• The Journal of Korean Society for Radiation Therapy
• /
• v.32
• /
• pp.93-109
• /
• 2020

Purpose: The radiochromic film (Gafchromic EBT3, Ashland Advanced Materials, USA) and 3-dimensional analysis system dosimetry checkTM (DC, MathResolutions, USA) were evaluated for patient-specific quality assurance (QA) of helical tomotherapy. Materials and Methods: Depending on the tumors' positions, three types of targets, which are the abdominal tumor (130.6㎤), retroperitoneal tumor (849.0㎤), and the whole abdominal metastasis tumor (3131.0㎤) applied to the humanoid phantom (Anderson Rando Phantom, USA). We established a total of 12 comparative treatment plans by the four geometric conditions of the beam irradiation, which are the different field widths (FW) of 2.5-cm, 5.0-cm, and pitches of 0.287, 0.43. Ionization measurements (1D) with EBT3 by inserting the cheese phantom (2D) were compared to DC measurements of the 3D dose reconstruction on CT images from beam fluence log information. For the clinical feasibility evaluation of the DC, dose reconstruction has been performed using the same cheese phantom with the EBT3 method. Recalculated dose distributions revealed the dose error information during the actual irradiation on the same CT images quantitatively compared to the treatment plan. The Thread effect, which might appear in the Helical Tomotherapy, was analyzed by ripple amplitude (%). We also performed gamma index analysis (DD: 3mm/ DTA: 3%, pass threshold limit: 95%) for pattern check of the dose distribution. Results: Ripple amplitude measurement resulted in the highest average of 23.1% in the peritoneum tumor. In the radiochromic film analysis, the absolute dose was on average 0.9±0.4%, and gamma index analysis was on average 96.4±2.2% (Passing rate: >95%), which could be limited to the large target sizes such as the whole abdominal metastasis tumor. In the DC analysis with the humanoid phantom for FW of 5.0-cm, the three regions' average was 91.8±6.4% in the 2D and 3D plan. The three planes (axial, coronal, and sagittal) and dose profile could be analyzed with the entire peritoneum tumor and the whole abdominal metastasis target, with planned dose distributions. The dose errors based on the dose-volume histogram in the DC evaluations increased depending on FW and pitch. Conclusion: The DC method could implement a dose error analysis on the 3D patient image data by the measured beam fluence log information only without any dosimetry tools for patient-specific quality assurance. Also, there may be no limit to apply for the tumor location and size; therefore, the DC could be useful in patient-specific QAl during the treatment of Helical Tomotherapy of large and irregular tumors.

• The Journal of Korean Society for Radiation Therapy
• /
• v.22 no.2
• /
• pp.131-134
• /
• 2010

Purpose: TOMO therapy treatment for a relatively long run Beam time and temperature-sensitive detector, such as CT clinics in optimal temperature ($20~21^{\circ}$) to maintain a constant temperature in addition to its own Chamber Cooling system is activating. TOMO This clinic has been reduced in the patients' body temperature to keep the sheets and covers over the treated area. Therefore, these materials for any changes in the organization gives the dose were analyzed. Materials and Methods: To compare changes in the organization Dose Phantom cheese (Cheese Phantom) were used, CT-simulation taking the center point of the cheese phantom PTV (Planning Target Volume, treatment planning target volume) by setting Daily dose 200 cGy, 3 meetings planned treatment. PTV, PTV +7 cm, PTV +14 cm, the total count points on the phantom using the Ion chamber cover without any substance to measure the dose, and one of the most commonly used treatment, including the frequently used four kinds of bedding materials (febric 0.8 mm, gown 1.4 mm, rug, 3.3 mm, blanket 13.7 mm) and covered with a phantom and the dose measured at the same location were analyzed 3 times each. Results: PTV, PTV +7 cm, PTV +14 cm from the point of any substance measured in the state are covered with four kinds of materials (fabric, gown, rug, blanket) was measured in the covered states and compares their results, PTV respectively -0.17%, -0.44%, -0.53% and -0.9% change, PTV +7 cm, respectively -0.04%, +0.07%, +0.06%, +0.07%, were changed, PTV +14 cm, respectively 0%, -0.06%, -0.02%, +0.6%, respectively. Conclusion: These results TOMO treatment to patients to maintain their body mass by using PTV thickness of the material decreased in proportion to. PTV +7 cm, but showed slight changes in the point, PTV +14 cm at the point of the dose was increased a little. Sejijeom all the difference in treatment tolerance ${\pm}3%$ range, this is confirmed in the coming treatment will not affect the larger should be considered.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.1
• /
• pp.83-89
• /
• 2014

Purpose : In case of the intensity modulated radiation therapy (IMRT) using Tomotherapy and linear accelerator (Linac), it was to compare and to evaluate the imaging dose of MVCT and CBCT that were performed daily for the correct set up of the patient. Materials and Methods : The human body model Phantom (Anderson rando Phantom, USA) was divided into the three parts as Head, Thorax, pelvis, and after GafChromic EBT3 film cut to the size of $0.5{\times}0.5cm2$.in the center of the recording area were situated on the ant, post, left, and right surface of the phantom and 2cm in depth from the ant, post, left, right, and center surface of the phantom, the surface dose and inner dose were measured repeatedly three times, respectively, using the tomotherapy (Hi Art) and the OBI of NovalisTx. The measured film calculated the output value by RIP version6.0 and then the average value of the dose was calculated by the one-way analysis of variance. Results : Using the human body model phantom, the results of MVCT and CBCT performance were that measurements of MVCT inner dose were showed $15.43cGy{\pm}6.05$ in the head, $16.62cGy{\pm}3.08$ in the thorax, $16.81cGy{\pm}5.24$ in the pelvis, and measurements of CBCT inner dose were showed $13.28{\pm}3.68$ in the head, from $13.66{\pm}4.04$ in the thorax, $15.52{\pm}3.52$ in the pelvis. The measurements of surface dose were showed in case of MVCT performance, $11.64{\pm}4.05$ in the head, $12.16{\pm}4.38$ in the thorax, $12.05{\pm}2.71$ in the pelvis, and in case of CBCT performance, $14.59{\pm}3.51$ in the head, $15.82{\pm}2.89$ in the thorax, $17.48{\pm}2.80$ in the pelvis, respectively. Conclusion : In case of Inner dose, the MVCT using MV energy showed higher than the CBCT using kV energy at 1.16 times in the head, at 1.22 times in the thorax, at 1.08 times in the pelvis, and in case of surface dose, the CBCT was higher than MVCT, at 1.25 times in the head, at 1.30 times in the thorax, at 1.45 times in the pelvis. Imaging dose was a small amount compared to the therapeutic dose but it was thought to affect partially to normal tissue because it was done in daily schedule. However, IMRT treatment was necessarily parallel with the IGRT treatment through the image-guide to minimize errors between planned and actual treatment. Thus, to minimize imaging dose that the patients receive, when planning the treatment, it should be set up a treatment plan considering imaging dose, or it must be performed by minimizing the scan range when shooting MVCT.

• Journal of radiological science and technology
• /
• v.40 no.1
• /
• pp.63-70
• /
• 2017

The purpose of this study was compare to the patient setup deviation of two different type thermoplastic immobilization masks for glottis cancer in the intensity-modulated radiation therapy (IMRT). A total of 16 glottis cancer cases were divided into two groups based on applied mask type: standard or alternative group. The mean error (M), three-dimensional setup displacement error (3D-error), systematic error (${\Sigma}$), random error (${\sigma}$) were calculated for each group, and also analyzed setup margin (mm). The 3D-errors were $5.2{\pm}1.3mm$ and $5.9{\pm}0.7mm$ for the standard and alternative groups, respectively; the alternative group was 13.6% higher than the standard group. The systematic errors in the roll angle and the x, y, z directions were $0.8^{\circ}$, 1.7 mm, 1.0 mm, and 1.5 mm in the alternative group and $0.8^{\circ}$, 1.1 mm, 1.8 mm, and 2.0 mm in the alternative group. The random errors in the x, y, z directions were 10.9%, 1.7%, and 23.1% lower in the alternative group than in the standard group. However, absolute rotational angle (i.e., roll) in the alternative group was 12.4% higher than in the standard group. For calculated setup margin, the alternative group in x direction was 31.8% lower than in standard group. In contrast, the y and z direction were 52.6% and 21.6% higher than in the standard group. Although using a modified thermoplastic immobilization mask could be affect patient setup deviation in terms of numerical results, various point of view for an immobilization masks has need to research in terms of clinic issue.

• Journal of the Korean Society of Radiology
• /
• v.6 no.5
• /
• pp.365-371
• /
• 2012

The radiation therapy treatment technique is developed from 3D-CRT, IMRT to Tomotherapy. and these three technique was most widely using methods. We find out a comparison normal tissue doses and tumor dose of 3D-CRT, IMRT(Linac Based), and Tomotherapy on Head and Neck Cancer. We achieved radiological image used the Human model phantom (Anthropomorphic Phantom) and it was taken CT simulation (Slice Thickness : 3mm) and GTV was nasopharngeal region and PTV(including set-up margin) was GTV plus 2mm area. and transfer those images to the radiation planning system (3D-CRT - ADAC-Pinnacle3, Tomotherapy - Tomotherapy Hi-Art System). The prescription dose was 7020 cGy and measuring PTV's dose and nomal tissue (parotid gland, oral cavity, spinal cord). The PTV's doses was Tomotherapy, Linac Based - IMRT, 3D-CRT was 6923 cGy, 6901 cGy and 6718 cGy its dose value was meet TCP because its value was up to the 95% based on 7020 cGy, Nomal tissue (parotid gland, oral cavity, spinal cord) was 1966 cGy(Tomotherapy), 2405 cGy(IMRT), 2468 cGy(3D-CRT)[parotid gland], 2991 cGy(Tomotherapy), 3062 cGy(IMRT), 3684 cGy (3D-CRT)[oral cavity], 1768 cGy(Tomotherapy), 2151 cGy(IMRT), 4031 cGy(3D-CRT)[spinal cord] its value did not exceeded NTCP. All the treatment techniques are equated with tumor and nomal tissue doses. The 3D-CRT was worse than other techniques on dose distribution, but it is reasonable in terms of TCP and NTCP baseline Tomotherapy, IMRT -dose distribution was relatively superior- was hard to therapy to claustrophobic patients and patients with respiratory failure. Particularly, in case on Tomotherapy, it take MVCT before treatment so dose measurement will be unnecessary radiation exposure to patients. Conclusion, Tomotherapy was the best treatment technique and 2nd was IMRT, and 3rd 3D-CRT. But applicable differently depending on the the patient's condition even though dose not matter.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.1
• /
• pp.69-76
• /
• 2014

Purpose : To evaluate the changes of the motion of abdominal cavity between interfraction and intrafraction by using abdominal compression for reducing abdominal motion. Materials and Methods : 60 MVCT images were obtained before and after tomotherapy from 10 prostate cancer patients over the whole radiotherapy period. Shift values ( X -lateral Y -longitudinal Z -vertical and Roll ) were measured and from it, the correlation of between interfraction set up change and intrafraction target motion was analyzed when applying abdominal compression. Results : The motion changes of interfraction were X-average $0.65{\pm}2.32mm$, Y-average $1.41{\pm}4.83mm$, Z-average $0.73{\pm}0.52mm$ and Roll-average $0.96{\pm}0.21mm$. The motion changes of intrafraction were X-average $0.15{\pm}0.44mm$, Y-average $0.13{\pm}0.44mm$, Z-average $0.24{\pm}0.64mm$ and Roll-average $0.1{\pm}0.9mm$. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : Abdominal compression can minimize the motion of internal organs and patients. So it is considered to be able to get more ideal dose volume without damage of normal structures from generating margin in small in producing PTV.