• Nuclear Engineering and Technology
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• v.54 no.4
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• pp.1414-1420
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• 2022

High dose rate (HDR) brachytherapy treatment planning usually involves optimization methods to deliver uniform dose to the target volume and minimize dose to the healthy tissues. Four optimizations were used to evaluate the high-risk clinical target volume (HRCTV) coverage and organ at risk (OAR). Dose-volume histogram (DVH) and dosimetric parameters were analyzed and evaluated. Better coverage was achieved with PGO (mean CI = 0.95), but there were no significant mean CI differences than GrO (p = 0.03322). Mean EQD₂ doses to HRCTV (D₉₀) were also superior for PGO with no significant mean EQD₂ doses than GrO (p = 0.9410). The mean EQD₂ doses to bladder, rectum, and sigmoid were significantly higher for NO plan than PO, GrO, and PGO. PO significantly reduced the mean EQD₂ doses to bladder, rectum, and sigmoid but compromising the conformity index to HRCTV. PGO was superior in conformity index (CI) and mean EQD₂ doses to HRCTV compared with the GrO plan but not statistically significant. The mean EQD₂ doses to the rectum by PGO plan slightly exceeded the limit from ABS recommendation (mean EQD₂ dose = 78.08 Gy EQD₂). However, PGO can shorten the treatment planning process without compromising the CI and keeping the OARs dose below the tolerance limit.

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.19-27
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• 1996

I. Project Title A Study of Brachytherapy for intraocular tumor II. Objective and Importance of the project The eye enucleation or external-beam radiation therapy that has been commonly used for the treatment of intraocular tumor have demerits of visual loss and in deficiency of effective tumor dose. Recently, brachytherapy using the plaques containing radioisotope-now treatment method that decrease the demerits of the above mentioned treatment methods and increase the treatment effect-is introduced and performed in the countries, Our purpose of this research is to design suitable shape of plaque for the ophthalmic brachytherapy, and to measure absorbed doses of Ir-192 ophthalmic plaque and thereby calculate the exact radiation dose of tumor and it's adjacent normal tissue. III. Scope and Contents of the project In order to brachytherapy for intraocular tumor, 1. to determine the eye model and selected suitable radioisotope 2. to design the suitable shape of plaque 3. to measure transmission factor and dose distribution for custom made plaques 4. to compare with the these data and results of computer dose calculation models IV. Results and Proposal for Applications The result were as followed. 1. Eye model was determined as a 25mm diameter sphere, Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15mm, 17mm and 20mm in diameter, and 1.5mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within ${\pm}10\%$ and distance deviations are within 0.4mm Maximum error is $-11.3\%$ and 0.8mm, respectively. As a result of it, we can treat the intraocular tumor more effectively by using custom made gold plaque and Ir-192 seeds.

• Progress in Medical Physics
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• v.26 no.4
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• pp.280-285
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• 2015

In radiation therapy fields, a brachytherapy is a treatment that kills lesion of cells by inserting a radioisotope that keeps emitting radiation into the body. We currently verify the consistency of radiation treatment plan and dose distribution through film/screen system (F/S system), provide therapy after checking dose. When we check dose distribution, F/S systems have radiation signal distortion because there is low resolution by penumbra depending on the condition of film developed. In this study, We fabricated a $HgI_2$ Semiconductor radiation sensor for base study in order that we verify the real dose distribution weather it's same as plans or not in brachytherapy. Also, we attempt to evaluate the feasibility of QA system by utilizing and evaluating the sensor to brachytherapy source. As shown in the result of detected signal with various source-to-detector distance (SDD), we quantitatively verified the real range of treatment which is also equivalent to treatment plans because only the low signal estimated as scatters was measured beyond the range of treatment. And the result of experiment that we access reproducibility on the same condition of ${\gamma}$-ray, we have made sure that the CV (coefficient of variation) is within 1.5 percent so we consider that the $HgI_2$ sensor is available at QA of brachytherapy based on the result.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.243-252
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• 1995

Purpose : Intraluminal high dose rate brachytherapy is an accepted treatment for the tumors of GI tract. However, there is only some limited clinical data for intraluminal high dose rate brachytherapy for the tumors of GI tract. Materials and Methods : Between February 1991 and July 1993, 18 Patients who have the tumors of GI tract (esophageal cancer-8 cases, rectal cancer-10 cases) were treated with high dose rate Iridium-192 afterloading system (Microselectron-HDR, Nucletron CO, Netherland) at the department of therapeutic radiology, St. Mary's hospital, Catholic university medical college. Age range was 47-87 years with a mean a9e 71 years. All patients were treated with intraluminal high dose rate brachytherapy within two weeks after conventional external radiation therapy and received 3-5 Gy/fraction 3-4 times per week to a total dose 12-20 Gy (mean 17 Gy). Standard fractionation and conventional dose were delivered for external radiation therapy. Total dose of external radiation therapy ranged 41.4-59.4 Gy (mean 49.6 Gy). Median follow up was 19 months Results : The analysis was based on 18 patients, The complete response and partial response in esophageal cancer was similar (38%). Two year rates for survival and median survival were 13% and 10 months, respectively. Among 10 patients of rectal cancers, partial response was obtained in 6 patients (60%). There was no complete response in the patients with rectal cancer, but good palliative results were achieved in all patients. Conclusion : Although the number of patients was not large and the follow-up period was relatively short, these findings suggested that intraluminal high dose rate brachytherapy could be useful in the treatment of the patients with advanced tumors of GI tract.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.433-440
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• 2023

High dose rate brachytherapy is a cancer treatment that intensively irradiates radiation to tumors by inserting isotopes with high dose rates into the body. For such a treatment, it is necessary to deliver an accurate dose to the tumor tissue through an accurate treatment plan while delivering only a minimum dose to the normal tissue. Therefore, it is very important to check the location accuracy of the source through accurate Quality Assurance (QA) in clinical practice. However, since the source position is determined using a ruler, automatic radiographer, video monitor, etc. in clinical practice, it yields inaccurate results. In this study, a semiconductor dosimeter using CsPbI₂Br and CsPbIBr₂ was fabricated. And, in order to analyze whether it is more suitable for the relative QA dosimeter for brachytherapy device among the two materials, the radiation detection ability of each was compared and evaluated. In order to evaluate the radiation detection ability in brachytherapy, the reproducibility and linearity of the two materials were evaluated in ¹⁹²IR. In the reproducibility evaluation, CsPbI₂Br presented a Relative Standard Deviatio(RSD) of 0.98% and CsPbIBr₂ presented an RSD of 3.45%. In the linearity evaluation, the coefficient of determination (R²) of CsPbI₂Br was presented as 0.9998, and the R² of CsPbIBr₂ was presented as 0.9994. As a result of the evaluation, it was found that CsPbI₂Br was more stable in radiation detection while satisfying the evaluation criteria in the dosimeter manufactured in this experiment. Therefore, CsPbI₂Br material is suitable for application as a relative dosimeter for radiation detection in brachytherapy devices.

• Progress in Medical Physics
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• v.11 no.2
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• pp.109-116
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• 2000

One consideration of radiation delivery in cervical cancer is the complication of critical organs, e.g., bladder and rectum. The absorbed dose of bladder and rectum in HDR intracavitary brachytherapy is measured indirectly with TLD dosimetry A method for the complication reduction of bladder and rectum is suggested. For two-hundred cervical cancer patients, follow-up MRI images were reviewed and distances from cervical central axis to bladder and rectum and vaginal wall thickness were measured. The sealed TLDs were placed upon the gauze packing of the ovoids and the distances to the TLDs from the ovoid center were measured in the simulation film and actual doses of bladder and rectum were calculated. From published data, maximal tolerance doses of bladder and rectum were derived and based on the permissible doses per fraction in HDR brachytherapy the packing thicknesses were determined in both directions. The required minimal packing thicknesses for bladder and rectum were 0.43 and 0.92 cm, respectively. The results were compared with computer calculation using the Meisberger polynomial approach. It is our hope this study can be used for a guideline for users in clinic in estimating critical organ dose in bladder and rectum in HDR brachytherapy in vivo dosimetry.

• Progress in Medical Physics
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• v.8 no.1
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• pp.25-29
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• 1997

Ir-192 source activity for high dose rate brachytherapy is measured using Farmertype ionization chamber. The source-to-chamber distance is 10 cm and the measured charge unit is converted to activity unit. The measured values are compared to the values provided from vendor. Because of time dependency of Ir-192 source activity, the activities are regularly checked and compared to calculated values. As the accuracy of Ir-192 source activity is depend on the mechanical measurement setup, we estimated the precision of remote controlled source dwell position using home-made device and film scanner. The difference between measured and predicted dwell position is within 1 mm. As a result, the errors of source activity are 0.7${\pm}$1.5 ％ for measured and vendor-provided values and 0.l${\pm}$1.2％ for measured and time-dependent calculated vlaues. In conclusion, our measured activity has been comparable to the values provided from vendor and our brachytherapy unit has been very accurate until now. Regular quality control of brachytherapy is essential for successful treatment which depends on the accuracy of source position and activity.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.303-309
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• 2017

To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to $2cm^3$ of bladder to less than 7.5 Gy, and $2cm^3$ of rectum to less than 5Gy. In one patient of 10 patients, $D_{2cm3}$ of rectal dose was over 5Gy and 6patients at $D_{2cm3}$ of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

• Progress in Medical Physics
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• v.9 no.1
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• pp.55-64
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• 1998

In recent, the demand of development of the high dose rate brachytherapy source increased for substitute for Co-60 source by iridium source, since the supplying Co-60 source is very depressed and the high dose rate brachytherapy sources are entirely imported from the abroad. This study investigated the exposure rates and isotropic dose distributions for the Ir-192 source produced from $\^$191/Ir(n,r)$\^$192/Ir by nuclear reactor in Korea Atomic Energy Research Institute. The activity of source was obtained an 1.012 Ci (the initial activity without encapsulation was 2,87Ci) by measurement with encapsuled stainless steel. The exposure rate of provided Ir-192 source was determined on 6.36 ${\pm}$ 0.147 Rm$^2$/h-GBq (2.350 ${\pm}$ 0.054 Rcm$^2$/mCi-hr) within ${\pm}$ 2.2% discrepancy with IC-10 ion chamber (0.14 cc) which was mounted on the acrylic jig to 5, 10 and 20 cm from the center of source. The calculated doses with 22 most significant spectrum lines were corrected with intrinsic efficiency of the germanium detector were compared to measured exposure dose rates within ${\pm}$3.8 % discrepancy. The authors confirmed the high dose rate Ir-192 source could be replaced the long decayed Co-60 source via investigation of the isotropic dose distributions in lateral, source axis and diagonal direction of source center are very closed to within 3% uncertainties. Especially, this exposure rate constant and isotropic dose distribution will be fundamental to build the high dose rate source and develop the computed therapy planning system.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3945-3949
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• 2015

Background: For brachytherapy of cervical cancer, applicator shifts can not be avoided. The present investigation concerned Utrecht interstitial applicator shifts and their effects on organ movement and DVH parameters during 3D CT-based HDR brachytherapy of cervical cancer. Materials and Methods: After the applicator being implanted, CT imaging was achieved for oncologist contouring CTVhr, CTVir, and OAR, including bladder, rectum, sigmoid colon and small intestines. After the treatment, CT imaging was repeated to determine applicator shifts and OARs movements. Two CT images were matched by pelvic structures. In both imaging results, we defined the tandem by the tip and the base as the marker point, and evaluated applicator shift, including X, Y and Z. Based on the repeated CT imaging, oncologist contoured the target volume and OARs again. We combined the treatment plan with the repeated CT imaging and evaluated the change range for the doses of CTVhr D90, D2cc of OARs. Results: The average applicator shift was -0.16 mm to 0.10 mm for X, 1.49 mm to 2.14 mm for Y, and 1.9 mm to 2.3 mm for Z. The change of average physical doses and EQD2 values in Gy${\alpha}/{\beta}$ range for CTVhr D90 decreased by 2.55 % and 3.5 %, bladder D2cc decreased by 5.94 % and 8.77 %, rectum D2cc decreased by 2.94 % and 4 %, sigmoid colon D2cc decreased by 3.38 % and 3.72 %, and small intestines D2cc increased by 3.72 % and 10.94 %. Conclusions: Applicator shifts and DVH parameter changes induced the total dose inaccurately and could not be ignored. The doses of target volume and OARs varied inevitably.