• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.129-138
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• 2018

Purpose : An aim of this study was to compare the effect of multi leaf collimator(MLC) types for high dimension radiotherapy in treatment sites used clinically. Material and Method : 70 patients with lung cancer, spine cancer, prostate cancer, whole pelvis, head and neck, breast cancer were included in this study. High definition(HD) MLC of TrueBeam STx (Varian Medical system, Palo Alto, CA) and millenium(M) MLC of VitalBeam (Varian Medical system, Palo Alto, CA) were used. Radiotherapy plans were performed for each patient under same treatment goals with Eclipse (Version 13.7, Varian Palo Alto USA, CA). To compare the indicators of the radiotherapy plans, planning target volume(PTV) coverage, conformity index(CI), homogeneity index(HI), and clinical indicators for each treatment sites in normal tissues were evaluated. To evaluate low dose distribution, $V_{30%}$ values were compared according to MLC types. Additionally, length and volume of targets for each treatment sites were investigated. Result : In stereotatictic body radiotherapy(SBRT) plan for lung, the average value of PTV coverage was reduced by 0.52 % with HD MLC. With SBRT plan using HD MLC for spine, the average value of PTV coverage decreased by 0.63 % and maximum dose decreased by 1.13 %. In the test of CI and HI, the values in SBRT plan with HD MLC for spine were 1.144, 1.079 and the values using M MLC were 1.160, 1.092 in SBRT plan for lung, The dose evaluation of critical organ was reduced by 1.48 % in the ipsilateral lung mean dose with HD MLC. In prostate cancer volumetric modulated arc therapy(VMAT) with HD MLC, the mean dose and the $V_{30}$ of bladder and the mean dose and the $V_{25}$ of rectum were reduced by 0.53 %, 1.42 %, 0.97 %, and 0.69 %, respectively (p<0.05). The average value of heart mean dose was reduced by 0.83 % in breast cancer VMAT with M MLC. Other assessment indices for treatment sites showed no significant difference between treatment plans with two types of MLC. Conclusion : Using HD MLC had a positive impact on the PTV coverage and normal tissue sparing in usually short or small targets such as lung and spine SBRT and prostate VMAT. But, there was no significant difference in targets with long and large such as lung, head and neck, and whole pelvis for VMAT.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.171-178
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• 2016

Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

• Journal of Radiation Protection and Research
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• v.35 no.4
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• pp.135-141
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• 2010

Purpose : The patients who visited this department for pulmonary disease and need CT scans for Follow-up to observe change of CT value, evaluation of image quality and decrease of radiation dose as change of kVp. Subjects and Methods : Subjects were the patients of 20 persons visited this department for pulmonary disease and Somatom Sensation 16(Semens, Enlarge, Germany) was used. Measurement of CT value as change of kVp was done by setting up ROI diameter of 1cm at the height of thyroid, aortic arch, right pulmonary artery in arterial phase image using 100 kVp, measuring 3 times, and recorded the average. CT value of phantom was measured by scanning phantoms which means contrast media diluted by normal saline by various ratio with tube voltage of 80 kVp, 100 kVp, 120 kVp, 140 kVp and recorded the average of 3 CT values of center of phantom image. In analysing radiation dose, CTDIVOL values of the latest arterial phase image of 120 kVp and as this research set that of 100 kVp were analyzed comparatively. 2 observers graded quality of chest images by 5 degrees (Unacceptable, Suboptimal, Adequate, Good, Excellent). Results : CT value of chest image increased at 100 kVp by 14.06%~27.26% in each ROI than 120 kVp. CT value of phantom increased as tube voltage lowered at various concentration of contrast media. CTDIVOL decreased at 100 kVp(5.00 mGy) by 36% than 120 kVp(7.80 mGy) in radiation dose analysis. here were 0 Unacceptable, 1 Suboptimal, 3 Adequate, 10 Good, 6 Excellent in totally 20 persons. Conclusion : Chest CT scanning with low kilo-voltage for patients who need CT scan repeatedly can bring images valuable for diagnose, and decrease radiation dose against patients.

• Journal of radiological science and technology
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• v.38 no.3
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• pp.187-197
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• 2015

This study analysed the effectiveness of aluminium(Al) filter in the added compound filtration for the removal of characteristic radiation by energy spectrum and image evaluation. 0.1, 0.2, 0.3 mm copper with and without 1 mm Al were evaluated. The energy spectrum was measured using the GATE and evaluated separately by each energy. Image quality was evaluated by PSNR, MAE, MSE, CNR, SNR and qualitative analysis was performed by seven items for resolution and contrast from chest x-ray criteria of National Cancer Screening and Cardiovascular evaluation table. In the analysis of the quality of the energy per photon spectrum with the exception of a low energy region, without Al were superior in all area. PSNR MAE, MSE, CNR, SNR and qualitative analysis were the same or slightly better. PSNR was over 30 dB and all significant and the p>0.05 in the T-test of qualitative analysis. The energy spectrum and image quality have little difference between before and after use of Al filter. Therefore, it is effective to use the Al filter for the radiation dose management with the compensation capability of DR system.

• Progress in Medical Physics
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• v.23 no.1
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• pp.33-41
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• 2012

For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.403-407
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• 2018

Currently, the highest cancer death rate in Korea is lung cancer, which is a typical cancer that is difficult to detect early. Low-dose chest CT is being used for early detection, which has a greater lung cancer diagnosis rate of about three times than regular chest x-ray images. However, low-dose chest CT not only significantly reduces image resolution but also has a weak signal and is sensitive to noise. Also, air filled lungs are low-density organs and the presence of noise can significantly affect early diagnosis of cancer. This study used Visual C++ to set a circle inside a large circle with a density of 2.0, with a density of 1.0, which is the density of water, in which five small circle of mathematics have different densities. Gaussian noise was generated by 1%, 2%, 3%, and 4% respectively to determine the effect of noise on the mean value, the standard deviation value, and the relative noise ratio(SNR). In areas where the density difference between the large and small circles was greatest in the event of 1 % noise, the SNR in the area with the greatest variation in noise was 4.669, and in areas with the lowest density difference, the SNR was 1.183. In addition, the SNR values can be seen to be high if the same results are obtained for both positive and negative densities. Quality was also clearly visible when the density difference was large, and if the noise level was increased, the SNR was reduced to significantly affect the noise. Low-density organs or organs in areas of similar density to cancers, will have significant noise effects, and the effects of density differences on the probability of noise will affect diagnosis.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.2
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• pp.109-121
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• 2016

To verify the accuracy of the image guided radiotherapy using ExacTrac 6D couch, the error values in six directions are randomly assigned and corrected and then the corrected values were compared with CBCT image to check the accurateness of ExacTrac. The therapy coordination values in the Rando head Phantom were moved in the directions of X, Y and Z as the translation group and they were moved in the directions of pitch, roll and yaw as the rotation group. The corrected values were moved in 6 directions with the combined and mutual reactions. The Z corrected value ranges from 1mm to 23mm. In the analysis of errors between CBCT image of the phantom which is corrected with therapy coordinate and 3D/3D matching error value, the rotation group showed higher error value than the translation group. In the distribution of dose for the error value of the therapy coordinate corrected with CBCT, the restricted value of dosage for the normal organs in two groups meet the prescription dose. In terms of PHI and PCI values which are the dose homogeneity of the cancerous tissue, the rotation group showed a little higher in the low dose distribution range. This study is designed to verify the accuracy of ExacTrac 6D couch using CBCT. It showed that in terms of the error value in the simple movement, it showed the comparatively accurate correction capability but in the movement when the angle is put in the couch, it showed the inaccurate correction values. So, if the body of the patient is likely to have a lot of changes in the direction of rotation or there is a lot of errors in the pitch, roll and yaw in ExacTrac correction, it is better to conduct the CBCT guided image to correct the therapy coordinate in order to minimize any side effects.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.961-968
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• 2019

The purpose of this study was to evaluate the usefulness of cerebral angiography in each energy level by using dual energy technique in CT. Methods were performed on 15 DE images and SE images of CT angiography. For the analysis of images, mean value, standard deviation, SNR and CNR value were determined by setting ROI on MCA, brain parenchyma tissue, and back ground. As a result of concurrent visual evaluation with Likert 5 point scale, the clearest MCA image was confirmed at DE 40 keV and SE 120 kVp(p>0.05). The SNR value of the SE image was measured to be similar to the 40 keV energy level of the DE image. The low energy level image of 40 keV and 50 keV was measured with a high SNR and the contrast ratio was higher than that of the high energy image.

• Journal of the Korean Society of Radiology
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• v.9 no.7
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• pp.439-443
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• 2015

An electrical signals of a conventional radiation medical imaging sensor are obtained by charge integration method. In this study, the polycrystalline cadmium telluride(p-CdTe) film was fabricated by a thermal evaporation method for the photon counting sensor development with excellent resolution in low exposure dose. From the fabricated p-CdTe sensor, the physical properties(SEM, XRD) and the electrical properties(leakage current, x-ray sensitivity, SNR) were evaluated. As a result, the leakage current of below $5nA/cm^2$ and $7{\mu}C/cm^2-R$ of the X-ray sensitivity were showed in below $1V/{\mu}m$. In addition, the signal to noise ratio showed the values of above 5000 at operating voltage.

• Radiation Oncology Journal
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• v.24 no.4
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• pp.280-284
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• 2006

$\underline{Purpose}$: To evaluate biological characteristics of neutron beam generated by MC50 cyclotron located in the Korea Institute of Radiological and Medical Sciences (KIRAMS). $\underline{Materials\;and\;Methods}$: The neutron beams generated with 15 mm Beryllium target hit by 35 MeV proton beam was used and dosimetry data was measured before in-vitro study. We irradiated 0, 1, 2, 3, 4 and 5 Gy of neutron beam to EMT-6 cell line and surviving fraction (SF) was measured. The SF curve was also examined at the same dose when applying lead shielding to avoid gamma ray component. In the X-ray experiment, SF curve was obtained after irradiation of 0, 2, 5, 10, and 15 Gy. $\underline{Results}$: The neutron beams have 84% of neutron and 16% of gamma component at the depth of 2 cm with the field size of $26{\times}26\;cm^2$, beam current $20\;{\mu}A$, and dose rate of 9.25 cGy/min. The SF curve from X-ray, when fitted to linear-quadratic (LQ) model, had 0.611 as ${\alpha}/{\beta}$ ratio (${\alpha}=0.0204,\;{\beta}=0.0334,\;R^2=0.999$, respectively). The SF curve from neutron beam had shoulders at low dose area and fitted well to LQ model with the value of $R^2$ exceeding 0.99 in all experiments. The mean value of alpha and beta were -0.315 (range, $-0.254{\sim}-0.360$) and 0.247 ($0.220{\sim}0.262$), respectively. The addition of lead shielding resulted in no straightening of SF curve and shoulders in low dose area still existed. The RBE of neutron beam was in range of $2.07{\sim}2.19$ with SF=0.1 and $2.21{\sim}2.35$ with SF=0.01, respectively. $\underline{Conclusion}$: The neutron beam from MC50 cyclotron has significant amount of gamma component and this may have contributed to form the shoulder of survival curve. The RBE of neutron beam generated by MC50 was about 2.2.