• The Journal of Korean Society for Radiation Therapy
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• v.29 no.1
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• pp.57-68
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• 2017

Purpose: The purpose of this study was to compare volumetric modulated arc therapy(VMAT) with fixed-field intensity modulated radiation therapy(IMRT) using non-coplanar beam when the shape of target is irregular and the location is adjacent to organ at risk(OAR). Materials and Methods: The subjects of this study were a total of 6 patients who had radiation therapy for whole scalp(2 patients), partial scalp(2 patients), and whole ventricle(2 patients) by True Beam STX(Varian Medical Systems, USA). VMAT plans consisted of coplanar or non-coplanar arcs which can minimize the volume of OAR included in beamlets. All fixed-field IMRT plans consisted of non-coplanar beams using more than 2 angles of Couch. Results: The VMAT and IMRT plans were compared with regard to the maximum dose of both lens, both optic nerves, optic chiasm, and brain stem and the mean dose of both eyeballs and hippocampus. VMAT plans showed higher dose than ncIMRT plans at more than 6 of all OARs in every patient, and the ratio was from 1.1 times to 8.2 times. In case of total scalp and partial scalp, the volume of brain which received more than 20 Gy in the VMAT plans was 2 times larger than the volume in the ncIMRT plans. In case of whole ventricle, there was no significant difference. Target coverage was satisfied in both plans($PTV_{100%}=95%$). The maximum dose in target volume and required monitor unit(MU) of ncIMRT were higher than them of VMAT plans. Conclusion: Even though ncIMRT is less efficient than VMAT with regard to required MU and treatment time, the dose to OARs is much lower than VMAT and PTV Coverage is similar with VMAT. If the shape of target is irregular and location is adjacent to OAR, comparison VMAT plan with ncIMRT plan deserves to be considered.

• Journal of the Korean Magnetics Society
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• v.25 no.6
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• pp.208-218
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• 2015

Recently, radiation therapy is used in the CT existing conventional two-dimensional radiation image, and set the size and location of the tumor in a manner that the image is going to change the treatment plan. After using the simulation using CT, radiation therapy it is four-dimensional or three-dimensional treatment made possible. and radiation therapy became the more effective ever before. High technology radiation therapy such as the treatment of SRS,IMRT, IGRT, SBRT, is a need to try contemplating the possibility to apply appropriate analysis and situation, so it has its own characteristics. and then it is believed that it is necessary to analyze and try it worries the proper applicability of the situation. The configuration of the various treatment that is applicable in many hospitals is necessary to try to determine how to practically apply the patients. Critical organs surrounding tumor give a small dose to avoid side effects and then the tumor has the therapeutic effect by providing a larger dose than before the radiation treatment.

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.255-255
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• 2002

• The Journal of Korean Society for Radiation Therapy
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• v.19 no.2
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• pp.91-97
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• 2007

Purpose: To evaluate the feasibility of a commercial ion chamber array for intensity modulated radiation therapy (IMRT) quality assurance (QA) was performed IMRT patient-specific QA Materials and Methods: A use of IMRT patient-specific QA was examined for nasopharyngeal patient by using 6MV photon beams. The MatriXX (Wellhofer Dosimetrie, Germany) was used for IMRT QA. The case of nasopharyngeal cancer was performed inverse treatment planning. A hybrid dose distribution made on the CT data of MatriXX and solid phantom all of the same gantry angle (0$^\circ$). The measurement was acquired with geometrical condition that equal to hybrid treatment planning. The $\gamma$-index (dose difference 3%, DTA 3 mm) histogram was used for quantitative analysis of dose discrepancies. An absolute dose was compared at the high dose low gradient region. Results: The dose distribution was shown a good agreement by gamma evaluation. A proportion of acceptance criteria was 95.8%, 97.52%, 96.28%, 98.20%, 97.78%, 96.64% and 92.70% for gantry angles were 0$^\circ$, 55$^\circ$, 110$^\circ$, 140$^\circ$, 220$^\circ$, 250$^\circ$ and 305$^\circ$, respectively. The absolute dose in high dose low gradient region was shown reasonable agreement with the RTP calculation within $\pm$3%. Conclusion: The MatriXX offers the dosimetric characteristics required for performing both relative and absolute measurements. If MatriXX use in the clinic, it could be simplified and reduced the IMRT patient-specific QA workload. Therefore, the MatriXX is evaluated as a reliable and convenient dosimeter for IMRT patient-specific QA.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.71-78
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• 2021

Purpose: To evaluate the inter-fractional position and respiratory reproducibility of lung and liver tumors using pressure conserving type(P-type) abdominal compressor in volumetric modulated arc therapy(VMAT). Materials and methods: Six lung cancer patients and three liver cancer patients who underwent VMAT using a P-type abdominal compressor were included in this study. Cone-beam computed tomography(CBCT) images were acquired before each treatment and compared with planning CT images to evaluate the inter-fractional position reproducibility. The position variation was defined as the difference of position shift values between target matching and bone matching. 4-dimensional cone-beam computed tomography(4D CBCT) images were acquired weekly before treatment and compared with planning 4DCT images to evaluate the inter-fractional respiratory reproducibility. The respiratory variation was calculated by the magnitude of excursions by breathing. Results: The mean ± standard deviation(SD) of overall position variation values, 3D vector in the three translational directions were 1.1 ± 1.4 mm and 4.5 ± 2.8 mm for the lung and liver, respectively. The mean ± SD of respiratory variation values were 0.7 ± 3.4 mm (p = 0.195) in the lung and 3.6 ± 2.6 mm (p < 0.05) in the liver. Conclusion: The use of P-type compressor in lung and liver VMAT was effective for stable control of inter-fractional position and respiratory variation by reproduction of abdominal compression. Appropriate PTV margin must be considered in treatment planning, and image guidance before each treatment are required in order to obtain more stable reproducibility

• Journal of radiological science and technology
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• v.40 no.1
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• pp.63-70
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• 2017

The purpose of this study was compare to the patient setup deviation of two different type thermoplastic immobilization masks for glottis cancer in the intensity-modulated radiation therapy (IMRT). A total of 16 glottis cancer cases were divided into two groups based on applied mask type: standard or alternative group. The mean error (M), three-dimensional setup displacement error (3D-error), systematic error (${\Sigma}$), random error (${\sigma}$) were calculated for each group, and also analyzed setup margin (mm). The 3D-errors were $5.2{\pm}1.3mm$ and $5.9{\pm}0.7mm$ for the standard and alternative groups, respectively; the alternative group was 13.6% higher than the standard group. The systematic errors in the roll angle and the x, y, z directions were $0.8^{\circ}$, 1.7 mm, 1.0 mm, and 1.5 mm in the alternative group and $0.8^{\circ}$, 1.1 mm, 1.8 mm, and 2.0 mm in the alternative group. The random errors in the x, y, z directions were 10.9%, 1.7%, and 23.1% lower in the alternative group than in the standard group. However, absolute rotational angle (i.e., roll) in the alternative group was 12.4% higher than in the standard group. For calculated setup margin, the alternative group in x direction was 31.8% lower than in standard group. In contrast, the y and z direction were 52.6% and 21.6% higher than in the standard group. Although using a modified thermoplastic immobilization mask could be affect patient setup deviation in terms of numerical results, various point of view for an immobilization masks has need to research in terms of clinic issue.

• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.633-640
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• 2023

With the recent development of static and dynamic modulated brachytherapy methods in brachytherapy, which use radiation shielding to modulate the dose distribution to deliver the dose, the amount of parameters and data required for dose calculation in inverse treatment planning and treatment plan optimization algorithms suitable for new directional beam intensity modulated brachytherapy is increasing. Although intensity-modulated brachytherapy enables accurate dose delivery of radiation, the increased amount of parameters and data increases the elapsed time required for dose calculation. In this study, a GPU-based CUDA-accelerated dose calculation algorithm was constructed to reduce the increase in dose calculation elapsed time. The acceleration of the calculation process was achieved by parallelizing the calculation of the system matrix of the volume of interest and the dose calculation. The developed algorithms were all performed in the same computing environment with an Intel (3.7 GHz, 6-core) CPU and a single NVIDIA GTX 1080ti graphics card, and the dose calculation time was evaluated by measuring only the dose calculation time, excluding the additional time required for loading data from disk and preprocessing operations. The results showed that the accelerated algorithm reduced the dose calculation time by about 30 times compared to the CPU-only calculation. The accelerated dose calculation algorithm can be expected to speed up treatment planning when new treatment plans need to be created to account for daily variations in applicator movement, such as in adaptive radiotherapy, or when dose calculation needs to account for changing parameters, such as in dynamically modulated brachytherapy.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.97-102
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• 2011

Purpose: IMRT QA using 2Dimensional array detector is carried out with condition for discrete dose distribution clinically. And it can affect uncertainty of evaluation using gamma method. We analyze gamma index variation according to grid size and suggest validate range of grid size for IMRT QA in Hospital. Materials and Methods: We performed QA using OniPro I'mRT system software version 1.7b on 10 patients (head and neck) for IMRT. The reference dose plane (grid size, 0.1 cm; location, [0, 0, 0]) from RTP was compared with the dose plane that has different grid size (0.1 cm, 0.5 cm, 1.0 cm, 2.0 cm, 4.0 cm) and different location (along Y-axis 0 cm, 0.2 cm, 0.5 cm, 1.0 cm). The gamma index variation was evaluated by observing the level of changes in Gamma pass rate, Average signal, Standard deviation for each case. Results: The average signal for each grid size showed difference levels of 0%, -0.19%, -0.04%, -0.46%, -8.32% and the standard deviation for each grid size showed difference levels of 0%, -0.30%, 1.24%, -0.70%, -7.99%. The gamma pass rate for each grid size showed difference levels of 0%, 0.27%, -1.43%, 5.32%, 5.60%. The gamma evaluation results according to distance in grid size range of 0.1 cm to 1.0 cm showed good agreement with reference condition (grid size 0.1 cm) within 1.5% and over 5% in case of the grid size was greater than 2.0 cm. Conclusion: We recognize that the grid size of gamma evaluation can make errors of IMRT QA. So we have to consider uncertainty of gamma evaluation according to the grid size and apply smaller than 2 cm grid size to reduce error and increase accuracy clinically.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.285-293
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• 2006

$\underline{Purpose}$: This study was to search the optimal slice thickness of computed tomography (CT) in an intensity modulated radiation therapy plan through changing the slice thickness and comparing the change of the calculated absorbed dose with measured absorbed dose. $\underline{Materials\;and\;Methods}$: An intensity modulated radiation therapy plan for a head and neck cancer patient was done, first of all. Then CT with various ranges of slice thickness ($0.125{\sim}1.0\;cm$) for a head and neck anthropomorphic phantom was done and the images were reconstructed. The plan parameters obtained from the plan of the head and neck cancer patient was applied into the reconstructed images of the phantom and then absorbed doses were calculated. Films were inserted into the phantom, and irradiated with 6 MV X-ray with the same beam data obtained from the head and neck cancer patient. Films were then scanned and isodoses were measured with the use of film measurement software and were compared with the calculated isodeses. $\underline{Results}$: As the slice thickness of CT decreased, the volume of the phantom and the maximum absorbed dose increased. As the slice thickness of CT changed from 0.125 to 1.0 cm, the maximum absorbed dose changed ${\sim}5%$. The difference between the measured and calculated volume of the phantom was small ($3.7{\sim}3.8%$) when the slice thickness of CT was 0.25 cm or less. The difference between the measured and calculated dose was small ($0.35{\sim}1.40%$) when the slice thickness of CT was 0.25 cm or less. $\underline{Conclusion}$: Because the difference between the measured and calculated dose in a head and neck phantom was small and the difference between the measured and calculated volume was small when the slice thickness of CT was 0.25 cm or less, we suggest that the slice thickness of CT should be 0.25 cm or less for an optimal intensity modulated radiation therapy plan.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.105-111
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• 2010

Purpose: There are various beam parameter in intensity modulated radiation therapy (IMRT). The aim of this study is to investigate how various dose rate affect the parotid in treatment plan of IMRT. Materials and Methods: The study was performed on 10 nasopharyngeal carcinoma patients who have undergone IMRT. CT images were scanned 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). The parameters for planning used 6 MV energy and 8 beams under the same dose volume constraint. The variation of dose rates were used 300, 400, 500 MU/min. The mean dose of both parotid was accessed from the calculated planning among the 10 patients. The mean dose of parotid was verificated by 2D diode array (Mapcheck from Sun Nuclear Corporation, Melbourne, Florida). Also, Total monitor unit (MU) and beam-on time was analysed. Results: According to the dose rate, the mean dose of parotid was increased by 0.8%, 2.0% each, when dose rate was changed from 300 MU/min to 400, 500 MU/min, moreover Total MU was increased by 5.4% and 10.6% each. There was also a dose upward trend in the dose measurement of parotid by 2D diode array. However, beam - on time difference of 1~2 minutes was no signigicant in the dose rate increases. Conclusion: From this study, when the dose rates increase, there was a signigicant increase of Total MU and the parotid dose accordingly, however the shortened treatment time was not significant. Hence, it is considered that there is a significant decrease of late side effect in parotid radiation therapy, if the precise dose rate in IMRT is used.