• Progress in Medical Physics
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• v.20 no.3
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• pp.180-190
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• 2009

Depth of prostate volume from the skin can vary due to intra-fractional and inter-fractional movements, which may result in dose reduction to the target volume. Therefore we evaluated the feasibility of automated depth determination-based adaptive proton therapy to minimize the effect of inter-fractional movements of the prostate. Based on the center of mass method, using three fiducial gold markers in the prostate target volume, we determined the differences between the planning and treatment stages in prostate target location. Thirty-eight images from 10 patients were used to assess the automated depth determination method, which was also compared with manually determined depth values. The mean differences in prostate target location for the left to right (LR) and superior to inferior (SI) directions were 0.9 mm and 2.3 mm, respectively, while the maximum discrepancies in location in individual patients were 3.3 mm and 7.2 mm, respectively. In the bilateral beam configuration, the difference in the LR direction represents the target depth changes from 0.7 mm to 3.3 mm in this study. We found that 42.1%, 26.3% and 2.6% of thirty-eight inspections showed greater than 1 mm, 2 mm and 3 mm depth differences, respectively, between the planning and treatment stages. Adaptive planning based on automated depth determination may be a solution for inter-fractional movements of the prostate in proton therapy since small depth changes of the target can significantly reduce target dose during proton treatment of prostate cancer patients.

• 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.14 no.4
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• pp.339-345
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• 1996

Purpose : This study was performed for adequate irradiating tumor area when 6 MV linear accerelator photon was used to treat the head and neck tumor. The skin surface dose and maximum build-up region was measured by using a spoiler which was located between skin surface and collimator. Methods : A spoiler was made of tissue equivalent material and the skin surface dose and maximum build-up region was measured varing with field size, thickness of spoiler and interval between skin and collimator. The results of skin surface dose and maximum build-up dose was represented as a build-up ratio and it was compared with dose distribution by using a bolus. Results : The skin surface dose was increased with appling spoiler and decreased by distance of the skin-spoiler separation. The maxium build-up region was 1.5 cm below the skin surface and it was markedly decreased near the skin surface. By using a 1.0-cm thickness spoiler, Dmax moved to 5, 10.2, 12.3 13.9 and 14.8 mm from the skin surface by separation of the spoiler from the skin 0, 5, 10, 15. 20 cm, respectively. Conclusion : The skin surface dose was increased and maximum build-up region was moved to the surface by using a spoiler. Therefore spoiler was useful in treating by high energy photon in the head and neck tumor.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.277-283
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• 1995

Purpose : This study was performed to measure dose alteration at the air-tissue interface resulting from rebuild-up to the loss of charged particle equilibrium in the tissues around the air-tissue interfaces. Materials and Methods : The 6 and 10-MV photon beam in dual energy linear accelerator were used to measure the surface dose at the air-tissue interface The polystyrene phantom sized $25{\times}25{\times}5\;cm^3$ and a water phantom sized $29{\times}29{\times}48\;cm^3$ which incorporates a parallel-plate ionization chamber in the distal side of air gap were used in this study. The treatment field sizes were $5{\times}5\;cm^2,\;10{\times}10\;cm^2\;and\;20{\times}20\;cm^2$. Air cavity thickness was variable from 10 mm to 50 mm. The observed-expected ratio (OER) was defined as the ratio of dose measured at the distal junction that is air-tissue interface to the dose measured at the same point in a homogeneous phantom. Results : In this experiment, the result of OER was close or slightly over than 1.0 for the large field size but much less (about 0.565) than 1.0 for the small field size in both photon energy. The factors to affect the dose distribution at the air-tissue interface were the field size, the thickness of air cavity. and the photon energy. Conclusion : Thus, the radiation oncologist should take into account dose reduction at the air-tissue interface when planning the head and neck cancer especially pharynx and laryngeal lesions, because the dose can be less nearly $29{\%}$ than predicted value.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.115-124
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• 1990

The characteristics of 23 MV photon beam have been presented with respect to clinical parameters of central axis depth dose, tissue-maxi mum ratios, scatter-maximum ratios, surface dose and scatter correction factors. The nominal accelerating potential was found to be $18.5\pm0.5$ MV on the central axis. The half-value layer (HVL) of this photon beam was measured with narrow beam geometry from central axis, and it has been showed the thickness of $24.5\;g/cm^2$. The tissue-maximum ratio values have been determined from measured percentage depth dose data. In our experimental dosimetry, the surface dose of maximum showed only $9.6\%$ of maximum dose at $10\times10\;cm^2$, 100 cm SSD, without blocking tray in. The TMR'S of $0\times0$ field size have been determined to get average $2.3\%$ uncertainties from three different methodis; are zero effective attenuation coefficient, non-ilnear least square fit of TMR's data and effective linear attenuation coefficient from the HVL of 23 MV photon beams of dual energy linear accelerator.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.147-153
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• 1992

It is ideal thing to compensate tissue deficit without skin contamination in curvatured irradiation field of high energy photon beam. The 3-dimensional compensating technique utilizing tissue equivalent materials to ensure an adequate dose distribution and skin sparing effect was described. This compensator was made of paraffin ($70\%$) and stearin wax ($30\%$) compound. The parameters for evaluation of the effect on skin dose in application of compensator were considered in the size of the field, the thickness of the compensator and the source-to-axis distance. The results are as follows; the skin doses were not changed even though application of the compensator, but depended on the field size and the source-to-axis distance, and the skin doses were only slightly changed within $1\%$ relative errors as increasing the thickness of the compensator in these experiments.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.985-991
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• 2023

A tissue-equivalent phantom is necessary for quality control of hyperthermia therapy. However, since there is no phantom for this purpose, phantoms made from agar are being used in various studies. The tissue-equivalent properties of the agar phantom were confirmed by comparison with the tissue-equivalent material bolus in this study. CT images of the agar phantom and bolus were acquired, and tissue equivalent characteristics were analyzed with image analysis and dose calculation using a computerized radiation therapy planning system. The average pixel value was 96.960±10.999 in bolus, 108.559±8.233 in 3% agar phantom, and 111.844±8.651 in 4% agar phantom. Using the SSD technique, 100 cGy was prescribed at a depth of 1.5 cm and 6 MV X -ray was set to irradiated to 10x10 cm2, and the absorbed dose according to depth was calculated from the central axis of the beam. The intraclass correlation coefficient of dose distribution of bolus, 3% agar phantom, and 4% agar phantom was 0.979 (p<.001, 95%CI .957-.991). The density (g/cm3) at the point where the absorbed dose was calculated was 0.990±0.020 at the bolus, 1.018±0.020 at the 3% agar phantom, and 1.035±0.024 at the 4% agar phantom. In this study, the internal density distribution and uniformity of the agar phantom were confirmed to be appropriate as a tissue equivalent material by analysis of CT images and a computerized radiation therapy planning system.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.150-156
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• 2000

Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.

• Radiation Oncology Journal
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• v.7 no.1
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• pp.85-92
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• 1989

Dosimerty based on electron spin resonance (ESR) analysis of radiation induced free radicals in amino acids is relevant to biological dosimetry applications. Alanine detectors are without walls and are tissue equivalent. Therefore, alanine ESR dosimetry looks promising for use in the therapy level. The dose range of the alanine/ESR dosimetry system can be extended down to 1 Gy. In water phantom the absorbed dose of electrons generated by a medical linear accelerator of different initial energies $(6\~21MeV)$ and therapeutic dose levels (1~60 Gy) was measured. Furthermore, depth dose measurements carried out with alanine dosimeters were compared with ionization chamber measurements. As the results, the measured absorbed doses for shallow depth of initial electron energies above 15 MeV were higher by$2\~5\%$ than those calculated by nominal energy $C_E$ factors. This seems to be caused by low energy scattered beams generated from the scattering foil and electron cones of beam projecting device in medical linear accelerator.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.253-260
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• 2019

Radiation dose enhancement is a method of increasing the cross section of interaction, thus increasing the deposited dose. This can contribute to linear energy transfer, LET and relative biological effectiveness, RBE. Previous studies on dose enhancement have been mainly focused on X, ${\gamma}-rays$, but in this study, the dose enhancement was analyzed for proton using Monte Carlo simulation using MCNP6. Based on the mathematical modeling method, energy spectrum and relative intensity of spread out Bragg-peak were calculated, and evaluated dose enhancement factor and dose distribution of dose enhancement material, such as aurum and gadolinium. Dose enhancement factor of 1.085-1.120 folds in aurum, 1.047-1.091 folds in gadolinium was shown. In addition, it showed a decrease of 95% modulation range and practical range. This may lead to an uncertain dose in the tumor tissue as well as dose enhancement. Therefore, it is necessary to make appropriate corrections for spread out Bragg-peak and practical range from mass stopping power. It is expected that Monte Carlo simulation for dose enhancement will be used as basic data for in-vivo and in-vitro experiments.