Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Patient Specific Quality Assurance of IMRT: Quantitative Approach Using Film Dosimetry and Optimization

강도변조방사선치료의 환자별 정도관리: 필름 선량계 및 최적화법을 이용한 정량적 접근

  • Shin Kyung Hwan (Research Institute and Hospital, National Cancer Center) ;
  • Park Sung-Yong (Research Institute and Hospital, National Cancer Center) ;
  • Park Dong Hyun (Research Institute and Hospital, National Cancer Center) ;
  • Shin Dongho (Research Institute and Hospital, National Cancer Center) ;
  • Park Dahl (Research Institute and Hospital, National Cancer Center) ;
  • Kim Tae Hyun (Research Institute and Hospital, National Cancer Center) ;
  • Pyo Hongryull (Research Institute and Hospital, National Cancer Center) ;
  • Kim Joo-Young (Research Institute and Hospital, National Cancer Center) ;
  • Kim Dae Yong (Research Institute and Hospital, National Cancer Center) ;
  • Cho Kwan Ho (Research Institute and Hospital, National Cancer Center) ;
  • Huh Sun Nyung (Department of Radiation Oncology, Seoul National University College of Medicine, National Cancer Center) ;
  • Kim Il Han (Department of Radiation Oncology, Seoul National University College of Medicine, National Cancer Center) ;
  • Park Charn Il (Department of Radiation Oncology, Seoul National University College of Medicine, National Cancer Center)
  • Published : 2005.09.01
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Abstract

Purpose: Film dosimetry as a part of patient specific intensity modulated radiation therapy quality assurance (IMRT QA) was peformed to develop a new optimization method of film isocenter offset and to then suggest new quantitative criteria for film dosimetry. Materials and Methods: Film dosimetry was peformed on 14 IMRT patients with head and neck cancers. An optimization method for obtaining the local minimum was developed to adjust for the error in the film isocenter offset, which is the largest part of the systemic errors. Results: The adjust value of the film isocenter offset under optimization was 1 mm in 12 patients, while only two patients showed 2 mm translation. The means of absolute average dose difference before and after optimization were 2.36 and $1.56\%$, respectively, and the mean ratios over a $5\%$ tolerance were 9.67 and $2.88\%$. After optimization, the differences in the dose decreased dramatically. A low dose range cutoff (L-Cutoff) has been suggested for clinical application. New quantitative criteria of a ratio of over a $5\%$, but less than $10\%$ tolerance, and for an absolute average dose difference less than $3\%$ have been suggested for the verification of film dosimetry. Conclusion: The new optimization method was effective in adjusting for the film dosimetry error, and the newly quantitative criteria suggested in this research are believed to be sufficiently accurate and clinically useful.

목적: 환자별 강도변조방사선치료 정도관리(IMRT QA) 중 필름 선량계를 임상에 적용하고, 필름 등선량중심점 치우침 교정 최적화법을 개발하였다. 최적화 후 필름 선량계에 대한 정량적 허용기준도 제시하고자 하였다. 대상 및 방법: IMRT 치료를 시행하기로 한 14명의 두경부종양 환자에서 필름 선량계를 시행하고, 가장 큰 계통적 오차 요인인 필름 등선량중심점 치우침 교정 최적화법을 고안하여 적용하였다. 결과: 필름 선량계의 필름 등선량중심점 치우침 교정 최적화법은 local minimum을 구하는 방식으로 고안하였으며, 환자에게 적용 시 조정값은 2 mm를 보인 2명을 제외하고 12명에서 1 mm로 나타났다. 필름 등선량중심점 치우침 교정 최적화 전후로 선량오차 결과를 산출하였으며, 최적화 전후의 절대 평균 선량오차의 평균은 각각 $2.36\%,\;1.56\%$, 점선량오차가 $5\%$ 이상인 지점의 비율은 평균은 각각 $9.67\%,\;2.88\%$로서 최적화 후 선량오차가 현저히 감소하였다. 최적화 후 절단 저선량 영역을 설정하였으며, 최적화 후 $5\%$ 이상의 점선량오차 지점 수 $10\%$ 미만, 절대평균 선량오차 $3\%$ 미만의 필름 선량계를 위한 정량적 허용 기준을 제시하였다. 결론: 본 연구에서 개발한 최적화법은 필름 선량계의 치우침 교정에 매우 유효하며, 최적화 후 제시된 정량적 허용 기준은 환자별 IMRT QA에 유용하게 사용될 수 있을 것으로 기대된다.

Keywords

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