• Journal of Radiation Protection and Research
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• v.41 no.3
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• pp.229-236
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• 2016

Background: In order to manage the patient exposure dose in X-ray diagnosis, it is preferred to evaluate the entrance skin dose; although there are some evaluations about entrance skin dose, a small number of report has been published for direct measurement of patient. We think that a small-type optically stimulated luminescence (OSL) dosimeter, named nanoDot, can achieve a direct measurement. For evaluations, the corrections of angular and energy dependences play an important role. In this study, we aimed to evaluate the angular and the energy dependences of nanoDot. Materials and Methods: We used commercially available X-ray diagnostic equipment. For angular dependence measurement, a relative response of every 15 degrees of nanoDot was measured in 40-140 kV X-ray. And for energy dependence measurement, mono-energetic characteristic X-rays were generated using several materials by irradiating the diagnostic X-rays, and the nanoDot was irradiated by the characteristic X-rays. We evaluated the measured response in an energy range of 8.1-75.5 keV. In addition, we performed Monte-Carlo simulation to compare experimental results. Results and Discussion: The experimental results were in good agreement with those of Monte-Carlo simulation. The angular dependence of nanoDot was almost steady with the response of 0 degrees except for 90 and 270 degrees. Furthermore, we found that difference of the response of nanoDot, where the nanoDot was irradiated from the randomly set directions, was estimated to be at most 5%. On the other hand, the response of nanoDot varies with the energy of incident X-rays; slightly increased to 20 keV and gradually decreased to 80 keV. These results are valuable to perform the precise evaluation of entrance skin dose with nanoDot in X-ray diagnosis. Conclusion: The influence of angular dependence and energy dependence in X-ray diagnosis is not so large, and the nanoDot OSL dosimeter is considered to be suitable dosimeter for direct measurement of entrance surface dose of patient.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.293-297
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• 1989

Electron contamination due to the interaction between radiation beam and material was analyzed for the factors such as source-skin distance (SSD), field size, tray characteristics and position of filter, which can affect the surface dose in Cobalt teletherapy. Surface dose in open beam was more influenced by SSD with increasing field size. Relative surface charge (RSC) increased with the use of tray (solid, circular hole, slotted), compared with open beam, which is thought to be due to increased electron contamination of the tray. To reduce the surface dose, 0.4mm thick Lipowitz metal filter was used. Compared with open beam, RSC decreased by 8.8%, 11.3%, 13.3%, 16.6%, 19.3% and 21.7% for the field size of $5{\times}5$, $10{\times}10$, $15{\times}15$, $20{\times}20$, $25{\times}25$ and $30{\times}30cm^2$, respectively. On the contrary, use of Lipowitz metal filter increased RSC at 60cm or less SSD. Surface dose was effectively reduced with Lpowitz metal filter placed right below solid tray in Cobalt teletherapy.

• The Journal of the Korea Contents Association
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• v.10 no.6
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• pp.360-363
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• 2010

This study evaluated surface dose of treatment immobilization devices such as Themo-plastic, Vac-lock, Cotton and Plaster according to their electron energy. Using a linear accelerater, a plane parallel chamber was set up on 6Mev, 9Mev, 12Mev and 15Mev. A distance between a source and a surface was 100cm and a field size was 10cm*10cm. An incident angle was 0 degree and a radiation dose was 100MU. To decrease an error, the measurement repeated 3 times. The analysis reveals that the surface dose of Vac-lock was the highest and Themo-plastic, Plaster and Cotton were high in order.

• Journal of Radiation Protection and Research
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• v.48 no.4
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• pp.197-203
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• 2023

Background: The thermoluminescent dosimeter (TLD) and Monte Carlo (MC) dosimetry are carried out to determine the occupational dose for personnel in the handling of ¹²⁵I seed sources. Materials and Methods: TLDs were placed in different layers of the Alderson-Rando phantom in the thyroid, lung and also eyes and skin surface. An ¹²⁵I seed source was prepared and its activity was measured using a dose calibrator and was placed at two distances of 20 and 50 cm from the Alderson-Rando phantom. In addition, the Monte Carlo N-Particle Extended (MCNPX 2.6.0) code and a computational phantom with a lattice-based geometry were used for organ dose calculations. Results and Discussion: The comparison of TLD and MC results in the thyroid and lung is consistent. Although the relative difference of MC dosimetry to TLD for the eyes was between 4% and 13% and for the skin between 19% and 23%, because of the existence of a higher uncertainty regarding TLD positioning in the eye and skin, these inaccuracies can also be acceptable. The isodose distribution was calculated in the cross-section of the head phantom when the ¹²⁵I seed was at two distances of 20 and 50 cm and it showed that the greatest dose reduction was observed for the eyes, skin, thyroid, and lungs, respectively. The results of MC dosimetry indicated that for near the head positions (distance of 20 cm) the absorbed dose rates for the eye lens, eye and skin were 78.1±2.3, 59.0±1.8, and 10.7±0.7 µGy/mCi/hr, respectively. Furthermore, we found that a 30 cm displacement for the ¹²⁵I seed reduced the eye and skin doses by at least 3- and 2-fold, respectively. Conclusion: Using a computational phantom to monitor the dose to the sensitive organs (eye and skin) for personnel involved in the handling of ¹²⁵I seed sources can be an accurate and inexpensive method.

• Radiation Oncology Journal
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• v.27 no.2
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• pp.103-110
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• 2009

Purpose: To investigate the feasibility of helical tomotherapy on a wide curved area of the skin, and its accuracy in calculating the absorbed dose in the superficial region. Materials and Methods: Two types of treatment plans were made with the cylinder-shaped 'cheese phantom'. In the first trial, 2 Gy was prescribed to a 1-cm depth from the surface. For the other trial, 2 Gy was prescribed to a 1-cm depth from the external side of the surface by 5 mm. The inner part of the phantom was completely blocked. To measure the surface dose and the depth dose profile, an EDR2 film was inserted into the phantom, while 6 TLD chips were attached to the surface. Results: The film indicated that the surface dose of the former case was 118.7 cGy and the latter case was 130.9 cGy. The TLD chips indicated that the surface dose was higher than these, but it was due to the finite thickness of the TLD chips. In the former case, 95% of the prescribed dose was obtained at a 2.1 mm depth, while the prescribed does was at 2.2 mm in the latter case. The maximum dose was about 110% of the prescribed dose. As the depth became deeper, the dose decreased rapidly. Accordingly, at a 2-cm depth, the dose was 20 % of the prescribed dose. Conclusion: Helical tomotherapy could be a useful application in the treatment of a wide area of the skin with curvature. However, for depths up to 2 mm, the planning system overestimated the superficial dose. For shallower targets, the use of a compensator such as a bolus is required.

• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.63-69
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• 2023

In head and neck radiation therapy, the thermoplastic immobilization mask used for fixing the patient's posture and reproducibility causes scattered rays by being in close contact with the skin. To investigate the increase in skin dose due to the scattered rays generated from the immobilization mask, we evaluated dose reduction by decreasing contact between face skin and immobilization mask in computerized radiotherapy planning system with CT scanned images. In addition, to confirm the reproducibility problem of the setup due to the decrease in the cover area of immobilizing, the difference of each setup was confirmed using DRR and CT images. As the mask area covered for immobilizing was reduced, the dose on the skin surface significantly decreased, and it was confirmed that there was no significant difference in reproducibility even if the entire face was not covered and fixed.

• Progress in Medical Physics
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• v.20 no.2
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• pp.88-96
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• 2009

Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

• Radiation Oncology Journal
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• v.13 no.1
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• pp.95-100
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• 1995

Purpose : To evaluate the effect on surface dose due to Aquaplast used for immobilizing the patients with head and neck cancers in photon beam radiotherapy Materials and Methods: To assess surface and buildup region dose for 6MV X-ray from linear accelerator(Siemens Mevatron 6740), we measured percent ionization value with the Markus chamber model 30-329 manufactured by PTW Frieburg and Capintec electrometer, model WK92. For measurement of surface ionization value, the chamber was embedded in $25{\times}25{\times}3cm^3$ acrylic phantom and set on $25{\times}25{\times}5cm^3$ polystyrene phantom to allow adequate scattering. The measurements of percent depth ionization were made by placing the polystyrene layers of appropriate thickness over the chamber. The measurements were taken at 100cm SSD for $5{\times}5cm^2$, $10{\times}10cm^2$ and $15{\times}15cm^2$ field sizes, respectively. Placing the layer of Aquaplast over the chamber, the same procedures were repeated. We evaluated two types of Aquaplast: 1.6mm layer of original Aquaplast(manufactured by WFR Aquaplast Corp.) and transformed Aquaplast similar to moulded one for immobilizing the patients practically. We also measured surface ionization values with blocking tray in presence or absence of transformed Aquaplast. In calculating percent depth dose, we used the formula suggested by Gerbi and Khan to correct overresponse of the Markus chamber. Results : The surface doses for open fields of $5{\times}5cm^2$, $10{\times}10cm^2$, and $15{\times}15cm^2$ were $79\%$, $13.6\%$, and $18.7\%$, respectively. The original Aquaplast increased the surface doses upto $38.4\%$, $43.6\%$, and $47.4\%$, respectively. For transformed Aquaplast, they were $31.2\%$, $36.1\%$, and $40.5\%$, respectively. There were little differences in percent depth dose values beyond the depth of Dmax. Increasing field size, the blocking tray caused increase of the surface dose by $0.2\%$, $1.7\%$, $3.0\%$ without Aquaplast, $0.2\%$, $1.9\%$, $3.7\%$ with transformed Aquaplast, respectively. Conclusion: The original and transformed Aquaplast increased the surface dose moderately. The percent depth doses beyond Dmax, however, were not affected by Aquaplast. In conclusion, although the use of Aquaplast in practice may cause some increase of skin and buildup region dose, reductioin of skin-sparing effect will not be so significant clinically.

• Progress in Medical Physics
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• v.28 no.1
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• pp.33-38
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• 2017

Creating individualized build-up material for superficial photon beam radiation therapy at irregular surface is complex with rice or commonly used flat shape bolus. In this study, we implemented a workflow using 3D printed patient specific bolus and describe our clinical experience. To provide better fitted build-up to irregular surface, the 3D printing technique was used. The PolyLactic Acid (PLA) which processed with nontoxic plant component was used for 3D printer filament material for clinical usage. The 3D printed bolus was designed using virtual bolus structure delineated on patient CT images. Dose distributions were generated from treatment plan for bolus assigned uniform relative electron density and bolus using relative electron density from CT image and compared to evaluate the inhomogeneity effect of bolus material. Pretreatment QA is performed to verify the relative electron density applied to bolus structure by gamma analysis. As an in-vivo dosimetry, Optically Stimulated Luminescent Dosimeters (OSLD) are used to measure the skin dose. The plan comparison result shows that discrepancies between the virtual bolus plan and printed bolus plan are negligible. (0.3% maximum dose difference and 0.2% mean dose difference). The dose distribution is evaluated with gamma method (2%, 2 mm) at the center of GTV and the passing rate was 99.6%. The OSLD measurement shows 0.3% to 2.1% higher than expected dose at patient treatment lesion. In this study, we treated Mycosis fungoides patient with patient specific bolus using 3D printing technique. The accuracy of treatment plan was verified by pretreatment QA and in-vivo dosimetry. The QA results and 4 month follow up result shows the radiation treatment using 3D printing bolus is feasible to treat irregular patient skin.

• Progress in Medical Physics
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• v.35 no.1
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• pp.10-15
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• 2024

Purpose: This study aimed to comprehensively investigate the diverse characteristics of a novel commercial bolus, CLEANBOLUS-WHITE (CBW), to ascertain its suitability for clinical application. Methods: The evaluation of CBW encompassed both physical and biological assessments. Physical parameters such as mass density and shore hardness were measured alongside analyses of element composition. Biological evaluations included assessments for skin irritation and cytotoxicity. Dosimetric properties were examined by calculating surface dose and beam quality using a treatment planning system (TPS). Additionally, doses were measured at maximum and reference depths, and the results were compared with those obtained using a solid water phantom. The effect of air gap on dose measurement was also investigated by comparing measured doses on the RANDO phantom, under the bolus, with doses calculated from the TPS. Results: Biological evaluation confirmed that CBW is non-cytotoxic, nonirritant, and non-sensitizing. The bolus exhibited a mass density of 1.02 g/cm³ and 14 shore 00. Dosimetric evaluations revealed that using the 0.5 cm CBW resulted in less than a 1% difference compared to using the solid water phantom. Furthermore, beam quality calculations in the TPS indicated increased surface dose with the bolus. The air gap effect on dose measurement was deemed negligible, with a difference of approximately 1% between calculated and measured doses, aligning with measurement uncertainty. Conclusions: CBW demonstrates outstanding properties for clinical utilization. The dosimetric evaluation underscores a strong agreement between calculated and measured doses, validating its reliability in both planning and clinical settings.