• Journal of the Korean Society of Radiology
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• v.16 no.1
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• pp.45-51
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• 2022

This study compared DLP values along with phantom entrance surface doses and the image quality of chest CT scans made using a Care Dose 4D+Care kV System, scans that are made using only the Care Dose 4D function, and scans that are made with changes made by applying 80 kVp, 100 kVp, 120 kVp, and 140 kVp to the Care Dose 4D and tube voltage to search for methods to maintain the highest image quality with minimal patient doses. It was shown that DLP values decreased 6.727% when scans were taken with Chest Care Dose 4D + Care kV semi 100 and 6.481% when scans were taken with Chest Care Dose 4D + Care kV. With Chest Non as a standard, skin surface doses decreased 16.519% when scans were taken with Chest Care Dose 4D + Care kV semi 100 and 15.705% when scans were taken with Chest Care Dose 4D + Care kV. With comparisons of image quality, when comparisons were made with Chest Non, comparisons made of SNR values and CNR values in all scanning conditions including Care Dose 4D + Care kV showed that there were no significant differences at P>0.05. Imaging using Chest Care Dose 4D + Care kV in chest CT showed that exposure doses decreased similarly to result values gained from the best conditions through manual adjustments of kV and mAS, and there were no significant differences in image SNR and CNR. If the Chest Care Dose 4D + Care kV function is used, image quality is maintained and patient exposure to radiation can be reduced.

• Journal of the Korean Society of Radiology
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• v.11 no.3
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• pp.109-115
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• 2017

The purpose of this study was to evaluate the clinical efficacy of 128 MDCT (multi-detector computed tomography) for reducing the CareDose 4D dose and comparing the image quality with the fixed tube current technique. For this purpose, we conducted the phantom and clinical studies to evaluate the exposure dose and image of the subject before and after applying the CareDose 4D system in abdominal examination using 128 MDCT. In the phantom study, ROI (Region of interest) was located at the center, 3, 6, 9, 12 o'clock, into two groups: group A without CareDose 4D and Group B applied were measured. In the clinical study, ROI was located at the liver 8 segments, divided into two groups too. The measured items were CT number, noise, and dose length product (DLP) dose. The result of CTDIvol (CT Dose Index volume) measurements in phantom and clinical studies were lower than those before CareDose 4D application, and dose and effective dose were also measured lower (p<.05). There was no difference in CT number before and after application (p>.05). In conclusion, using CareDose 4D, we can obtain optimal image information without deteriorating image quality while reducing patient dose.

• Journal of Radiation Industry
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• v.11 no.3
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• pp.131-137
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• 2017

To compare the radiation dose and image noise of low dose computed tomography (CT) and high resolution CT using the fixed tube current technique and automatic tube current modulation (CARE Dose 4D). Chest CT and human anthropomorphic phantom were used the RPL (radiophotoluminescence) dosimeters. For image evaluation, standard deviation of mean CT attenuation coefficient and CT attenuation coefficient was measured using ROI analysis function. The effective dose was calculated using CTDIvol and DLP. CARE Dose 4D was reduced by 74.7% and HRCT by 64.4% compared to the fixed tube current technique in low dose CT of chest phantom. In CTDIvol and DLP, the dose of CARE Dose 4D was reduced by fixed tube current technique. For effective dose, CARE Dose 4D was reduced by 47% and HRCT by 46.9% compared to the fixed tube current method, and the dose of CARE Dose 4D was significantly different (p<.05). Noise in the image was higher than that in the fixed tube current technique. Noise difference in the image of CARE Dose 4D in low dose CT was significant (p<.05). The low radiation dose and the noise difference of the CARE Dose 4D were compared with the fixed tube current technique in low dose CT and HRCT using chest phantom. The radiation doses using CARE Dose 4D were in accordance with the national and international dose standards. CARE Dose 4D should be applied to low dose CT and HRCT for clinical examination.

• Progress in Medical Physics
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• v.28 no.1
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• pp.27-32
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• 2017

We investigated the effect of a commercial iterative reconstruction technique (iDose, Philips) on the image quality and the dose calculation for the treatment plan. Using the electron density phantom, the 3D CT images with five different protocols (50, 100, 200, 350 and 400 mAs) were obtained. Additionally, the acquired data was reconstructed using the iDose with level 5. A lung phantom was used to acquire the 4D CT with the default protocol as a reference and the low dose (one third of the default protocol) 4D CT using the iDose for the spine and lung plans. When applying the iDose at the same mAs, the mean HU value was changed up to 85 HU. Although the 1 SD was increased with reducing the CT dose, it was decreased up to 4 HU due to the use of iDose. When using the low dose 4D CT with iDose, the dose change relative to the reference was less than 0.5% for the target and OARs in the spine plan. It was also less than 1.1% in the lung plan. Therefore, our results suggests that this dose reduction technique is applicable to the 4D CT image acquisition for the radiation treatment planning.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.25-28
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• 2012

Purpose : It is important to reduce radiation dose associated with computed tomography (CT) scanning to as low as reasonably achievable (ALARA). With Dose Modulation Technic, user select a desired image quality and the system adapts tube current to obtain the desired image quality with greater radiation dose efficiency. In this paper, we presents a comprehensive description of fundamentals, clinical applications and radiation dose benefits of Dose Modulation Technic depending on Body Mass Index(BMI). Materials and Methods : In this study, 149 patients were examined(The mean age : $58{\pm}12.4$ years old). Biograph True Point 40 (Siemens, USA) and Gemini TF 64 (Philips. Cleveland) were used for equipment. When we used Care Dose 4D (Siemens, USA) and D-dom (Philips, Cleveland), we measured dose reduction and Computed Tomography Dose Index (CTDI) depending on BMI. Then we analyze data using SPSS Ver.18. Results : When we used Care Dose 4D, p-value is considered statistically significant by groups with the result that we compared Care Dose 4D with D-dom. On the other hand, p-value isn't considered statistically significant by groups using D-dom. Conclusion : Dose modulation based on the projection angle didn't affect degree of obesity. And When using Care Dose 4D, dose reduction rate in the normal patients were higher than the obese. In this study, there are errors on somato type. So I think more research have to be done. Then application of Dose Modulation technic can help in maintaining acceptable image quality while reducing radiation dose by 20-60% in most instances.

• Progress in Medical Physics
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• v.27 no.4
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• pp.203-212
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• 2016

Dose differences between three-dimensional (3D) and four-dimensional (4D) doses could be varied according to the geometrical relationship between a planning target volume (PTV) and an organ at risk (OAR). The purpose of this study is to evaluate the correlation between the overlap volume histogram (OVH), which quantitatively shows the geometrical relationship between the PTV and OAR, and the dose differences. 4D computed tomography (4DCT) images were acquired for 10 liver cancer patients. Internal target volume-based treatment planning was performed. A 3D dose was calculated on a reference phase (end-exhalation). A 4D dose was accumulated using deformation vector fields between the reference and other phase images of 4DCT from deformable image registration, and dose differences between the 3D and 4D doses were calculated. An OVH between the PTV and selected OAR (duodenum) was calculated and quantified on the basis of specific overlap volumes that corresponded to 10%, 20%, 30%, 40%, and 50% of the OAR volume overlapped with the expanded PTV. Statistical analysis was performed to verify the correlation with the OVH and dose difference for the OAR. The minimum mean dose difference was 0.50 Gy from case 3, and the maximum mean dose difference was 4.96 Gy from case 2. The calculated range of the correlation coefficients between the OVH and dose difference was from -0.720 to -0.712, and the R-square range for regression analysis was from 0.506 to 0.518 (p-value <0.05). However, when the 10% overlap volume was applied in the six cases that had OVH value ${\leq}2$, the average percent mean dose differences were $34.80{\pm}12.42%$. Cases with quantified OVH values of 2 or more had mean dose differences of $29.16{\pm}11.36%$. In conclusion, no significant statistical correlation was found between the OVH and dose differences. However, it was confirmed that a higher difference between the 3D and 4D doses could occur in cases that have smaller OVH value.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.4
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• pp.1714-1720
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• 2012

The purpose of the study was to evaluation of the radiation dose reduction and the possibility of the maintainability of the adequate image quality using various automatic exposure control (AEC) systems in multi-detector computed tomography (MDCT). We used three AEC systems for the study: General Electric Healthcare (Auto-mA 3D), Philips Medical systems (DoseRight) and Siemens Medical Solutions (Care Dose 4D). The general scanning protocol was created for the each examination with the same scanning parameters as many as possible. In the various AEC systems, the evaluation of reduced-dose was evaluated by comparing to fixed mAs with using human phantom. The image quality of the phantom was evaluated with measuring the image noise (standard deviation) by insert regions of interests. Finally, when we applied to AEC for three manufacturers, the radiation dose reduction decreased each 35.3% in the Auto-mA 3D, 58.2% in the DoseRight, and 48.6% in the Care Dose 4D. And, there was not statistical significant difference among the image quality in the Strong/Weak of the Care Dose 4D(P=.269). This applies to variety of the AEC systems which will be very useful to reduce the dose and to maintain the high quality.

• Progress in Medical Physics
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• v.30 no.4
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• pp.120-127
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• 2019

Purpose: This study was designed to evaluate the dosimetric performance of Mobius3D by comparison with an aSi-based electronic portal imaging device (EPID) and Octavius 4D, which are conventionally used for patient-specific prescription dose verification. Methods: The study was conducted using nine patients who were treated by volumetric modulated arc therapy. To evaluate the feasibility of Mobius3D for prescription dose verification, we compared the QA results of Mobius3D to an aSi-based EPID and the Octavius 4D dose verification methods. The first was the comparison of the Mobius3D verification phantom dose, and the second was to gamma index analysis. Results: The percentage differences between the calculated point dose and measurements from a PTW31010 ion chamber were 1.6%±1.3%, 2.0%±0.8%, and 1.2%±1.2%, using collapsed cone convolution, an analytical anisotropic algorithm, and the AcurosXB algorithm respectively. The average difference was found to be 1.6%±0.3%. Additionally, in the case of using the PTW31014 ion chamber, the corresponding results were 2.0%±1.4%, 2.4%±2.1%, and 1.6%±2.5%, showing an average agreement within 2.0%±0.3%. Considering all the criteria, the Mobius3D result showed that the percentage dose difference from the EPID was within 0.46%±0.34% on average, and the percentage dose difference from Octavius 4D was within 3.14%±2.85% on average. Conclusions: We conclude that Mobius3D can be used interchangeably with phantom-based dosimetry systems, which are commonly used as patient-specific prescription dose verification tools, especially under the conditions of 3%/3 mm and 95% pass rate.

• Progress in Medical Physics
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• v.20 no.1
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• pp.14-20
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• 2009

We measured the dose distribution for spinal cord and tumor using Gafchromic film, applying 3D and 4D-Treatment Planning for lung tumor within the phantom. A measured dose distribution was compared with a calculated dose distribution generated from 3D radiation treatment planning and 4D radiation treatment planning system. The agreement of the dose distribution in tumor for 3D and 4D treatment planning was 90.6%, 97.64% using gamma index computed for a distance to agreement of 1 mm and a dose difference of 3%. However, a gamma agreement index of 3% dose difference tolerence of and 2 mm distance to agreement, the accordance of the dose distribution around cord for 3D and 4D radiation treatment planning was 57.13%, 90.4%. There are significant differences between a calculated dose and a measured dose for 3D radiation treatment planning, no significant differences for 4D treatment planning. The results provide the effectiveness of the 4D treatment planning as compared to 3D. We suggest that the 4-dimensional treatment planning should be considered in the case where such equipments as Cyberknife with the real time tracking system are used to treat the tumors in the moving organ.

• Journal of radiological science and technology
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• v.42 no.4
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• pp.271-277
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• 2019

CareDose 4D which is the Siemens's Automatic Exposure Control (AEC) can adjust the level of radiation dose distribution which is based on organ characteristic unlike other manufacturer's AEC. Currently, a wide scan range containing different organs is sometimes examined at once (defined as one scan). The purpose of this study was to figure out which organ characteristic option is suitable when one scan method is utilized. Two types of anthropomorphic phantoms were scanned in the same range which were from frontal bone to carina level according to three different organ characteristics such as Thorax, Abdomen, and Neck. All scans and image reconstruction parameters were equally applied and radiation dose were compared. Radiation dose with Thorax organ characteristic was lower than that with Neck. Also, that with Abdomen oran characteristic was lower than Thorax. There were significant differences in radiation dose according to different organ characteristics at the same parameters (P<0.05). Usage of Neck organ characteristic had a result of the highest radiation dose to all phantom. On the other hand, utilization of Abdomen organ characteristic showed the lowest radiation dose. As a result, it is desirable to set appropriate organ characteristic according to examined body part when you checkup patients. Also, when you implement one scan method, selection of Abdomen-based organ characteristic has reduced more radiation dose compared with two different organ characteristic.