• Progress in Medical Physics
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• v.17 no.1
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• pp.6-16
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• 2006

The goal of this study was to develop new indices for effectively evaluating the dose coverage and homogeneity based on the target-volume dose-volume histogram (TV-DVH) of intensity-modulated radio-therapy treatment plans. A new coverage Index and a new homogeneity index were developed by integrating a modified TV-DVH and by fitting a TV-DVH with a modified step function, respectively. The coverage index, named the l-index, indicates whether the dose coverage for the target volume is adequate based on user-defined criteria. A lower l-index indicates higher dose coverage of the tumor volume. The index for assessing dose homogeneity in a target volume, named the n-index, is more accurate than the conventional method in evaluating the dose homogeneity in a tumor volume. The baseline treatment plan for a target volume coverage and homogeneity is discussed. The proposed simple indices have been demonstrated to be effective in evaluating the dose coverage and homogeneity for TV-DVHs.

• Progress in Medical Physics
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• v.27 no.4
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• pp.220-223
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• 2016

Generally, it is recommended that the dosimetric effect of carbon fiber couch should be considered especially for an intensity-modulated therapy with a large portion of monitor units from posterior angles. Even a flattening filter free (FFF) beam has been used for stereotactic body radiation therapy (SBRT), the effect of carbon fiber couch for FFF beam is not well known. This work is an effort to evaluate the dosimetric effect of carbon fiber couch for flattened and FFF beam of Elekta linac empirically. The absorbed doses were measured with Farmer type chamber and water-equivalent phantoms with and without couch. And differences of the absorbed doses between with and without couch defined as "couch effect". By comparing calculated dose in treatment planning system (TPS) with measured dose, the optimal density of couch was evaluated. Finally, differences on patient's skin dose and target dose by couch were evaluated in TPS. As a result, the couch effect for 6 and 10 MV flattened beam were -2.71% and -2.32%, respectively. These values were agreed with provided data by vendor within 0.5%. The couch effect for 6 and 10 MV FFF beam were -3.75% and -2.80%, respectively. The patient's skin dose was increased as 18.6% and target dose was decreased as 0.87%, respectively. It was realized that the couch effect of FFF beam was more severe than that of flattened beam. Patient's skin dose and target dose were changed by the couch effect.

• Journal of Radiation Protection and Research
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• v.32 no.1
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• pp.15-20
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• 2007

An empirical formula fur the neutron dose equivalent at the maze entrance of medical accelerator treatment rooms was derived on the basis of a Monte Carlo simulation. The simulated neutron dose equivalents around the Varian medical accelerator by the MCNPX code were employed. Two cases of target rotational planes were considered: parallel and perpendicular to maze walls. Most of the maximum neutron dose equivalents at the doorway were found when the target rotational planes were parallel to maze walls and the beams were directed to the inner maze entrances. The neutron dose equivalents at the outer maze entrances were calculated for about 698 medical accelerator facilities which were generated from the geometry configurations of running treatment rooms, based on such gantry rotation that produces the maximum neutron dose at the doorway. The results calculated with the empirical formula in this study were compared with those calculated by the Kersey method for 7 operating facilities. It was found that the maximum disagreement between the calculation of this study and that of the Kersey method was a factor of 8.54 with the value calculated by the Kersey method exceeding that of this study. It was concluded that the kersey method estimated the neutron dose equivalent at the doorway computed by MCNPX more conservatively than this study technique.

• Journal of radiological science and technology
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• v.44 no.2
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• pp.109-115
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• 2021

In this study, a physical evaluation of internal radiation exposure in children was conducted using nuclear medicine test(Renal DTPA Dynamic Study) to simulate the distribution and effects of the radiation throughout the tracer kinetics over time. Monte Carlo simulations were performed to determine the internal medical radiation exposure during the tests and to provide basic data for medical radiation exposure management. Specifically, dose variability based on changes in the tracer kinetic was simulated over time. The internal exposure to the target organ (kidney) and other surrounding organs was then quantitatively evaluated and presented. When kidney function was normal, the dose to the target organ(kidney) was approximately 0.433 mGy/mCi, and the dose to the surrounding organs was approximately 0.138-0.266 mGy/mCi. When kidney function was abnormal, the dose to the surrounding organs was 0.228-0.419 mGy/mCi. This study achieved detailed radiation dose measurements in highly sensitive pediatric patients and enabled the prediction of radiation doses according to kidney function values. The proposed method can provide useful insights for medical radiation exposure management, which is particularly important and necessary for pediatric patients.

• Progress in Medical Physics
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• v.30 no.4
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• pp.104-111
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• 2019

Purpose: Online magnetic resonance-guided adaptive radiotherapy (MRgART), an emerging technique, is used to address the change in anatomical structures, such as treatment target region, during the treatment period. However, the electron density map used for dose calculation differs from that for daily treatment, owing to the variation in organ location and, notably, air pockets. In this study, we evaluate the dosimetric effect of electron density override on air pockets during online ART for pancreatic cancer cases. Methods: Five pancreatic cancer patients, who were treated with MRgART at the Seoul National University Hospital, were enrolled in the study. Intensity modulated radiation therapy plans were generated for each patient with 60Co beams on a ViewrayTM system, with a 45 Gy prescription dose for stereotactic body radiation therapy. During the treatment, the electron density map was modified based on the daily MR image. We recalculated the dose distribution on the plan, and the dosimetric parameters were obtained from the dose volume histograms of the planning target volume (PTV) and organs at risk. Results: The average dose difference in the PTV was 0.86Gy, and the observed difference at the maximum dose was up to 2.07 Gy. The variation in air pockets during treatment resulted in an under- or overdose in the PTV. Conclusions: We recommend the re-contouring of the air pockets to deliver an accurate radiation dose to the target in MRgART, even though it is a time-consuming method.

• Nuclear Engineering and Technology
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• v.53 no.12
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• pp.4098-4105
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• 2021

The aim of this study is to calculate the JO-IMRT dose distributions based on the AAPM TG-119 using Monte Carlo (MC) simulation and Prowess Panther treatment planning system (TPS) (Panther, Prowess Inc., Chico, CA). JO-IMRT dose distributions of AAPM TG-119 were calculated by the TPS and were recalculated by MC simulation. The DVHs and 3D gamma index using global methods implemented in the PTW-VeriSoft with 3%/3 mm were used for evaluation. JO-IMRT dose distributions calculated by TPS and MC were matched the TG-119 goals. The gamma index passing rates with 3%/3 mm were 98.7% for multi-target, 96.0% for mock prostate, 95.4% for mock head-and-neck, and 96.6% for C-shape. The dose in the planning target volumes (PTV) for TPS was larger than that for the MC. The relative dose differences in D99 between TPS and MC for multi-target are 1.52%, 0.17% and 1.40%, for the center, superior and inferior, respectively. The differences in D95 are 0.16% for C-shape; and 0.06% for mock prostate. Mock head-and-neck difference is 0.40% in D99. In contrast, the organ curve for TPS tended to be smaller than MC values. JO-IMRT dose distributions for the AAPM TG-119 calculated by the TPS agreed well with the MC.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.35-40
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• 2018

Purpose : The range of force differs from the size of proton energy used in our hospital. The compensator enables to change energy size based on distal thickness which also makes changes in dose rate. Therefore, the purpose of this study is to evaluate the effect of changing the thickness of compensator distal on dose range and beam on time. Subject and Methodology : Five low energy patients who have received proton therapy were selected as subjects for this study. Beam on was checked for the selected patients during the existing therapy. After then, the thickness of distal of compensator was increased by 2 cm up to 14 cm through proton therapy plan system(TPS) for comparative analysis. For the evaluation of dose range, the value of the target's conformity index(CI) and the maximum dose of rear side target's organ at risk(OAR) were compared. Furthermore, to evaluate the effect of therapy time, beam on time was compared by making compensator distal in each thickness. Result : The result of homogeneity index and conformity index of the increased compensator distal showed the same level in all patients. The comparison results of OAR of target rear side showed 7 cGy at spine cord of abdomen at maximum, 88 cGy at eyeball's RT lens, 391 cGy at RT lens of nasal cavity 51 cGy at trachea of the mediastinum, and 661 cGy at a small bowl of the pelvis. The comparison results of the beam on time showed a reduction from 126 seconds to 62 seconds for the abdomen, from 105 seconds to 37 seconds for the eyeball, from 187 seconds to 134 seconds for nasal cavity, from 100 seconds to 40 seconds for mediastinum, from 440 seconds to 118 seconds for the pelvis. Conclusion : The research result showed that as the distal thickness of compensator increased, the size of energy increased. In addition, beam on decreased due to the increase of dose rate. It is expected that the result would help reduce the treatment time and increase the convenience of patients if it is applied to liver patients who need respiratorygated therapy and pediatric patients. However, distal penumbra increased as the size energy increased. Therefore, in treating cases where OAR is in the vicinity of the target rear side, the influence of penumbra should be taken into account in adjusting thickness level of the compensator in proton therapy plan.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2243-2248
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• 2013

Background: To compare the dosimetric coverage of target volumes and organs at risk in the radical treatment of nasopharyngeal carcinoma (NPC) between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: Data from 10 consecutive patients treated with IMRT from June-October 2011 in Penang General Hospital were collected retrospectively for analysis. For each patient, dose volume histograms were generated for both the IMRT and 3DCRT plans using a total dose of 70Gy. Comparison of the plans was accomplished by comparing the target volume coverage (5 measures) and sparing of organs at risk (17 organs) for each patient using both IMRT and 3DCRT. The means of each comparison target volume coverage measures and organs at risk measures were obtained and tested for statistical significance using the paired Student t-test. Results: All 5 measures for target volume coverage showed marked dosimetric superiority of IMRT over 3DCRT. V70 and V66.5 for PTV70 showed an absolute improvement of 39.3% and 24.1% respectively. V59.4 and V56.4 for PTV59.4 showed advantages of 18.4% and 16.4%. Moreover, the mean PTV70 dose revealed a 5.1 Gy higher dose with IMRT. Only 4 out of 17 organs at risk showed statistically significant difference in their means which were clinically meaningful between the IMRT and 3DCRT techniques. IMRT was superior in sparing the spinal cord (less 5.8Gy), V30 of right parotid (less 14.3%) and V30 of the left parotid (less 13.1%). The V55 of the left cochlea was lower with 3DCRT (less 44.3%). Conclusions: IMRT is superior to 3DCRT due to its dosimetric advantage in target volume coverage while delivering acceptable doses to organs at risk. A total dose of 70Gy with IMRT should be considered as a standard of care for radical treatment of NPC.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.53-59
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• 2020

Purpose: The purpose of this study is to compare and analyze the difference between the MLC log file-based software (Mobius) and the conventional phantom-ionization chamber (ArcCheck) dose verification method according to the change of target volume. Material and method: Radius 0.25cm, 0.5cm, 1cm, 2cm, 3cm, 4cm, 5cm, 6cm, 7cm, 8cm, 9cm, 10cm with a Sphere-shaped target Twelve plans were created and dose verification using Mobius and ArcCheck was conducted three times each. The irradiated data were compared and analyzed using the point dose error value and the gamma passing rate (3%/3mm) as evaluation indicators. Result: Mobius point dose error values were -9.87% at a radius of 0.25cm and -4.39% at 0.5cm, and the error value was within 3% at the remaining target volume. The gamma passing rate was 95% at a radius of 9cm and 93.9% at 10cm, and a passing rate of more than 95% was shown in the remaining target volume. In ArcCheck, the average error value of the point dose was about 2% in all target volumes. The gamma passing rate also showed a pass rate of 98% or more in all target volumes. Conclusion: For small targets with a radius of 0.5cm or less or a large target with a radius of 9cm or more, considering the uncertainty of DQA based on MLC log files, phantom-ionized DQA is used in complementary ways to include point dose, gamma index, DVH, and target coverage. It is believed that it is desirable to verify the dose delivery through a comprehensive analysis.

• Progress in Medical Physics
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• v.7 no.2
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• pp.19-28
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• 1996

It is important that the precise decision of the region and the accurate delivery of radiation dose required for treatment in the stereotactic radiosurgery. In this research, radiosurgery was carried with Leksell streotactic frame(LSF) which is especially developed water phantom to verify in experiment. Leksell Gamma Knife and LSF are used in radiosurgery is the spherical water phantom has the thickness of 2 mm, the radius of 160mm. The film for target localization and ionchamber for dose delivery was used in measurement instruments We compare the coordinate of target which is initialized by biplannar film with simple X-ray to the coordinate of film measured directly. The calculated dose by computer simulation and the measured dose by ionization chamber are compared. In this research, the target localization has the range ${\pm}$0.3mm for the acceptable error range and the absolute dose is :${\pm}$0.3mm for the acceptable error range. This research shows that the values measured by using the especially manufactured phantom are included the acceptable error range. Thus, this water phantom will be used continuously in the periodic quality assurance of Gamma Knife Unit and Leksell Stereotactic Frame.