• Progress in Medical Physics
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• v.12 no.2
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• pp.103-112
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• 2001

Purpose: The purpose of this study was to investigate the current status of performing nuclear medicine quality control in korea and to test selected protocols of quality control of nuclear medicine counting system and gamma camera. Materials and Methods: Fifty three hospitals were included to investigate the current status of nuclear medicine quality control in korea. The precision of dose calibrator and thyroid uptake system was measured with Tc-99m 35.52 MBq for 2 minuets and Tc-99m 5.14 MBq for 10 sec every one minute, respectively. The sensitivity of CeraSPECT$^{TM}$ with low energy high resolution parallel hole collimator was measured using two cylindrical phantoms with 15 cm in diameter and 12 cm and 30 cm in heights containing Tc-99m. The correction factor for sensitivity of CeraSPECT$^{TM}$ was calculated using phantom data. The system planar sensitivity, uniformity, count rate and spatial resolution were measured for Varicam gamma camera with low energy high resolution parallel hole collimator using 140 keV centered 20% energy window, 256$\times$256 or 512$\times$512 matrix sizes. Results: The quality control of dose calibrator and well counter were showed poor performance status. On the other hand, The quality control of gamma camera and other systems were showed relatively good performance status. The results of precision of dose calibrator and thyroid uptake system was $\pm$1.4%(<$\pm$5%) and chi^2=29.7(>16.92), respectively. It showed that the sensitivity of CeraSPECT$^{TM}$ was higher in center slices compared with the edge slices. After correction of nonuniform sensitivities for patient data, it showed better results compare with prior to correction. System planar sensitivity of Varicam gamma camera was 4.39 CPM/MBq. The observed count rate at 20% loss was 102,407 counts/sec (head 1), 113,427 counts/sec (head 2), when input count rate was 81,926 counts/sec (head 1), 90,741 counts/sec (head 2). The spatial resolution without scatter medium were 8.16 mm of FWHM and 14.85 mm of FWTM. The spatial resolution with scatter medium were 8.87 mm of FWHM and 18.87 mm of FWTM. Conclusion: It is necessary to understand the importance of quality control and to perform quality control of nuclear medicine devices.vices.

• Progress in Medical Physics
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• v.14 no.2
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• pp.131-140
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• 2003

As the importance of accuracy in measurings of 3-D anatomical structures continues to be stressed, an objective and quantitative of assessing image quality and accuracy of 3-D volume-rendered images is required. The purpose of this study was to evaluate the quantitative accuracy of 3-D rendered images obtained with MDCT, scanned at various scanning parameters (scan modes, slice thicknesses and reconstruction slice thickness). Twelve clinically significant points that play an important role for the craniofacial bone in plastic surgery and dentistry were marked on the surface of a dry human skull. The direct distances between the reference points were defined as gold standards to assess the measuring errors of 3-D images. Then, we scanned the specimen with acquisition parameters of 300 mA, In kVp, and 1.0 sec scan time in axial and helical scan modes (pitch 3:1 and 6:1) at 1,25 mm, 2.50 mm, 3.75 mm and 5.00 mm slice thicknesses. We performed 3-D visualizations and distance measurements with volumetric analysis software and statistically evaluated the quantitative accuracy of distance measurements. The accuracy of distance measurements on the 3-D images acquired with 1.25, 2.50, 3,75 and 5.00 mm slice thickness were 48%, 33%, 23%, 14%, respectively, and those of the reconstructed 1.25 mm were 53%, 41%, 43%, 36% respectively. Meanwhile, there were insignificant statistical differences (P-value<0.05) in the accuracy of the distance measurements of 3-D images reconstructed with 1.25 mm thickness. In conclusion, slice thickness, rather than scan mode, influenced the quantitative accuracy of distance measurements in 3-D rendered images with MDCT. The quantitative analysis of distance measurements may be a useful tool for evaluating the accuracy of 3-D rendered images used in diagnosis, surgical planning, and radiotherapeutic treatment.

• Radiation Oncology Journal
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• v.15 no.1
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• pp.71-78
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• 1997

Purpose : To collect beam data for dynamic wedge fields using conventional measurement tools without the multi-detector system, such as the linear diode detectors or ionization chambers. Materials and Methods : The accelerator CL 2100 C/D has two photon energies of 6MV and 15MV with dynamic wedge an91es of 15o, 30o, 45o and 60o. Wedge transmission factors, percentage depth doses(PDD's) and dose Profiles were measured. The measurements for wedge transmission factors are performed for field sizes ranging from $4\times4cm^2\;to\;20\times20cm^2$ in 1-2cm steps. Various rectangular field sizes are also measured for each photon energy of 6MV and 15MV, with the combination of each dynamic wedge angle of 15o 30o. 45o and 60o. These factors are compared to the calculated wedge factors using STT(Segmented Treatment Table) value. PDD's are measured with the film and the chamber in water Phantom for fixed square field. Converting parameters for film data to chamber data could be obtained from this procedure. The PDD's for dynamic wedged fields could be obtained from film dosimetry by using the converting parameters without using ionization chamber. Dose profiles are obtained from interpolation and STT weighted superposition of data through selected asymmetric static field measurement using ionization chamber. Results : The measured values of wedge transmission factors show good agreement to the calculated values The wedge factors of rectangular fields for constant V-field were equal to those of square fields The differences between open fields' PDDs and those from dynamic fields are insignificant. Dose profiles from superposition method showed acceptable range of accuracy(maximum 2% error) when we compare to those from film dosimetry. Conclusion : The results from this superposition method showed that commissionning of dynamic wedge could be done with conventional dosimetric tools such as Point detector system and film dosimetry winthin maximum 2% error range of accuracy.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.51-56
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• 2004

The aim of this study is to evaluate the effect of skin dose and PDD by using wounds protecting gauzes or Vaselinespread gauzes. And it was studied that the possibility to substitute custom bolus into gauzes. 4MV photon (CL600C, varian, US), Polystyrene Phantom (30(W) X30(L) X 30(H)) with Markus chamber(PTW, US) were used for dose measurement. This study was distinguished natural gauzes and spread over Vaseline gauzes. We gave variety to the gauze thickness at 5, 10 and 15 sheets respectively. For comparison between using bolus and not that, we had used 1.0 cm thickness bolus so that analyzed surface dose and PDD at the same conditions above mentioned. When maximum point was defined as reference point, surface dose was measured as $35\%$ in open beam. When the gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased as 69, 80 and $91\%$ respectively according to thickness of gauzes. When spread over Vaseline gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased respectively as 98, 100 and $98\%$ according to thickness of gauzes. Also when 0.5 cm bolus and 5 sheets gauzes were composed, surface dose was measured as $98\%$. The gauzes that were attached to skin surface in radiation therapy had been scattering material and contributed increasing surface dose without variation of percentage depth dose. However, if we want to delivery much dose to skin surface then we have to apply many sheets of gauzes to skin surface. Although we get easy that result by bolus or spread over Vaseline gauzes, we have to revise percentage depth dose at calculation. Therefore, if we find pertinent conditions based on measured data that are considered skin dose and patient setup efficiency, to replace custom bolus with gauzes will be helpful to efficient treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.21 no.1
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• pp.1-7
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• 2009

Purpose: The purpose is to evaluate the accuracy of correcting the targeting error through the Target Location System (TLS) for the location change error of the reference point which arises from the movement or motion of patient during the treatment using the CyberKnife. Materials and Methods: In this test, Gafchromic MD-55 film was inserted into the head and neck phantom to analyze the accuracy of the targeting, and then the 6 MV X-ray of CyberKnife (CyberKnife Robotic Radiosurgery System G4, Accuray, US) was irradiated. End to End (E2E) program was used to analyze the accuracy of targeting, which is provided by Accuray Corporation. To compute the error of the targeting, the test was carried out with the films that were irradiated 12 times by maintaining the distance within the rage of $0{\pm}0.2\;mm$ toward x, y, z from the reference point and maintaining the angle within the rage of $0{\pm}0.2^{\circ}$ toward roll, pitch, yaw, and then with the films which were irradiated 6 times by applying intentional movement. And the correlation in the average value of the reference film and the test film were analyzed through independent samples t-test. In addition, the consistency of dose distribution through gamma-index method (dose difference: 3%) was quantified, compared, and analyzed by varying the distance to agreement (DTA) to 1 mm, 1.5 mm, 2 mm, respectively. Results: E2E test result indicated that the average error of the reference film was 0.405 mm and the standard deviation was 0.069 mm. The average error of the test film was 0.413 mm with the standard deviation of 0.121 mm. The result of independent sampling t-test for both averages showed that the significant probability was P=0.836 (confidence level: 95%). Besides, by comparing the consistency of dose distribution of DTA through 1 mm, 1.5 mm, 2 mm, it was found that the average dose distribution of axial film was 95.04%, 97.56%, 98.13%, respectively in 3,314 locations of the reference film, consistent with the average dose distribution of sagittal film that was 95.47%, 97.68%, 98.47%, respectively. By comparing with the test film, it was found that the average dose distribution of axial film was 96.38%, 97.57%, 98.04%, respectively, at 3,323 locations, consistent with the average dose distribution of sagittal film which was 95.50%, 97.87%, 98.36%, respectively. Conclusion: Robotic CyberKnife traces and complements in real time the error in the location change of the reference point caused by the motion or movement of patient during the treatment and provides the accuracy with the consistency of over 95% dose distribution and the targeting error below 1 mm.

• Journal of Radiation Protection and Research
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• v.40 no.2
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• pp.118-123
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• 2015

The frequency of diagnostic radiation examinations in medical institutions has recently increased to 220 million cases in 2011, and the annual exposure dose per capita was 1.4 mSv, 51% and 35% respectively, compared to those in 2007. The number of chest radiography was found to be 27.59% of them, the highest frequency of normal radiography. In this study, we developed a shielding device to minimize radiation exposure by shielding areas of the body which are unnecessary for image interpretation, during the chest radiography. And in order to verify its usefulness, we also measured the difference in entrance surface dose (ESD) and the absorbed dose, before and after using the device, by using an international standard pediatric (10 years) phantom and a glass dosimeter. In addition, we calculated the effective dose by using a Monte Carlo simulation-based program (PCXMC 2.0.1) and evaluated the reduction ratio indirectly by comparing lifetime attributable risk of cancer incidence (LAR). When using the protective device, the ESD decreased by 86.36% on average, nasal cavity $0.55{\mu}Sv$ (74.06%), thyroid $1.43{\mu}Sv$ (95.15%), oesophagus $6.35{\mu}Sv$ (78.42%) respectively, and the depth dose decreased by 72.30% on average, the cervical spine(upper spine) $1.23{\mu}Sv$ (89.73%), salivary gland $0.5{\mu}Sv$ (92.31%), oesophagus $3.85{\mu}Sv$ (59.39%), thyroid $2.02{\mu}Sv$ (73.53%), thoracic vertebrae(middle spine) $5.68{\mu}Sv$ (54.01%) respectively, so that we could verify the usefulness of the shielding mechanism. In addition, the effective dose decreased by 11.76% from $8.33{\mu}Sv$ to $7.35{\mu}Sv$ before and after wearing the device, and in LAR assessment, we found that thyroid cancer decreased to male 0.14 people (95.12%) and female 0.77 people (95.16%) per one million 10-year old children, and general cancers decreased to male 0.14 people (11.70%) and female 0.25 people (11.70%). Although diagnostic radiation examinations are necessary for healthcare such as the treatment of diseases, based on the ALARA concept, we should strive to optimize medical radiation by using this shielding device actively in the areas of the body unnecessary for the diagnosis.

• Progress in Medical Physics
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• v.9 no.2
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• pp.65-71
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• 1998

The aims are to evaluate the effects of an 1.0 cm acrylic plate and SSD on the dose profile and depth dose distribution of 9 MeV electron beam and to analyse adequacy for using an acrylic plate to reduce energy of electron beams. An acrylic plate of 1.0 cm thickness was used to reduce energy of 9 MeV electron beam to 7 MeV. The plate was put on an electron applicator at 65.4 cm distance from x-ray target. The size of the applicator was 10${\times}$l0cm at 100 cm SSD. For 100cm, l05cm and 110cm SSD, depth dose on beam axis and dose profiles at d$\_$max/ on two principal axes were measured using a 3D water phantom. From depth dose distributions, d$\_$max/, d$\_$85/, d$\_$50/ and R$\_$p/, surface dose, and mean energy and peak energy at surface were compared. From dose profiles flatness, penumbra width and actual field size were compared. For comparison, 9 MeV electron beams were measured. Surface dose of 7 MeV electron beams was changed from 85.5% to 82.2% increasing SSD from 100 cm to 110 cm, and except for dose buildup region, depth dose distributions were independent of SSD. Flatness of 7 MeV ranged from 4.7% to 10.4% increasing SSD, comparing 1.4% to 3.5% for 9 MeV. Penumbra width of 7 MeV ranged from 1.52 cm to 3.03 cm, comparing 1.14 cm to 1.63 cm for 9 MeV. Actual field size increased from 10.75 cm to 12.85 cm with SSD, comparing 10.32 cm to 11.46 cm for 9 MeV. Virtual SSD's of 7 and 9 MeV were respectively 49.8 cm and 88.5cm. In using energy reducer in electron therapy, depth dose distribution were independent of SSD except for buildup region as well as open field. In case of using energy reducer, increasing SSD made flatness to deteriorate more severely, penumbra width more wide, field size to increase more rapidly and virtual SSD more short comparing with original electron beam. In conclusion, it is desirable to use no energy reducer for electron beam, especially for long SSD.

• Progress in Medical Physics
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• v.17 no.1
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• pp.1-5
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• 2006

A parallel plate detector containing PTFE films in FEP film for relative dosimetry was designed to measure the response of detectors to S and 10 MV X-rays from a medical linear accelerator through different thicknesses of lead. The dielectric materials were 100 m thick. The set-up conditions for measurements with this detector were as follows: SSD=100 cm the test detector was at a depth of 5 cm and the reference chamber was at a depth of 10 cm from the phantom surface for 6 and 10 MV X-rays. Lead blocks were designed to cover the irradiated field. They were added to the tray to increase thickness sequentially. We found that the detector response decreased exponentially with the thickness of lead added. The linear attenuation coefficients of the test detector and reference chamber were 0.1414 and 0.541, respectively, for 6 MV X-rays and 0.1358 and 0.5279 for 10 MV X-rays. The test detector response was greater than that of the reference chamber. The response function was calculated from the measured values of the test detector and reference chamber using optimization. These optimized constants for the detector response function were independent of theenergy. As a result of optimizing the response function between detectors, the use of a relative dosimeter was validated, because the response of the test detector was 1% for 6 MV X-rays and 4% for 10 MV X-rays.

• Progress in Medical Physics
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• v.15 no.4
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• pp.202-209
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• 2004

Flat panel based digital radiography (DR) systems have recently become useful and important in the field of diagnostic radiology. For DRs with amorphous silicon photosensors, CsI(TI) is normally used as the scintillator, which produces visible light corresponding to the absorbed radiation energy. The visible light photons are converted into electric signal in the amorphous silicon photodiodes which constitute a two dimensional array. In order to produce good quality images, detailed behaviors of DR detectors to radiation must be studied. The relationship between air exposure and the DR outputs has been investigated in many studies. But this relationship was investigated under the condition of the fixed tube voltage. In this study, we investigated the relationship between the DR outputs and X-ray in terms of the absorbed energy in the detector rather than the air exposure using SPEC-l8, an X-ray energy spectrum model. Measured exposure was compared with calculated exposure for obtaining the inherent filtration that is a important input variable of SPEC-l8. The absorbed energy in the detector was calculated using algorithm of calculating the absorbed energy in the material and pixel values of real images under various conditions was obtained. The characteristic curve was obtained using the relationship of two parameter and the results were verified using phantoms made of water and aluminum. The pixel values of the phantom image were estimated and compared with the characteristic curve under various conditions. It was found that the relationship between the DR outputs and the absorbed energy in the detector was almost linear. In a experiment using the phantoms, the estimated pixel values agreed with the characteristic curve, although the effect of scattered photons introduced some errors. However, effect of a scattered X-ray must be studied because it was not included in the calculation algorithm. The result of this study can provide useful information about a pre-processing of digital radiography.

• Progress in Medical Physics
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• v.26 no.2
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• pp.87-92
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• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.