• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.82-82
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• 2003

Introduction: With the development of dose calculation algorithms for electron beams, 3D RTP systerns are available for electron beam dose distribution commercially. However, no studies evaluated the accuracy of dose calculation with ADAC Pinnacle system for electron beams. So, the accuracy of the ADAC system is investigated by comparing electron dose distributions from ADAC system against the BEAMnrc/DOSXYZnrc. Methods: A total of 33 breast cancer patients treated with 6, 9, and 12MeV electrons in our institution was selected for this study. The first part of this study is to compare the dose distributions of measurement, TPS and the BEAMnrc/DOSXYZnrc code in flat water phantom at gantry zero position and for a 10 ${\times}$ 10 $\textrm{cm}^2$ field. The second part is to evaluate the monitor unit obtained from measurement and TPS. Adding actual breast patient's irregular blocks to the first part, monitor units to deliver 100 cGy to the dose maximum (dmax) were calculated from measurement and 3D RTP system. In addition, the dose distributions using blocks were compared between TPS and the BEAMnrc/DOSXYZnrc code. Finally, the effects of tissue inhomogeneities were studied by comparing dose distributions from Pinnacle and Monte Carlo method on CT data sets. Results: The dose distributions calculated using water phantom by the TPS and the BEAMnrc/ DOSXYZnrc code agreed well with measured data within 2% of the maximum dose. The maximum differences of monitor unit between measured and Pinnacle TPS in flat water phantom at gantry zero position were 4% for 6 MeV and 2% for 9 and 12 MeV electrons. In real-patient cases, comparison of depth doses and lateral dose profiles calculated by the Pinnacle TPS, with BEAMnrc/DOSXYZnrc code has generally shown good agreement with relative difference less than +/-3%. Discussion: For comparisons of real-patient cases, the maximum differences between the TPS and BEAMnrc/DOSXYZnrc on CT data were 10%. These discrepancies were due in part to the inaccurate dose calculation of the TPS, so that it needs to be improved properly. Conclusions: On the basis of the results presented in this study, we can conclude that the ADAC Pinnacle system for electron beams is capable of giving results absolutely comparable to those of a Monte Carlo calculation.

• Journal of radiological science and technology
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• v.45 no.5
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• pp.449-455
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• 2022

This study is to present a Geant4 code for the simulation of the absorbed dose distribution given by a medical linac for 6 MV photon beam. The dose distribution was verified by comparison with calculated beam data and beam data measured in water phantom. They were performed for percentage depth dose(PDD) and beam profile of cross-plane for two field sizes of 10 × 10 and 15 × 15 cm². Deviations of a percentage and distance were obtained. In energy spectrum, the mean energy was 1.69 MeV. Results were in agreement with PDD and beam profile of the phantom with a tolerance limit. The differences in the central beam axis data 𝜹₁ for PDD had been less than 2% and in the build up region, these differences increased up to 4.40% for 10 cm square field. The maximum differences of 𝜹₂ for beam profile were calculated with a result of 4.35% and 5.32% for 10 cm, 15 cm square fields, respectively. It can be observed that the difference was below 4% in 𝜹₃ and 𝜹₄. For two field sizes of 𝜹_50-90 and RW₅₀, the results agreed to within 2 mm. The results of the t-test showed that no statistically significant differences were found between the data for PDD of 𝜹₁, p>0.05. A significant difference on PDD was observed for field sizes of 10 × 10 cm², p=0.041. No significant differences were found in the beam profile of 𝜹₃, 𝜹₄, RW₅₀, and 𝜹_50-90. Significant differences on beam profile of 𝜹₂ were observed for field sizes of 10 × 10 cm², p=0.025 and for 15 × 15 cm², p=0.037. This work described the development and reproducibility of Geant4 code for verification of dose distribution.

• Radiation Oncology Journal
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• v.34 no.4
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• pp.313-321
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• 2016

Purpose: Total scalp irradiation (TSI) is a rare but challenging indication. We previously reported that non-coplanar intensity-modulated radiotherapy (IMRT) was superior to coplanar IMRT in organ-at-risk (OAR) protection and target dose distribution. This consecutive treatment planning study compared IMRT with volumetric-modulated arc therapy (VMAT). Materials and Methods: A retrospective treatment plan databank search was performed and 5 patient cases were randomly selected. Cranial imaging was restored from the initial planning computed tomography (CT) and target volumes and OAR were redelineated. For each patients, three treatment plans were calculated (coplanar/non-coplanar IMRT, VMAT; prescribed dose 50 Gy, single dose 2 Gy). Conformity, homogeneity and dose volume histograms were used for plan. Results: VMAT featured the lowest monitor units and the sharpest dose gradient (1.6 Gy/mm). Planning target volume (PTV) coverage and homogeneity was better in VMAT (coverage, 0.95; homogeneity index [HI], 0.118) compared to IMRT (coverage, 0.94; HI, 0.119) but coplanar IMRT produced the most conformal plans (conformity index [CI], 0.43). Minimum PTV dose range was 66.8%-88.4% in coplanar, 77.5%-88.2% in non-coplanar IMRT and 82.8%-90.3% in VMAT. Mean dose to the brain, brain stem, optic system (maximum dose) and lenses were 18.6, 13.2, 9.1, and 5.2 Gy for VMAT, 21.9, 13.4, 14.5, and 6.3 Gy for non-coplanar and 22.8, 16.5, 11.5, and 5.9 Gy for coplanar IMRT. Maximum optic chiasm dose was 7.7, 8.4, and 11.1 Gy (non-coplanar IMRT, VMAT, and coplanar IMRT). Conclusion: Target coverage, homogeneity and OAR protection, was slightly superior in VMAT plans which also produced the sharpest dose gradient towards healthy tissue.

• Progress in Medical Physics
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• v.34 no.2
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• pp.15-22
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• 2023

This study compared the dose calculated using the electron Monte Carlo (eMC) dose calculation algorithm employing the old version (eMC V13.7) of the Varian Eclipse treatment-planning system (TPS) and its newer version (eMC V16.1). The eMC V16.1 was configured using the same beam data as the eMC V13.7. Beam data measured using the VitalBeam linear accelerator were implemented. A box-shaped water phantom (30×30×30 cm³) was generated in the TPS. Consequently, the TPS with eMC V13.7 and eMC V16.1 calculated the dose to the water phantom delivered by electron beams of various energies with a field size of 10×10 cm². The calculations were repeated while changing the dose-smoothing levels and normalization method. Subsequently, the percentage depth dose and lateral profile of the dose distributions acquired by eMC V13.7 and eMC V16.1 were analyzed. In addition, the dose-volume histogram (DVH) differences between the two versions for the heterogeneous phantom with bone and lung inserted were compared. The doses calculated using eMC V16.1 were similar to those calculated using eMC V13.7 for the homogenous phantoms. However, a DVH difference was observed in the heterogeneous phantom, particularly in the bone material. The dose distribution calculated using eMC V16.1 was comparable to that of eMC V13.7 in the case of homogenous phantoms. The version changes resulted in a different DVH for the heterogeneous phantoms. However, further investigations to assess the DVH differences in patients and experimental validations for eMC V16.1, particularly for heterogeneous geometry, are required.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.1
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• pp.33-39
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• 2010

Purpose: It is very important to confirm conformance of dose distribution that is formed with treatment planning from IMRS or IMRT. It has been a problem dropped accuracy and conformance when the field size is getting smaller because of character of the 2D ion chamber. Verification of MatriXX Phantom dose distribution with a change in the SAD. Dose distribution measurement and analysis to improve the accuracy and should be useful to evaluate the award. Materials and Methods: A use of Novalis linear accelerator 6 MV photon beams. In general, IMRS were 25 patients with small field size. The selected patients were divided into three groups on the basis of the field size. SAD was changed from 80 to 130 cm and field size to determine the dose distribution to the change, each dose was measured using MatriXX Phantom. Analysis of measured values obtained from the program for each patient through the treatment planning system comparison and analysis of the dose distribution and gamma values were expressed. Result: SAD 80, 100, and 120 cm in size in the gamma value to the investigation of patients less than $3\;cm^2$ average 0.939, 0.969, and 0.979, respectively. Patients with more than $5\;cm^2$ 0.962, 0.983, and 0.988, respectively. $5\;cm^2$ or more patients 0.982, 0.990, and 0.992, respectively. Conclusion: The error rate of less than $3\;cm^2$ field size is increased rapidly. If the field size is increased, resolution is increased by 2D ion chambers. It has been approved that it can be credible if it is around $3\;cm^2$ when measuring dose distribution using MatriXX. Adjusting geometric field size by changing SAD is likely to be very useful when you measure dose distribution using MatriXX.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.47-50
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• 2005

The aim of radiosurgery cures a patient to deliver the lower dose at the normal organ and the higher dose at the tumor. Therefore accuracy of the dose is required to gain effect of radiosurgery in surgical planning. In this paper, we developed the methods of target approximation for a fast treatment planning. Nominally, the stereotactic radiosurgery(SRS) using Linac and Gamma knife produces spherical dose distribution through circular collimators using multiple arcs and 201 holes on semi-spherical helmet by $^{60}Co$. We developed an automatic radiosurgical plan about spherical packing arrangement. To automatically plan the SRS, new planning methods based on cylinder and cube structure for target shaping was developed. This approach using heuristic and stochastic algorithm is a useful radiosurgical plan without restrictions in the various tumor shapes and the different modalities.

• Radiation Oncology Journal
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• v.1 no.1
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• pp.55-60
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• 1983

To evaluate the usefulness of computed tomography (CT) in radiotherapy treatment planning in malignant tumors of thoracic cage, the computer generated dose distributions were compared between plans based on conventional studies and those based on CT scan. 22 cases of thoracic malignancies, 15 lung cancers and 7 esophageal cancers, diagnosed and treated in Department of Therapeutic Radiology of Seoul National University Hospital from September, 1982 to April, 1983, were analyzed. In lung cancers, dose distribution in plans using AP, PA parallel opposing ports with posterior spinal cord block and in plans using box technique both based on conventional studies were compared with dose distribution using AP, PA and two oblique ports based on CT scan. In esophageal cancers, dose distribution in plans based on conventional studies and those based on CT scans, both using 3 port technique were compared. The results are as follows: 1. Parallel opposing field technique were inadequate in all cases of lung cancers, as portion of primary tumor in 13 of 15 cases and portion of mediastinum in all were out of high dose volume. 2. Box technique was inadequate in 5 of 15 lung cancers as portion of primary tumor was not covered and in every case the irradiated normal lung volume was quite large. 3. Plans based on CT scan were superior to those based on conventional studies as tumor was demarcated better with CT and so complete coverage of tumor and preservation of more normal lung volume could be made. 4. In 1 case of lung cancer, tumor localization was nearly impossible with conventional studies, but after CT scan tumor was more clearly defined and localized. 5. In 1 of 7 esophageal cancers, the radiation volume should be increased for marginal coverage after CT scan. 6. Depth dose correction for tissue inhomogeneity is possible with CT, and exact tumor dose can be calculated. As a result radiotherapy treatment planning based on CT scan has a pteat advantage over that based on conventional studies.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.217-224
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• 2014

Purpose : Conventional, IMRT, at CSI treatment with VMAT, this study compare the treatment plan with dose changes measured at Junction field according to the error of Setup. Materials and Methods : This study established Conventional, the IMRT, VMAT treatment planning for CSI therapy using the Eclipse 10.0 (Eclipse10.0, Varian, USA) and chose person in Seoul National University Hospital. Verification plan was also created to apply IMRT QA phantom for each treatment plan to the film measurements. At this time, the error of Setup was applied to the 2, 4, 6mm respectively with the head and foot direction. ("+" direction of the head, "-" means that the foot direction.) Using IMRT QA Phantom and EBT2 film, was investigated by placing the error of Setup for each Junction. We check the consistency of the measured Film and plan dose distribution by gamma index (Gamma index, ${\gamma}$). In addition, we compared the error of Setup by the dose distribution, and analyzing the uniformity of the dose distribution within the target by calculating the Homogeneity Index (HI). Results : It was figured out that 90.49%-gamma index we obtained with film is agreement with film scan score and dose distribution of treatment plan. Also, depend on the dose distribution on distance, if we make the error of Setup 2, 4, 6mm in the head direction, it showed that 3.1, 4.5, 8.1 at $^*Diff$(%) of Conventional, 1.1, 3.5, 6.3 at IMRT, and 1.6, 2.5, 5.7 at VMAT. In the same way, if we make the error of Setup 2, 4, 6mm in the foot direction, it showed that -1.6, -2.8, -4.4 at $^*Diff$(%) of Conventional, -0.9, -1.6, -2.9 at IMRT, and -0.5, -2.2, -2.5 at VMAT. Homogeneity Index(HI)s are 1.216 at Conventional, 1.095 at IMRT and 1.069 at VMAT. Discussion and Conclusion : The dose-change depend on the error of Setup at the CSI RT(radiation therapy) using IMRT and VMAT which have advantages, Dose homogeneity and the gradual dose gradients on the Junction part is lower than that of Conventional CSI RT. This a little change of dose means that there is less danger on patients despite of the error of Setup generated at the CSI RT.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.22-42
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• 2001

Background : A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time. Methods : The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured. Results : About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly. Conclusion : The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

• Journal of radiological science and technology
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• v.42 no.2
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• pp.137-143
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• 2019

The aim of this study was analyzed the setup error of breast cancer patients in intensity modulated radiation therapy(IMRT) with deep inspiration breath holding(DIBH) and was analyzed the dose distribution due to setup error. A total of 45 breast cancer cases were performed a retrospective clinical analysis of setup error. In addition, the re-treatment planning was carried by shifting the setup error from the isocenter at the treatment. Based on this, the dose distribution of PTV and OARs was compared and analyzed. The 3D error for small breast group and medium breast group and large breast group were 3.1 mm and 3.7 mm and 4.1 mm, respectively. The difference between the groups was statistically significant(P=0.003). DVH results showed HI, CI for the PTV difference between standard treatment plan and re-treatment plan of 14.4%, 4%. The difference in $D_5$ and $V_{20}$ of the ipsilateral lung was 5.6%, 13% respectively. The difference in $D_5$ and $V_5$ of the heart of right breast cancer patients was 6.8%, 8% respectively. The difference in $D_5$, $V_{20}$ of the heart of left breast cancer patients was 7.2%, 23.5% respectively. In this study, there was a significant association between breast size and significant setup error in breast cancer patients with DIBH. In addition, it was found that the dose distribution of the PTV and OARs varied according to the setup error.