• 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.

• Progress in Medical Physics
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• v.25 no.1
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• pp.23-30
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• 2014

The purpose of this study is to evaluate the developed dose verification program for in vivo dosimetry based on transit dose in radiotherapy. Five intensity modulated radiotherapy (IMRT) plans of lung cancer patients were used in the irradiation of a homogeneous solid water phantom and anthropomorphic phantom. Transit dose distribution was measured using electronic portal imaging device (EPID) and used for the calculation of in vivo dose in patient. The average passing rate compared with treatment planning system based on a gamma index with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit was 95% for the in vivo dose with the homogeneous phantom, but was reduced to 81.8% for the in vivo dose with the anthropomorphic phantom. This feasibility study suggested that transit dose-based in vivo dosimetry can provide information about the actual dose delivery to patients in the treatment room.

• 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.

• 대한방사선방어학회:학술대회논문집
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• 2010.04a
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• pp.56-57
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• 2010

• Radiation Oncology Journal
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• v.27 no.2
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• pp.91-102
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• 2009

Purpose: To compare the accuracy and efficacy of EDR2 film, a 2D ionization chamber array (MatriXX) and an amorphous silicon electronic portal imaging device (EPID) in the pre-treatment QA of IMRT. Materials and Methods: Fluence patterns, shaped as a wedge with 10 steps (segments) by a multi-leaf collimator (MLC), of reference and test IMRT fields were measured using EDR2 film, the MatriXX, and EPID. Test fields were designed to simulate leaf positioning errors. The absolute dose at a point in each step of the reference fields was measured in a water phantom with an ionization chamber and was compared to the dose obtained with the use of EDR2 film, the MatriXX and EPID. For qualitative analysis, all measured fluence patterns of both reference and test fields were compared with calculated dose maps from a radiation treatment planning system (Pinnacle, Philips, USA) using profiles and $\gamma$ evaluation with 3%/3 mm and 2%/2 mm criteria. By measurement of the time to perform QA, we compared the workload of EDR2 film, the MatriXX and EPID. Results: The percent absolute dose difference between the measured and ionization chamber dose was within 1% for the EPID, 2% for the MatriXX and 3% for EDR2 film. The percentage of pixels with $\gamma$%>1 for the 3%/3 mm and 2%/2 mm criteria was within 2% for use of both EDR2 film and the EPID. However, differences for the use of the MatriXX were seen with a maximum difference as great as 5.94% with the 2%/2 mm criteria. For the test fields, EDR2 film and EPID could detect leaf-positioning errors on the order of -3 mm and -2 mm, respectively. However it was difficult to differentiate leaf-positioning errors with the MatriXX due to its poor resolution. The approximate time to perform QA was 110 minutes for the use of EDR2 film, 80 minutes for the use of the MatriXX and approximately 55 minutes for the use of the EPID. Conclusion: This study has evaluated the accuracy and efficacy of EDR2 film, the MatriXX and EPID in the pre-treatment verification of IMRT. EDR2 film and the EPID showed better performance for accuracy, while the use of the MatriXX significantly reduced measurement and analysis times. We propose practical and useful methods to establish an effective QA system in a clinical environment.

• Progress in Medical Physics
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• v.9 no.2
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• pp.105-113
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• 1998

Accurate radiation dosimetric characters is very important to determine of dose to a radiotherapeutic patient. Medical linear accelerators have been developed not only its new quality of convenient operation but also electric moderation. It is reliable to measure more detail physical parameter that linac's internal ability. Typically, radiation dosimetric tool is classified ionization chamber, film, thermoluminescence dosimeter, etc. Nowaday, Electronic Portal Imaging Device is smeared in radiation field to verification of treatment region. EPID's image was focused that using both on-line image verification and absolutely minimum absorbed dose during radiotherapy. So, Electronic Portal Imaging was tested for quality evaluation of medical linear accelerator had its pure conditional flash. This study has performed symmetry, Light/Radiation field congruence, and energy check, geometry difference on wedge filter using a liquid filled ion chamber (EPID). Prior to irradiated on EPID, high energy photon beam is checked with ion chamber. Using these results more convenient dosimetric method is accomplished by EPID that taken digital image. Medical image is acquired with EPID too. Therefore, EPID can be analyzed by numerical information for what want to see or get more knowledge for natural human condition.

• 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.26 no.2
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• pp.87-92
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• 2015

The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.83-91
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• 2017

Objectives: The purpose of this study was to evaluate the error of the leaf position accuracy of the MLC due to the gravity effect according to the gantry angle by using picket fence test using EPID and GafChromic EBT3 film. Materials and Methods: A 5 cm solid phantom was placed on the table and the SAD was set to 100 cm. The EBT3 film was placed exactly over the solid phantom and covered a 1.5 cm solid phantom and the picket fence test was performed. The EPID was measured under the same conditions as the EBT3 film at SID 100 cm. The gantry angles were measured at $0^{\circ}$, $90^{\circ}$, $180^{\circ}$ and $270^{\circ}$ in order to evaluate the position of the MLC according to the gantry angle. For the geometric evaluation of the MLC, the leaf position accuracy of the MLC was analyzed using the analysis program. Results: In case of EPID, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.18 mm, 0.31 mm, 0.20 mm, 0.26 mm on the average and the maximum values of the errors were respectively 0.44 mm, 0.54 mm, 0.34 mm, 0.44 mm. In case of EBT3 film, when the gantry angle was changed to $0^{\circ}$, $90^{\circ}$, $180^{\circ}$, $270^{\circ}$, the difference of the position errors of the leaves was 0.19 mm, 0.21 mm, 0.19 mm, 0.31 mm on the average and the maximum values of the errors were respectively 0.35 mm, 0.45 mm, 0.36 mm, 0.48 mm. Conclusion: In this study, we analyzed the position error of the leaf of the MLC according to the gantry angle, and confirmed the position error of the leaf by gravity effect. As a result of comparing the leaf position accuracy using EPID and EBT3 film according to the variation of gantry angle, a larger error occurred in the error analysis method using EPID than that of EBT3 film. Therefore, in the case of IMRT based on MLC, as well as verification of accurate dosimetry should be conducted, it is considered that the quality control and verification for the precise operation of the MLC will be needed. and it is necessary to compare and verify the method of analysis.