• Journal of Radiation Protection and Research
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• v.48 no.1
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• pp.9-14
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• 2023

Background: The detectors of both computed radiography (CR) and direct digital radiography (DR) have a wide dynamic range that could tolerate high values of exposure factors without an adverse effect on image quality. Therefore, this study aims to assess patient radiation dose and proposes institutional diagnostic reference levels (DRLs) for two teaching hospitals in Ghana. Materials and Methods: CR and DR systems were utilized in this study from two teaching hospitals. The CR system was manufactured by Philips Medical Systems DMC GmbH, while the DR system was manufactured by General Electric. The entrance skin doses (ESDs) were calculated using the standard equation and the tube output measurements. Free-in-air kerma (µGy) was measured using a calibrated radiation dosimeter. The proposed institutional DRLs were estimated using 75^th percentiles values of the estimated ESDs for nine radiographic projections. Results and Discussion: The calculated DRLs were 0.4, 1.6, 3.4, 0.5, 0.4, 1.1, 1.0, 1.2, and 1.7 mGy for chest posteroanterior (PA), lumbar spine anteroposterior (AP), lumbar spine lateral (LAT), cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively in CR system. In the DR system, the values were 0.3, 1.6, 3.1, 0.4, 0.3, 0.7, 0.6, 0.9, and 1.3 for chest PA, lumbar spine AP, lumbar spine LAT, cervical spine AP, cervical spine LAT, skull PA, pelvis AP, and abdomen AP, respectively. Conclusion: Institutional DRLs in nine radiographic projections have been proposed for two teaching hospitals in Ghana for the first time. The proposed DRLs will serve as baseline data for establishing local DRLs in the hospitals and will be a valuable tool in optimizing patient doses.

• Journal of radiological science and technology
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• v.46 no.6
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• pp.509-517
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• 2023

This study analyzed imaging conditions and exposure index through clinical information collection and dose calculation programs in coronary angiography examinations. Through this, we aim to analyze the effective dose according to examination conditions and provide basic data for dose optimization. In this study, ALARA(As Low As Reasonably Achievable)-F(Fluoroscopy), a program for evaluating the radiation dose of patients and the collected clinical data, was used. First, analysis of imaging conditions and exposure index was performed based on the data of the dose report generated after coronary angiography. Second, after evaluating organ dose according to 9 imaging directions during coronary angiography, with the LAO fixed at 30°, dose evaluation was performed according to tube voltage, tube current, number of frames, focus-skin distance, and field size. Third, the effective dose for each organ was calculated according to the tissue weighting factors presented in ICRP(International Commission on Radiological Protection) recommendations. As a result, the average sum of air kerma during coronary angiography was evaluated as 234.0±112.1 mGy, the dose-area product was 25.9±13.0 Gy·cm², and the total fluoroscopy time was 2.5±2.0 min. Also, the organ dose tended to increase as the tube voltage, milliampere-second, number of frames, and irradiation range increased, whereas the organ dose decreased as the FSD increased. Therefore, medical radiation exposure to patients can be reduced by selecting the optimal tube voltage and field size during coronary angiography, maximizing the focal-skin distance, using the lowest tube current possible, and reducing the number of frames.

• Progress in Medical Physics
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• v.20 no.1
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• pp.21-29
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• 2009

Breast cancer is the most common form of cancer among korean woman. Therefore, the early detection activities of breast cancer such as breast self-examinations, clinical breast examinations, mammography are important. A yearly mammography examination has been recommended for women aged 40 and older for the early detection of breast cancer in asymptomatic periods. However, the glandular tissue of breast is the most radiation-sensitive tissue, and the determination of average glandular dose (AGD) forms an important part of the quality control of the mammographic systems. Because of the difficulty of estimating AGD directly, it is often estimated from the measurements of the incident air kerma and by applying the appropriate conversion factors. The primary objective of this study was to standardize the method of measuring AGD. The secondary objective was to evaluate the relationships between AGD per various composition and thickness of the breast using Monte Carlo simulations. As a result, we standardized the method of measuring AGD according to International Atomic Energy Agency (IAEA) guidelines (CoP: an international code of practice). Overall, AGD for mammographic practice in Korea was less than 3.0 mGy recommended by the Korea Food and Drug Adminstration (KFDA) protocol, and Korean Institute for Accreditation of Medical Image (KIAMI). The measured and simulated AGD for a given condition were calculated as 1.7 and 1.6 mGy, respectively. For the AGDs obtained, there was no significant difference between them. The simulated AGD was dependent on the fraction of glandular tissue of the breast. The AGD increases with increasing of the breast glandularity due to increasing absorption of low energy photons. The AGD also increases as a function of breast thickness. In conclusion, the results of this study could be used as a baseline to establish a reference level of radiation dose in mammography.

• Journal of radiological science and technology
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• v.28 no.4
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• pp.293-299
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• 2005

In the present investigation, we analyzed the data of 1,318 patients (2,636 images) who underwent mammographic examinations and obtained the distribution of the patient age and compressed breast thickness. We measured also average glandular doses (AGD) as function of compressed breast thickness. In order to obtain the values of AGD, we measured half value layer (HVL) and tube output (mR/mAs) for each kVp and target/filter combination. Entrance surface air kerma (ESAK) was calculated from the tube output as measured for each voltage used under clinical conditions and from the tube loading (mAs). AGD per exposure were calculated by multiplying the ESAK values by the conversion factors tabulated by Dance. We obtained in this study the following conclusions. The mean value of compressed breast thickness for cranio-caudal (CC) view was 35.8mm and that for medio-lateral oblique (MLO) view was 43.3 mm. The mean value of AGD for CC view was 1.55 mGy and that for MLO view was 1.70 mGy. The AGD for MLO view was 0.15 mGy (10%) higher than that for CC view because the thickness for MLO view was on average 4.8 mm higher than that for CC view. The values of AGD increased with increasing compressed brest thickness. The increased AGD value was on average 0.34 mGy per 10 mm in the thickness ranges $10{\sim}80\;mm$, therefore differences between the AGD values of each thickness were relative large. Thus, it is considered to need limited doses for mammography with the upper end of exposure range at several different compressed brest thickness.

• Progress in Medical Physics
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• v.22 no.2
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• pp.92-98
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• 2011

This study is to keep the accuracy and stability of the output dose evaluations for linear accelerator photon beams by using the air ionization chambers (TM31010, 0.125 cc, PTW) through the Task Group 51 protocol. The absorbed dose to water calibration factor $N_{dw}{^{Co-60}}$ was delivered from the air kerma calibration factor $N_k$ which was provided from manufacture through SSDL calibration for determination of output factor. The ionization chamber of TM31010 series was reviewed the calibration factor and other parameters for reduce the uncertainty within ${\pm}2%$ discrepancy and we found the supplied $N_{dw}{^{Co-60}}$ which was derived from Nk has shown a -2.8% uncertainty compare to that of PSDL. The authors provided the program to perform the output dosimetry with TG-51 protocol as it is composed same screen of TG-51 worksheets. The evaluated dose by determination of output factor delivered to postal TLD block for comparison the output dose to that of MDACC (RPC) in postal monitoring program. The results have shown the $1.001{\pm}0.013$ for 6 MV and $0.997{\pm}0.012$ discrepancy for 15 MV X rays for 5 years followed. This study shows the evaluated outputs for linear accelerate photon beams are very close to that of international output monitor with small discrepancy of ${\pm}1.3%$ with high reliability and showing the gradually stability after 2010.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.153-156
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• 2004

Korea Food and Drug Administration(KFDA) has peformed the calibration of therapy level dosimeters for Co-60 radiation since 1979. The reference standard ionization chamber has been calibrated at BIPM in France. The uncertainty on the KFDA calibration coefficients is 0.9 %(k=2) for air kerma and absorbed dose to water. Since 1999 a national quality audit program for ensuring dosimetry accuracy in Korea radiotherapy centers has been performed by the KFDA. The uncertainty associated with the determination of the absorbed dose to water from the TLD readings for high energy x-ray is 1.6 %(k=1). The correction factors for energy, non-linearity dose response, and TLD holder are used in the dose determination. Agreement between the user stated dose and KFDA measured dose within ${\pm}$ 5 % is considered acceptable. KFDA TLD postal dose quality audit program was peformed for 71 beam qualities of 53 domestic radiotherapy centers in 2003. The results for quality assurance showed that 63 out of 71 beam qualifies (89 %) satisfied the acceptance limit. The second audit was carried out for the centers outside the limit and ail of them have been corrected.

• Progress in Medical Physics
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• v.20 no.1
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• pp.7-13
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• 2009

This work is for the preliminary study for the calibration of an $^{192}Ir$ brachytherapy source based on an absorbed dose to water standards. In order to calibrate brachytherapy sources based on absorbed dose to water standards using a clyndirical ionization chamber, the beam quality correction factor $k_{Q,Q_0}$ is needed. In this study $k_{Q,Q_0}s$ were determined by both Monte carlo simulation and semiexperimental methods because of the realistic difficulties to use primary standards to measure an absolute dose at a specified distance. The 5 different serial numbers of the PTW30013 chamber type were selected for this study. While chamber to chamber variations ran up to maximum 4.0% with the generic $k^{gen}_{Q,Q_0}$, the chamber to chamber variations were within a maximum deviation of 0.5% with the individual $k^{ind}_{Q,Q_0}$. The results show why and how important ionization chambers must be calibrated individually for the calibration of $^{192}Ir$ brachytherapy sources based on absorbed dose to water standards. We hope that in the near future users will be able to calibrate the brachytherapy sources in terms of an absorbed dose to water, the quantity of interest in the treatment, instead of an air kerma strength just as the calibration in the high energy photon and electron beam.

• Progress in Medical Physics
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• v.16 no.2
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• pp.53-61
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• 2005

The quality factors for cylindrical ionization chambers for kV X-rays were determined by Monte Carlo calculation and measurement. In this study, the X-rays of 60-300 kV beam (lSO-4037) installed in KFDA and specified in energy spectra and beam qualities, and the chambers of PTW N23333 and N30001 were investigated. In calculations, the $R_{\mu}\;and\;R_{Q,Q_{0}}$ in IAEA dosimetry protocols were determined from the air kerma and the cavity dose obtained by theoretical and Monte Carlo calculations. It is shown that the N30001 chamber has a flat response of $\pm1.7\%$ in $110\~300kV$ region, while the response range of two chambers were shown to $\pm3\~4\%$ in $80\~250kV$ region. From this work we have discussed dosimetry protocol for the kV X-rays and we have found that the estimation of energy dependency is more important to apply dosimetry protocol for kV X-rays.

• Progress in Medical Physics
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• v.16 no.3
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• pp.116-124
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• 2005

Absorbed dose dosimetry protocols of high energy photon and electron beams, which are widely used and based on an air kerma calibration factors, have somewhat complex formalism and limitations for improving dosimetric accuracy due to uncertainty of the physical parameters used. Recently the IAEA and the AAPM published the absorbed dose to water-based dosimetry protocol. In this work web-based dose calibration program for IAEA TRS-398 and AAPM TG-51 protocols were developed. This program developed using the Visual C$\#$ language can be used in the internet. User selectable dosimetry protocol on the web allows the absorbed dose to water data of the two protocols at a reference point to be easily compared, and enables to conveniently manage and understand the current status of the dosimetry calibration performed at participating institutions in korea. This program and the resultant database from the web-based calibration can be useful in developing new dosimetry protocols in Korea.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.27-33
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• 2016

The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this study, we investigate the diagnostic reference level (DRL) of the cardiovascular intervention (CI) carried out by medical institutions and use it as a tool to reduce patient exposure dose. In this study, the DRL was set by acquiring information about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), radiography DAP, cumulative DAP, air kerma, number of video clips, and the total number of images from the cardiac angiography and interventional procedures performed on 147 patients. The DAPs corresponding to the DRL of cardiac angiography(CA) and that of the interventional procedures were shown to be $44.4Gy{\cdot}cm2$ and $298.6Gy{\cdot}cm2$, respectively; the corresponding DRLs of fluoroscopy time were shown to be 191.5s and 1935.3s, respectively. A DRL is not a strict upper bound for radiation exposure. However, the process of setting, enacting, and reviewing the DRLs for the dose by medical institutions will contribute to a reduction in the unnecessary exposure dose of patients.