• Progress in Medical Physics
• /
• v.17 no.1
• /
• pp.24-31
• /
• 2006

Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

• Progress in Medical Physics
• /
• v.25 no.2
• /
• pp.89-94
• /
• 2014

We investigated whether regional hyperthermia (HT) increased post-surgical complications in patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT). Between 1996 and 2007, 205 patients treated with preoperative CCRT and curative surgery were evaluable for the analysis of acute and late toxicities. A total dose of 39.6 Gy or 45 Gy was delivered concurrently with one or two cycles of chemotherapy (5-fluorouracil, leucovorin). Eighty-eight patients received regional HT twice a week using an 8-MHz radiofrequency capacitive heating device. Surgery was performed 4~6 weeks after the completion of preoperative CCRT. The median age was 59 years (range, 18~83) and the median follow-up period was 61months (range, 2~191). The 5-year overall survival and complication-free survival rate of all patients was 77.4% and 73.7%, respectively. Early leakage, delayed leakage, anastomotic stricture, fistula, and small bowel obstruction occurred in 1.0%, 2.9%, 1.5%, 5.9%, and 17.1%, respectively. HT did not increase all kinds of complications. The 5-year complication-free survival rate was 71.8% in the non-HT group and 76.3% in the HT group (p=0.293). Regional HT did not increase postoperative complications in patients with locally advanced rectal cancer treated with preoperative CCRT followed by curative surgery.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 2003.09a
• /
• pp.45-45
• /
• 2003

The aim of this study was the characterization and performance validation of new prototype avalanche photodiode (APD) arrays for positron emission tomography (PET). Two different APD array prototypes (noted A and B) developed by Radiation Monitoring Device (RMD) have been investigated. Principal characteristics of the two APD array were measured and compared. In order to characterize and evaluate the APD performance, capacitance, doping concentration, quantum efficiency, gain and dark current were measured. The doping concentration that shows the impurity distribution within an APD pixel as a function of depth was derived from the relationship between capacitance and bias voltage. Quantum efficiency was measured using a mercury vapor light source and a monochromator used to select a wavelength within the range of 300 to 700 nm. Quantum efficiency measurements were done at 500 V, for which the APD gain is equal to one. For the gain measurements, a pencil beam with 450 nm in wavelength was illuminating the center of each pixel. The APD dark currents were measured as a function of gain and bias. A linear fitting method was used to determine the value of surface and bulk leakage currents. Mean quantum efficiencies measured at 400 and 450 nm were 0.41 and 0.54, for array A, and 0.50 and 0.65 for array B. Mean gain at a bias voltage of 1700 V, was 617.6 for array A and 515.7 for type B. The values based on linear fitting were 0.08${\pm}$0.02 nA 38.40${\pm}$6.26 nA, 0.08${\pm}$0.0l nA 36.87${\pm}$5.19 nA, and 0.05${\pm}$0.00 nA, 21.80${\pm}$1.30 nA in bulk surface leakage current for array A and B respectively. Results of characterization demonstrate the importance of performance measurement validating the capability of APD array as the detector for PET imaging.

• Progress in Medical Physics
• /
• v.8 no.1
• /
• pp.53-67
• /
• 1997

General hospitals have being under the influence of various and specific environment of electromagnetic field. The factors are development of medical electric equipment and device with enlarged functional demands, in high power and multi-frequency. It has all of both faces, EMI(electromagnetic interference) and EMS(electromagnetic susceptibility). In additional, expansion of personal communication system(cellular phone) has many unreliable factor of using time and area, making noise of electromagnetic fields. We studied actual conditions of EMI in the medical site, where is numerous medical equipment, especially central operation room and ICU(intensive care unit), AKR(artificial kidney room : hemo-dialysis unit), etc. The influence, most of medical equipments made electromagnetic nosie has various factors in its band of frequency, harmonics and strength. In the experimental use of electro-surgical unit and cellular phone, noticeable and considerable noise of eletromagnetic fields were measured. All of that can make trouble and errors on the steadiness of bioelectrical devices. In conclusion, It is necessary to reconsiderations of reallocating EMI source vs. EMS factor, and set to definite forbiding area of using cellular phone. For maintenance of steady normal conditions, in spite of existing any other legal standards of safty level, it need considering all of alternative electromagnetic situations on a case-by-case basis.

• Progress in Medical Physics
• /
• v.11 no.2
• /
• pp.117-122
• /
• 2000

The IP(imaging plate) has been widely used to measure the two-dimensional distribution of incident radiation since it has a high sensitivity, reusability, a wide dynamic range, a high position resolution. Particularly, the easiness of acquiring digitized image using IP poses a strong merit because recent trend of data handling prefers image digitization. In order to test its usefulness in photon beam dosimetry, we measured the off-axis ratio(OAR) on portal planes and percent depth dose(PDD) within a phantom using IP, and compared the results with the data based on EGS4 Monte Carlo particle transport code, ion-chambers, conventional films. For the measurement, we used 6 MV X-rays, various field sizes. As a result, IP showed significant deviation from ion-chamber measurement: a significant overresponse, 100% greater than that of ion-chamber measurement at deep part of the phantom. Filtration of low-energy scattered photons at deep part of the phantom using 0.5 mm thick lead sheets did improve the result, only to the unacceptable extent. However, portal dose measurement showed possibilities of If as a dosimeter by showing errors less than 5%, as compared with film measurement.

• Progress in Medical Physics
• /
• v.8 no.1
• /
• pp.25-29
• /
• 1997

Ir-192 source activity for high dose rate brachytherapy is measured using Farmertype ionization chamber. The source-to-chamber distance is 10 cm and the measured charge unit is converted to activity unit. The measured values are compared to the values provided from vendor. Because of time dependency of Ir-192 source activity, the activities are regularly checked and compared to calculated values. As the accuracy of Ir-192 source activity is depend on the mechanical measurement setup, we estimated the precision of remote controlled source dwell position using home-made device and film scanner. The difference between measured and predicted dwell position is within 1 mm. As a result, the errors of source activity are 0.7${\pm}$1.5 ％ for measured and vendor-provided values and 0.l${\pm}$1.2％ for measured and time-dependent calculated vlaues. In conclusion, our measured activity has been comparable to the values provided from vendor and our brachytherapy unit has been very accurate until now. Regular quality control of brachytherapy is essential for successful treatment which depends on the accuracy of source position and activity.

• Progress in Medical Physics
• /
• v.14 no.3
• /
• pp.151-160
• /
• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

• Progress in Medical Physics
• /
• v.19 no.3
• /
• pp.143-149
• /
• 2008

The aim of this study is to suggest the method for image enhancement of digital chest radiograph and evaluate clinically the quality of the resultant image. A nonlinear iterative filter was developed in order to reduce quantum noise preserving edge. Dynamic range was adjusted and adaptive image enhancement was performed based on the property of anatomic region and the degree of compatibility with neighboring pixels. The lung fields were enhanced appropriately to visualize effectively vascular tissue, bronchus and lung tissue with the desired mediastinum enhancement. Clinic evaluation was performed by three radiologists with at least 8 years experience. The anatomic regions of 11 in PA and 9 in Lateral were observed carefully in each 100 radiographs according to ITU (International Telecommunication Union) recommendation 500 protocol. The result showed the mean 3.4 between good and adequate. This means that the clinical utility of the image quality is enough. In this study, image enhancement was carried out considering image display device and human perceptual system to prevent the loss of useful anatomic information. In order to increase the diagnostic accuracy in digital radiograph, the continuous study on image enhancement is needed.

• Progress in Medical Physics
• /
• v.22 no.3
• /
• pp.155-162
• /
• 2011

The analog image based system consisted of a simulator and medical linear accelerator (LINAC) for radiotherapy was upgraded to digital medical image based system by exchanging the X-ray film with Computed Radiography (CR). With minimum equipments shift and similar treatment process, it was possible that the new digital image system was adapted by the users in short time. The film cassette and the film developer device were substituted with a CR cassette and a CR Reader, where the ViewBox was replaced with a small size PC and a monitor. The viewer software suitable for radiotherapy was developed to maximize the benefit of digital image, and as the result the convenience and the effectiveness was improved. It has two windows to display two different images in the same time and equipped various search capability, contouring, window leveling, image resizing, translation, rotation and registration functions. In order to avoid any discontinuance of the treatment while the transition to digital image, the film and the CR was used together for 1 week, and then the film developer was removed. Since then the CR System has been operated stably for 2 months, and the various requests from users have been reflected to improve the system.

• Progress in Medical Physics
• /
• v.17 no.4
• /
• pp.238-245
• /
• 2006

To assess the ability of an extravasation defection accessory (EDA) to detect the clinically important extravascular Injection of iodinated contrast material that was delivered with an automated mechanical power injector. The purpose of this study was to assess the ability of this device during clinically important episodes of extravasation. The EDA system was composed of a strain gage, an amplifier and a computer-based system. In the rabbit experimental cases, there were seven true-positive cases (range of the extravasation volumes: $14{\sim}23 ml$). The algorithm results showed seven true-positive cases (range of the extravasation volumes: $7{\sim}16ml$), nineteen true-negative cases, two false-positive cases and no false-negative cases. The EDA system had a sensitivity of 100% and a specificity of 90% for the detection of clinically important extravasation. The EDA system had good sensitivity for the detection of clinically important extravasation and the EDA system has the clinical potential for the early detection of extravasation of the contrast medium that is administered with power injectors.