• Progress in Medical Physics
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• v.17 no.1
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• pp.17-23
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• 2006

In Vivo dosimetry is a method to evaluate the radiotherapy; it is used to find the dosimetric and mechanical errors of radiotherapy unit. In this study, on-line In Vivo dosimetry was enabled by measuring the skin dose with MOSFET detectors attached to patient's skin during treatment. MOSFET dosimeters were found to be reproducible and independent on beam directions. MOSFET detectors were positioned on patient's skin underneath of the dose build-up material which was used to minimize dosimetric error. Delivered dose calculated by the plan verification function embedded in the radiotherapy treatment planning system (RTPs), was compared with measured data point by point. The dependency of MOSFET detector used in this study for energy and dose rate agrees with the specification provided by manufacturer within 2% error. Comparing the measured and the calculated point doses of each patient, discrepancy was within 5%. It was enabled to verify the IMRT by using MOSFET detector. However, skin dosimetry using conventional ion chamber and diode detector is limited to the simple radiotherapy.

• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.55-71
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• 2020

Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.165-171
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• 2002

Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

• Progress in Medical Physics
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• v.15 no.1
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• pp.9-16
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• 2004

The intensity modulated radiation therapy (IMRT) is believed to be on of the best treatment techniques for the goal of radiation therapy: to irradiate fatal dose to tumor region while minimizing dose to critical organs. It is essential to have comprehensive quality assurance program to assure the precision and the accuracy of the treatment due to the characteristic of the IMRT. The quality assurance technique for the Corvus treatment planning system was developed and its effectiveness was tested with the treatment planning of H&N region. Acrylic phantom, film and ionization chamber were used for this study, the discrepancy between the treatment planning and the film measurements showed 0.03 cm and 0.28 cm for the 90% of isodose line in each directions. Dose measurements showed 1% and 1.2% differences for ionization chamber and TLD, respectively. This concluded that the system can be used for clinic.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2005.04a
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• pp.39-41
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• 2005

본 연구에서는 두경부암 환자에게 세기조절 방사선치료계획을 수립한 후 환자 위치의 정확한 재현성과 치료선량의 정확한 전달을 위한 정도관리를 본원에 설치되어 있는 21ex 선형가속기와 세기조절방사선치료계획 장치인 CORVUS 시스템을 사용하였다. 세기조절 방사선치료계획을 QA 아크릴 팬텀으로 옮겨 계산된 계산치가 1.50 Gy였으며, 같은 조건으로 QA 아크릴 팬텀을 설치하여 측정한 선량은 1.485 Gy였으며, TLD에서의 측정치는 1.483 Gy였다. 측정치의 비교에서 이온챔버와 TLD에서 각각 1.0%, 1.2%의 차이를 보여 세기조절방사선치료의 환자 적용에의 적합성을 확인하였다. 나아가 환자치료시 정확하게 치료되고 있는지에 대한 검정과정을 개발하였다.

• Progress in Medical Physics
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• v.14 no.2
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• pp.90-98
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• 2003

Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.69-75
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• 2013

Purpose: Transbronchial brachytherapy used in the two-dimensional treatment planning difficult to identify the location of the tumor in the affected area to determine the process analysis. In this study, we have done a comparative analysis for the patient's treatment planning using a CT simulator. Materials and Methods: The analysis was performed by the patients who visited the hospital to June 2012. The patient carried out CT-image by CT simulator, and we were plan to compare with a two-dimensional and threedimensional treatment planning using a Oncentra Brachy planning system (Nucletron, Netherland). Results: The location of the catheter was confirmed the each time on a treatment planning for fractionated transbronchial brachytherapy. GTV volumes were $3.5cm^3$ and $3.3cm^3$. Also easy to determine the dose distribution of the tumor, the errors of a dose delivery were confirmed dose distribution of the prescibed dose for GTV. In the first treatment was 92% and the second was 88%. Conclusion: In order to compensate for the problem through a two-dimensional treatment planning, it is necessary to be tested process for the accurate identification and analysis of the treatment volume and dose distribution. Quantitatively determine the dose delivery error process that is reflected to the treatment planning is required.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.58-58
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• 2003

목적 : 본 연구에서는 C-arm과 CT에 사용 가능한 자궁경부암용 팬톰을 개발하고 이를 이용하여 기존의 필름 방법에 기반한 위치 확인 방법과 CT 재구성 방법의 정확성을 비교 연구하고자 한다. 정확성이 검증된 후에는 두 방법의 장점을 이용하기 위해 CT로 재구성된 좌표를 필름의 좌표로 변환시켜 현재 사용되고 있는 필름에 기반한 근접 치료 계획 시행에 도움을 주고자 한다. 방법 : 자체 제작한 자궁경부암용 팬톰은 인체 등가 물질인 물과 아크릴을 사용하였고, 크게 localizer 부분과 팬톰 부분으로 구성되어 있다. 또한, 실제 자궁경부암 환자의 임상적인 구조를 모사하여 제작하였다. 자궁경부암 치료시 중요 장기인 방광과 직장을 구와 원기둥으로 설계하였고, 고선량율 applicator는 아크릴 판의 흠으로 고정시켜 제작하였기 때문에 CT 촬영시 applicator를 제거한 영상에서도 applicator의 구조가 정확하게 묘사될 수 있도록 제작하였다. 두 시스템에서 재구성된 좌표를 비교하기 위해 각각의 시스템에서의 얻은 재구성 좌표와 팬톰 자체의 localizer와 재구성 알고리즘을 바탕으로 개발된 프로그램을 이용하여 얻은 좌표로 두 재구성 좌표의 비교 연구를 수행하였다. 정확성이 검증되고 장기의 정보가 담긴 CT의 좌표는 자체 개발된 프로그램으로 2 차원의 필름 좌표로 변환되었다. 본 연구에 사용된 모든 프로그램은 ILD 5.5를 사용하여 개발되었다. 결과 : 두 시스템의 좌표 비교 결과 x, y 축은 차이가 2mm 이내로 비교적 정확한 실험 결과를 얻을 수 있었고, z 축의 경우 CT 슬라이드의 굵기에 따라 2mm-3mm 이내의 차이가 있음을 관찰할 수 있었다. z 축을 제외한 좌표의 차이는 획득한 영상에서 컴퓨터로 좌표를 옮기는 localizer 좌표 선택 과정에 발생했을 것으로 예상된다. 또한, 이 검증된 좌표와 개발된 프로그램을 이용하여 우리는 CT의 좌표를 2차원의 필름 좌표로 정확하게 변환할 수 있었다. 결론 : 이 연구로부터 기존의 C-arm 재구성 방법과 CT 재구성 방법의 비교를 통해 각 치료 기기의 신뢰성을 직접 확인할 수 있었으며, 비교를 통해 검증된 CT의 좌표를 필름 좌표로 변환시킴으로서, 각 시스템의 장점만을 결합한 효과적인 치료 계획을 세울 수 있는 가능성을 제시하였다. 또한 물과 아크릴을 사용한 비교적 간단하고 경제적인 방법으로 C-arm, CT 그리고 MRI에 모두 이용 가능한 팬톰을 제작하여 쉽고 정확하게 위치를 확인할 수 있었다. 더 나아가, 본 연구에서 제작된 자궁경부암 팬톰은 근접치료를 포함하여 관련 팬톰 개발에 도움을 줄 수 있을 것으로 예상된다.

• Journal of the Korean Society of Radiology
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• v.14 no.2
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• pp.105-109
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• 2020

Intensity-modulated radiotherapy(IMRT) has disadvantages such as increasing the low doses of irradiation to normal tissues and accumulated dose for the whole volume by leakage and transmission of the Multi Leaf Collimator (MLC). The accumulated dose and low dose may increase the occurrence of secondary malignant neoplasms. For this reasons, the jaw tracking function of the TrueBeam (Varian Medical Systems, Palo Alto, CA) was developed to reduce the leakage and transmission dose of the MLC with existing linear accelerators. But quantitative analysis of the dose reduction has not been verified. Therefore, in the present study, we intended to verify the clinical possibility of utilizing the jaw tracking function in brain tumor with comparison of treatment plans. To accomplish this, 3 types of original treatment plans were made using Eclipse11 (Varian Medical Systems, Palo Alto, CA): 1) beyond 2 cm distance from the Organs At Risk (OARs); 2) within 2 cm distance from the OARs; and 3) intersecting with the OARs. Jaw tracking treatment plans were also made with copies of the original treatment planning using Smart LMC Version 11.0.31 (Varian Medical Systems, Palo Alto, CA). A comparison between the 2 types of treatment planning methods was performed using the difference of the mean dose and maximum dose to the OARs in cumulative Dose Volume Histogram (DVH). In the DVH comparison, the maximum difference of 0.5 % was observed between the planning methods in the case of over 2 cm distance, and the maximum of 0.6 % was obtained for within the 2 cm distance. For the case intersecting with the OAR, the maximum difference of 2 % was achieved. According to these results, it could be realized that the differences of mean dose and maximum dose to the OARs was larger when the OARs and PTV were closer. Therefore, treatment plans with the jaw tracking function consistently affected the dose reduction and the clinical possibility could be verified.

• Progress in Medical Physics
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• v.9 no.3
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• pp.175-184
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• 1998

The dose distribution evaluation program for the stereotactic radiosurgery treatment planning system using a gamma knife has been built in order to work on PC. And this custom-made dose distribution is compared with that of commercial treatment planning program. 201 source position of a radiation unit were determined manually using a gamma knife collimator draft and geometrical coordinates. Dose evaluation algorithm was modified for our purpose from the original KULA, a commercial treatment planning program. With the composed program, dose distribution at the center of a spherical phantom, 80 mm in diameter, was evaluated into axial, coronal and sagittal image per each collimator. Along with this evaluated data, the dose distribution at a arbitrary point of inside the phantom was compared with those from KULA. Radiochromic film was set up at the center of the phantom and was irradiated by gamma knife, for the verification of dose distribution. In result, the deviation of the dose distribution from that of KULA is less than ${\pm}$3%, which is equivalent to ${\pm}$0.3 mm in 50% isodose distribution for all examined coordinates and film verification. The custom-made program, GPl is proven to be a good tool for the stereotactic radiosurgery treatment planning program.