• Progress in Medical Physics
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• v.28 no.3
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• pp.111-121
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• 2017

Verification of dose distribution is an essential part of ensuring the treatment planning system's (TPS) calculated dose will achieve the desired outcome in radiation therapy. Each measurement have uncertainty associated with it. It is desirable to reduce the measurement uncertainty. A best approach is to reduce the uncertainty associated with each step of the process to keep the total uncertainty under acceptable limits. Point dose patient specific quality assurance (QA) is recommended by American Association of Medical Physicists (AAPM) and European Society for Radiotherapy and Oncology (ESTRO) for all the complex radiation therapy treatment techniques. Relative and absolute point dose measurement methods are used to verify the TPS computed dose. Relative and absolute point dose measurement techniques have a number of steps to measure the point dose which includes chamber cross calibration, electrometer reading, chamber calibration coefficient, beam quality correction factor, reference conditions, influences quantities, machine stability, nominal calibration factor (for relative method) and absolute dose calibration of machine. Keeping these parameters in mind, the estimated relative percentage uncertainty associated with the absolute point dose measurement is 2.1% (k=1). On the other hand, the relative percentage uncertainty associated with the relative point dose verification method is estimated to 1.0% (k=1). To compare both point dose measurement methods, 13 head and neck (H&N) IMRT patients were selected. A point dose for each patient was measured with both methods. The average percentage difference between TPS computed dose and measured absolute relative point dose was 1.4% and 1% respectively. The results of this comparative study show that while choosing the relative or absolute point dose measurement technique, both techniques can produce similar results for H&N IMRT treatment plans. There is no statistically significant difference between both point dose verification methods based upon the t-test for comparing two means.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.302-304
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• 2002

In linac-based stereotactic radiosurgery, assuring the quality of the planning and delivery of external photon beam requires accurate evaluation of beam parameters, usually including output factors, tissue-phantom ratio and off-axis ratios, and measurement of actual dose distributions from simulated treatment. We're going to test the use of calibrated radio chromic film (Gafchromic film; type MD-55, Nuclear associate) using a Lumiscan 75 digitizer to measure absolute dose and relative dose distributions for linac-based radiosurgery unit Relative dose distribution of a human-style spherical acryl phantom were measured using radiochromic film and calculated by treatment planning system. The absolute dose at the sphere center was measured by radiochromic film and micro chamber (Exradin A-14, 0.009cc). What we want to demonstrate in this work, the 'well selected' radiochromic films when external photon beam are used in linac-based stereotactic radiosurgery are very accurate detector for dosimetry.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.11-19
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• 2014

Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.11-22
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• 1998

The absolute absorbed dose can be determined according to the measurement conditions ; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of $10{\times}10cm$ field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations on phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG2l and IAEA protocol. The differences between two protocols are within $1\%\;while\;the\;average\;value\;of\;IAEA\;protocol\;was\;0.5\%$ smaller than TG2l protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within $1\%,\;but\;individual\;discrepancies\;are\;in\;the\;range\;of\;-2.5\%\;to\;1.2\%$ depending upon the choice of measurement combination. The largest discrepancy of $-25\%$ was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coefficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, It shows that absorbed dose could be affected by phantom material other than water.

• Progress in Medical Physics
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• v.29 no.1
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• pp.16-22
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• 2018

Current dosimetry protocols recommend the use of parallel-plate chambers in electron dosimetry because the electron fluence perturbation can be effectively minimized. However, substitutable methods to calibrate and measure the electron output and energy with the widely used cylindrical chamber should be developed in case a parallel-plate chamber is unavailable. In this study, we measured the correction factors and absolute dose-to-water of electrons with energies of 4, 6, 9, 12, 16, and 20 MeV using Farmer-type and Roos chambers by varying the dose rates according to the AAPM TG-51 protocol. The ion recombination factor and absolute dose were found to be varied across the chamber types, energy, and dose rate, and these phenomena were remarkable at a low energy (4 MeV), which was in good agreement with literature. While the ion recombination factor showed a difference across chamber types of less than 0.4%, the absolute dose differences between them were largest at 4 MeV at approximately 1.5%. We therefore found that the absolute dose with respect to the dose rate was strongly influenced by ion-collection efficiency. Although more rigorous validation with other types of chambers and protocols should be performed, the outcome of the study shows the feasibility of replacing the parallel-plate chamber with the cylindrical chamber in electron dosimetry.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.51-58
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• 2011

Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

• The Journal of Korean Medicine
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• v.24 no.1
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• pp.41-53
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• 2003

The effect of Banhasasim-tang extracts on the hepatic, splenic and cardiac toxicity induced by doxorubicin administration (three injection protocol) were monitored using male ICR mice. Changes of body weight, clinical signs, necropsy findings and organ weights of liver, spleen and heart were observed with blood GOT and GPT levels. The results were as follows: 1. Decrease of body weight after doxorubicin treatment was dose-dependently inhibited by Banhasasim-tang extracts. 2. The degrees of anorexia, ataxia and dehydration that were observed in doxombicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. 3. Increase of absolute and relative liver weight observed in the doxorubicin treatment group were dose-dependently inhibited by Banhasasim-tang extracts. In addition, the degrees of liver congestion and necrotic spot were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of the doxorubicin-only treatment group. It is also demonstrated that elevated serum GOT and GPT levels in the doxorubicin treatment group were significantly decreased in the Banhasasim-rang extracts dosing group. 4. Decrease of absolute and relative spleen weight observed in doxorubicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. In addition, the degrees of splenic atrophy were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of doxorubicin-only treatment group. 5. Increase of absolute and relative heart weight observed in doxorubicin treatment groups were dose-dependently inhibited by Banhasasim-rang extracts. In addition, the degrees of heart congestion and enlargement were significantly and dose-dependently decreased in the Banhasasim-rang extracts dosing group compared to that of the doxorubicin-only treatment group. In conclusion, the toxicity of doxorubicin treatment (decrease of body weight, clinical signs such as anorexia, ataxia and dehydration, changes of organ weights of liver, spleen and heart, elevation of serum GOT and GPT levels) was inhibited and/or prevented by Banhasasim-rang extracts. According to these results, it is considered that Banhasasim-rang has some preventive effect against the toxicity induced by doxorubicin.

• Journal of Radiation Protection and Research
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• v.43 no.2
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• pp.59-65
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• 2018

Background: We analyzed changes in the doses, structure volumes, and dose-volume histograms (DVHs) when data were transferred from one commercial treatment planning system (TPS) to another commercial TPS. Materials and Methods: A total of 22 volumetric modulated arc therapy (VMAT) plans for nasopharyngeal cancer were generated with the Eclipse system using 6-MV photon beams. The computed tomography (CT) images, dose distributions, and structure information, including the planning target volume (PTV) and organs at risk (OARs), were transferred from the Eclipse to the MRIdian system in digital imaging and communications in medicine (DICOM) format. Thereafter, DVHs of the OARs and PTVs were generated in the MRIdian system. The structure volumes, dose distributions, and DVHs were compared between the MRIdian and Eclipse systems. Results and Discussion: The dose differences between the two systems were negligible (average matching ratio for every voxel with a 0.1% dose difference criterion = $100.0{\pm}0.0%$). However, the structure volumes significantly differed between the MRIdian and Eclipse systems (volume differences of $743.21{\pm}461.91%$ for the optic chiasm and $8.98{\pm}1.98%$ for the PTV). Compared to the Eclipse system, the MRIdian system generally overestimated the structure volumes (all, p < 0.001). The DVHs that were plotted using the relative structure volumes exhibited small differences between the MRIdian and Eclipse systems. In contrast, the DVHs that were plotted using the absolute structure volumes showed large differences between the two TPSs. Conclusion: DVH interpretation between two TPSs should be performed using DVHs plotted with the absolute dose and absolute volume, rather than the relative values.

• Journal of radiological science and technology
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• v.45 no.6
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• pp.553-560
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• 2022

The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.

• Progress in Medical Physics
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• v.28 no.4
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• pp.190-196
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• 2017

For the $ViewRay^{(R)}$ system (ViewRay Inc., Cleveland, OH, USA) which is representative of magnetic resonance (MR) guided radiotherapy machine, it is important to evaluate effectiveness of AAPM's TG-51 protocol and the effect of the magnetic field on absolute dosimetry. In order to measure the absolute dose, MR-compatible chamber and water phantom system manufactured in this study were used. The materials of the water phantom system were plastic of polymethyl methacrylate (PMMA) and non-ferrous materials. Due to the inherent feature of the $ViewRay^{(R)}$, all Co-60 sources are not located at gantry angle of $0^{\circ}$ while being located at gantry angle of $90^{\circ}$. For this reason, absolute dosimetry was performed based on the measurements in solid water phantom (SWP) and water which determine the SWP to water correction factor. For evaluation of output constancy with gantry angle, measurements were made with ionization chamber inserted in cylindrical water-equivalent phantom. For measured doses in water, the values of dose deviation according to a reference dose of 200 cGy for Head 1, Head 2 and Head 3 were -0.27%, -0.45% and -0.22%, respectively. For measured doses in SWP, the values of dose deviation according to a reference dose of 200 cGy for Head 1, Head 2 and Head 3 were -1.91%, -2.07% and -1.84%, respectively. All values of dose measured in SWP tended to be less than those measured in water by -1.63%. With the reference gantry angles of $0^{\circ}$ and $90^{\circ}$, the maximum values of deviation for Head 1, Head 2 and Head 3 were 0.48%, 1.06% and 0.40%, respectively. The measurement agreement is within the range of results obtainable for conventional treatment machines. The low strength of the magnetic field does not affect dose measurements. Using the SWP to water correction factor, absolute doses for $ViewRay^{(R)}$ system can be measured.