• Radiation Oncology Journal
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• v.30 no.1
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• pp.27-35
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• 2012

Purpose: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. Materials and Methods: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. Results: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The $V_{20Gy}$ of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. Conclusion: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.116-118
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• 2002

It has been noted that Monte Carlo simulations are the most accurate method to calculate dose distributions in any material and geometry. Monte Carlo transport algorithms determine the absorbed dose by following the path of representative particles as they travel through the medium. Accurate Monte Carlo dose calculations rely on detailed modeling of the radiation source. We modeled the effects of beam modifiers such as collimators, blocks, wedges, etc. of our accelerator, Varian Clinac 600C/D to ensure accurate representation of the radiation source using the EGSnrc based BEAM code. These were used in the EGSnrc based DOSXYZ code for the simulation of particles transport through a voxel based Cartesian coordinate system. Because Monte Carlo methods use particle-by-particle methods to simulate a radiation transport, more particle histories yield the better representation of the actual dose. But the prohibitively long time required to get high resolution and accuracy calculations has prevented the use of Monte Carlo methods in the actual clinical spots. Our ultimate aim is to develop a Monte Carlo dose calculation system designed specifically for radiation therapy planning, which is distinguished from current dose calculation methods. The purpose of this study in the present phase was to get dose calculation results corresponding to measurements within practical time limit. We used parallel processing and some variance reduction techniques, therefore reduced the computational time, preserving a good agreement between calculations of depth dose distributions and measurements within 5% deviations.

• Progress in Medical Physics
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• v.31 no.4
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• pp.153-162
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• 2020

Purpose: We aim to evaluate the accuracy and effectiveness of an automatically converted radiation therapy plan between Radixact machines by comparing the original plan with the transferred plan. Methods: The study involved a total of 20 patients for each randomly selected treatment site who received radiation treatment with Radixact. We set up the cheese phantom (Gammex RMI, Middleton, WI, USA) with an Exradin A1SL ion chamber (Standard Imaging, Madison, WI, USA) and GAFCHROMIC EBT3 film (International Specialty Products, Wayne, NJ, USA) inserted. We used three methods to evaluate an automatically converted radiation therapy plan using the features of the Plan transfer. First, we evaluated and compared Planning target volume (PTV) coverage (homogeneity index, HI; conformity index, CI) and organs at risk (OAR) dose statistics. Second, we compared the absolute dose using an ion chamber. Lastly, we analyzed gamma passing rates using film. Results: Our results showed that the difference in PTV coverage was 1.72% in HI and 0.17% in CI, and majority of the difference in OAR was within 1% across all sites. The difference (%) in absolute dose values was averaging 0.74%. In addition, the gamma passing rate was 99.64% for 3%/3 mm and 97.08% for 2%/2 mm. Conclusions: The Plan transfer function can be reliably used in appropriate situations.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.149-155
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• 1987

The success of radioation therapy depends on exact treatment of the tumor with significant high dose for maximizing local control and excluding the normal tissues for minimizing unwanted complications. To achieve these goals, correct estimation of target volume in three dimension, exact dose distribution in tumor and normal critical structures and correction of tissue inhomogeneity are required. The effect of therapy oriented CT (plannng CT) were compared with conventional simulation method in necessity of planning change, set dose, and proper distribution of tumor dose. Of 365 new patients examined, planning CT was performed in 104 patients $(28\%)$. Treatment planning was changed in $47\%$ of head and neck tumor, $79\%$ of intrathoracic tumor and $63\%$ of abdmonial tumor. in breast cancer and musculoskeletal tumors, planning CT was recommended for selection of adequate energy and calculation of exact dose to critical structures such as kidney or spinal cord. The average difference of tumor doses between CT planning and conventional simulation was $10\%$ in intrathoracic and intra-abdominal tumors but $20\%$ in head and neck tumors which suggested that tumor dose may be overestimated in conventional simulation Although some limitations and disadvantages including the cost and irradiation during CT are still criticizing, our study showed that CT Planning is very helpful in radiotherapy Planning.

• Journal of the Korean Society of Radiology
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• v.9 no.5
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• pp.287-293
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• 2015

Because of esophageal cancer has the long length of the lesion and also inhomogeneous in depth. So, the radiation dose distribution was inhomogeneous in radiation therapy. To overcomes the dose distribution uniformity using half beam method. Patient's CT image was used radiation treatment planning. We used two planning methods that one is the using normal beam and another is using half beam. Than comparing the two radiotherapy planning using target coverage, dose volume histogram, conformity index, homogeneity index and normal tissues - heart, spinal cord, lung -. In results, Treatment planning using half beam is little more than normal beam in target coverage, dose volume histogram, conformity index, homogeneity index and normal tissues covering. However, If the patient is not correct position patients may arise a side effect. Thus, the using in Half beam involving the geometrically exact under lung cancer is considered to advantage.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3365-3370
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• 2015

Radiotherapy has an important role in the treatment of prostate cancer. Three-dimensional conformal radiation therapy (3D-CRT), intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques are all applied for this purpose. However, the risk of secondary radiation-induced bladder cancer is significantly elevated in irradiated patients compared surgery-only or watchful waiting groups. There are also reports of risk of secondary cancer with low doses to normal tissues. This study was designed to compare received volumes of low doses among 3D-CRT, IMRT and VMAT techniques for prostate patients. Ten prostate cancer patients were selected retrospectively for this planning study. Treatment plans were generated using 3D-CRT, IMRT and VMAT techniques. Conformity index (CI), homogenity index (HI), receiving 5 Gy of the volume (V5%), receiving 2 Gy of the volume (V2%), receiving 1 Gy of the volume (V1%) and monitor units (MUs) were compared. This study confirms that VMAT has slightly better CI while thev olume of low doses was higher. VMAT had lower MUs than IMRT. 3D-CRT had the lowest MU, CI and HI. If target coverage and normal tissue sparing are comparable between different treatment techniques, the risk of second malignancy should be a important factor in the selection of treatment.

• Progress in Medical Physics
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• v.15 no.1
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• pp.9-16
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• 2004

The intensity modulated radiation therapy (IMRT) is believed to be on of the best treatment techniques for the goal of radiation therapy: to irradiate fatal dose to tumor region while minimizing dose to critical organs. It is essential to have comprehensive quality assurance program to assure the precision and the accuracy of the treatment due to the characteristic of the IMRT. The quality assurance technique for the Corvus treatment planning system was developed and its effectiveness was tested with the treatment planning of H&N region. Acrylic phantom, film and ionization chamber were used for this study, the discrepancy between the treatment planning and the film measurements showed 0.03 cm and 0.28 cm for the 90% of isodose line in each directions. Dose measurements showed 1% and 1.2% differences for ionization chamber and TLD, respectively. This concluded that the system can be used for clinic.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.33-41
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• 2019

Purpose : To evaluate the effectiveness of Jaw-tracking(JT) technique in Intensity-modulated radiation therapy(IMRT) and Volumetric-modulated arc therapy(VMAT) for radiation therapy of esophageal cancer by analyzing volume dose of perimetrical normal organs along with the low-dose volume regions. Materials and Method: A total of 27 patients were selected who received radiation therapy for esophageal cancer with using $VitalBeam^{TM}$(Varian Medical System, U.S.A) in our hospital. Using Eclipse system(Ver. 13.6 Varian, U.S.A), radiation treatment planning was set up with Jaw-tracking technique(JT) and Non-Jaw-tracking technique(NJT), and was conducted for the patients with T-shaped Planning target volume(PTV), including Supraclavicular lymph nodes(SCL). PTV was classified into whether celiac area was included or not to identify the influence on the radiation field. To compare the treatment plans, Organ at risk(OAR) was defined to bilateral lung, heart, and spinal cord and evaluated for Conformity index(CI) and Homogeneity index(HI). Portal dosimetry was performed to verify a clinical application using Electronic portal imaging device(EPID) and Gamma analysis was performed with establishing thresholds of radiation field as a parameter, with various range of 0 %, 5 %, and 10 %. Results: All treatment plans were established on gamma pass rates of 95 % with 3 mm/3 % criteria. For a threshold of 10 %, both JT and NJT passed with rate of more than 95 % and both gamma passing rate decreased more than 1 % in IMRT as the low dose threshold decreased to 5 % and 0 %. For the case of JT in IMRT on PTV without celiac area, $V_5$ and $V_{10}$ of both lung showed a decrease by respectively 8.5 % and 5.3 % in average and up to 14.7 %. A $D_{mean}$ decreased by $72.3{\pm}51cGy$, while there was an increase in radiation dose reduction in PTV including celiac area. A $D_{mean}$ of heart decreased by $68.9{\pm}38.5cGy$ and that of spinal cord decreased by $39.7{\pm}30cGy$. For the case of JT in VMAT, $V_5$ decreased by 2.5 % in average in lungs, and also a little amount in heart and spinal cord. Radiation dose reduction of JT showed an increase when PTV includes celiac area in VMAT. Conclusion: In the radiation treatment planning for esophageal cancer, IMRT showed a significant decrease in $V_5$, and $V_{10}$ of both lungs when applying JT, and dose reduction was greater when the irradiated area in low-dose field is larger. Therefore, IMRT is more advantageous in applying JT than VMAT for radiation therapy of esophageal cancer and can protect the normal organs from MLC leakage and transmitted doses in low-dose field.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.31-39
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• 2020

Purpose: The aims of this study were to compare the superficial dose with Optically Stimulated Luminescence Dosimeter(OSLD) measurement and Treatment Planning System(TPS) calculation for 6MV-Flattening Filter Free(FFF) energy using HalcyonTM and TrueBeamTM. Materials and methods: Phantom study was performed using the CT images of human phantom. In the treatment planning system, the Planning Target Volume(PTV) was contoured which is similar to Glottic cancer. Furthermore, Point(M), Point(R), and Point(L) were contoured at the iso-center of head and neck region and 5mm bolus was applied to the body contour. Each treatment plans using 6MV-FFF energy from HalcyonTM and TrueBeamTM with static Intensity Modulated Radiation Therapy(IMRT) and Volumetric Modulated Arc Therapy(VMAT) were established with eclipse. To reproduce the same position as the TPS, OSLDs were placed at the iso-center point and 5mm bolus was applied to compare the error rate after the dose delivery. Result: The results of the study using human phantom are as follows. In case of HalcyonTM, the mean absolute error rates of the point dose using the treatment planning system and the dose measured by OSLD were 1.7%±1.2% for VMAT and 4.0±2.8% for IMRT. Also TrueBeamTM was identified as 2.4±0.4% and 8.6±1.8% respectively for VMAT and IMRT. Conclusion: Through the results of this study, TrueBeamTM confirmed that the average error rate was 2.4 times higher for VMAT and 3.6 times higher for IMRT than HalcyonTM. Therefore, based on the results of this study, If we need a more accurate dose assessment for the superficial dose, It is expected that using HalcyonTM would be better than TrueBeamTM.

• The Journal of Korean Society for Radiation Therapy
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• v.9 no.1
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• pp.64-70
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• 1997

The goal of radiation treatment planning is to deliver the dose to the patient within $5\%$ of that prescribed. We have often encountered the situation that the area which have not only several irregular contours but also tissue heterogeneities should be treated. With conventional devices such as wedges, missing tissue compensator. there are some limitations to achieve the uniform dose distribution in treatment volume. The use of CT simulator, 3-D planning system, computer-controlled milling machine enables it to deliver the dose uniformally. This report includes the whole procedure which have patient data acquisition 3D planning, computer-controlled milling, performance verification of 3D compensator, and TLD evaluation. We applied it for the treatment of head and heck cancer only. In Spite of the irregular contour and different electron density of tessue, we have achieved the uniformity of the dose distribution within ${\pm}3\%$ relatively. Although there are some problems which are not only verification of performance but uncertainties of using the new treatment device, we believe that the improvement of dosimetry will eliminate the uncertainties of that application. so the other lesions besides head and neck can will be ale to use the 3D compensator to achieve the dose uniformity