• Progress in Medical Physics
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• v.14 no.2
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• pp.81-89
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• 2003

The dose distributions of designed Ir-192 micro-source were investigated by dose computations which were accomplished by employing shape of encapsule material and thickness of the source for self-absorption. The computation dose derived from air-kerma rate (S$_{k}$ ) and dose rate constant (Λ) includes the anisotropy of dose distribution around the source. We got the dose rate constants in a water medium is 1.154 cGy h$^{-1}$ U$^{-1}$ . The size of the source was 0.5 mm in diameter and 3.5 mm in length and it was encapsuled in 1.1 mm$\Phi$${\times}$5.5 mm of stainless steel sealed with 0.3 mm of filter thickness. The tissue dose of reference point at 1.0 cm radial distance of the source axis was delivered 1.154 Uh$^{-1}$ (1.3167${\times}$10$^{-3}$ cGy/mCi-sec) from the S$_{k}$ 4.108U/mCi of Ir-192 source. The filtration effect contributed to air-kerma strength as exponential filtering effect of 86.2% in total attenuation, but self-absorption was 88.4% from radial dose distributions. In particular, the dose attenuations showed a rapid anisotropic distributions as 56% of reference dose along to $\pm$10 degrees from the tip of source axis and 50% for of that to source-cable direction. We persist in use the large diameter of applicator will avoid the dose anisotropy by the filtered attenuation effects along the axis of Ir-192 micro-source.

• Progress in Medical Physics
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• v.9 no.4
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• pp.259-266
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• 1998

To achieve the 2D dose distribution around the designed high dose rate Ir-192 source substitution for Co-60 brachytherapy source, we determined the exposure rate constant and tissue attenuation factors as a large depth as a 20 cm from source center. The exposure rate constant is used for apparent activity in designed source with self-absorption and encapsulation steel wall. The tissue dose delivered from the 4401 segments of 2.5 mm in a diameter and 2.5 mm height of disk-type source layer. In the experiments, the tissue attenuation factors include the tissue attenuation and multiple scattering in a medium surrounding the source. The fitted the polynomial regression with 4th order for the tissue attenuation factors are very closed to the experimental measurement data within ${\pm}$1% discrepancy. The Meisberger's constant showed the large uncertainty in large distance from source. The exposure rate constant 4.69 Rcm$^2$/mCi-hr was currently used for determination of apparent activity of source and air kerma strength was obtained 0.973 for tissue absorbed dose from the energy spectrum of Ir-192 source. In our experiments with designed high dose rate brachytherapy source, the apparent activity of Ir-192 source was delivered from the 54.6 % of actual physical source activity through the self-absorption and encapsulation wall attenuations. This paper provides the 2-dimensional dose tabulation from unit apparent activity in a water medium for dose planning includes the multiple scattering, source anisotropy effect and geometric factors.

• Radiation Oncology Journal
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• v.20 no.3
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• pp.283-293
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• 2002

Purpose : A PC based brachytherapy planning system was developed to display dose distributions on simulation images by 2D isodose curve including the dose profiles, dose-volume histogram and 30 dose distributions. Materials and Methods : Brachytherapy dose planning software was developed especially for the Ir-192 source, which had been developed by KAERI as a substitute for the Co-60 source. The dose computation was achieved by searching for a pre-computed dose matrix which was tabulated as a function of radial and axial distance from a source. In the computation process, the effects of the tissue scattering correction factor and anisotropic dose distributions were included. The computed dose distributions were displayed in 2D film image including the profile dose, 3D isodose curves with wire frame forms and dosevolume histogram. Results : The brachytherapy dose plan was initiated by obtaining source positions on the principal plane of the source axis. The dose distributions in tissue were computed on a $200\times200\;(mm^2)$ plane on which the source axis was located at the center of the plane. The point doses along the longitudinal axis of the source were $4.5\~9.0\%$ smaller than those on the radial axis of the plane, due to the anisotropy created by the cylindrical shape of the source. When compared to manual calculation, the point doses showed $1\~5\%$ discrepancies from the benchmarking plan. The 2D dose distributions of different planes were matched to the same administered isodose level in order to analyze the shape of the optimized dose level. The accumulated dose-volume histogram, displayed as a function of the percentage volume of administered minimum dose level, was used to guide the volume analysis. Conclusion : This study evaluated the developed computerized dose planning system of brachytherapy. The dose distribution was displayed on the coronal, sagittal and axial planes with the dose histogram. The accumulated DVH and 3D dose distributions provided by the developed system may be useful tools for dose analysis in comparison with orthogonal dose planning.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.82-93
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• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

• Progress in Medical Physics
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• v.12 no.1
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• pp.19-29
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• 2001

In dose modeling, the shape of actual source and sealed capsule are important parameter to determine the physical dose computation. The author investigated the effect of filter of source self-absorption and sealed capsule to designed the high dose rate Ir-192 source for Ralstron(Japan) unit. The size of source designed to 1.5 mm $\Phi$ x 1.5mm length of actual source sealed with stainless steel which is 3.0mm $\Phi$ x 12.0mm length connected to driving cable. The dose attenuation was derived 66.3 % from 2655 segmented source at reference point of 10mm lateral distance of source. The output dose rate factor in tissue for designed source showed 0.0013511 cGy/mCi-sec in reference point at 1cm lateral distance of source center. The dose distribution at inferior of source showed the 52% of that of source tip region, however, the filtering effect was small as 4% at 45degrees of source axis. The dose attenuation within 20 degrees of source axis at near source-cable connector showed large filtering effect as 40% over, but the small effect was revealed isotropic dose distribution at large angle.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.279-285
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• 1989

Central axis depth dose data for 6 MV X-rays, including tissue maximum ratios, were measured for wedge fields according to Tatcher's equation. In wedge fields, the differences in magnitude which increased with depth, field size, and wedge thickness increased when compared with the corresponding open field data. However, phantom scatter correction factors for wedge fields differed less than $1\%$ from the corresponding open field factors. The differences in central axis percent depth dose between two types of fields indicated beam hardening by the wedge filter The deviation of percent depth doses and scatter correction factors between the effective wedge field and the nominal wedge field at same angle was negligible. The differences were less than $3.20\%$ between the nominal or effective wedge fields and the open fields for percent depth doses to the depth 7cm in $6cm{\times}6cm$ field. For larger $(10cm{\times}10cm)$ field size, however, the deviation of percnet depth doses between the nominal or effective wedge fields and the open fields were greater-dosimetric errors were $3.56\%$ at depth 7cm and nearly $5.30\%$ at 12cm. We suggest that the percent depth doses of individual wedge and wedge transmission factors should be considered for the dose calculation or monitor setting in the treatment of deep seated tumor.

• Progress in Medical Physics
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• v.27 no.1
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• pp.14-24
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• 2016

Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.333-339
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• 2011

The purpose of this study is to compare DNA repair characteristics of normal fibroblast cell (MRC-5) and neuroblastoma cell (SK-N-SH) induced by proton beam. Cells were irradiated with 2Gy, 5Gy and 8Gy proton beam. The rate of DNA rejoining was measured by alkaline version of the comet assay. After a repair time, tail moment was measured again. The tail moment of MRC-5 was lower than SK-N-SH. However, after 8Gy of exposure, the tail moment of MRC-5 was measured as 50.320223.17155 which represents dangerous level of DNA damage. The cells were repaired practically within 25 hours after 2 and 5Gy of exposure while they were not fully recovered after 8Gy of exposure. Especially, tail moment of MRC-5 after 25 hours was 18.15364.42849. In the distal declining edge of SOBP, the RBE value is increased by high LET. The RBE differences of SOBP in high-dose were greater than low-dose. After the high-dose exposure, MRC-5 of normal fibroblast cell could lead to lasting DNA damage as shown in this study. In conclusion, we has to pay special attention when the region of the treatment volume is close to sensitive tissues.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.179-187
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• 1999

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Seondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.238-244
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• 2003

Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.