• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.857-862
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• 2022

The purpose of this study was to evaluate a three-dimensional conformal radiotherapy (3D-CRT) treatment plan with regard to head tilting in whole-brain radiotherapy (WBRT) using TomoDirect (TD) mode in Tomotherapy. WBRT 3D-CRT by TD was compared for a total of five head tilt angles (-20°, -10°, 0°. +10° and +20°). The dose homogeneity index (HI) and prescription dose index (CI) were calculated to confirm the target coverage. The maximum and average doses for critical organs such as the lens, eyeball and parotid glands were calculated for different angles of head tilting. The HI and CI were closet to the result value of 1 at the head tilted angle +10° and +20°. At a head tilted angle of +10°, the dose to the lens and eyeballs decreased by about 74% and about 30%, when compared with the reference angle (0°), respectively. The results of this study suggest that a head angle of +10 with chin-up would save adequate target coverage and reduce exposure dose to the lens.

• Journal of radiological science and technology
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• v.31 no.1
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• pp.11-16
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• 2008

Purpose : The aim of this study was to predict radiation dose at 1 meter with BMI(body mass index) in thyroid cancer patients treated with radio-iodine and provide the efficient guideline in the management of patients. Methods : 140 patients from thyroidectomy for thyroid cancer were enrolled. All subjects under went 150 mCi radio-iodine therapy and performed whole body scan 1 week later. BMI(weight divided by square of height) was calculated to evaluate the amount of fatty tissue indirectly. The radiation dose at 1 meter was measured initially and on 2nd days. the relation of values with BMI were analyzed statically. As for the method of statistical analysis, using Med calc Version 9,2,2,0 Program. Results : (1) The initial effective dose was inversely correlated with the BMI. Significance level was 0.0004. (2) We obtained the following formula from the data of initial effective dose and BMI: Y = -30.91X + 350.4(${\mu}Sv/h$)(Y: initial radiation dose, x: Group). (3) After 21.55 hours, than radiation dose was less than those recommended by ICRP or NRC in 53% of the population. Conclusion : Using BMI, the initial radiation dose and 2nd days dose can be predicted in thyroid cancer patients before radio-iodine therapy. It may be used for predicting the time of discharge and control the isolation room. We were able to predict the radiation exposure after discharge using this calculated value.

• 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.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.91-96
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• 2011

Purpose: The aim of study is to expose a more uniform dose depending on the relationship between a body mass index in patients who underwent radiation therapy and an acquired dosimetric information by using a thermoluminescent dosimeter. Materials and Methods: Since 2006 to August 2011 we investigated 28 people who underwent radiation therapy were enrolled in AMC. Each patient was measured on the head, neck, chest, abdomen, pelvis, thigh, knee joint, and ankle joint using the thermoluminescent dosimeter. The measurement value of each points compared with the prescribed center point, abdominal point, and dose measurements of points on which to base the abdomen and the patient's body mass index (BMI) were compared with reference point, abdomen dose. Results: 28 patients on prescribed dose in the abdomen by which the center point, an average dose was $100.6{\pm}5.5%$, and the other seven measuring points with the average maximum difference among the head, neck, chest, pelvic, thigh, knee, and ankle were $92.8{\pm}4.2%$, $97.6{\pm}6.2%$, $96.4{\pm}5.5%$, $102.6{\pm}5.3%$, $103.4{\pm}7.9%$, $95.8{\pm}5.9%$, $96.1{\pm}5.5%$. The relationship of abdominal point dose and the patient's body mass index (BMI) was analyzed a scatter plot, and the result of linear relationship analysis by regression method, the regression of the dose (y) was -1.009 BMI (x) plus 123.3 and coefficient of determination ($R^2$) was represented 0.697. Conclusion: The total body irradiation treatment process was evaluated the dose deviation and then the prescribed dose by which the average abdominal dose was satisfied with $100.6{\pm}5.5%$. Results of the relationship analysis between BMI and dose, if we apply the correction value for each patients, it can be achieved more uniform dose delivery.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.21-28
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• 2014

Purpose : For non-small cell lung cancer, if the treatment volume is large or the total lung volume is small, and the tumor is located in midline of patient's body, total lung dose tends to increase due to tolerance dose of spinal cord. The purpose of this study is to compare and evaluate the total lung dose of three dimensional conformal radiotherapy(3D CRT), intensity modulated radiotherapy(IMRT) and volumetric modulated arc therapy(VMAT) using restricted angle for non-small cell lung cancer patients. Materials and Methods : The treatment plans for four patients, being treated on TrueBeam STx($Varian^{TM}$, USA) with 10 MV and prescribed dose of 60 Gy in 30 fractions, 3D CRT, restricted angle IMRT and VAMT radiotherapy plans were established. Planning target volume(PTV), dose to total lung and spinal cord were evaluated using the dose volume histogram(DVH). Conformity index(CI), homogeneity index(HI), Paddick's index(PCI) for the PTV, $V_{30}$, $V_{20}$, $V_{10}$, $V_5$, mean dose for total lung and maximum dose for spinal cord was assessed. Results : Average value of CI, HI and PCI for PTV was $0.944{\pm}0.009$, $1.106{\pm}0.027$, $1.084{\pm}0.016$ respectively. $V_{20}$ values from 3D CRT, IMRT and VMAT plans were 30.7%, 20.2% and 21.2% for the first patient, 33.0%, 29.2% and 31.5% for second patient, 51.3%, 34.3% and 36.9% for third patient, finally 56.9%, 33.7% and 40.0% for the last patient. It was noticed that the $V_{20}$ was lowest in the IMRT plan using restricted angle. Maximum dose for spinal cord was evaluated to lower than the tolerance dose. Conclusion : For non-small cell lung cancer, IMRT with restricted angle or VMAT could minimize the lung dose and lower the dose to spinal cord below the tolerance level. Considering PTV coverage and tolerance dose to spinal cord, it was possible to obtain IMRT plan with smaller angle and this could result in lower dose to lung when compared to VMAT.

• Journal of radiological science and technology
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• v.36 no.3
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• pp.237-244
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• 2013

The purpose of this study is to compare method in the treatment of breast cancer using dose index. And, it is to find the optimized treatment technique to the patient. The phantom filled with tissue-equivalent material were used simulation and treatment as techniques of 3D-CRT, IMRT, VMAT was planned using Eclipse v10. By using HI(homogeneity index), CI(Conformity index), OED(Organ equivalent dose), EAR(Excess Absolute Risk), were assessed for each treatment plans. HI and CI of 3D-CRT, IMRT, VMAT were calculated 16.89, 11.21, 9.55 and 0.59, 0.61, 0.83. The organ average doses of Lt lung, Rt lung, liver, heart, esophagus, cord, Lt breast, trachea and stomach were 0.01 ~ 2.02 Gy, 0.36 ~ 5.01 Gy, 0.25 ~ 2.49 Gy, 0.14 ~ 6.92 Gy, 0.03 ~ 2.02 Gy, 0.01 ~ 1.06 Gy, 0.25 ~ 6.08 Gy, 0.08 ~ 0.59 Gy, 0.01 ~ 1.34 Gy, respectively. The OED, EAR of the IMRT and VMAT show higher than 3D-CRT. As the result of this study, we could confirm being higher dose index(HI, CI) in IMRT and VMAT than 3D-CRT, but doses of around normal organs was higher IMRT, VMAT than 3D-CRT.

• Journal of Radiation Protection and Research
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• v.38 no.1
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• pp.29-36
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• 2013

The aim of this study was to determine the correlation between exposure index (EI) and dose factors related to radiation dose optimization in digital radiography (DR) system. Two phantoms with built-in regional test object for quantitative assessment of images were used to produce image signals that acquired in chest radiography background. EI and entrane surface dose (ESD) increased proportionally with rise of radiation dose (kVp, mAs) in both DR and CR systems. Especially, DR detector was effective to form good contrast and hence, reached easily to improvement of image quality with minimal dose changes. It made operators possible to expect the accuracy of EI values deeply related to absorbed dose of the detector. The evaluation of images was obtained specially employed calculation of noise to signal ratio (NSR) and contrast to noise ratio (CNR). These measurements were performed for how exposure factors affect image quality. NSR was inversely proportional to kVp and mAs and low NSR represented high signal detection efficiency. Consequently, EI values was the measure of the amount of exposure received by the image receptor and it was proportional to exposure factors. Therefore the EI in a recommended range from manufacturer can offer optimal image quality. Also, continuous monitoring of EI values in the digital radiography can reduce the unnecessary patient dose and help the quality control of the system.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.11-19
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• 2014

Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

• Journal of Radiation Protection and Research
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• v.11 no.1
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• pp.37-43
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• 1986

Dosimetric quantities for 300 keV neutrons in the ICRU standard tissue sphere were evaluated. The Monte Carlo code NEDEP which performs neutron-photon-charged particles coupled transport was used in the direct estimation of absorbed dose and dose equivalent. Some important quantities calculated are as follows; Deep dose equivalent index $H_{I,d}:1.78{\times}10^{11}\;Sv-cm^2$ Shallow dose equivalent index $H_{I,s}:2.08{\times}10^{-11}\;Sv-cm^2$ Ambient dose equivalent $H^*(0.07):1.7{\times}10^{-11}\;Sv-cm^2$ Ambient dose equivalent $H^*(10):1.78{\times}10^{-11}\;Sv-cm^2$ Effective quality factor $\bar{Q}^*(10):12.4$

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.83-95
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• 2018

Purpose : After planning the Respiratory Gated Radiotherapy for Lung cancer, the movement and volume change of sparing normal structures nearby target are not often considered during dose evaluation. This study carried out 4-D dose evaluation which reflects the movement of normal structures at certain phase of Respiratory Gated Radiotherapy, by using Deformable Image Registration that is well used for Adaptive Radiotherapy. Moreover, the study discussed the need of analysis and established some recommendations, regarding the normal structures's movement and volume change due to Patient's breathing pattern during evaluation of treatment plans. Materials and methods : The subjects were taken from 10 lung cancer patients who received Respiratory Gated Radiotherapy. Using Eclipse(Ver 13.6 Varian, USA), the structures seen in the top phase of CT image was equally set via Propagation or Segmentation Wizard menu, and the structure's movement and volume were analyzed by Center-to Center method. Also, image from each phase and the dose distribution were deformed into top phase CT image, for 4-dimensional dose evaluation, via VELOCITY Program. Also, Using $QUASAR^{TM}$ Phantom(Modus Medical Devices) and $GAFCHROMIC^{TM}$ EBT3 Film(Ashland, USA), verification carried out 4-D dose distribution for 4-D gamma pass rate. Result : The movement of the Inspiration and expiration phase was the most significant in axial direction of right lung, as $0.989{\pm}0.34cm$, and was the least significant in lateral direction of spinal cord, as -0.001 cm. The volume of right lung showed the greatest rate of change as 33.5 %. The maximal and minimal difference in PTV Conformity Index and Homogeneity Index between 3-dimensional dose evaluation and 4-dimensional dose evaluation, was 0.076, 0.021 and 0.011, 0.0 respectfully. The difference of 0.0045~2.76 % was determined in normal structures, using 4-D dose evaluation. 4-D gamma pass rate of every patients passed reference of 95 % gamma pass rate. Conclusion : PTV Conformity Index was more significant in all patients using 4-D dose evaluation, but no significant difference was observed between two dose evaluations for Homogeneity Index. 4-D dose distribution was shown more homogeneous dose compared to 3D dose distribution, by considering the movement from breathing which helps to fill out the PTV margin area. There was difference of 0.004~2.76 % in 4D evaluation of normal structure, and there was significant difference between two evaluation methods in all normal structures, except spinal cord. This study shows that normal structures could be underestimated by 3-D dose evaluation. Therefore, 4-D dose evaluation with Deformable Image Registration will be considered when the dose change is expected in normal structures due to patient's breathing pattern. 4-D dose evaluation with Deformable Image Registration is considered to be a more realistic dose evaluation method by reflecting the movement of normal structures from patient's breathing pattern.