• 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.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.401-408
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• 2021

Proton therapy using the Bragg peak is one of the radiation therapies and can deliver its maximum energy to the tumor with giving least energy for normal tissue. A cross-sectional image of the human body taken with the computed tomography (CT) has been used for radiation therapy planning. The HU values change according to the tube voltage, which lead to the change in the boundary and thickness of the anatomical structure on the CT image. This study examined the changes in the Bragg peak of the brain region according to the thickness variation in the head phantom composed of several materials using the Geant4. In the phantom composed of a single material, the Bragg peak according to the type of media and the incident energy of the proton beams were calculated, and the reliability of Geant4 code was verified by the Bragg peak. The variation of the peak in the brain region was examined when each thickness of the head phantom was changed. When the thickness of the soft tissue was changed, there was no change in the peak position, and for the skin the change in the peak was small. The change of the peak position was mainly changed when the bone thickness. In particular, when the bone was changed only or the bone was changed together with other tissues, the amount of change in the peak position was the same. It is considered that measurement of the accurate bone thickness in CT images is one of the key factors in depth-dose distribution of the radiation therapy planning.

• Journal of the Korean Society of Radiology
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• v.14 no.1
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• pp.7-14
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• 2020

The purpose of this study is to assess the usefulness of IR to compensate for uncertainties in inserting high density artificial objects in radiation treatment planning in the 3D-CRT treatment technique. CT images of the subjects with phantom and titanium inserted were obtained from images without IR and images with IR, and the dose evaluation factors HI, MU and volume evaluation factors Volume and PCI were compared. The results of the stainless steel and titanium phantom experiments showed that the volume of high density artificial material was reduced by 4.850% and 11.456% respectively when applying IR. MU decreased 0.924% and 1.181%. HI was down 0.106% and 0.272%. PCI decreased 0.358% and 0.867%. When IR was applied to CT images of subjects with vertebroplasty, Femur alignment pin and wrist alignment pin, the volume of artifacts decreased by 47.76%, 23.841%, and 49.339%. MU also decreased 0.924%, 0.294% and 1.675%, while HI decreased 1.232%, 0.412% and 1.695%. PCI decreases 4.022%, 0.512%, and 13.472%. In conclusion, When IR was applied to 3D-CRT treatment plan, both dose and volume in phantom and subject case with high density artificial insert were reduced.

• Journal of the Korean Society of Radiology
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• v.15 no.1
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• pp.21-28
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• 2021

Computed tomography (CT) has the problem of having more radiation exposure compared to other radiographic apparatus. There is a low-dose imaging technique for reducing exposure, but it has a disadvantage of increasing noise in the image. To compensate for this, various noise reduction algorithms have been developed that improve image quality while reducing the exposure dose of patients, of which the median modified Wiener filter (MMWF) algorithm that can be effectively applied to CT devices with excellent time resolution has been presented. The purpose of this study is to optimize the mask size of MMWF algorithm and to see the excellence of noise reduction of MMWF algorithm for existing algorithms. After applying the MMWF algorithm with each mask sizes set from the MASH phantom abdominal images acquired using the MATLAB program, which includes Gaussian noise added, and compared the values of root mean square error (RMSE), peak signal-to-noise ratio (PSNR), coefficient correlation (CC), and universal image quality index (UQI). The results showed that RMSE value was the lowest and PSNR, CC and UQI values were the highest in the 5 x 5 mask size. In addition, comparing Gaussian filter, median filter, Wiener filter, and MMWF with RMSE, PSNR, CC, and UQI by applying the optimized mask size. As a result, the most improved RMSE, PSNR, CC, and UQI values were showed in MMWF algorithms.

• Progress in Medical Physics
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• v.29 no.1
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• pp.1-7
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• 2018

The $TomoTherapy^{(R)}$ beam-delivery method creates helical beam-junctioning patterns in the dose distribution within the target. In addition, the dose discrepancy results in the particular region where the resonance by pattern of dose delivery occurs owing to the change in the position and shape of internal organs with a patient's respiration during long treatment times. In this study, we evaluated the dose pattern of the longitudinal profile with the change in respiration. The superior-inferior motion signal of the programmable respiratory motion phantom was obtained using AbChes as a four-dimensional computed tomography (4DCT) original moving signal. We delineated virtual targets in the phantom and planned to deliver the prescription dose of 300 cGy using field widths of 1.0 cm, 2.5 cm, and 5.0 cm. An original moving signal was fitted to reflecting the beam delivery time of the $TomoTherapy^{(R)}$. The EBT3 film was inserted into the phantom movement cassette, and static, without the movement and with the original movement, was measured with signal changes of 2.0 s, 4.0 s, and 5.0 s periods, and 2.0 mm and 4.0 mm amplitudes. It was found that a dose fluctuation within ${\pm}4.0%$ occurred in all longitudinal profiles. Compared with the original movement, the region of the gamma index above 1 partially appeared within the target and the border of the target when the period and amplitude were changed. Gamma passing rates were 95.00% or more. However, cases for a 5.0 s period and 4.0 mm amplitude at a field width of 2.5 cm and for 2.0 s and 5.0 s periods at a field width of 5.0 cm have gamma passing rates of 92.73%, 90.31%, 90.31%, and 93.60%. $TomoTherapy^{(R)}$ shows a small difference in dose distribution according to the changes of period and amplitude of respiration. Therefore, to treat a variable respiratory motion region, a margin reflecting the degree of change of respiration signal is required.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.93-109
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• 2020

Purpose: The radiochromic film (Gafchromic EBT3, Ashland Advanced Materials, USA) and 3-dimensional analysis system dosimetry checkTM (DC, MathResolutions, USA) were evaluated for patient-specific quality assurance (QA) of helical tomotherapy. Materials and Methods: Depending on the tumors' positions, three types of targets, which are the abdominal tumor (130.6㎤), retroperitoneal tumor (849.0㎤), and the whole abdominal metastasis tumor (3131.0㎤) applied to the humanoid phantom (Anderson Rando Phantom, USA). We established a total of 12 comparative treatment plans by the four geometric conditions of the beam irradiation, which are the different field widths (FW) of 2.5-cm, 5.0-cm, and pitches of 0.287, 0.43. Ionization measurements (1D) with EBT3 by inserting the cheese phantom (2D) were compared to DC measurements of the 3D dose reconstruction on CT images from beam fluence log information. For the clinical feasibility evaluation of the DC, dose reconstruction has been performed using the same cheese phantom with the EBT3 method. Recalculated dose distributions revealed the dose error information during the actual irradiation on the same CT images quantitatively compared to the treatment plan. The Thread effect, which might appear in the Helical Tomotherapy, was analyzed by ripple amplitude (%). We also performed gamma index analysis (DD: 3mm/ DTA: 3%, pass threshold limit: 95%) for pattern check of the dose distribution. Results: Ripple amplitude measurement resulted in the highest average of 23.1% in the peritoneum tumor. In the radiochromic film analysis, the absolute dose was on average 0.9±0.4%, and gamma index analysis was on average 96.4±2.2% (Passing rate: >95%), which could be limited to the large target sizes such as the whole abdominal metastasis tumor. In the DC analysis with the humanoid phantom for FW of 5.0-cm, the three regions' average was 91.8±6.4% in the 2D and 3D plan. The three planes (axial, coronal, and sagittal) and dose profile could be analyzed with the entire peritoneum tumor and the whole abdominal metastasis target, with planned dose distributions. The dose errors based on the dose-volume histogram in the DC evaluations increased depending on FW and pitch. Conclusion: The DC method could implement a dose error analysis on the 3D patient image data by the measured beam fluence log information only without any dosimetry tools for patient-specific quality assurance. Also, there may be no limit to apply for the tumor location and size; therefore, the DC could be useful in patient-specific QAl during the treatment of Helical Tomotherapy of large and irregular tumors.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.341-349
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• 2011

This study was to measure the patient dose difference between 3D treatment planning CT and 4D respiratory gating CT. Study was performed with each 10 patients who have lung and liver cancer for measured patient exposure dose by using SOMATON SENSATION OPEN(SIMENS, GERMANY). CTDIvol and DLP value was used to analyze patient dose, and actual dose was measured in the location of liver and kidney for abdominal examination and lung, heart and spinal cord for chest examination. Rando phantom were used for the experiment. OSLD was used for in-vitro and in-vivo dosimetry. Increasing overall actual dose in 4D respiratory gated CT-simulation using OSLD increase the dose by 5.5 times for liver cancer patients and 6 times for lung cancer patients. In CT simulation of 10 lung cancer patients, CTDIvol value was increased by 5.7 times and DLP 2.4 times. For liver cancer patients, CTDIvol was risen by 3.8 times and DLP 1.6 times. The accuracy of treatment volume could be increased in 4D CT planning for position change due to the breaths of patient in the radiation therapy. However, patients dose was increased in 4D CT than 3D CT. In conclusion, constant efforts is required to reduce patients dose by reducing scan time and scan range.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.10
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• pp.4418-4424
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• 2011

This study is aimed to assess the effect of the gamma ray of 511keV energy which is emitted from phantom where the positron emission radionuclide was injected on X-ray CT image. As a scanning method, the CT number and pixel value of the reference image where water was injected(0 mCi), and those acquired by changing the capacity of 18F(Fluorine), positron emission radionuclide, into 1 mCi, 2 mCi, 5 mCi, and 10 mCi were measured. As a result of measuring the CT number(HU) of the phantom image where the positron emission radionuclide($^{18}F$) was injected, there were reference water ($-7.58{\pm}0.66$ HU), 1 mCi($-9.85{\pm}0.50$ HU), 2 mCi($-10.27{\pm}0.21$ HU), 5 mCi($-11.31{\pm}0.66$ HU), and 10 mCi($-13.47{\pm}0.38$ HU). Compared with the image where it was filled with water, there was a reduction of 5.89 Hu in 10 mCi, 3.73 in 5 mCi, 2.69 HU in 2 mCi, and 2 HU in 1 mCi. As for the pixel value of the phantom image, there were reference water ($-2.70{\pm}0.75$), 1 mCi($-4.72{\pm}0.58$), 2 mCi($-6.01{\pm}0.78$), 5 mCi($-6.10{\pm}0.84$), and 10 mCi($-8.20{\pm}0.60$). Compared with the reference image, there was a reduction of 5.50 in 10 mCi, 3.40 in 5 mCi, 3.10 in 2 mCi, and 2.02 in 1 mCi. Through this experiment, it was indicated that, with the increase in the dose of the positron emission radionuclide($^{18}F$), the CT number and the pixel value of the image reduced proportionally, and the width of reduction showed a similar value, too. Accordingly, according to the degree of change in X-ray CT image due to the positron emission radionuclide in the quality control item of PET/CT, the proper standard should be established and it should be periodically managed.

• Progress in Medical Physics
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• v.17 no.2
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• pp.105-113
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• 2006

This study peformed to confirm the corrected dose In different electron density materials using the superposition/FFT convolution method in radiotherapy Planning system. The experiments of the $K_2HPO_4$ diluted solution for bone substitute, Cork for lung and n-Glucose for soft tissue are very close to effective atomic number of tissue materials. The image data acquisited from the 110 KVp and 130 KVp CT scanner (Siemes, Singo emotions). The electron density was derived from the CT number (H) and adapted to planning system (Xio, CMS) for heterogeneity correction. The heterogeneity tissue phantom used for measurement dose comparison to that of delivered computer planning system. In the results, this investigations showed the CT number is highly affected in photoelectric effect in high Z materials. The electron density in a given energy spectrum showed the relation of first order as a function of H in soft tissue and bone materials, respectively. In our experiments, the ratio of electron density as a function of H was obtained the 0.001026H+1.00 in soft tissue and 0.000304H+1.07 for bone at 130 KVp spectrum and showed 0.000274H+1.10 for bone tissue in low 110 KVp. This experiments of electron density calibrations from CT number used to decide depth and length of photon transportation. The Computed superposition and FFT convolution dose showed very close to measurements within 1.0% discrepancy in homogeneous phantom for 6 and 15 MV X rays, but it showed -5.0% large discrepancy in FFT convolution for bone tissue correction of 6 MV X rays. In this experiments, the evaluated doses showed acceptable discrepancy within -1.2% of average for lung and -2.9% for bone equivalent materials with superposition method in 6 MV X rays. However the FFT convolution method showed more a large discrepancy than superposition in the low electron density medium in 6 and 15 MV X rays. As the CT number depends on energy spectrum of X rays, it should be confirm gradient of function of CT number-electron density regularly.

• Progress in Medical Physics
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• v.20 no.4
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• pp.324-330
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• 2009

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System ($Synchrony^{TM}$, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were $11.5{\pm}3.09\;mm$ for desynchronization and $0.14{\pm}0.08\;mm$ for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was $0.18{\pm}0.06\;mm$. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was $17.39{\pm}0.14\;mm$ for inactivity and $1.37{\pm}0.11\;mm$ for activity. The mean difference of absolute dose was $0.68{\pm}0.38%$ in static target and $1.31{\pm}0.81%$ in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.