• 한국의학물리학회지:의학물리
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• 제28권3호
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• pp.129-133
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• 2017

The machine log files recorded by a scanning control unit in proton beam therapy system have been studied to be used as a quality assurance method of scanning beam deliveries. The accuracy of the data in the log files have been evaluated with a standard calibration beam scan pattern. The proton beam scan pattern has been delivered on a gafchromic film located at the isocenter plane of the proton beam treatment nozzle and found to agree within ${\pm}1.0mm$. The machine data accumulated for the scanning beam proton therapy of five different cases have been analyzed using a statistical method to estimate any systematic error in the data. The high-precision scanning beam log files in line scanning proton therapy system have been validated to be used for off-line scanning beam monitoring and thus as a patient-specific quality assurance method. The use of the machine log files for patient-specific quality assurance would simplify the quality assurance procedure with accurate scanning beam data.

• 한국의학물리학회지:의학물리
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• 제32권4호
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• pp.107-115
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• 2021

Purpose: The purpose of this study was to compare the clinical quality assurance results of portal dosimetry using an electronic portal imaging device, a method that is extensively used for patient-specific quality assurance, and the newly released Mobius3D for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Methods: This retrospective study includes data from 122 patients who underwent IMRT and VMAT on the Novalis Tx and VitalBeam linear accelerators between April and June 2020. We used a paired t-test to compare portal dosimetry using an electronic portal imaging device and the average gamma passing rates of MobiusFX using log files regenerated after patient treatment. Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm) were 99.43%±1.02% and 99.32%±1.87% in VitalBeam and 97.53%±3.34% and 96.45%±13.94% in Novalis Tx, respectively. Comparison of the gamma passing rate results of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm as per the manufacturer's manual) does not show any statistically significant difference. Conclusions: Log file-based patient-specific quality assurance, including independent dose calculation, can be appropriately used in clinical practice as a second-check dosimetry, and it is considered comparable with primary quality assurance such as portal dosimetry.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.108-115
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• 2022

Background: This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT). Methods: The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and Brain-LAB) between June 2019 and March 2021. We analyzed the multileaf collimator DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm-1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm). Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1% (95.5%-100%) and 97.5% (92.3%-99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm-0.9%/0.9 mm). Conclusion: This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

• 대한방사선기술학회지:방사선기술과학
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• 제41권1호
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• pp.39-45
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• 2018

The purpose of this study is to evaluate the usefulness of a software-based quality assurance system based on Volumetric Modulated Arc Therapy treatment plan. Evaluate treatment plan through the D VH analysis, PTV mean dose ($D_{mean}$) and PTV 95% dose($D_{95}$) compare the MFX based on original treatment plan, Average error rate was $0.9{\pm}0.6%$, $1.0{\pm}0.8%$, respectively. Measuring point dose using phantom and ion chamber, the average error rate between the ionization chamber and MFX was $0.9{\pm}0.7%$, $1.1{\pm}0.7%$ (high dose region), $1.1{\pm}0.9%$, $1.2{\pm}0.7%$ (low dose region). The average gamma though of MFX and $Delta^{4PT}$ is $98.7{\pm}1.2%$, $98.4{\pm}.3%$, respectively. Through this study, A software based QA system that simplifies hardware based QA procedures that involve a lot of time and effort. It can be used as a simple and useful tool in clinical practice.

• 대한방사선기술학회지:방사선기술과학
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• 제46권3호
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• pp.231-238
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• 2023

This study aimed to compare the results of delivery quality assurance (DQA) using MapCHECK and OCTAVIUS for radiation therapy. Thirty patients who passed the DQA results were retrospectively included in this study. The point dose difference (DD) and gamma passing rate (GPR) were analyzed to evaluate the agreement between the measured and planned data for all cases, Plan complexity was evaluated to analyze dosimetric accuracy by quantifying the degree of modulation according to each plan. We analyzed the monitor units (MUs) and total MUs for each plan to evaluate the correlation between the MUs and plan complexity. We used a paired t-test to compare the DD and GPRs that were obtained using the two devices. The DDs and GPRs were within the tolerance range for all cases. The average GPRs difference between the two devices was statistically significant for the brain, and head and neck for gamma criteria of 3%/3 mm and 2%/2 mm. There was no significant correlation between the modulation index and total MUs for any of the cases. These DQA devices can be used interchangeably for routine patient-specific QA in radiation therapy.

• 대한치과의사협회지
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• 제52권3호
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• pp.153-163
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• 2014

3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

• 한국의학물리학회지:의학물리
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• 제29권2호
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• pp.53-58
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• 2018

This paper evaluates patient-specific quality assurance (PSQA) in the treatment of small and multiple tumors by the CyberKnife system with fixed collimators, using an ion chamber and EBT3 films. We selected 49 patients with single or multiple brain tumors, and the treatment plans include one to four targets with total volumes ranging from 0.12 cc to 3.74 cc. All PSQA deliveries were performed with a stereotactic dose verification phantom. The A16 microchamber (Standard Imaging, WI, USA) and Gafchromic EBT3 film (Ashland ISP Advanced Materials, NJ, USA) were inserted into the phantom to measure the point dose of the target and the dose distribution, respectively. The film was scanned 1 hr after irradiation by a film digitizer scanner and analyzed using RIT software (Radiological Imaging Technology, CO, USA). The acceptance criteria was <5% for the point dose measurement and >90% gamma passing rate using 3%/3 mm and relative dose difference, respectively. The point dose errors between the calculated and measured dose by the ion chamber were in the range of -17.5% to 8.03%. The mean point dose differences for 5 mm, 7.5 mm, and 10 mm fixed cone size was -11.1%, -4.1%, and -1.5%, respectively. The mean gamma passing rates for all cases was 96.1%. Although the maximum dose distribution of multiple targets was not shown in the film, gamma distribution showed that dose verification for multiple tumors can be performed. The use of the microchamber and EBT3 film made it possible to verify the dosimetric and mechanical accuracy of small and multiple targets. In particular, the correction factors should be applied to small fixed collimators less than 10 mm.

• 한국의학물리학회지:의학물리
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• 제19권1호
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• pp.35-41
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• 2008

양성자치료는 양성자의 물리적 특성으로 인해 인체 내의 특정범위에 모든 에너지를 전달하고 감쇠되어 타겟조직 뒤에 존재하는 정상조직에는 방사선이 조사되지 않는 큰 장점을 가진 치료법이다. 이 방법은 인체 내의 암 조직을 타겟으로 했을 때, 빔 방향에서의 타겟의 2차원적인 모양은 황동으로 제작된 블럭을 통해 정상조직에 들어가는 방사선을 차폐하고 마진을 주어서 GTV (eross Tumor Volume)에 90% 이상의 선량이 전달되도록 조절한다. 그리고, 양성자 빔의 날줄방향 (longitudinal)에서의 타겟의 3차원적인 모양을 고려하여 PMMA로 이루어진 보상체(compensator)를 밀링머신으로 조각하여 타겟에 방사선이 정확하게 분포되도록 한다. 이러한 보상체의 정확한 정도 관리를 위해 현재 사용되는 수동적인 방법을 보완하여 X선 영상으로 해당하는 보상체의 영상을 획득하여 이 영상을 기반으로 정도관리를 할 수 있는 방법을 제안하였고, 제안한 방법으로 보상체의 각각의 깎여진 평면의 모양과 두께를 정성적으로 비교 및 평가할 수 있었으며 두 영상의 차이가 80% 이상 맞는 것으로 확인되었다. 이를 바탕으로 영상을 이용한 정도관리 프로그램을 보완하여 추후 실제 양성자치료 정도관리에 사용될 예정이다.

• 한국의학물리학회지:의학물리
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• 제30권4호
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• pp.120-127
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• 2019

Purpose: This study was designed to evaluate the dosimetric performance of Mobius3D by comparison with an aSi-based electronic portal imaging device (EPID) and Octavius 4D, which are conventionally used for patient-specific prescription dose verification. Methods: The study was conducted using nine patients who were treated by volumetric modulated arc therapy. To evaluate the feasibility of Mobius3D for prescription dose verification, we compared the QA results of Mobius3D to an aSi-based EPID and the Octavius 4D dose verification methods. The first was the comparison of the Mobius3D verification phantom dose, and the second was to gamma index analysis. Results: The percentage differences between the calculated point dose and measurements from a PTW31010 ion chamber were 1.6%±1.3%, 2.0%±0.8%, and 1.2%±1.2%, using collapsed cone convolution, an analytical anisotropic algorithm, and the AcurosXB algorithm respectively. The average difference was found to be 1.6%±0.3%. Additionally, in the case of using the PTW31014 ion chamber, the corresponding results were 2.0%±1.4%, 2.4%±2.1%, and 1.6%±2.5%, showing an average agreement within 2.0%±0.3%. Considering all the criteria, the Mobius3D result showed that the percentage dose difference from the EPID was within 0.46%±0.34% on average, and the percentage dose difference from Octavius 4D was within 3.14%±2.85% on average. Conclusions: We conclude that Mobius3D can be used interchangeably with phantom-based dosimetry systems, which are commonly used as patient-specific prescription dose verification tools, especially under the conditions of 3%/3 mm and 95% pass rate.

• 대한방사선치료학회지
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• 제35권
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• pp.15-21
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• 2023

목 적: 전자포탈영상장치 기반의 환자특이적 정도관리를 위한 portal dose image prediction (PDIP)와 anisotropic analytical algorithm (AAA)을 비교하여 성능을 분석하고, AAA를 사용한 portal dosimetry의 임상적 사용 가능성을 평가하고자 한다. 대상 및 방법: 폐암 환자 15명과 간암 환자 17명, 총 32명의 환자를 후향적으로 선정하였다. PDIP와 AAA를 사용하여 검증용 치료계획을 생성하였다. 계산된 분포와 측정된 분포를 비교한 감마통과율(Gamma passing rate, GPR)과 다엽콜리메이터(Multileaf collimator, MLC) 위치 차이를 얻었다. 결 과: 폐암 환자군의 GPR 평균값은 PDIP 사용시 3%/3 mm에 대해 99.5% ± 1.1%, 1%/1 mm에 대해 90.6% ± 5.8%였다. AAA 사용시 3%/3 mm에 대해 98.9% ± 1.7%, 1%/1 mm에 대해 87.8% ± 5.2%였다. 간암 환자군의 GPR 평균값은 PDIP 사용시 3%/3 mm에 대해 99.9% ± 0.3%, 1%/1 mm에 대해 96.6% ± 4.6%였다. AAA 사용시 3%/3 mm에 대해 99.6% ± 0.5%, 1%/1 mm에 대해 89.5% ± 6.4%였다. MLC 위치 차이는 0.013 mm ± 0.002 mm로 적었으며, 감마통과율과 상관관계를 보이지 않았다. 결 론: 전자포탈영상장치 기반 환자특이적 정도관리를 수행할 때 AAA를 임상적으로 portal dosimetry 계산 알고리즘으로써 사용할 수 있다.