• Progress in Medical Physics
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• v.17 no.1
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• pp.40-46
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• 2006

Hepatoma is one of 3 most common malignancies in Korea, the survival rate is not improved since last decades because of delayed diagnosis and limited treatment conditions. Radiation was one of treatment options but the impact on the survival is not remarkable. High dose exposure to target area was suggested for improved effect but low tolerance dose of normal liver tissue is the main limited factor. IMRT is the advanced form of 3DCRT, for focusing high dose on target with minimal dose to surrounding normal tissues. Motion of the tumor by respiration, cardiac pulsation and peristalsis is the main treatment harrier of IMRT for treatment of hepatoma patients. Development of QA technique for acceptable geometrical uncertainties and dose error on target volume is essential for IMRT in clinical treatment but proper QA technique is not yet developed. This study compared the verification film dosimetry with measured dose in phantom and calculated dose in planning computer on exactly same conditions of patient treatments. Within 3% dose differences between 3 groups were confirmed. We suggest that our verification QA technique is easy, economic, iterative and acceptable in clinical application for advanced hepatoma patients.

• Nuclear Engineering and Technology
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• v.55 no.8
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• pp.2935-2940
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• 2023

A polystyrene phantom was developed following the guidance of the International Atomic Energy Association (IAEA) for gamma knife (GK) quality assurance. Its performance was assessed by measuring the absorbed dose rate to water and dose distributions. The phantom was made of polystyrene, which has an electron density (1.0156) similar to that of water. The phantom included one outer phantom and four inner phantoms. Two inner phantoms held PTW T31010 and Exradin A16 ion chambers. One inner phantom held a film in the XY plane of the Leksell coordinate system, and another inner phantom held a film in the YZ or ZX planes. The absorbed dose rate to water and beam profiles of the machine-specific reference (msr) field, namely, the 16 mm collimator field of a GK Perfexion^TM or Icon^TM, were measured at seven GK sites. The measured results were compared to those of an IAEA-recommended solid water (SW) phantom. The radius of the polystyrene phantom was determined to be 7.88 cm by converting the electron density of the plastic, considering a water depth of 8 g/cm². The absorbed dose rates to water measured in both phantoms differed from the treatment planning program by less than 1.1%. Before msr correction, the PTW T31010 dose rates (PTW Freiberg GmbH, New York, NY, USA) in the polystyrene phantom were 0.70 (0.29)% higher on average than those in the SW phantom. The Exradin A16 (Standard Imaging, Middleton, WI, USA) dose rates were 0.76 (0.32)% higher in the polystyrene phantom. After msr correction factors were applied, there were no statistically significant differences in the A16 dose rates measured in the two phantoms; however, the T31010 dose rates were 0.72 (0.29)% higher in the polystyrene phantom. When the full widths at half maximum and penumbras of the msr field were compared, no significant differences between the two phantoms were observed, except for the penumbra in the Y-axis. However, the difference in the penumbra was smaller than variations among different sites. A polystyrene phantom developed for gamma knife dosimetry showed dosimetric performance comparable to that of a commercial SW phantom. In addition to its cost effectiveness, the polystyrene phantom removes air space around the detector. Additional simulations of the msr correction factors of the polystyrene phantom should be performed.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.115-121
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• 2013

Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.

• Progress in Medical Physics
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• v.26 no.4
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• pp.250-257
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• 2015

Multi-leaf collimator (MLC) systems are frequently used to deliver photon-based radiation, and allow conformal shaping of treatment beams. Many proton beam centers currently make use of aperture and snout systems, which involve use of a snout to shape and focus the proton beam, a brass aperture to modify field shape, and an acrylic compensator to modulate depth. However, it needs a lot of time and cost of preparing treatment, therefore, we developed the manual MLC for solving this problem. This study was carried out with the intent of designing an MLC system as an alternative to an aperture block system. Radio-activation and dose due to primary proton beam leakage and the presence of secondary neutrons were taken into account during these iterations. Analytical calculations were used to study the effects of leaf material on activation. We have fabricated tray model for adoption with a wobbling snout ($30{\times}40cm^2$) system which used uniform scanning beam. We designed the manual MLC and tray and can reduce the cost and time for treatment. After leakage test of new tray, we upgrade the tray with brass and made the safety tool. First, we have tested the radio-activation with usually brass and new brass for new manual MLC. It shows similar behavior and decay trend. In addition, we have measured the leakage test of a gantry with new tray and MLC tray, while we exposed the high energy with full modulation process on film dosimetry. The radiation leakage is less than 1%. From these results, we have developed the design of the tray and upgrade for safety. Through the radio-activation behavior, we figure out the proton beam leakage level of safety, where there detects the secondary particle, including neutron. After developing new design of the tray, it will be able to reduce the time and cost of proton treatment. Finally, we have applied in clinic test with original brass aperture and manual MLC and calculated the gamma index, 99.74% between them.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.57-64
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• 1997

Purpose : Before we report the results of curative radiotherapy in cervix cancer patients, we review the significance and safety of our dose specification methods in the brachytherapy system to have the insight of the potential Predictive value of doses at specified points. Matersials and Methods : We analyze the 리5 cases of cervix cancer patients treated with intracavitary brachytherapy in the lateral simulation film we draw the isodose curve and observe the absorbed dose rate of point A, the reference point of bladder(SBD) and rectum(SRD). In the sagittal view of Pelvic MRI film we demarcate the tumor volume(TV) and determine whether the prescription dose curve of point A covers the tumor volume adequately by drawing the isodose curve as correctly as possible. Also we estimate the maximum Point dose of bladder(MBD) and rectum(MRD) and calculate the inclusion area where the absorbed dose rate is higher than that of point A in the bladder(HBV) and rectum(HRV), respectively. Results : Of forty-five cases, the isodose curve of point A seems to cover tumor volume optimally in only 24(53%). The optimal tumor coverage seems to be associated not with the stage of the disease but with the tumor volume. There is no statistically significant association between SBD/SRD and MBD/MRD, respectively. SRD has statistically marginally significant association with HRV, while TV has statistically significant association with HBV and HRV. Conclusion : Our current treatment calculation methods seem to have the defect in the aspects of the nonoptimal coverage of the bulky tumor and the inappropriate estimation of bladder dose. We therefore need to modify the applicator geometry to optimize the dose distribution at the position of lower tandem source. Also it appears that the position of the bladder in relation to the applicators needs to be defined individually to define 'hot spots'.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.91-99
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• 2004

Purpose : For the head and neck radiotherapy, abutting photon field with electron field is frequently used for the irradiation of posterior neck when tolerable dose on spinal cord has been reached. Materials and methods : Using 6 MV X-ray and 9 MeV electron beams of Clinac1800(Varian, USA) linear accelerator, we performed film dosimetry by the X-OMAT V film of Kodak in solid water phantom according to depths(0 cm, 1.5 cm, 3 cm, 5 cm). 6 MV X-ray and 9 MeV electron(1Gy) were exposes to 8cm depth and surface(SSD 100cm) of phantom. The dose distribution to the junction line between photon($10cm{\times}10cm$ field with block) and electron($15cm{\times}15cm$ field with block) fields was also measured according to depths(0 cm, 0.5 1.5 cm, 3 cm, 5 cm). Results : At the junction line between photon and electron fields, the hot spot was developed on the side of the photon field and a cold spot was developed on that of the electron field. The hot spot in the photon side was developed at depth 1.5 cm with 7 mm width. The maximum dose of hot spot was increased to $6\%$ of reference doses in the photon field. The cold spot in the electron side was developed at all measured depths(0.5 cm-3 cm) with 1-12.5 mm widths. The decreased dose in the cold spot was $4.5-30\%$ of reference dose in the electron field. Conclusion : When we make use of abutting photon field with electron field for the treatment of head and neck cancer we should consider the hot and cold dose area in the junction of photon and electron field according to location of tumor.

• Progress in Medical Physics
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• v.23 no.3
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• pp.138-144
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• 2012

Dose distribution throughout the clinical organ range of motion was analyzed using a respiratory-motion simulator that was equipped with a polymer gel dosimeter and EBT2 film. The normoxic polymer gel dosimeter was synthesized from gelatin, MAA, HQ, THPC and HPLC. The gel dosimeter and EBT2 film were irradiated with Co-60 gamma rays that were moved along the x-axis and y-axis in ${\pm}1.5cm$ steps at five-second intervals. The field size was $5{\times}5cm^2$. The SSD was 80 cm and set to 10 Gy at a depth of 2 cm. The PDD at a depth of 50 mm was 75.2% in the ion chamber, 82.3% in the static state and 86.1% in the dynamic state in the gel dosimeter. The penumbra for the dynamic state target, which was measured using the gel dosimeter, averaged 10.89 mm, this is a 40.5% increase over the penumbra of the static state target of 7.74 mm. In addition, when measuring with gel dosimetry, the value for the penumbra is 36.6% smaller in the static state and 29.4% smaller in the dynamic state compared to measuring with film. The aim of this study was to investigate the dosimetric properties of a normoxic polymethacrylic acid gel dosimeter in static and dynamic states and to evaluate the potentiality as a relative dosimeter for dynamic therapeutic radiation.

• Progress in Medical Physics
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• v.25 no.1
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• pp.46-52
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• 2014

Liquid ionization chamber is filled with liquid equivalent material unlike air filled ionization chamber. The high density material allow very small-volume chamber to be constructed that still have a sufficiently high sensitivity. However liquid ionization chamber should be considered for both initial recombination and general recombination. We, therefore, studied using the Co-60 beam as the continuous beam and the microLion chamber (PTW) for comparing the ion collection efficiency by Greening theory, two-dose rate method and our experiment method. The measurements were carried out using Theratron 780 as the cobalt machine and water phantom and 0.6 cc Farmer type ionization chamber was used with microLion chamber in same condition for measuring the charge of microLion chamber according to the dose rates. Dose rate was in 0.125~0.746 Gy/min and voltages applied to the microLion chamber were +400, +600 and +800 V. As the result, the collection efficiency by three method was generally less than 1%. In particular, our experimental collection efficiency was in good agreement within 0.3% with Greening theory except the lowest two dose rates. The collection efficiency by two-dose rate method also agreed with Greening theory generally less than 1%, but the difference was about 4% when the difference of two dose rates were lower. The ion recombination correction factors by Greening theory, two-dose rate method and our experiment were 1.0233, 1.0239 and 1.0316, respectively, in SSD 80 cm, depth 5 cm recommended by TRS-398 protocol. Therefore we confirmed that the loss by ion recombination was about 3% in this condition. We think that our experiment method for ion recombination correction will be useful tool for radiation dosimetry in continuous beam.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.60-71
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• 2009

Purpose: We assessed the absorbed dose to the tumor ($Dose_{tumor}$) by using pretreatment FDG-PET and whole-body (WB) planar images in repeated radioimmunotherapy (RIT) with $^{131}I$ rituximab for NHL. Materials and Methods: Patients with NHL (n=4) were administered a therapeutic dose of $^{131}I$ rituximab. Serial WB planar images alter RIT were acquired and overlaid to the coronal maximum intensity projection (MIP) PET image before RIT. On registered MIP PET and WB planar images, 2D-ROls were drawn on the region of tumor (n=7) and left medial thigh as background, and $Dose_{tumor}$ was calculated. The correlation between $Dose_{tumor}$ and the CT-based tumor volume change alter RIT was analyzed. The differences of $Dose_{tumor}$ and the tumor volume change according to the number of RIT were also assessed. Results: The values of absorbed dose were $397.7{\pm}646.2cGy$ ($53.0{\sim}2853.0cGy$). The values of CT-based tumor volume were $11.3{\pm}9.1\;cc$ ($2.9{\sim}34.2cc$), and the % changes of tumor volume before and alter RIT were $-29.8{\pm}44.3%$ ($-100.0%{\sim}+42.5%$), respectively. $Dose_{tumor}$ and the tumor volume change did not show the linear relationship (p>0.05). $Dose_{tumor}$ and the tumor volume change did not correlate with the number of repeated administration (p>0.05). Conclusion: We could determine the position and contour of viable tumor by MIP PET image. And, registration of PET and gamma camera images was possible to estimate the quantitative values of absorbed dose to tumor.

• Progress in Medical Physics
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• v.22 no.1
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• pp.35-41
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• 2011

For overall system test, hidden-target test have been used using film which leads to inherent analysis error. The purpose of our study is to quantify this error and to propose gel dosimeter based verification technique for 3-dimensional target point error. The phantom was made for simulation of human head and this has ability to equip 10 gel-dosimeter. $BANGkit^{TM}$ which we are able to manufacture whenever it is needed as well as to easily change the container with different shapes was used as a gel dosimeter. The 10 targets were divided into two groups based on shapes of areas with a planned 50% isodose line. All treatment and analysis was performed three times using Novalis and $BrainSCAN^{TM}$. The target point error is $0.77{\pm}0.15mm$ for 10 targets and directional target point error in each direction is $0.54{\pm}0.23mm$, $0.37{\pm}0.08mm$, $0.33{\pm}0.10mm$ in AP (anterior-posterior), LAT (lateral), and VERT (vertical) direction, respectively. The result of less than 1 mm shows that the treatment was performed through each precise step in treatment procedure. In conclusion, the 3-dimensional target point verification technique can be one of the techniques for overall system test.