• The Journal of Korean Society for Radiation Therapy
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• v.29 no.1
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• pp.93-101
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• 2017

Purpose: In breast cancer radiotherapy, brass mesh bolus has been recently studied to overcome disadvantage of conventional bolus. The purpose of this study is to investigate the stability of first introduced the brass mesh in the country, and evaluate the skin surface dose of that. Materials and Methods: The measurement of skin surface dose was evaluated to verify similar thickness of the Brass mesh bolus that compared conformal tissue equivalent bolus with 5 mm thickness. We used 6 MV photons on an ELEKTA VERSA linear accelerator and optically stimulated luminescent dosimeter (OSLD). In addition, two opposed beam using IMRT phantom was applied to comparative study of brass mesh bolus between tissue equivalent bolus. Results: The results showed that similar thickness of the Brass mesh bolus was 3 mm compared with 5 mm tissue equivalent bolus by measuring the skin surface dose of solid phantom. The surface dose for IMRT thorax phantom using 3 mm brass mesh bolus was about 1.069 times greater than that using tissue equivalent bolus. Conclusion: In this study, we found that the brass mesh bolus improved better reduction of skin sparing effect and dose uniformity than tissue equivalent bolus. However evaluation for various clinic cases should be investigated.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.985-991
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• 2023

A tissue-equivalent phantom is necessary for quality control of hyperthermia therapy. However, since there is no phantom for this purpose, phantoms made from agar are being used in various studies. The tissue-equivalent properties of the agar phantom were confirmed by comparison with the tissue-equivalent material bolus in this study. CT images of the agar phantom and bolus were acquired, and tissue equivalent characteristics were analyzed with image analysis and dose calculation using a computerized radiation therapy planning system. The average pixel value was 96.960±10.999 in bolus, 108.559±8.233 in 3% agar phantom, and 111.844±8.651 in 4% agar phantom. Using the SSD technique, 100 cGy was prescribed at a depth of 1.5 cm and 6 MV X -ray was set to irradiated to 10x10 cm2, and the absorbed dose according to depth was calculated from the central axis of the beam. The intraclass correlation coefficient of dose distribution of bolus, 3% agar phantom, and 4% agar phantom was 0.979 (p<.001, 95%CI .957-.991). The density (g/cm3) at the point where the absorbed dose was calculated was 0.990±0.020 at the bolus, 1.018±0.020 at the 3% agar phantom, and 1.035±0.024 at the 4% agar phantom. In this study, the internal density distribution and uniformity of the agar phantom were confirmed to be appropriate as a tissue equivalent material by analysis of CT images and a computerized radiation therapy planning system.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.1001-1007
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• 2023

Dose limits are not applied to medical radiation exposure therefore justification and optimization should be essential for protecting radiation. This study explores methods to reduce exposure dose undergoing general radiation exam by bolus(tissue equivalent material) with keeping image quality. Hand PA projection with 50 kVp, 5 mAs, SID 100 cm, and 8×10 inch is referred by covered bolus of thickness 0, 3, 5, 8, and 10 mm for evaluation entrance dose and SNR. The entrance dose (μGy) to the hand by bolus thickness was 125.41±0.288, 106.85±0.255, 104.97±0.221, 91.68±0.299, and 90.94±0.106 showing a significant reduction in radiation exposure depending on if the bolus was used and bolus thickness. The SNR of the image was 13.997, 13.906, 12.240, 12.538, and 12.548 at each bolus thickness, showing no significant difference. It was confirmed that if appropriate thickness and size of bolus is used depending on the type of radiological imaging exam and the body site, a significant radiation dose reduction effect can be achieved without deteriorating image quality.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.241-246
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• 2019

Among the 4th Industrial Revolution technologies, evaluated bolus applicability through dose assesment according to the materials of 3D printing technology. Dose assesment was using MCNPX which was applied Monte Carlo method and 3D print materials were ABS, PC and PLA. Thus, the thickness with the same effect as the bolus 10 mm was found to be ABS 10 mm, PC 9 mm and PLA 9 mm for the 6 MeV electron. For 6 MV X-ray, ABS 11 mm, PC 10 mm and PLA 9 mm were shown. This study showed that tissue equivalent materials made from 3D printer materials can replace bolus.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2278-2284
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• 2012

Exposure-dose reducing effect was measured by using bolus, a tissue-equivalent material as a shield to obtain useful diagnostic images while minimizing the radiation exposure of thyroid which is highly sensitive to radiation during panoramic radiography. The experiment was performed within the period of 1 June 2001 through 30 June 2011 by measuring entrance surface dose and deep dose at the thyroid-corresponding site of a head and neck phantom. As a result, the entrance surface dose in the thyroid for using no shield was 43.84 ${\mu}Gy$ on the average, and the thyroid shield of bolus 10 mm in thickness reduced the dose by 15.45 ${\mu}Gy$(35.24%) to 28.39 ${\mu}Gy$ on the average. The use of a 20 mm thyroid shield resulted in the dose of 25.38 ${\mu}Gy$ on the average, a 18.46 ${\mu}Gy$(42.10%) drop from 43.84 ${\mu}Gy$ for using no shield. On the site 20 mm below the surface, a thyroid shield 10 mm in thickness had no dose-reducing effect, while a 20 mm thyroid shield reduced the dose by 0.06 mSv(20%).

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.75-81
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• 2019

Purpose: Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer. Methods and materials: For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse. Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room. Results: The Hounsfield unit (HU) of the bolus measured by CT was $52{\pm}37.1$. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was $179.66{\pm}2.62cGy$, $184.33{\pm}1.24cGy$ and $195.33{\pm}1.69cGy$. And the error rates were -3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was $182.00{\pm}1.63cGy$, $193.66{\pm}2.05cGy$ and $196{\pm}2.16cGy$. The error rates were -2.46 %, 0.23 % and 2.83 %. Conclusions: The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator in 3D printer, will increase later.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.61-71
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• 2015

Purpose : 3D Printers are used to create three-dimensional models based on blueprints. Based on this characteristic, it is feasible to develop a bolus that can minimize the air gap between skin and bolus in radiotherapy. This study aims to compare and analyze air gap and target dose at the branded 1 cm bolus with the developed customized bolus using 3D printers. Materials and Methods : RANDO phantom with a protruded tumor was used to procure images using CT simulator. CT DICOM file was transferred into the STL file, equivalent to 3D printers. Using this, customized bolus molding box (maintaining the 1 cm width) was created by processing 3D printers, and paraffin was melted to develop the customized bolus. The air gap of customized bolus and the branded 1 cm bolus was checked, and the differences in air gap was used to compare $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$ and $V_{95%}$ in treatment plan through Eclipse. Results : Customized bolus production period took about 3 days. The total volume of air gap was average $3.9cm^3$ at the customized bolus. And it was average $29.6cm^3$ at the branded 1 cm bolus. The customized bolus developed by the 3D printer was more useful in minimizing the air gap than the branded 1 cm bolus. In the 6 MV photon, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 102.8%, 88.1%, 99.1%, 95.0%, 94.4% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 101.4%, 92.0%, 98.2%, 95.2%, 95.7%, respectively. In the proton, at the customized bolus, $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of GTV were 104.1%, 84.0%, 101.2%, 95.1%, 99.8% and the $D_{max}$, $D_{min}$, $D_{mean}$, $D_{95%}$, $V_{95%}$ of branded 1cm bolus were 104.8%, 87.9%, 101.5%, 94.9%, 99.9%, respectively. Thus, in treatment plan, there was no significant difference between the customized bolus and 1 cm bolus. However, the normal tissue nearby the GTV showed relatively lower radiation dose. Conclusion : The customized bolus developed by 3D printers was effective in minimizing the air gap, especially when it is used against the treatment area with irregular surface. However, the air gap between branded bolus and skin was not enough to cause a change in target dose. On the other hand, in the chest wall could confirm that dose decrease for small the air gap. Customized bolus production period took about 3 days and the development cost was quite expensive. Therefore, the commercialization of customized bolus developed by 3D printers requires low-cost 3D printer materials, adequate for the use of bolus.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.289-295
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• 2017

The aim of this study was to evaluate the dose comparison using Radon phantom with 5 mm and 10 mm tissue equivalent materials, FIF, Wedge(15, 30 angle) and IMRT, to reduce the skin dose of the contralateral breast during breast cancer radiation therapy(Total dose: 50.4Gy). The dose was measured for each treatment plan by attaching to the 8 point of the contralateral breast of the treated region using a optical-stimulated luminance dosimeter(OSLD) as a comparative dose evaluation method. Of the OSLD used in the study, 10 were used with reproducibility within 3%. As a result, the average reduction rates of 5 mm and 10 mm in the FIF treatment plan were 37.23 cGy and 41.77 cGy, respectively, and the average reduction rates in the treatment plan using Wedge $15^{\circ}$ were 70.69 cGy and 87.57 cGy, respectively. The IMRT showed a reduction of 67.37 cGy and 83.17 cGy, respectively. The results of using bolus showed that as the thickness of the bolus increased in all treatments, the dose reduction increased. We concluded that mastectomy as well as general radiotherapy for breast cancer would be very effective for patients who are more likely to be exposed to scattered radiation due to a more demanding or complex treatment plan.

• Radiation Oncology Journal
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• v.30 no.2
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• pp.49-52
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• 2012

Purpose: To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. Materials and Methods: A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. Results: In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. Conclusion: When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.189-196
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• 2012

Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.