• Radiation Oncology Journal
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• v.27 no.4
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• pp.240-248
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• 2009

Purpose: To provide a simple research tool that may be used to analyze a dose volume histogram from different radiation therapy planning systems for NTCP (Normal Tissue Complication Probability), OED (Organ Equivalent Dose) and so on. Materials and Metohds: A high-level computing language was chosen to implement Niemierko's EUD, Lyman-Kutcher-Burman model's NTCP, and OED. The requirements for treatment planning analysis were defined and the procedure, using a developed GUI based program, was described with figures. The calculated data, including volume at a dose, dose at a volume, EUD, and NTCP were evaluated by a commercial radiation therapy planning system, Pinnacle (Philips, Madison, WI, USA) for comparison. Results: The volume at a special dose and a dose absorbed in a volume on a dose volume histogram were successfully extracted using DVH data of several radiation planning systems. EUD, NTCP and OED were successfully calculated using DVH data and some required parameters in the literature. Conclusion: A simple DVH analyzer program was developed and has proven to be a useful research tool for radiation therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.85-95
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• 2010

Purpose: The degradation of an image quality and error of the beam dose calculation can be caused because the metal artifact is generated during the CT simulation of head and neck patient. The usability of the gantry tilt scan for reducing the metal artifact tries to be appraised. Materials and Methods: The inferior $20^{\circ}$ gantry tilt scan was made in order to reduce the metal artifact and $0^{\circ}$ reconstruction image was acquired. The AAPM CT performance Phantom was used in order to compare the CT number of the reconstructed image and Original image. the difference of volume was compared by using the acrylic phantom. The homogeneity of the CT number was evaluated the Intensity volume Histogram (IVH) as in order to evaluate an influence by the metal artifact. A dose was evaluated as the Dose Volume Histogram (DVH). Results: in the comparison of the CT number and volume, the difference showed up less than 0.5%. As to the comparison of IVH, in the gantry tilt scan, influence by an artifact was reduced and the homogeneity of the CT number was improved. The comparison of DVH result reduced the mean dose error of the both sides parotid 0.2~6%. Conclusion: In the Head & Neck radiation therapy, It is difficult and to distinguish tumor and normal tissue and the error of dose is generated by the metal artifact. The delineation of the exact organization was possible if the Gantry tilt scan was used. The CT number homogeneity was improved and the error of dose could be reduced. The Gantry tilt scan confirmed in the Head & Neck radiation therapy to be very useful in the exact radiation therapy.

• Radiation Oncology Journal
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• v.30 no.1
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• pp.43-48
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• 2012

Purpose: To develop the dose volume histogram (DVH) management software which guides the evaluation of radiotherapy (RT) plan of a new case according to the biological consequences of the DVHs from the previously treated patients. Materials and Methods: We determined the radiation pneumonitis (RP) as an biological response parameter in order to develop DVH management software. We retrospectively reviewed the medical records of lung cancer patients treated with curative 3-dimensional conformal radiation therapy (3D-CRT). The biological event was defined as RP of the Radiation Therapy Oncology Group (RTOG) grade III or more. Results: The DVH management software consisted of three parts (pre-existing DVH database, graphical tool, and $Pinnacle^3$ script). The pre-existing DVH data were retrieved from 128 patients. RP events were tagged to the specific DVH data through retrospective review of patients' medical records. The graphical tool was developed to present the complication histogram derived from the preexisting database (DVH and RP) and was implemented into the radiation treatment planning (RTP) system, $Pinnacle^3$ v8.0 (Phillips Healthcare). The software was designed for the pre-existing database to be updated easily by tagging the specific DVH data with the new incidence of RP events at the time of patients' follow-up. Conclusion: We developed the DVH management software as an effective tool to incorporate the phenomenological consequences derived from the pre-existing database in the evaluation of a new RT plan. It can be used not only for lung cancer patients but also for the other disease site with different toxicity parameters.

• Progress in Medical Physics
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• v.17 no.1
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• pp.6-16
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• 2006

The goal of this study was to develop new indices for effectively evaluating the dose coverage and homogeneity based on the target-volume dose-volume histogram (TV-DVH) of intensity-modulated radio-therapy treatment plans. A new coverage Index and a new homogeneity index were developed by integrating a modified TV-DVH and by fitting a TV-DVH with a modified step function, respectively. The coverage index, named the l-index, indicates whether the dose coverage for the target volume is adequate based on user-defined criteria. A lower l-index indicates higher dose coverage of the tumor volume. The index for assessing dose homogeneity in a target volume, named the n-index, is more accurate than the conventional method in evaluating the dose homogeneity in a tumor volume. The baseline treatment plan for a target volume coverage and homogeneity is discussed. The proposed simple indices have been demonstrated to be effective in evaluating the dose coverage and homogeneity for TV-DVHs.

• Radiation Oncology Journal
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• v.37 no.2
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• pp.127-133
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• 2019

Purpose: The aim of this study was to identify volume changes and dose variations of rectum and bladder during radiation therapy in prostate cancer (PC) patients. Materials and Methods: We analyzed 20 patients with PC treated with helical tomotherapy. Daily image guidance was performed. We re-contoured the entire bladder and rectum including its contents as well as the organ walls on megavoltage computed tomography once a week. Dose variations were analyzed by means of Dmedian, Dmean, Dmax, V₁₀ to V₇₅, as well as the organs at risk (OAR) volume. Further, we investigated the correlation between volume changes and changes in Dmean of OAR. Results: During treatment, the rectal volume ranged from 62% to 223% of its initial volume, the bladder volume from 22% to 375%. The average Dmean ranged from 87% to 118% for the rectum and 58% to 160% for the bladder. The Pearson correlation coefficients between volume changes and corresponding changes in Dmean were -0.82 for the bladder and 0.52 for the rectum. The comparison of the dose wall histogram (DWH) and the dose volume histogram (DVH) showed that the DVH underestimates the percentage of the rectal and bladder volume exposed to the high dose region. Conclusion: Relevant variations in the volume of OAR and corresponding dose variations can be observed. For the bladder, an increase in the volume generally leads to lower doses; for the rectum, the correlation is weaker. Having demonstrated remarkable differences in the dose distribution of the DWH and the DVH, the use of DWHs should be considered.

• Radiation Oncology Journal
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• v.38 no.1
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• pp.60-67
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• 2020

Purpose: We performed three-dimensional (3D) dose reconstruction-based pretreatment verification to evaluate gamma analysis acceptance criteria in volumetric modulated arc therapy (VMAT) for prostate cancer. Materials and Methods: Pretreatment verification for 28 VMAT plans for prostate cancer was performed using the COMPASS system with a dolphin detector. The 3D reconstructed dose distribution of the treatment planning system calculation (TC) was compared with that of COMPASS independent calculation (CC) and COMPASS reconstruction from the dolphin detector measurement (CR). Gamma results (gamma failure rate and average gamma value [GFR and γAvg]) and dose-volume histogram (DVH) deviations, 98%, 2% and mean dose-volume difference (DD_98%, DD_2% and DD_mean), were evaluated. Gamma analyses were performed with two acceptance criteria, 2%/2 mm and 3%/3 mm. Results: The GFR in 2%/2 mm criteria were less than 8%, and those in 3%/3 mm criteria were less than 1% for all structures in comparisons between TC, CC, and CR. In the comparison between TC and CR, GFR and γAvg in 2%/2 mm criteria were significantly higher than those in 3%/3 mm criteria. The DVH deviations were within 2%, except for DD_mean (%) for rectum and bladder. Conclusions: The 3%/3 mm criteria were not strict enough to identify any discrepancies between planned and measured doses, and DVH deviations were less than 2% in most parameters. Therefore, gamma criteria of 2%/2 mm and DVH related parameters could be a useful tool for pretreatment verification for VMAT in prostate cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.41-52
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• 2003

I. Purpose The dose distribution in normal tissues and target lesions is very important in the treatment planning. To make the uniform dose distribution in target lesions, many methods has been used. Especially in the head and neck, the dose inhomogeneity at the skin surface should be corrected. Conventional methods have a limitation in delivering the enough doses to the planning target volume (PTV) with minimized dose to the parotid gland and spinal cord. In this study, we investigated the feasibility and the practical QA methods of the forward IMRT. II. Material and Methods The treatment plan of the forward IMRT with the partial block technique using the dynamic multi-leaf collimator (dMLC) for the patients with the nasopharyngeal cancer was verified using the dose volume histogram (DVH). The films and pinpoint chamber were used for the accurate dose verification. III. Results As a result of verifying the DVH for the 2-D treatment plan with the forward IMRT, the dose to the both parotid gland and spinal cord were reduced. So the forward IMRT could save the normal tissues and optimize the treatment. Forward IMRT can use the 3-D treatment planning system and easily assure the quality, so it is easily accessible comparing with inverse IMRT IV. Conclusion The forward IMRT could make the uniform dose in the PTV while maintaining under the tolerance dose in the normal tissues comparing with the 2-D treatment.

• Progress in Medical Physics
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• v.13 no.3
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• pp.129-134
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• 2002

The radiosurgery is planned that prescribed dose was irradiated to tumor for obtaining expected remedial value in stereotactic radiosurgery. The planning for many irregular tumor shape requires long computation time and skilled planners. Due to the rapid development in computer power recently, many optimization methods using computer has been proposed, although the practical method is still trial and error type of plan. In this study, many beam variables were considered and many tumor shapes were assumed cylinderical ideal models. Then, beam variables that covered the target within 50％ isodose curve were searched, the result was compared and analysed. The beam variables considered were isocenter separation distance, number of isocenters and collimator size. Dose distributions obtained with these variables were analysed by dose volume histogram(DVH) and dose profile at orthogonal plane. According to the results compared, the use of more isocenters than specified isocenter dosen't improve DVH and dose profile but only increases complexity of plan. The best result of DVH and dose profile are obtainedwhen isocenter separation was 1.0-1.2 in using same number of isocenter.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.261-267
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• 1999

Purpose : In FSRT (Fractionated stereotactic radiotherapy) planning, we studied the usefulness between multiple arc FSRT and conformal FSRT by comparing tumor shape and DVH (dose volume histogram). Materials and Methods In Chungnam Univ. hospital, we had treated the sixteen patients with FSRT from Aug. 1997 to Dec. 1998. In choosing multiple arc FSRT or conformal FSRT, we had considered If (irregular factor) after calculating tumor volume and surface area. We had considered multiple arc FSRT if tumor shape was similar to sphere or the value of If was less than 1.25, conformal FSRT if tumor shape was very irregular or If was more than 1.3. For evaluation of treatment planning, we had considered the appropriate DVH for tumor volume and for critical organs. Results : The errors between reference point and the coordinates point on AP, Lat radiography were less than 1 mm before treatment. We had planned $3\~$5 arcs for multiple arc FSRT, $5\~6$ports for conformal FSRT. The mean dose distribution of tumor volume of cumulative DVH between multiple arc FSRT and conformal FSRT was 90.6, 85%, respectively. The dose of critical organs irradiated was less than $5\%$ maximum dose of cumulative DVH. Conclusion : We had obtained the similar value between multiple arc FSRT and conformal FSRT, so that we had appropriate treatment planning of FSRT for multiple arc FSRT and conformal FSRT according to tumor shape and size.

• Journal of radiological science and technology
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• v.43 no.2
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• pp.105-114
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• 2020

This study aimed to assess of beam-matching accuracy for an 8 MV beam between the same model linear accelerators(Linac) commissioned over two years. Two models were got the customer acceptance procedure(CAP) criteria. For commissioning data for beam-matched linacs, the percentage depth doses(PDDs), beam profiles, output factors, multi-leaf collimator(MLC) leaf transmission factors, and the dosimetric leaf gap(DLG) were compared. In addition, the accuracy of beam matching was verified at phantom and patient levels. At phantom level, the point doses specified in TG-53 and TG-119 were compared to evaluate the accuracy of beam modelling. At patient level, the dose volume histogram(DVH) parameters and the delivery accuracy are evaluated on volumetric modulated arc therapy(VMAT) plan for 40 patients that included 20 lung and 20 brain cases. Ionization depth curve and dose profiles obtained in CAP showed a good level for beam matching between both Linacs. The variations in commissioning beam data, such as PDDs, beam profiles, output factors, TF, and DLG were all less than 1%. For the treatment plans of brain tumor and lung cancer, the average and maximum differences in evaluated DVH parameters for the planning target volume(PTV) and the organs at risk(OARs) were within 0.30% and 1.30%. Furthermore, all gamma passing rates for both beam-matched Linacs were higher than 98% for the 2%/2 mm criteria and 99% for the 2%/3 mm criteria. The overall variations in the beam data, as well as tests at phantom and patient levels remains all within the tolerance (1% difference) of clinical acceptability between beam-matched Linacs. Thus, we found an excellent dosimetric agreement to 8 MV beam characteristics for the same model Linacs.