• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.78-80
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• 2004

본 연구에서는 쐐기형태의 선량분포를 구현할 수 있도록 고안된 미국 Varian사 동적쐐기(EDW ; Enhanced Dynamic Wedge)의 표면선량(surface dose)과 주변선량(peripheral dose) 특성을 분석하였다. 쐐기각도 15${\circ}$, 30${\circ}$, 45${\circ}$, 50${\circ}$를 대상으로 금속쐐기를 사용했을 경우와 동적쐐기를 사용했을 경우에 대해 해당 선량특성을 비교, 분석하였다. 표면선량 측정 결과, 동적쐐기가 금속쐐기보다 더 높은 선량 분포를 보였으며, 주변선량의 경우, 금속쐐기가 동적쐐기보다 더 높은 선량분포를 보였다. 이는 금속쐐기의 빔 필터링에 의한 빔 경화(hardening) 현상과 광자선과의 산란 현상에 기인한 결과로 방사선치료 계획 시 동적쐐기의 적용에 있어 고려해야 할 주요 특성이라 사료된다.

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.77-82
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• 2007

Purpose: This study investigates peripheral dose from physical wedge and dynamic wedge system on a multileaf collimator (MLC) equipment linear accelerator. Materials and Methods: Measurments were performed using a 2D array ion chamber and solid water phantom for a 10$\times$10 cm, source-surface distance (SSD) 90 cm, 6 and 15 MV photon beam at depths of 0.5 cm, 5 cm through dmax. Measurments of peripheral dose at 0.5 cm and 5 cm depths were performed from 1 cm to 5 cm outside of fields for the dynamic wedge and physical wedge 15$^\circ$, 45$^\circ$. Dose profiles normalized to dose at the maximum depth. Results: At 6 MV photon beam, the average peripheral dose of dynamic wedge were lower by 1.4% and 0.1%. At 15 MV photon beam, the peripheral dose of dynamic wedge were lower by maximum 1.6%. Conclusion: This study showed that dynamic wedge can reduce scattered dose of clinical organ close to the field edge and reduced treatment time. The wedge systems produce significantly different peripheral dose that should be considered in properly choosing a wedge system for clinical use.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.407-413
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• 2008

Measurements of the peripheral dose were performed using a 2D array ion chamber and solid water phantom for a $10{\times}10cm$, source-surface distance (SSD) 90cm, 6 and 15MV photon beam at depths of 0.5cm, 5cm through $d_{max}$. Measurements of peripheral dose at 0.5cm and 5cm depths were performed from 1cm to 5cm outside of fields for the dynamic wedge and physical wedge $15^{\circ}$, $45^{\circ}$. For 6MV photon beam, the average peripheral dose of dynamic wedge were lower by 1.4% and 0.1% than that of physical wedge For 15MV photon beam, the peripheral dose of dynamic wedge were lower by maximum 1.6% that of physical wedge. The results showed that dynamic wedge can reduce scattered dose of clinical organ close to the field edge. The wedge systems produce different peripheral dose that should be considered in properly choosing a wedge system for clinical use.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.323-332
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• 1996

Purpose : The wedge filter is the most commonly used beam modifying device during radiation therapy Recently dynamic wedge technique is available through the computer controlled asymmetric collimator, independent jaw. But dosimetric characteristics of dynamic wedge technique is not well known. Therefore we evaluate dosimetric characteristics of dynamic wedge compared to conventional fixed wedge. Materials and Methods : We evaluated dosimetric characteristics of dynamic wedge and fixed wedge by ion chamber, film dosimetry and TLD in phantoms such as water, polystyrene and average breast phantom. Six MV x-ray was used in $15{\times}15cm$ field with 15,30 and 45 degree wedge of dynamic/liked wedge system, Dosimeric characteristics are interpreted by Wellhofer Dosimetrie system WP700/WP700i and contralateral breast dose (CBD) with tangential technique was confirmed by TLD. Results : 1) Percent depth dose through the dynamic wedge technique in tissue equivalent phantom was similar to open field irradiation and there was no beam hardening effect compared to fixed wedge technique. 2) Isodose line composing wedge angle of dynamic wedge is more straight than hard wedge. And dynamic wedge technique was able to make any wedge angle on any depth and field size. 3) The contralateral breast dose in primary breast irradiation was reduced by dynamic wedge technique compared to fixed wedge. When the dynamic wedge technique was applied, the scatter dose was similar to that of open field irradiation. Conclusion : The dynamic wedge technique was superior to fixed wedge technique in dosimetric characteristics and may be more useful in the future.

• Progress in Medical Physics
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• v.16 no.2
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• pp.70-76
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• 2005

For clinical implementation of Enhanced Dynamic Wedge (EDW), it is necessary to adequately analyze and commission its dosimetric properties in comparison to common physical metal wedge (MTW). This study was implemented with the essential measurements of parameters for clinical application, such as percentage depth dose, peripheral dose, surface dose, effective wedge factor, and wedge profile. In addition, through the comparison study of EDW with open and MTW, the analysis was performed to characterize the EDW. We also compared EDW dose profiles of measured values using chamber array 24 (CA24) with calculated values using radiation treatment planning system. PDDs of EDW showed good agreements between $0.2\~0.5\%$ of open beam, but $2\%$ differences with MTW. In the result of the measurements of peripheral dose, it was shown that MTW was about $1\%$ higher than open field and EDW. The surface doses of $60^{\circ}$ MTW showed 10% lower than the others. We found that effective wedge factor of EDW had linear relationships according to Y jaw sizes and was independent of X jaw sizes and was independent of X jaw sizes and asymmetric Y jaw opening. In comparison with measured values and calculate values from Golden-STT based radiation treatment planning system (RTP system), it showed very good agreement within difference of $1\%$. It could be concluded that EDW is a very reliable and useful tool as a beam modification substitute for conventional MTW.

• Progress in Medical Physics
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• v.9 no.2
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• pp.77-88
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• 1998

Wedge shaped isodoses are desired in a number of clinical situations. Hard wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths along with the practical consequendes of filter handling and placement problems. Dynamic wedging uses a combination of a moving collimator and changing monitor dose to achieve angled isodoses. The segmented treatment tables(STT) that monitor unit setting by every distance of moving collimator, was induced by numerical formular. The characteristics of dynamic wedge by STT compared with real dosimetry. Methods and Materials : The accelerator CLINAC 2100C/D at Yonsei Cancer Center has two photon energies (6MV and 10MV), currently with dynamic wedge angles of 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$. The segmented treatment tables(STT) that drive the collimator in concert with a changing monitor unit are unique for field sizes ranging from 4.0cm to 20.0cm in 0.5cm steps. Transmission wedge factors were measured for each STT with an standard ion chamber. Isodose profiles, isodose curves, percentage depth dose for dynamic wedge filters were measured with film dosimetry. Dynamic wedge angle by STT was well coincident with film dosimetry. Percent depth doses were found to be closer to open field but more shallow than hard wedge filter. The wedge transmission factor were decreased by increased the wedge angle and more higher than hard wedge filters. Dynamic wedging probided more consistent gradients across the field compared with hard wedge filters. Dynamic wedging has practical and dosimetric advantages over hard filters for rapid setup and keeping from table collisions. Dynamic wedge filters are positive replacement for hard filters and introduction of dynamic conformal radiotherapy and intensity modulation radiotherapy in a future.

• Progress in Medical Physics
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• v.15 no.3
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• pp.161-166
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• 2004

A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

• Journal of radiological science and technology
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• v.33 no.2
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• pp.133-141
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• 2010

The evaluation of Varian enhanced dynamic wedges (EDW) were performed in terms of quality assurance in external radiotherapy. The seven (10, 15, 20, 25, 30, 45, 60 deg.) EDW angles were evaluated for 6 and 15 MV x-rays in Varian Linac. The STT (segmented treatment table) for a field were calculated and compared with actual movement of the jaw using Dynalog files in order to evaluate mechanical operation. Two dimensional array detector and an ionization chamber were used to measure dose distributions in phantom from Linac. The mechanical movement of jaw was agreed with its expectation and two dimensional dose distributions including beam profiles were in agreement with RTP data approximately. In comparison with RTP calculations the percentage difference of output dose values for 100 MU irradiation was less than 2.9% and measured wedge factor was less than 2.6%. These results are shown that there is no problem in clinical applications of EDW equipped on this linac.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.157-164
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• 2012

The purpose of this study is to analyze the dose distribution when wedge filter is used in the various tissue electron density materials. The dose distribution was assessed that the enhanced dynamic wedge filter and physical wedge filter were used in the solid water phantom, cork phantom, and air cavity. The film dosimetry was suitable simple to measure 2D dose distribution. Therefore, the radiochromic films (Gafchromic EBT2, ISP, NJ, USA) were selected to measure and to analyze the dose distributions. A linear accelerator using 6 MV photon were irradiated to field size of $10{\times}10cm^2$ with 400 MUs. The dose distributions of EBT2 films were analyzed the in-field area and penumbra regions by using dose analysis program. In the dose distributions of wedge field, the dose from a physical wedge was higher than that from a dynamic wedge at the same electron density materials. A dose distributions of wedge type in the solid water phantom and the cork phantom were in agreements with 2%. However, the dose distribution in air cavity showed the large difference with those in the solid water phantom or cork phantom dose distributions. Dose distribution of wedge field in air cavity was not shown the wedge effect. The penumbra width, out of the field of thick and thin, was observed larger from 1 cm to 2 cm at the thick end. The penumbra of physical wedge filter was much larger average 6% than the dynamic wedge filter. If the physical wedge filter is used, the dose was increased to effect the scatter that interacted with photon and physical wedge. In the case of difference in electron like the soft tissue, lung, and air, the transmission, absorption, and scattering were changed in the medium at high energy photon. Therefore, the treatment at the difference electron density should be inhomogeneity correction in treatment planning system.

• Progress in Medical Physics
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• v.18 no.3
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• pp.107-117
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• 2007

In order to evaluate the radio-protective advantage of an enhanced dynamic wedge (EDW) over a physical wedge (PW), we measured peripheral doses scattered from both types of wedges using a 2D array of ion-chambers. A 2D array of ion-chambers was used for this purpose. In order to confirm the accuracy of the device we first compared measured profiles of open fields with the profiles calculated by our commissioned treatment planning system. Then, we measured peripheral doses for the wedge angles of $15^{\circ},\;30^{\circ},\;45^{\circ},\;and\;60^{\circ}$ at source to surface distances (SSD) of 80 cm and 90 cm. The measured points were located at 0.5 cm depth from 1 cm to 5 cm outside of the field edge. In addition, the measurements were repeated by using thermoluminescence dosimeters (TLD). The peripheral doses of EDW were (1.4% to 11.9%) lower than those of PW (2.5% to 12.4%). At 15 MV energy, the average peripheral doses of both wedges were 2.9% higher than those at 6MV energy. At a small SSD (80 cm vs. 90 cm), peripheral dose differences were more recognizable. The average peripheral doses to the heel direction were 0.9% lower than those to the toe direction. The results from the TLD measurements confirmed these findings with similar tendency. Dynamic wedges can reduce unnecessary scattered doses to normal tissues outside of the field edge in many clinical situations. Such an advantage is more profound in the treatment of steeper wedge angles, and shorter SSD.