• Progress in Medical Physics
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• v.25 no.3
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• pp.167-175
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• 2014

The purpose of this study is to evaluate the variation of the dose which is delivered to the patients with glottis cancer under IMRT (intensity modulated radiation therapy) by using the 3D registration with CBCT (cone beam CT) images and the DIR (deformable image registration) techniques. The CBCT images which were obtained at a one-week interval were reconstructed by using B-spline algorithm in DIR system, and doses were recalculated based on the newly obtained CBCT images. The dose distributions to the tumor and the critical organs were compared with reference. For the change of volume depending on weight at 3 to 5 weeks, there was increased of 1.38~2.04 kg on average. For the body surface depending on weight, there was decreased of 2.1 mm. The dose with transmitted to the carotid since three weeks was increased compared be more than 8.76% planned, and the thyroid gland was decreased to 26.4%. For the physical evaluation factors of the tumor, PITV, TCI, rDHI, mDHI, and CN were decreased to 4.32%, 5.78%, 44.54%, 12.32%, and 7.11%, respectively. Moreover, $D_{max}$, $D_{mean}$, $V_{67.50}$, and $D_{95}$ for PTV were increased or decreased to 2.99%, 1.52%, 5.78%, and 11.94%, respectively. Although there was no change of volume depending on weight, the change of body types occurred, and IMRT with the narrow composure margin sensitively responded to such a changing. For the glottis IMRT, the patient's weight changes should be observed and recorded to evaluate the actual dose distribution by using the DIR techniques, and more the adaptive treatment planning during the treatment course is needed to deliver the accurate dose to the patients.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.613-620
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• 2017

Planning dose must be delivered accurately for radiation therapy. Also, It must be needed accurately setup. However, patient positioning images were need for accuracy setup. Then patient positioning images is followed by additional exposure to radiation. For 45 points in the phantom, we measured the doses for 6 MV and 10 MV photon beams, OBI(On Board Imager) and CBCT(Conebeam Computed Tomography) using OSLD(Optically Stimulated Luminescent Dosimeter). We compared the differences in the cases where posture confirmation imaging at each point was added to the treatment dose. Also, we tried to propose a photography cycle that satisfies the 5% recommended by AAPM(The American Association of Physicists in Medicine). As a result, a maximum of 98.6 cGy was obtained at a minimum of 45.27 cGy at the 6 MV, a maximum of 99.66 cGy at a minimum of 53.34 cGy at the 10 MV, a maximum of 2.64 cGy at the minimum of 0.19 cGy for the OBI and a maximum of 17.18 cGy at the minimum of 0.54 cGy for the CBCT.The ratio of the radiation dose to the treatment dose is 3.49% in the case of 2D imaging and the maximum is 22.65% in the case of 3D imaging. Therefore, tolerance of 2D image is 1 exposure per day, and 3D image is 1 exposure per week. And it is need to calculation of separate in the parallelism at additional study.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.345-354
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• 2014

Purpose : We evaluated the usefulness of $Fraxion^{(R)}$ system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. Materials and Methods : 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while $Fraxion^{(R)}$ system was used for the other 3 patients (group2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. Results : The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when $Fraxion^{(R)}$ system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using $Fraxion^{(R)}$ system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when s-thermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using $Fraxion^{(R)}$ system showed only 1.9%. All percentage were calculated with respect to average value. Conclusion : Using $Fraxion^{(R)}$ system including mouthpiece, Fraxion frame, frontpiece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.35-46
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• 2021

Purpose : By comparing and analyzing treatment plans using abdominal compression and The Continuous Positive Air Pressure(CPAP) during SABR of lung cancer, we try to contribute to the improvement of radiotherapy effect. Materials & Methods : In two of the lung SABR patients(A, B patient), we developed a SABR plan using abdominal compression device(the Body Pro-Lok, BPL) and CPAP and analyze the treatment plan through homogeneity, conformity and the parameters proposed in RTOG 0813. Furthermore, for each phase, the X, Y, and Z axis movements centered on PTV are analyzed in all 4D CTs and compared by obtaining the volume and average dose of PTV and OAR. Four cone beam computed tomography(CBCT) were used to measure the directions from the center of the PTV to the intrathoracic contacts in three directions out of 0°, 90°, 180° and 270°, and compare the differences from the average distance values in each direction. Result : Both treatment plans obtained using BPL and CPAP followed recommendations from RTOG, and there was no significant difference in homogeneity and conformity. The X-axis, Y-axis, and Z-axis movements centered on PTV in patient A were 0.49 cm, 0.37 cm, 1.66 cm with BPL and 0.16 cm, 0.12 cm, and 0.19 cm with CPAP, in patient B were 0.22 cm, 0.18 cm, 1.03 cm with BPL and 0.14 cm, 0.11 cm, and 0.4 cm with CPAP. In A patient, when using CPAP compared to BPL, ITV decreased by 46.27% and left lung volume increased by 41.94%, and average dose decreased by 52.81% in the heart. In B patient, volume increased by 106.89% in the left lung and 87.32% in the right lung, with an average dose decreased by 44.30% in the stomach. The maximum difference of A patient between the straight distance value and the mean distance value in each direction was 0.05 cm in the a-direction, 0.05 cm in the b-direction, and 0.41 cm in the c-direction. In B patient, there was a difference of 0.19 cm in the d-direction, 0.49 cm in the e-direction, and 0.06 cm in the f-direction. Conclusion : We confirm that increased lung volume with CPAP can reduce doses of OAR near the target more effectively than with BPL, and also contribute more effectively to restriction of tumor movement with respiration. It is considered that radiation therapy effects can be improved through the application of various sites of CPAP and the combination with CPAP and other treatment machines.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.199-206
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• 2014

Purpose : According to the rapid increase recently in image-guided radiation therapy, It is necessary to control of the image guidance system completely. In particular for the main subject to the accuracy of image guided radiation therapy device to be done essentially the quality assurance. We made efficient phantom in AMC for the management of the accurate and efficient. Materials and Methods : By setting up of five very important as a quality assurance inventory of the Image guidance system, we made (AMC G-Box) phantom for quality assurance efficient and accurate. Quality assurance list were the Iso-center align, the real measurement, the center align of four direction, the accuracy of table movement and the reproducibility of Hounsfield Unit. The rectangular phantom; acrylic with a thickness of 1 cm to $10cm{\time}10cm{\time}10cm$ was inserted the three materials with different densities respectively for measure the CBCT HU. The phantom was to perform a check of consistency centered by creating a marker that indicates the position of the center fixed. By performing the quality assurance using the phantom of existing, comparing the resulting value to the different resulting value using the AMC G-Box, experiment was analyzed time and problems. Therapy equipment was used Varian device. It was measured twice at 1-week intervals. Results : When implemented quality assurance of an image guidance system using AMC G-Box and a phantom existing has been completed, the quality assurance result is similar in $0.2mm{\pm}0.1$. In the case of the conventional method, it was 45 minutes at 30 minutes. When using AMC G-Box, it takes 20 minutes 15 minutes, and declined to 50% of the time. Conclusion : The consistency and accurate of image guidance system tend to decline using device. Therefore, We need to perform thoroughly on the quality assurance related. It needs to be checked daily to consistency check especially. When using the AMC G-Box, It is possible to enhance the accuracy of the patient care and equipment efficiently performing accurate quality assurance.

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

• Journal of radiological science and technology
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• v.33 no.2
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• pp.109-120
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• 2010

The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.