the prescription dose was irradiated to 95% or more of the target volume. We evaluated The reproducibility of the bolus position by measuring the length of the air gap in the CBCT (Cone Beam CT) image. to evaluate dose reproducibility, we compared The dose distribution in the plan and CBCT and measured in vivo for patient 2. Results: The difference between the air gap in patient 1's simulation CT and the mean air gap (M1) during 10 treatments in the CBCT image was -0.42±1.24mm. In patient 2, the difference between the average air gap between the skin and the bolus (M2) during 14 treatments was -1.08±1.3mm, and the air gap between the bolus (M3) was 0.49±1.16. The difference in the dose distribution between Plan CT and CBCT was -1.38% for PTV1 D95 and 0.39% for SKIN (max) in patient 1. In patient 2, PTV1 D95 showed a difference of 0.63% and SKIN (max) -0.53%. The in vivo measurement showed a difference of -1.47% from the planned dose. Conclusion: thermoplastic Bolus is simpler and takes less time to manufacture compared to those produced by 3D printer. Also compared to conventional bolus, it has high reproducibility in the set-up side and stable results in terms of dose delivery.

Measurement of the Skin Dose of Patient Using the Optically Stimulated Luminescent Dosimeter at Diagnostic Radiography (진단방사선촬영에서 광자극발광선량계를 이용한 환자 피부선량의 측정)

  • Kim, Jong-Eon;Im, In-Chul;Min, Byung-In
    • The Journal of the Korea Contents Association
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    • v.11 no.9
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    • pp.437-442
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    • 2011
  • The purpose of this study is an measurement of the skin dose of a patient by using the OSLD(optically stimulated luminescent dosimeter) under several irradiation conditions of the X-ray beam for diagnostic radiography. The measurements of skin dose were performed for head, chest, and pelvis. And test of reproducibility was carried out at the chest. As a result, we obtained the skin dose at forehead of head to be 1.30 mSv. The skin doses at xiphoid process, breast and apex of the lung of the chest were acquired 0.92, 0.52 and 0.70 mSv, respectively. And we obtained the skin doses at the left pelvis and the right pelvis to be 2.78 and 3.08 mSv, respectively. As for reproducibility, a coefficient of variation was 0.033. The skin doses were exhibited the values corresponding from 1/100 to 1/17 of the dose limit of the public(50 mSv) at the deterministic effect. In order to make accurate measurements of the skin doses for each tube voltage, the measured values have to multiply by the displayed values of reader by a correction factor. The energy response of the OSLD with the tube voltage will be studied in the near future.

Clinical Implementation of 3D Printing in the Construction of Patient Specific Bolus for Photon Beam Radiotherapy for Mycosis Fungoides

  • Kim, Sung-woo;Kwak, Jungwon;Cho, Byungchul;Song, Si Yeol;Lee, Sang-wook;Jeong, Chiyoung
    • Progress in Medical Physics
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    • v.28 no.1
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    • pp.33-38
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    • 2017
  • Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

A Survey on Medical Radiation Dose by the Radiographic Conditions of Chest (흉부 X선촬영 조건에 따르는 의료피폭에 관한 조사연구)

  • Huh, Joon;Kim, Sun-Soo;Park, Jun-Chul
    • Journal of radiological science and technology
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    • v.15 no.1
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    • pp.79-87
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    • 1992
  • It is a matter of common knowledge that madical radiation is most accented for of radiation is doses applied to the whole of people, and of them the radation dose by radiography diagnosis is mainly prevalent. In applying X-rays to a certain man for radiography diagnosis a radiologyist will have to have an absolute sense of mission concerning the reduction and prevention of the patient's radiation dose as the radiologyist obligation. Accordingly, the radiography conditions of the patient's chest employed 197 medical facilites were surveyed and skin dose was computated by the IPH Bit system and examined. As a result, it was shown that the average skin dose was $288\;{\mu}Sv$, its minimum value was $1600\;{\mu}Sv$, which was over 32 times its minimum value. This shows that the appropriate radiography method has not been applied at applying X-ray to the patient. It comes from the performance of X-ray equipment, the choice of auxiliary equipment materials etc. But the most important thing is to master the appropriate radiography condition, and therefore this point will have to be kept in mind.

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