• Journal of the Institute of Electronics Engineers of Korea SC
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• v.43 no.6 s.312
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• pp.68-75
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• 2006

During cancer therapy by using high energy radiation, it is possible to improve the radiation therapy efficiency by performing a precise radiation therapy after verification of generated setup errors. In this paper, the video based electronic portal imaging device (EPID) which could display the portal image with near real time was developed to verify treatment position errors in radiation therapy instead of an analog typed portal film. This EPID system for applying QA tool of radiation therapy machine was consisted of a metal/fluorescent screen, $45^{\circ}$mirror, camera and image grabber. Radiation field verification has been performed to check quality assurance of the treatment machine itself by using this EPID system. The radiation field error was easily observed by edge detection of irradiated field size on EPID image when $0.6^{\circ}$ shift of collimator angle was generated. So, this implemented EPID system could be used as a radiation QA tool.

• Journal of Biomedical Engineering Research
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• v.21 no.2
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• pp.119-127
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• 2000

금속판/형과스크린 계측기와 CCD 카메라를 이용한 방사선영상장치가 현재 전자포탈영상에 널리 쓰이고 있다. 이 장치의 효율적인 영상획득을 위해 계측효율이 좋고, 공간분해능력이 뛰어난 금속판/ 형과스크린 계측기의 두께를 최적화할 필요가 있었다. 이 논문에서는 금속판과 형광스크린의 두께가 계측효율과 공간분해능에 미치는 영향이 연구되었다. 이 결과는 치료 엑스선 영상장치에 쓰일 수 있는 금속판/형과스크린 계측기의 최적화된 두께를 결정하는데 쓰일 수 있다. 몬테칼로 방법을 이용하여 계산한6 MV 선형가속기에서 발생되는 엑시선의 에너지 스펙트럼을 바탕으로, 여러 가지 두께의 금속판/형광스크린에 대하여 계측효율과 공간분해능을 계산하였고, 이를 실험을 통해 검증하였다. 계측효율은 입사된 엑스선의 에너지가 형광스크린에 흡수된 비율로 계산되며, 공간분해능은 흡수된 에너지의 공간 분포를 통해 계산되었다. 계측효율은 금속판의 두께에 의해, 공간분해능은 형광스크린의 두께에 의해 결정될 수 있음을 본 연구를 통해 확인할 수 있었고, 이로써 특정이용에 관련된 금속판/형광스크린의 두께에 대한 서로 보상 (trade-off) 관계에 있음을 계산과 측정결과를 통해 확인할 수 있었고, 이로써 특정이용에 관련된 금속판/형광스크린 계측기의 최적화된 두께를 산출할 수 있게 되었다. 계산을 바탕으로 CCD를 이용한 전자포탈영상장치의 시작품을 설계 및 제작하였고 팬텀을 이용하여 영상을 얻었다. 단일 프레임 영상은 노이즈가 많으나, 프레임 평균 방법을 이용하여 영상의 질을 향상시킬 수 있었다.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.77-84
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• 2012

Purpose: To develop a geometrical quality control real-time analysis program using an electronic portal imaging to replace film evaluation method. Materials and Methods: A geometrical quality control item was established with the Eclipse treatment planning system (Version 8.1, Varian, USA) after the Electronic Portal Imaging Device (EPID) took care of the problems occurring from the fixed substructure of the linear accelerator (CL-iX, Varian, USA). Electronic portal image (single exposure before plan) was created at the treatment room's 4DTC (Version 10.2, Varian, USA) and a beam was irradiated in accordance with each item. The gaining the entire electronic portal imaging at the Off-line review and was evaluated by a self-developed geometrical quality control real-time analysis program. As for evaluation methods, the intra-fraction error was analyzed by executing 5 times in a row under identical conditions and procedures on the same day, and in order to confirm the infer-fraction error, it was executed for 10 days under identical conditions of all procedures and was compared with the film evaluation method using an Iso-align$^{TM}$ quality control device. Measurement and analysis time was measured by sorting the time into from the device setup to data achievement and the time amount after the time until the completion of analysis and the convenience of the users and execution processes were compared. Results: The intra-fraction error values for each average 0.1, 0.2, 0.3, 0.2 mm at light-radiation field coincidence, collimator rotation axis, couch rotation axis and gantry rotation axis. By checking the infer-fraction error through 10 days of continuous quality control, the error values obtained were average 1.7, 1.4, 0.7, 1.1 mm for each item. Also, the measurement times were average 36 minutes, 15 minutes for the film evaluation method and electronic portal imaging system, and the analysis times were average 30 minutes, 22 minutes. Conclusion: When conducting a geometrical quality control using an electronic portal imaging, it was found that it is efficient as a quality control tool. It not only reduces costs through not using films, but also reduces the measurement and analysis time which enhances user convenience and can improve the execution process by leaving out film developing procedures etc. Also, images done with evaluation from the self-developed geometrical quality control real-time analysis program, data processing is capable which supports the storage of information.

• Progress in Medical Physics
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• v.14 no.3
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• pp.151-160
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• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.46 no.3
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• pp.44-51
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• 2009

It is very important to verify generated setup errors in cancer therapy by using a high energy radiation and to perform the precise radiation therapy. Specially, the verification of treatment position is very crucial in special therapies like fractionated stereotatic radiotherapy (FSRT). The FSRT uses normally high-dose, small field size for treating small intracranial lesions. To estimate the developed FSRT system, the isocenter accuracy of gantry, couch and collimator were performed and a total of inaccuracy was less than ${\pm}1mm$. Precise beam targeting is crucial when using high-dose, small field size FSRT for treating small intracranial lesions. The EPID image of the 3mm lead ball mounted on the isocenter with a 25mm collimator cone was acquired and detected to the extent of one pixel (0.76mm) after comparing the difference between the center of a 25mm collimator cone and a 3 mm ball after processing the EPID image. In this paper, the radiation treatment efficiency can be improved by performing precise radiation therapy with a developed video based EPID and FSRT at near real time

• Progress in Medical Physics
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• v.9 no.3
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• pp.127-136
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• 1998

On-line geometrical quality assurance system has been developed using electronic portal imaging system(OQuE). EPID system is networked into Pentium PC in order to transmit the acquisited images to analysis PC. Geometrical QA parameters, including light-radiation field congruence, collimator rotation axis, and gantry rotation axis can be easily analyzed with the help of graphic user interface(GUI) software. Equipped with the EPID (Portal Vision, Varian, USA), geometrical quality assurance of a linear accelerator (CL/2100/CD, Varian, USA), which is networked into OQuE, was performed to evaluate this system. Light-radiation field congruence tests by center of gravity analysis shows 0.2～0.3mm differences for various field sizes. Collimator (or Gantry) rotation axis for various angles could be obtained by superposing 4 shots of angles. The radius of collimator rotation axis is measured to 0.2mm for upper jaw collimator, and 0.1mm for lower jaw. Acquisited images for various gantry angles were rotated according to the gantry angle and actual center of image point obtained from collimator axis test. The rotated images are superpositioned and analyzed as the same method as collimator rotation axis. The radius of gantry rotation axis is calculated 0.3mm for anterior/posterior direction (gantry 0$^{\circ}$ and 170$^{\circ}$) and 0.7mm for right/left direction(gantry 90$^{\circ}$ and 260$^{\circ}$). Image acquisition for data analysis is faster than conventional method and the results turn out to be excellent for the development goal and accurate within a milimeter range. The OQuE system is proven to be a good tool for the geometrical quality assurance of linear accelerator using EPID.

• Progress in Medical Physics
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• v.17 no.1
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• pp.24-31
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• 2006

Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

• Progress in Medical Physics
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• v.11 no.2
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• pp.117-122
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• 2000

The IP(imaging plate) has been widely used to measure the two-dimensional distribution of incident radiation since it has a high sensitivity, reusability, a wide dynamic range, a high position resolution. Particularly, the easiness of acquiring digitized image using IP poses a strong merit because recent trend of data handling prefers image digitization. In order to test its usefulness in photon beam dosimetry, we measured the off-axis ratio(OAR) on portal planes and percent depth dose(PDD) within a phantom using IP, and compared the results with the data based on EGS4 Monte Carlo particle transport code, ion-chambers, conventional films. For the measurement, we used 6 MV X-rays, various field sizes. As a result, IP showed significant deviation from ion-chamber measurement: a significant overresponse, 100% greater than that of ion-chamber measurement at deep part of the phantom. Filtration of low-energy scattered photons at deep part of the phantom using 0.5 mm thick lead sheets did improve the result, only to the unacceptable extent. However, portal dose measurement showed possibilities of If as a dosimeter by showing errors less than 5%, as compared with film measurement.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.57-67
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• 2013

Purpose: Replacing the film which used to be used for checking the set-up of the patient and dosimetry during radiation therapy, more and more EPID equipped devices are in use at present. Accordingly, this article tried to evaluated the accuracy of the position check-up and the usefulness of dosimetry during the use of an electronic portal imaging device. Materials and Methods: On 50 materials acquired with the search of Korea Society Radiotherapeutic Technology, The Korean Society for Radiation Oncology, and Pubmed using "EPID", "Portal dosimetry", "Portal image", "Dose verification", "Quality control", "Cine mode", "Quality - assurance", and "In vivo dosimetry" as indexes, the usefulness of EPID was analyzed by classifying them as history of EPID and dosimetry, set-up verification and characteristics of EPID. Results: EPID is developed from the first generation of Liquid-filled ionization chamber, through the second generation of Camera-based fluoroscopy, and to the third generation of Amorphous-silicon EPID imaging modes can be divided into EPID mode, Cine mode and Integrated mode. When evaluating absolute dose accuracy of films and EPID, it was found that EPID showed within 1% and EDR2 film showed within 3% errors. It was confirmed that EPID is better in error measurement accuracy than film. When gamma analyzing the dose distribution of the base exposure plane which was calculated from therapy planning system, and planes calculated by EDR2 film and EPID, both film and EPID showed less than 2% of pixels which exceeded 1 at gamma values (r%>1) with in the thresholds such as 3%/3 mm and 2%/2 mm respectively. For the time needed for full course QA in IMRT to compare loads, EDR2 film recorded approximately 110 minutes, and EPID recorded approximately 55 minutes. Conclusion: EPID could easily replace conventional complicated and troublesome film and ionization chamber which used to be used for dosimetry and set-up verification, and it was proved to be very efficient and accurate dosimetry device in quality assurance of IMRT (intensity modulated radiation therapy). As cine mode imaging using EPID allows locating tumors in real-time without additional dose in lung and liver which are mobile according to movements of diaphragm and in rectal cancer patients who have unstable position, it may help to implement the most optimal radiotherapy for patients.

• Progress in Medical Physics
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• v.8 no.2
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• pp.59-65
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• 1997

We have designed the software for geometrical QC/QA for medical linear accelerator using electronic portal imaging devices (EPID). The radiation-light field congruence, the collimator rotation axis, and the gantry rotation axis could be estimated with this software. Precision of the system is within 1mm. The collimator and the gantry rotation axis could be measured by superpositioning the images from 4 different collimator (or gantry) angles. The EPID system and the analysis software which was developed in this study make it possible that the quantitative and the objective geometrical QC/QA of the linear accelerator.