• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.1-9
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• 2008

Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.1
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• pp.45-55
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• 2005

Purpose : To evaluate the usefulness of the handmade patient immobilization device and to report the clinical results of it. Materials and methods : We made two fusion images and analyzed those images. One image is made with diagnostic MR image and CT image, the other with therapeutic planning MR image and CT image. With open head holder, we measured the skin dose and attenuation dose. Also, we made the planning CT couch plate with acrylic plate and styrofoam and compared artifact. Results : We could get more accurate fusion image when we use MR head holder(within 2mm error). The skin dose was reduced 2 times and the attenuation dose was reduced more than $20\%$ when open head holder used. The planning CT couch plate was more convenient than conventional board and reduced artifact remarkably. Conclusion : We could verify the localization point in the MR image which is taken with MR head holder. So we could fuse the image more accurately. The same method could be applied to PET and US image, if the alike immobilization device used. With open head holder, the skin dose and the attenuation dose was reduced. And those above devices could substitute for expensive foreign device, if those are manufactured adequately.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.123-130
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• 2008

Purpose: To provide practical education, most universities should be equipped with medical appliances in need. As compensatory measures, Gimcheon College has produced in-house dummy linac and dummy accessories, we are going to report efficiency and its usage. Materials and Methods: Dummy linear accelerator (DLINAC-001) has the same mechanical functions as rotation of gantry and collimation in linear accelerator. In addition, to maximize practical education, we have produced and utilized in-house custom blocks, wedge filters, electron cones and head rests. Results: The in-house produced linear accelerator with the same mechanical functions as the linear accelerator, DLINAC-001 can be effectively used in practicing diverse medical instruments. Conclusion: We have produced dummy linear accelerators and dummy accessories and utilized them in practice classes, which can provide the students with clinical training in diverse fields. Consequently, the students exposed to the maximized educational effectiveness can be easily equipped with the practical competence required in real clinical fields.

• Radiation Oncology Journal
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• v.16 no.2
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• pp.167-175
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• 1998

Purpose : It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or sing1e plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms(cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. Materials and Methods : Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent(5 cases) or primary(3 cases) cervical cancers or primary vaginal cancer(1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a sing1e plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material$(Provil^{(R)})$. The applicators were customized individually according to the tumor size and its location Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles(Microselectron Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. Results : Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant procedure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. Conclusion : The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylanide and dental mold material $(Provil^{(R)})$.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.84-89
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• 2013

Purpose: Patients' movement during long image acquisition time for the fusion image of PET-CT (Positron Emission Tomography-Computed Tomography) results in unconformity, and greatly affects the quality of the image and diagnosis. The arm support fixtures provided by medical device companies are not manufactured considering the convenience and safety of the patients; the arm and head movements (horizontal and vertical) during PET/CT scan cause defects in the brain fundus images and often require retaking. Therefore, this study aims to develop patient-compensation device that would minimize the head and arm movements during PET/CT scan, providing comfort and safety, and to reduce retaking. Materials and Methods: From June to July 2012, 20 patients who had no movement-related problems and another 20 patients who had difficulties in raising arms due to shoulder pain were recruited among the ones who visited nuclear medicine department for PET Torso scan. By using Patient Holding System (PHS), different range of motion (ROM) in the arm ($25^{\circ}$, $27^{\circ}$, $29^{\circ}$, $31^{\circ}$, $33^{\circ}$, $35^{\circ}$) was applied to find the most comfortable angle and posture. The manufacturing company was investigated for the permeability of the support material, and the comfort level of applying bands (velcro type) to fix the patient's head and arms was evaluated. To find out the retake frequency due to movements, the amount of retake cases pre/post patient-compensation were analyzed using the PET Torso scan data collected between January to December 2012. Results: Among the patients without movement disorder, 18 answered that PHS and $29^{\circ}$ arm ROM were the most comfortable, and 2 answered $27^{\circ}$ and $31^{\circ}$, respectively. Among the patients with shoulder pain, 15 picked $31^{\circ}$ as the most comfortable angle, 2 picked $33^{\circ}$, and 3 picked $35^{\circ}$. For this study, the handle was manufactured to be adjustable for vertical movements. The material permeability of the patient-compensation device has been verified, and PHS and the compensation device were band-fixed (velcro type) to prevent device movements. A furrow was cut for head fixation to minimize the head and neck movements, fixing bands were attached for the head, wrist, forearm, and upper arm to limit movements. The retake frequency of PET Torso scan due to patient movements was 11.06% (191 cases/1,808 patients) before using the movement control device, and 2.65% (48 cases/1,732 patients) after using the device; 8.41% of the frequency was reduced. Conclusion: Recent change and innovation in the medical environment are making expensive medical image scans, and providing differentiated services for the customers is essential. To secure patient comfort and safety during PET/CT scans, ergonomic patient-compensation devices need to be provided. Therefore, this study manufactured a patientcompensation device with vertically adjustable ergonomic ROM according to the patient's body shape and condition during PET Torso scan. The defects in the basal ganglia images due to arm movements were reduced, and retaking was decreased.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.95-103
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• 2005

Purpose : In the radiosurgery, to obtain CT image to find more accurate tumor position during respiration, and using them, to increase the accuracy of radiation treatment by applying image guided. Materials and Methods : Using the self-made vacuum cushion for the body SRS, CT images were obtained three for each patient during respiration (shallow, inhalation, exhalation). They were transformed to the RTP computer and then were fused. Global GTVs were delineated on the fused images and more appropriated treatment planning was established. Results : We can find the tumor position is moving toward cranio-caudal with max 10 mm margin and volume is transformed. As a result from the comparision of DVH (pre & post radio surgery), we observed about 100% dose to tumor. Conclusion : BSRS was skeptical due to the tumor movement during respiration. More accurate by the combination of the development of immobilization devices and BSRS based on Image Guide, it will be applied to more cases for BSRS.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.189-196
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• 2012

Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.41-49
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• 2011

Purpose: This study is designed to investigate radiotherapic valuation of Paraffin Wax, which is newly formed for this study and generally utilized in dentistry, and Mouth Piece and Putty impression, which are commonly used in radiotherapy, for oral cavity as a compensator. Materials and Methods: Each compensator was formed by $10{\times}10{\times}1cm$ and measured radiation dose attenuation ratio with reference of water phantom which is made of tissue-equivalent materials. Two patients with oral cancer underwent DRR (Digitally Reconstructed Radiogrph) of Offline Review Program of Aria System and Portal vision for 5 times for each material to evaluate reproducibility by each filling materials. Moreover, MU (monitor unit) changes by dose absorption were considered in the case of inevitable implication of an filling materials in the range for radiotherapy. Results: Radiation dose attenuation ratios were shown -0.7~+3.7% for Mouth Piece, +0.21~+0.39% for Paraffin Wax and -2.71~-1.76% for Putty impression. Error ranges of reproducibility of positions were measured ${\pm}3mm$ for Mouth Piece, ${\pm}2mm$ for Paraffin Wax and ${\pm}2mm$ mm for Putty impression. Difference of prescription MU from dose absorption with an filling material increased +7.8% (250 MU) in Putty impression and -0.9% (230 MU) in Paraffin Wax as converted into a percentage from the standard phantom, Water 232 MU. Conclusion: Dose reduction of boundary between cavity and tissue was observed for Mouth Piece. Mouth Piece also had low reproducibility of positions as it had no reflection of anatomy of oral cavity even though it was a proper material to separate Maxilla and Mandible during therapy. On the other hand, Putty impression was a suitable material to correctly re-position oral cavity as before. However, it risked normal tissues getting unnecessary over irradiation and it caused radiation dose decrease by -2.5% for 1cm volume in comparison of it of water phantom. Dose reduction in Paraffin Wax, Fat Tissue-Equivalent Material, was smaller than other impressions and position reproducibility of it was remarkable as it was possible to make an anatomy reflected impression. It was also well fitted to oral cavity to transfer radiation dose planned in radiotherapy. Thus, Paraffin Wax will be an ideal material in radiotherapy for patients with oral cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.109-117
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• 2011

Purpose: To analyze the accuracy of tumor volume dose following field width change, to check the difference of dose change by using self-made moving car, and to evaluate practical delivery tumor dose when tomotherapy in the treatment of organ influenced by breathing. Materials and Methods: By using self-made moving car, the difference of longitudinal movement (0.0 cm, 1.0 cm, 1.5 cm, 2.0 cm) was applied and compared calculated dose with measured dose according to change of field width (1.05 cm, 2.50 cm, 5.02 cm) and apprehended margin of error. Then done comparative analysis in degree of photosensitivity of DQA film measured by using Gafchromic EBT film. Dose profile and Gamma histogram were used to measure degree of photosensitivity of DQA film. Results: When field width were 1.05 cm, 2.50 cm, 5.02 cm, margin of error of dose delivery coefficient was -2.00%, -0.39%, -2.55%. In dose profile of Gafchromic EBT film's analysis, the movement of moving car had greater motion toward longitudinal direction and as field width was narrower, big error increased considerably at high dose part compared to calculated dose. The more field width was narrowed, gamma index had a large considerable influence of moving at gamma histogram. Conclusion: We could check the difference of longitudinal dose of moving organ. In order to small field width and minimize organ moving due to breathing, it is thought to be needed to develop breathing control unit and fixation tool.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.35 no.6
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• pp.599-607
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• 2011

In this paper, a reaction-force compensation system for an XY linear motion stage, without an additional external isolation structure or extra motors, is developed. This system consists of a movable magnet track, a spring, a dummy weight, and a dedicated sensor module that measures the relative positions of the movable magnet track with respect to the motor coil. The reaction force compensation system is modeled, and simulations are carried out to optimize design parameters such as the moving distance of the magnet track, the transmission force, the dummy weight, and the allowed size of the mechanism. An XY linear motion stage is built, incorporating the reaction force compensation system, and the performance of the system is verified experimentally. For acceleration and deceleration values of 10 m/$s^2$, 85% of the reaction force is absorbed by the reaction force compensation system.