• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.29-32
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• 2004

In this study, we had modelled Siemens type MLC using BEAM Monte Carlo code and tested the feasibility of the modelling. To model the Primus linac MLC, we had measured the actual dimensions of MLC and each leaves, then approximated the leaf shape. VARMLC component module was used for the modelling and leakage, tongue-and-groove effect were also considered. Simulation result showed the good agreement with the film measurement.

• Progress in Medical Physics
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• v.19 no.3
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• pp.164-171
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• 2008

One of the most important task in commissioning intensity modulated radiotherapy (IMRT) into a clinic is the characterization of dosimetry performance under small monitor unit delivery conditions. In this study, method of evaluating dose monitor linearity, beam flatness and symmetry, and MLC positioning accuracy using a diode array is investigated. Siemens Primus linear accelerator (LA) with 6 and 10 MV x-rays was used to deliver radiation and the characteristics were measured using a multi array diodes. Monitor unit stabilities were measured for both x-ray energies. The dose linearity errors for the 6 MV x-ray were 2.1, 3.4, 6.9, 8.6, and 15.4 % when 20 MU, 10 MU, 5 MU, 4 MU, and 2 MU was delivered, respectively. Greater errors were observed for 10 MV x-rays with a maximum of 22% when 2 MU was delivered. These errors were corrected by adjusting D1_C0 values and reduced to less than 2% in all cases. The beam flatness and symmetry were appropriate without any correction. The picket fence test performed using diode array and film measurement showed similar results. The use of diode array is a convenient method in characterizing beam stability, symmetry and flatness, and positioning accuracy of MLC for IMRT commissioning. In addition, adjustment of D1-C0 value must be performed when a Siemens LA is used for IMRT because factory value usually gives unacceptable beam stability error when the MU/segment is smaller than 20.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.2
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• pp.69-79
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• 2004

In the process of photon treatments, linear accelerators with energies higher than 10 MV produce neutrons through the (${\gamma}$, n) interactions with the composite materials of the linac head md these materials further produce the induced radiations. We investigate the possible risks from these induced radiations especially in the wedge filters to the radiation workers. Wedge filters are used to modify the isodose profiles in the radiation treatment using the linear accelerator and always be handled by the radiation workers. For the background radiation, we measured the radiation in both the waiting room and the outside of the building for two hospitals, S and H. The results of S hospital were $0.11\;{\mu}Sv/hr$ and $0.10\;{\mu}Sv/hr$ for waiting room and outside respectively, and in the case of H hospital, they were $0.12\;{\mu}Sv/hr$ and $0.11\;{\mu}Sv/hr$. Using a survey meter, we measured the radiation from wedge filters inserted in 10 MV and 15 MV Siemens linear accelerators. The time series measurements were done in ${\sim}1$ minutes after exposure of 5 Gy of monitor units for the field size of $25{\times}25cm^2$. The starting value of 10 MV machine was about $3.26\;{\mu}Sv/hr$, which was three times higher than that of 10 MV. The measured radiation was from $^{28}Al$ and $^{53}Fe$ with a half life of 3.5 min. If the treatment patients are $20{\sim}50$ per day and the number of process of wedge filter change per patient is one or two, the annual dose equivalent is $0.08{\sim}0.4\;mSv$ for 10 MV, and $0.27{\sim}1.36\;mSv$ for 15 MV, which are in the range of dose equivalent limits of radiation workers.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1685-1689
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• 2016

Physical wedges still can be used as missing tissue compensators or filters to alter the shape of isodose curves in a target volume to reach an optimal radiotherapy plan without creating a hotspot. The aim of this study was to investigate the dosimetric properties of physical wedges filters such as off-axis photon fluence, photon spectrum, output factor and half value layer. The photon beam quality of a 6 MV Primus Siemens modified by 150 and 450 physical wedges was studied with BEAMnrc Monte Carlo (MC) code. The calculated present depth dose and dose profile curves for open and wedged photon beam were in good agreement with the measurements. Increase of wedge angle increased the beam hardening and this effect was more pronounced at the heal region. Using such an accurate MC model to determine of wedge factors and implementation of it as a calculation algorithm in the future treatment planning systems is recommended.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.1-9
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• 2003

I. Purpose The multileaf collimator(MLC) has many advantages, but use of the MLC increased effective penumbra and isodose undulation in dose distribution compared with that of an alloy block. In this work, we introduced the HD-270 MLC, which can improve the above disadvantages of MLC, and reported its feasibility study. II. Method and Materials The HD-270 MLC is a technique which combines the use of the existing Siemens multileaf collimator(3D MLC) with patient translation perpendicular to the leaf plane. The technique produces a smoothed isodose distribution with the reduced isodose undulation and effective penumbra. To assess the efficacy of the HD-270 technique and determine the appropriate resolution, a polygonal shaped MLC field was made to produce field edge angles from 0 degree to 75 degree with a step of 15 degree. Each HD-270 group was generated according to the allowed resolution, i. e., 5, 3, and 2mm. The experiment was carried out on Primus, a Siemens linear accelerator configured with HD-270 MLC. The total 60 MU of 6 MV photon beam was delivered to X-Omat film(Kodak, USA) at a SAD of 100 cm and 1.5 cm depth in solid water phantom. Exposed films were scanned by Lumiscan75(LUMISYS) and analyzed using RIT113 software(Radiological Imaging Technology Inc., USA). To test the mechanical accuracy of table movement, the transverse, longitudinal, and vertical positions were controlled by a consol with ${\pm}5\;mm,\;{\pm}4\;mm,\;{\pm}3\;mm,\;and\;{\pm}2\;mm$ steps, and then measured using a dial gauge with an accuracy of 0.001 inch. During the experiments, the table loaded with about 50Kg human phantom to simulate the real treatment situation. III. Results The effective penumbra and isodose undulation became larger with increase the resolution and field edge angle. The accuracy of the table movement on each direction is good within the ${\pm}1\;mm$. IV. Conclusion Clinical use of the MLC can be increased by using of the HD-270 MLC which complements to the disadvantages of the MLC.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.56-56
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• 2003

For the treatment of superficial tumors like squamous cell carcinoma of the head and neck, 6 MV photon beam is not appropriate and a spoiler is widely used to increase dose in the buildup region, while preserving the skin sparing effect. However, commercially available treatment planning systems assume a normal unspoiled beam, thereby cannot predict the buildup dose with spoiler accurately. We aimed to implement a Monte Carlo (MC) based planning system to apply it to the radiation treatment of head and neck. Lucite with thickness of 10-mm was used for the beam spoiler with Siemens Primus 6 MV photon beam. BEAM/DOSXYZ MC system was employed to model the linac and the spoiler. To verify the calculation accuracy of MC simulations, the percent depth doses (PDDs) and profiles with and without spoiler were measured using a parallel-plate chamber. For the MC based planning, we adopted a hybrid interface system between Pinnacle (Philips, USA) and BEAM/DOSXYZ to support treatment parameters of Siemens linac and the spoiler. The measurements of PDDs and profiles agreed with the corresponding MC simulations within 2% (lSD), which demonstrate the reliability of our MC simulations. The spoiler generated electrons make a contribution to the absorbed dose up to depth of 2cm, which shows that the dominant source of increased dose from spoiler system is the contaminating electrons created by the spoiler. The whole procedures necessary for MC based treatment planning were performed seamlessly between Pinnacle and BEAM/DOSXYZ system. This ability helps to increase the clinical efficiency of the spoiler technique. In conclusion, we implemented a MC based treatment planning system for a 6 MV photon beam with a spoiler. We demonstrate sophisticated MC technique makes it possible to predict dose distributions around buildup region accurately.

• Radiation Oncology Journal
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• v.17 no.1
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• pp.78-83
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• 1999

Purpose : We have compared the characteristics of Siemens virtual wedge device with physical wedges for clinical application. Materials and Methods : We investigated the characteristics of virtual and physical wedges for various wedge angles (15, 30, 45, and 60$^{\circ}$) using 6- and 15MV photon beams. Wedge factors were measured in water using an ion chamber for various field sizes and depths. In case of virtual wedge device, as upper jaw moves during irradiation, wedge angles were estimated by accumulated doses. These measurements were performed at off-axis points perpendicular to the beam central axis in water for a 15cm${\times}$20cm radiation field size at the depth of loom. Surface doses without and with virtual or physical wedges were measured using a parallel plate ion chamber at surface. Field size was 15cm H20cm and a polystyrene phantom was used. Results : For various field sizes, virtual and physical wedge factors were changed by maximum 2.1% and 3.9%) , respectively. For various depths, virtual and physical wedge factors were changed by maximum 1.9% and 2.9%, respectively. No major difference was found between the virtual and physical wedge angles and the difference was within 0.5$^{\circ}$ . Suface dose with physical wedge was reduced by maximum 20% (x-ray beam :6 MV, wedge angle:45$^{\circ}$, 550: 80 cm) relative to one with virtual wedge or without wedge. Conclusions : Comparison of the characteristics of Siemens virtual wedge device with physical wedges was performed. Depth dependence of virtual wedge factor was smaller than that of physical wedge factor. Virtual and physical wedge factors were nearly independent of field sizes. The accuracy of virtual and physical wedge angles was excellent. Surface dose was found to be reduced using physical wedge.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.