• Journal of radiological science and technology
• /
• v.42 no.6
• /
• pp.447-454
• /
• 2019

In order to improve and supplement the shielding method for electron beam treatment, we designed a patient-specific shielding method using a 3D printer, and evaluated the usefulness by comparing and analyzing the distribution of electron beam doses to adjacent organs. In order to treat 5 cm sized superficial tumors around the lens, a CT Simulator was used to scan the Alderson Rando phantom and the DICOM file was converted into an STL file. The converted STL file was used to design a patient-specific shield and mold that matched the body surface contour of the treatment site. The thickness of the shield was 1 cm and 1.5 cm, and the mold was printed using a 3D printer, and the patient customized shielding block (PCSB) was fabricated with a cerrobend alloy with a thickness of 1 cm and 1.5 cm. The dosimetry was performed by attaching an EBT3 film on the surface of the Alderson Rando phantom eyelid and measuring the dose of 6, 9, and 12 MeV electron beams on the film using four shielding methods. Shielding rates were 83.89%, 87.14%, 87.39% at 6, 9, and 12 MeV without shielding, 1 cm (92.04%, 87.48%, 86.49%), 1.5 cm (91.13%, 91.88% with PSCB), 92.66%) The shielding rate was measured as 1 cm (90.7%, 92.23%, 88.08%) and 1.5 cm (88.31%, 90.66%, 91.81%) when the shielding block and the patient-specific shield were used together. PCSB fabrication improves shielding efficiency over conventional shielding methods. Therefore, PSCB may be useful for clinical application.

• The Journal of Korean Society for Radiation Therapy
• /
• v.31 no.1
• /
• pp.75-81
• /
• 2019

Purpose: Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer. Methods and materials: For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse. Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room. Results: The Hounsfield unit (HU) of the bolus measured by CT was $52{\pm}37.1$. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was $179.66{\pm}2.62cGy$, $184.33{\pm}1.24cGy$ and $195.33{\pm}1.69cGy$. And the error rates were -3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was $182.00{\pm}1.63cGy$, $193.66{\pm}2.05cGy$ and $196{\pm}2.16cGy$. The error rates were -2.46 %, 0.23 % and 2.83 %. Conclusions: The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator in 3D printer, will increase later.

• Journal of radiological science and technology
• /
• v.39 no.1
• /
• pp.35-42
• /
• 2016

Room-temperature operating CdZnTe(CZT) material is an innovative radiation detector which could reduce the patient dose to one-tenth level of conventional CT (Computed Tomography) and mammography system. The pixel and pixel pitch in the imaging device determine the conversion efficiency of incident X-or gamma-ray and the cross-talk of signal, that is, image quality of detector system. The weighting potential is the virtual potential determined by the position and geometry of electrode. The weighting potential obtained by computer-based simulation in solving Poisson equation with proper boundaries condition. The pixel was optimized by considering the CIE (charge induced efficiency) and the signal cross-talk in CT detector system. The pixel pitch was 1-mm and the detector thickness was 2-mm in the simulation. The optimized pixel size and inter-pixel distance for maximizing the CIE and minimizing the signal cross-talk is about $750{\mu}m$ and $125{\mu}m$, respectively.

• The Journal of Korean Society for Radiation Therapy
• /
• v.27 no.1
• /
• pp.45-52
• /
• 2015

Purpose : The dose distribution of organ at risk (OAR) and normal tissue is affected by treatment technique in postoperative radiation therapy for prostate cancer. The aim of this study was to compare dose distribution characteristic and to evaluate treatment efficiency by devising VMAT plans according to applying differed number of arc and IMRT plan for postoperative patient of prostate cancer radiation therapy using a rectal balloon. Materials and Methods : Ten patients who received postoperative prostate radiation therapy in our hospital were compared. CT images of patients who inserted rectal balloon were acquired with 3 mm thickness and 10 MV energy of HD120MLC equipped Truebeam STx (Varian, Palo Alto, USA) was applied by using Eclipse (Version 11.0, Varian, Palo Alto, USA). 1 Arc, 2 Arc VMAT plans and 7-field IMRT plan were devised for each patient and same values were applied for dose volume constraint and plan normalization. To evaluate these plans, PTV coverage, conformity index (CI) and homogeneity index (HI) were compared and $R_{50%}$ was calculated to assess low dose spillage as per treatment plan. $D_{25%}$ of rectum and bladder Dmean were compared on OAR. And to evaluate the treatment efficiency, total monitor units(MU) and delivery time were considered. Each assessed result was analyzed by average value of 10 patients. Additionally, portal dosimetry was carried out for accuracy verification of beam delivery. Results : There was no significant difference on PTV coverage and HI among 3 plans. Especially CI and $R_{50%}$ on 7F-IMRT were the highest as 1.230, 3.991 respectively(p=0.00). Rectum $D_{25%}$ was similar between 1A-VMAT and 2A-VMAT. But approximately 7% higher value was observed on 7F-IMRT compare to the others(p=0.02) and bladder Dmean were similar among the all plan(P>0.05). Total MU were 494.7, 479.7, 757.9 respectively(P=0.00) for 1A-VMAT, 2A-VMAT, 7F-IMRT and at the most on 7F-IMRT. The delivery time were 65.2sec, 133.1sec, 145.5sec respectively(p=0.00). The obvious shortest time was observed on 1A-VMAT. All plans indicated over 99.5%(p=0.00) of gamma pass rate (2 mm, 2%) in portal dosimetry quality assurance. Conclusion : As a result of study, postoperative prostate cancer radiation therapy for patient using a rectal balloon, there was no significant difference of PTV coverage but 1A-VMAT and 2A-VMAT were more efficient for dose reduction of normal tissue and OARs. Between VMAT plans. $R_{50%}$ and MU were little lower in 2A-VMAT but 1A-VMAT has the shortest delivery time. So it is regarded to be an effective plan and it can reduce intra-fractional motion of patient also.

• Radiation Oncology Journal
• /
• v.14 no.2
• /
• pp.149-158
• /
• 1996

Purpose : To get an accute steepness of dose gradients at outside the target volume in intracranial lesion and a less limitation of beam selection avoiding the high dose at normal brain tissue, this Photon Knife Radiosurgery System was developed in order to provide the three-dimensional dose distribution through the reconstruction of CT scan and the combined stereotactic trans-multiarc beam mode based on linear accelerator photon beam. Materials and methods : This stereotactic radiosurgery, Photon Knife based on linear accelerator photon beam was provided the non-coplanar multiarc and trans-multiarc irradiations. The stereotactic trans-multiarc beam mode can be obtained from the patient position in decubitus. This study has provided the 3-dimensional isodose curve and anatomical structures with the surface rendering technique. The dose distribution from the combined two trans-multiarcs (2M 2TM) was compared to that of four non-coplanar multiarcs (4M) with same collimator size of 25 mm in a diameter and total gantry movements. Results : In this study, it shows that the dose distributions of stereotactic beam mode are significantly depended on the selected couch and gantry angle in same collimator size. Practical dose distribution of combined stereotactic trans-multiarc beam has shown a more small rim thickness than that of the non-coplanar multiarc beam mode in axial, sagittal and coronal plane in our study. 3-Dimensional dose line displayed with surface rendering of irregular target shape is helpful to determine the target dose and to predict the prognosis in follow-up radiosurgery. Conclusions : 3-Dimensional dose line displayed with surface rendering of irregular target shape is essential in stereotactic radiosurgery. This combined stereotactic trans-multiarc beam has shown a less limitation of the selection couch and gantry beam angles for the target surrounding critical organs. It has shown that the dose distribution of combined trans-multiarc beam greatly depended on the couch and gantry angles. In our experiments, the absorbed dose has been decreased to $27%$ / mm in maximum at the interval of $50\%$ to $80\%$ of isodose line.

• The Journal of Korean Society for Radiation Therapy
• /
• v.25 no.1
• /
• pp.1-8
• /
• 2013

Purpose: A selection of proper energy in treatment planning is very important because of having different dose distribution in body as photon energy. In generally, the low energy photon has been used in intensity-modulated radiation therapy (IMRT) for head and neck (H&N) cancer. The aim of this study was to evaluate the effect of partially used high energy photon at posterior oblique fields on IMRT plan for H&N cancer. Materials and Methods: The study was carried out on 10 patients (nasopharyngeal cancer 5, tonsilar cancer 5) treated with IMRT in Seoul National University Bundang Hospital. CT images were acquired 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). Two plans were generated under same planing objectives, dose volume constraints, and eight fields setting: (1) The low energy plan (LEP) created using 6 MV beam alone, (2) the partially used high energy plan (PHEP) created partially using 15 MV beam at two posterior oblique fields with deeper penetration depths, while 6 MV beam was used at the rest of fields. The plans for LEP and PHEP were compared in terms of coverage, conformity index (CI) and homogeneity index (HI) for planning target volume (PTV). For organs at risk (OARs), $D_{mean}$ and $D_{50%}$ were analyzed on both parotid glands and $D_{max}$, $D_{1%}$ for spinal cord were analyzed. Integral dose (ID) and total monitor unit (MU) were compared as addition parameters. For the comparing dose to normal tissue of posterior neck, the posterior-normal tissue volume (P-NTV) was set on the patients respectively. The $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ for P-NTV were evaluated by using dose volume histogram (DVH). Results: The dose distributions were similar with regard to coverage, CI and HI for PTV between the LEP and PHEP. No evident difference was observed in the spinal cord. However, the $D_{mean}$, $D_{50%}$ for both parotid gland were slightly reduced by 0.6%, 0.7% in PHEP. The ID was reduced by 1.1% in PHEP, and total MU for PHEP was 1.8% lower than that for LEP. In the P-NTV, the $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ of the PHEP were 1.6%, 1.8% and 2.9% lower than those of LEP. Conclusion: Dose to some OARs and a normal tissue, total monitor unit were reduced in IMRT plan with partially used high energy photon. Although these reduction are unclear how have a clinical benefit to patient, application of the partially used high energy photon could improve the overall plan quality of IMRT for head and neck cancer.

• Radiation Oncology Journal
• /
• v.21 no.1
• /
• pp.82-93
• /
• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

• Progress in Medical Physics
• /
• v.25 no.4
• /
• pp.271-280
• /
• 2014

Recently, digital breast tomosynthesis (DBT) has been investigated to overcome the limitation of conventional mammography for overlapping anatomical structures and high patient dose with cone-beam computed tomography (CBCT). However incomplete sampling due to limited angle leads to interference on the neighboring slices. Many studies have investigated to reduce artifacts such as interference. Moreover, appropriate filters for tomosynthesis have been researched to solve artifacts resulted from incomplete sampling. The primary purpose of this study is finding appropriate filter scheme with FBP reconstruction for DBT system to reduce artifacts. In this study, we investigated characteristics of various filter schemes with simulation and prototype digital breast tomosynthesis under same acquisition parameters and conditions. We evaluated artifacts and noise with profiles and COV (coefficinet of variation) to study characteristic of filter. As a result, the noise with parameter 0.25 of Spectral filter reduced by 10% in comparison to that with only Ramp-lak filter. Because unbalance of information reduced with decreasing B of Slice thickness filter, artifacts caused by incomplete sampling reduced. In conclusion, we confirmed basic characteristics of filter operations and improvement of image quality by appropriate filter scheme. The results of this study can be utilized as base in research and development of DBT system by providing information that is about noise and artifacts depend on various filter schemes.