• Title/Summary/Keyword: 4D Planning

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Comparison of the Efficacy of 2D Dosimetry Systems in the Pre-treatment Verification of IMRT (세기조절방사선치료의 환자별 정도관리를 위한 2차원적 선량계의 유용성 평가)

  • Hong, Chae-Seon;Lim, Jong-Soo;Ju, Sang-Gyu;Shin, Eun-Hyuk;Han, Young-Yih;Ahn, Yong-Chan
    • 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.

The study on the entry of dental technicians in the public health center for a manpower supply and demand plane (Centering around a denture insurance policy in 2012) (인력수급 대책을 위한 치과기공사의 보건지소 진출에 관한 연구 - 2012년 틀니보험화 정책을 중심으로 -)

  • Lee, Jong-Do;Kim, Jeong-Sook;Park, Kwang-Sig
    • Journal of Technologic Dentistry
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    • v.32 no.4
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    • pp.417-433
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    • 2010
  • Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.

Clinical Significance of Low-colony Count Scotochromogen Nontuberculous Mycobacteria (균집락수가 적은 암색소성 비결핵항산균 배양의 임상적 의미)

  • Lee, Jung Yeon;Kim, Mi-Na;Chung, Hee-Jung;Jun, Kyung Ran;Choi, Hee Jin;Lee, Hyeyoung;Joung, Eun Young;Oh, Yeon-Mok;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.1
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    • pp.39-46
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    • 2005
  • Background : Even though it has been suggested that low-colony, scotochromogen nontuberculous mycobacteria (NTM) are usually contaminants and not true pathogens, evidence for this hypothesis has not been provided. This study investigated the colony characteristics, organism identification, and clinical significance of low-colony scotochromogen. Methods : The laboratory cultured 6,898 respiratory clinical specimens for an examination of mycobacteria over a three-month period. A low-colony count was arbitrarily defined as ${\leq}20$ colonies. This study analyzed the recovery rate of the mycobacteria, the number of colonies and their gross characteristics, and their clinical significance. PCR-restriction fragment length polymorphism analysis was carried out to identify the NTM species. NTM pulmonary disease was defined according to the American Thoracic Society. Results : A total of 6,898 respiratory specimens for mycobacterium were cultured. Of these, 263 (3.8%) grew NTM, and 382 (5.5%) grew M. tuberculosis. Of the 263 cultured NTM specimens, 124 (47.1%) were scotochromogens. The smear-positive rate was significantly lower in these scotochromogens (4.8%) than in the non-scotochromogens (23.7%) (p<0.05). The most common isolates were M. gordonae (83/102, 81.4%) in the scotochromogens, and MAC (52/121, 43.0%) in the non-scotochromogens. Even though three out of 113 patients with a low-colony scotochromogen has been diagnosed with NTM pulmonary disease, the isolated scotochromogen was not considered to be the cause of the NTM disease but was just a contaminant. Conclusion : In this study, the most common isolate of a low-colony count scotochromogen was M. gordonae, which appeared to be contaminants and not true pathogens. Greater efforts in the quality control of a mycobacterium laboratory are needed in cases where there is a high recovery rate of low-colony count scotochromogen.

Development of Movement Analysis Program and its Feasibility Test in Streotactic Body Radiation Threrapy (복부부위의 체부정위방사선치료시 호흡에 의한 움직임분석 프로그램 개발 및 유용성 평가)

  • Shin, Eun-Hyuk;Han, Young-Yih;Kim, Jin-Sung;Park, Hee-Chul;Shin, Jung-Suk;Ju, Sang-Gyu;Lee, Ji-Hea;Ahn, Jong-Ho;Lee, Jai-Ki;Choi, Doo-Ho
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.107-116
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    • 2011
  • Respiratory gated radiation therapy and stereotactic body radiation therapy require identical tumor motions during each treatment with the motion detected in treatment planning CT. Therefore, this study developed a tumor motion monitoring and analysis system during the treatments employing RPM data, gated setup OBI images and a data analysis software. A respiratory training and guiding program which improves the regularity of breathing was used to patients. The breathing signal was obtained by RPM and the recorded data in the 4D console was read after treatment. The setup OBI images obtained gated at 0% and 50% of breathing phases were used to detect the tumor motion range in crenio-caudal direction. By matching the RPM data recorded at the OBI imaging time, a factor which converts the RPM motion to the tumor motion was computed. RPM data was entered to the institute developed data analysis software and the maximum, minimum, average of the breathing motion as well as the standard deviation of motion amplitude and period was computed. The computed result is exported in an excel file. The conversion factor was applied to the analyzed data to estimate the tumor motion. The accuracy of the developed method was tested by using a moving phantom, and the efficacy was evaluated for 10 stereotactic body radiation therapy patients. For the sine wave motion of the phantom with 4 sec of period and 2 cm of peak-to-peak amplitude, the measurement was slightly larger (4.052 sec) and the amplitude was smaller (1.952 cm). For patient treatment, one patient was evaluated not to qualified to SBRT due to the usability of the breathing, and in one patient case, the treatment was changed to respiratory gated treatment due the larger motion range of the tumor than treatment planed motion. The developed method and data analysis program was useful to estimate the tumor motion during treatment.

Verification of Non-Uniform Dose Distribution in Field-In-Field Technique for Breast Tangential Irradiation (유방암 절선조사 시 종속조사면 병합방법의 불균등한 선량분포 확인)

  • Park, Byung-Moon;Bae, Yong-Ki;Kang, Min-Young;Bang, Dong-Wan;Kim, Yon-Lae;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.277-282
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    • 2010
  • The study is to verify non-uniform dose distribution in Field-In-Field (FIF) technique using two-dimensional ionization chamber (MatriXX, Wellhofer Dosimetrie, Germany) for breast tangential irradiation. The MatriXX and an inverse planning system (Eclipse, ver 6.5, Varian, Palo Alto, USA) were used. Hybrid plans were made from the original twenty patients plans. To verify the non-uniform dose distribution in FIF technique, each portal prescribed doses (90 cGy) was delivered to the MatriXX. The measured doses on the MatriXX were compared to the planned doses. The quantitative analyses were done with a commercial analyzing tool (OmniPro IMRT, ver. 1.4, Wellhofer Dosimetrie, Germany). The delivered doses at the normalization points were different to average 1.6% between the calculated and the measured. In analysis of line profiles, there were some differences of 1.3-5.5% (Avg: 2.4%), 0.9-3.9% (Avg: 2.5%) in longitudinal and transverse planes respectively. For the gamma index (criteria: 3 mm, 3%) analyses, there were shown that 90.23-99.69% (avg: 95.11%, std: 2.81) for acceptable range ($\gamma$-index $\geq$ 1) through the twenty patients cases. In conclusion, through our study, we have confirmed the availability of the FIF technique by comparing the calculated with the measured using MatriXX. In the future, various clinical applications of the FIF techniques would be good trials for better treatment results.

Comparison of the Survey of Teaching Demand for Distance Education Support for the 2021 and 2022 Academic Years : For D Community Colleges in Daegu (2021학년도와 2022학년도 원격교육지원에 대한 교수 수요도 조사 비교: 대구지역 D전문대학을 대상으로)

  • Park, Jeong-Kyu
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.491-497
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    • 2022
  • In this study, we tried to secure basic data to create an environment necessary for distance learning through a survey on professor demand. Among the 184 full-time faculty members of the university, 73 (39.89%) respondents in 2021 and 87 (47.28%) in 2022 were included. As a result of the research on professor demand, in the 2021 school year, 27 people (37%) were classified as LMS improvement items when checking attendance, 38 people (23.3%) were pin-mics as content development support items, and 26 people (35.6%), 33 people (45.2%) of GOM Mix and 25 people (34.2%) of the distance education support center wanted to learn video editing program as the item of video editing program they are currently using. In the 2022 school year, 27 people (31.03%) said mobile upgrade as an LMS improvement item, 52 people (59.8%) of pin-microphone as a content development support item, 33 people (37.9%), but currently using the content creation intention using a studio. As for the video editing program they are working on, 47 people (54%) of GOM Mix Pro and 23 people (26.4%) of the distance education support center want to learn content creation method. In addition, the intention to produce content using the studio for the 2021 and 2022 academic year and the desired educational topic of the distance education support center in the future appeared insignificant (p > 0.05). In this distance education support center, we are working to solve the class of LMS attendance, upgrade mobile, and plan to distribute pin microphones. We are planning to increase the usability of the studio and provide training on how to use video editing programs and how to create video content. In order for a smooth class to take place in a university distance class, the university authorities should seek ways to support the instructor so that he/she does not have difficulties in performing his/her role as a teaching designer, such as setting learning goals, organizing and organizing content, motivating learning, and establishing effective class participation plans. there is a need

Studies on Development of Prediction Model of Landslide Hazard and Its Utilization (산지사면(山地斜面)의 붕괴위험도(崩壞危險度) 예측(豫測)모델의 개발(開發) 및 실용화(實用化) 방안(方案))

  • Ma, Ho-Seop
    • Journal of Korean Society of Forest Science
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    • v.83 no.2
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    • pp.175-190
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    • 1994
  • In order to get fundamental information for prediction of landslide hazard, both forest and site factors affecting slope stability were investigated in many areas of active landslides. Twelve descriptors were identified and quantified to develop the prediction model by multivariate statistical analysis. The main results obtained could be summarized as follows : The main factors influencing a large scale of landslide were shown in order of precipitation, age group of forest trees, altitude, soil texture, slope gradient, position of slope, vegetation, stream order, vertical slope, bed rock, soil depth and aspect. According to partial correlation coefficient, it was shown in order of age group of forest trees, precipitation, soil texture, bed rock, slope gradient, position of slope, altitude, vertical slope, stream order, vegetation, soil depth and aspect. The main factors influencing a landslide occurrence were shown in order of age group of forest trees, altitude, soil texture, slope gradient, precipitation, vertical slope, stream order, bed rock and soil depth. Two prediction models were developed by magnitude and frequency of landslide. Particularly, a prediction method by magnitude of landslide was changed the score for the convenience of use. If the total store of the various factors mark over 9.1636, it is evaluated as a very dangerous area. The mean score of landslide and non-landslide group was 0.1977 and -0.1977, and variance was 0.1100 and 0.1250, respectively. The boundary value between the two groups related to slope stability was -0.02, and its predicted rate of discrimination was 73%. In the score range of the degree of landslide hazard based on the boundary value of discrimination, class A was 0.3132 over, class B was 0.3132 to -0.1050, class C was -0.1050 to -0.4196, class D was -0.4195 below. The rank of landslide hazard could be divided into classes A, B, C and D by the boundary value. In the number of slope, class A was 68, class B was 115, class C was 65, and class D was 52. The rate of landslide occurrence in class A and class B was shown at the hige prediction of 83%. Therefore, dangerous areas selected by the prediction method of landslide could be mapped for land-use planning and criterion of disaster district. And also, it could be applied to an administration index for disaster prevention.

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Studies on a Plan for Afforestation at Tong-ri Beach Resort(II) -Analyses of Crown Amounts and Soil Properties in the Disaster-damage Prevention Forests of Pinus thunbergii PARL., the Valuation on Soil Properties for Planting and Planning for Afforestation- (통리(桶里) 해수욕장(海水浴場) 녹지대(綠地帶) 조성(造成)에 관(關)한 연구(硏究)(II) -곰솔 해안방재림(海岸防災林)의 수관량(樹冠量) 및 토양분석(土壤分析), 식재기반평가(植栽基盤評價) 및 녹지대계획(綠地帶計劃)-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.77 no.3
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    • pp.303-314
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    • 1988
  • Tong-ri beach has not enough vegetation to be enjoyed by the sea bathers and to be satisfied with preventing the disaster-damages, but mixed forest near the beach can work its funtions and the old forest of Pirus thunbergii $P_{ARL}$. near the beach do a Little. Therefore it is very urgent to plant more trees near the beach for bathers and disaster-damage prevention. This study was carried out for planning an afforestation, with reporting upon the crown amounts and soil properties of disaster-damage prevention forests of P. thunbergii $P_{ARL}$. planted on the coast sand dunes in 1970 and 1976, and with reporting upon the valuation on soil properties of the lands near the beach in order to set the afforestation site. The results are as follows : 1. In disaster-damage prevention forests, crown surface area and crown volume became increasingly greater in proportion to the height. To D.B.H., crown volume also became increasingly greater in proportion, but crown surface area was directly proportional. 2. In comparison to sail characteristics of sand dune, those of the forests were in large quantity in OM, T-N and avail. $SiO_2$, and almost in the same in avail. $P_2O_5$, but in small quantity in exchangeable canons : K, Ca, Mg and Na. 3. EC, Cl and pH were in small value in the forest soils, but CEC was in large value in those soils. 4. Above facts showed that the forests fulfill their functions for preventing disaster-damages and improve their soil properties. 5. The forests have naturally been thinned up to 34% in 17 years and 39% in 11 years, and one can easily pass through the forest(planted in 1970), because of its sufficient clear-length(2.71m) and its space to pass. 6. A plan for afforestation was oracle nut after judging several sites by the evaluation on the soil properties and considering the best relaxation and the prevention of the various disaster-damages upon which were reported in the last issue. 7. Afforestation should be kept for maintaining its appropriate density for best relaxation and disaster-damage prevention.

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Color Analyses on Digital Photos Using Machine Learning and KSCA - Focusing on Korean Natural Daytime/nighttime Scenery - (머신러닝과 KSCA를 활용한 디지털 사진의 색 분석 -한국 자연 풍경 낮과 밤 사진을 중심으로-)

  • Gwon, Huieun;KOO, Ja Joon
    • Trans-
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    • v.12
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    • pp.51-79
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    • 2022
  • This study investigates the methods for deriving colors which can serve as a reference to users such as designers and or contents creators who search for online images from the web portal sites using specific words for color planning and more. Two experiments were conducted in order to accomplish this. Digital scenery photos within the geographic scope of Korea were downloaded from web portal sites, and those photos were studied to find out what colors were used to describe daytime and nighttime. Machine learning was used as the study methodology to classify colors in daytime and nighttime, and KSCA was used to derive the color frequency of daytime and nighttime photos and to compare and analyze the two results. The results of classifying the colors of daytime and nighttime photos using machine learning show that, when classifying the colors by 51~100%, the area of daytime colors was approximately 2.45 times greater than that of nighttime colors. The colors of the daytime class were distributed by brightness with white as its center, while that of the nighttime class was distributed with black as its center. Colors that accounted for over 70% of the daytime class were 647, those over 70% of the nighttime class were 252, and the rest (31-69%) were 101. The number of colors in the middle area was low, while other colors were classified relatively clearly into day and night. The resulting color distributions in the daytime and nighttime classes were able to provide the borderline color values of the two classes that are classified by brightness. As a result of analyzing the frequency of digital photos using KSCA, colors around yellow were expressed in generally bright daytime photos, while colors around blue value were expressed in dark night photos. For frequency of daytime photos, colors on the upper 40% had low chroma, almost being achromatic. Also, colors that are close to white and black showed the highest frequency, indicating a large difference in brightness. Meanwhile, for colors with frequency from top 5 to 10, yellow green was expressed darkly, and navy blue was expressed brightly, partially composing a complex harmony. When examining the color band, various colors, brightness, and chroma including light blue, achromatic colors, and warm colors were shown, failing to compose a generally harmonious arrangement of colors. For the frequency of nighttime photos, colors in approximately the upper 50% are dark colors with a brightness value of 2 (Munsell signal). In comparison, the brightness of middle frequency (50-80%) is relatively higher (brightness values of 3-4), and the brightness difference of various colors was large in the lower 20%. Colors that are not cool colors could be found intermittently in the lower 8% of frequency. When examining the color band, there was a general harmonious arrangement of colors centered on navy blue. As the results of conducting the experiment using two methods in this study, machine learning could classify colors into two or more classes, and could evaluate how close an image was with certain colors to a certain class. This method cannot be used if an image cannot be classified into a certain class. The result of such color distribution would serve as a reference when determining how close a certain color is to one of the two classes when the color is used as a dominant color in the base or background color of a certain design. Also, when dividing the analyzed images into several classes, even colors that have not been used in the analyzed image can be determined to find out how close they are to a certain class according to the color distribution properties of each class. Nevertheless, the results cannot be used to find out whether a specific color was used in the class and by how much it was used. To investigate such an issue, frequency analysis was conducted using KSCA. The color frequency could be measured within the range of images used in the experiment. The resulting values of color distribution and frequency from this study would serve as references for color planning of digital design regarding natural scenery in the geographic scope of Korea. Also, the two experiments are meaningful attempts for searching the methods for deriving colors that can be a useful reference among numerous images for content creator users of the relevant field.

Dosimetric evaluation of using in-house BoS Frame Fixation Tool for the Head and Neck Cancer Patient (두경부암 환자의 양성자 치료 시 사용하는 자체 제작한 BoS Frame 고정장치의 선량학적 유용성 평가)

  • Kim, kwang suk;Jo, kwang hyun;Choi, byeon ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.35-46
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    • 2016
  • Purpose : BoS(Base of Skull) Frame, the fixation tool which is used for the proton of brain cancer increases the lateral penumbra by increasing the airgap (the distance between patient and beam jet), due to the collision of the beam of the posterior oblique direction. Thus, we manufactured the fixation tool per se for improving the limits of BoS frame, and we'd like to evaluate the utility of the manufactured fixation tool throughout this study. Materials and Methods : We've selected the 3 patients of brain cancer who have received the proton therapy from our hospital, and also selected the 6 beam angles; for this, we've selected the beam angle of the posterior oblique direction. We' ve measured the planned BoS frame and the distance of Snout for each beam which are planned for the treatment of the patient using the BoS frame. After this, we've proceeded with the set-up that is above the location which was recommended by the manufacturer of the BoS frame, at the same beam angle of the same patient, by using our in-house Bos frame fixation tool. The set-up was above 21 cm toward the superior direction, compared to the situation when the BoS frame was only used with the basic couch. After that, we've stacked the snout to the BoS frame as much as possible, and measured the distance of snout. We've also measured the airgap, based on the gap of that snout distance; and we've proceeded the normalization based on each dose (100% of each dose), after that, we've conducted the comparative analysis of lateral penumbra. Moreover, we've established the treatment plan according to the changed airgap which has been transformed to the Raystation 5.0 proton therapy planning system, and we've conducted the comparative analysis of DVH(Dose Volume Histogram). Results : When comparing the result before using the in-house Bos frame fixation tool which was manufactured for each beam angle with the result after using the fixation tool, we could figure out that airgap than when not used in accordance with the use of the in-house Bos frame fixation tool was reduced by 5.4 cm ~ 15.4 cm, respectively angle. The reduced snout distance means the airgap. Lateral Penumbra could reduce left, right, 0.1 cm ~ 0.4 cm by an angle in accordance with decreasing the airgap while using each beam angle in-house Bos frame fixation tool. Due to the reduced lateral penumbra, Lt.eyeball, Lt.lens, Lt. hippocampus, Lt. cochlea, Rt. eyeball, Rt. lens, Rt. cochlea, Rt. hippocampus, stem that can be seen that the dose is decreased by 0 CGE ~ 4.4 CGE. Conclusion : It was possible to reduced the airgap by using our in-house Bos frame fixation tool for the proton therapy; as a result, it was possible to figure out that the lateral penumbra reduced. Moreover, it was also possible to check through the comparative analysis of the treatment plan that when we reduce the lateral penumbra, the reduction of the unnecessary irradiation for the normal tissues. Therefore, Using the posterior oblique the Brain cancer proton therapy should be preceded by decreasing the airgap, by using our in-house Bos frame fixation tool; also, the continuous efforts for reducing the airgap as much as possible for the proton therapy of other area will be necessary as well.

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