• Progress in Medical Physics
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• v.27 no.2
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• pp.79-85
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• 2016

The objective of this study is to increase the accuracy of dose transmission in radiation therapy using two types of treatment tables, standard exact couch (Varian 21EX, Varian Medical Systems, Milpitas, CA) and 6D robotic couch (Novalis, BrainLAB A.G., Heimstetten, Germany)). We examined the dose attenuation based on the two types of treatment tables and studied the dose of attenuation using the phase (In/Out) for the standard exact couch. We measured the relative dose according to the incident angle of a penetrative photon beam under a treatment table. The incident angle of the photon beam was from $0^{\circ}$ to $360^{\circ}$ in the increments of $5^{\circ}$. The reference angle was set to $0^{\circ}$. Furthermore, the relative dose of the 6D robotic couch was measured using 6 MV and 15 MV, and that of the standard exact couch was measured at the sliding rail position (In-Out) using 6 MV and 10 MV. In the case of the standard exact couch, the measured relative dose was 16.53% (rails at the "In position," $175^{\circ}$, 6 MV), 12.42% (rails at the "In position," $175^{\circ}$, 10 MV), 13.13% (rails at the "Out position," $175^{\circ}$, 6 MV), and 9.96% (rails at the "Out position," $175^{\circ}$, 10 MV). In the case of the 6D robotic couch, the measured relative dose was 6.82% ($130^{\circ}$, 6 MV) and 4.92% ($130^{\circ}$, 15 MV). The photon energies were surveyed at the same incident angle. The dose attenuation for an energy of 10 MV was 4~5% lower than that for 6 MV. This indicated that the higher photon energy, lesser is the attenuation. The results of this study indicated that the attenuation rate for the 6D robotic couch was confirmed to be 1% larger than that for the standard exact couch at 6 MV and $180^{\circ}$. In the case of the standard exact couch, the dose attenuation was found to change rapidly in accordance with the phase ("In position" and "Out position") of the sliding rail.

• Progress in Medical Physics
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• v.22 no.1
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• pp.12-17
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• 2011

This study has its own goal to deliver the accurate dose on the target volume by calculating and modifying the attenuation rate of photon beam transmitting the couch top with geometric model. The experiment was that the transmission rate and attenuation rate of photon beam transmitting the couch top was predicted by the geometric model, then compared and analyzed with what was measured experimentally based on that. The result showed that the predicted value by the geometric model accorded closely with the experimental value. In addition, in order to judge whether the practical clinical application is available, the point dose, measured after modifying the attenuation rate modelinged according to the treatment plan of a patient of spine radiosurgery, was compared with the one done nothing. The result was that the former showed decreased error range with treatment planned one than the latter. This papers calculated the transmission and attenuation rate with the geometric model transmitting the couch top and verified it experimentally. This method is expected to be very useful in not only the radiosurgery using Novalis but also the general radiation therapy.

• Progress in Medical Physics
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• v.16 no.1
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• pp.39-46
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• 2005

For the QA of IMRT treatment of head and neck cancer by using M3 (BrainLAB Inc. Germany), it is not easy to measure delivery dose exactly because the dose attenuation appears by the couch according to the position of table and gantry. In order to solve this problem, we fabricated head and neck phantom which would be implemented on the couch mount of Brain Lab Inc. We investigated dose attenuation by the couch and found the difference of dose distribution by the couch, in the applying this phantom to the clinic. After measurement, we found that point dose attenuation was 35% at maximum and dose difference was 5.4% for a point dose measurement of actual patient quality assurance plan.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.1
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• pp.45-55
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• 2005

Purpose : To evaluate the usefulness of the handmade patient immobilization device and to report the clinical results of it. Materials and methods : We made two fusion images and analyzed those images. One image is made with diagnostic MR image and CT image, the other with therapeutic planning MR image and CT image. With open head holder, we measured the skin dose and attenuation dose. Also, we made the planning CT couch plate with acrylic plate and styrofoam and compared artifact. Results : We could get more accurate fusion image when we use MR head holder(within 2mm error). The skin dose was reduced 2 times and the attenuation dose was reduced more than $20\%$ when open head holder used. The planning CT couch plate was more convenient than conventional board and reduced artifact remarkably. Conclusion : We could verify the localization point in the MR image which is taken with MR head holder. So we could fuse the image more accurately. The same method could be applied to PET and US image, if the alike immobilization device used. With open head holder, the skin dose and the attenuation dose was reduced. And those above devices could substitute for expensive foreign device, if those are manufactured adequately.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.43-51
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• 2017

Purpose: The purpose of this study is to evaluate the dosimetric effects of couch attenuation and air gaps using 3D phantom for prone breast radiation therapy. Materials and method: A 3D printer(Builder Extreme 1000) and computed tomography (CT) images of a breast cancer patient were used to manufacture the customized breast phantom. Eclipse External Beam Planning 13.6 (Varian Medical Systems Palo Alto, CA, USA) was used to create the treatment plan with a dose of 200 cGy per fraction with 6 MV energy. The Optically Stimulated Luminescence Detector(OSLD) was used to measure the skin dose at four points (Med 1, Med 2, Lat 1, Lat 2) on the 3D phantom and ion-chamber (FC65-G) were used to perform the in-vivo dosimetry at the two points (Anterior, Posterior). The Skin dose and in-vivo dosimetry were measured with reference air gap (3 cm) and increased air gaps (1, 2, 3, 4, 5, 6 cm) from reference distance between the couch and 3D phantom. Results: As a result, measurement for the skin dose at lateral point showed a similar value within ${\pm}4%$ compared to the plan. While the air gap increased, skin dose at medial 1 was reduced. And it was also reduced over 7 % when the air gap was more than 3 cm compared to radiation therapy plan. At medial 2 it was reduced over 4 % as well. The changes of dose from variety of the air gap showed similar value within ${\pm}1%$ at posterior. As the air gap was increased, the dose at anterior was also increased and it was increased by 1 % from the air gap distance more than 3 cm. Conclusion: Dosimetrical measurement using 3D phantom is very useful to evaluate the dosimetric effects of couch attenuation and air gaps for prone breast radiation therapy. And it is possible to reduce the skin dose and increase the accuracy of the radiation dose delivery by appling the optimized air gap.

• The Journal of Korean Society for Radiation Therapy
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• v.28 no.1
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• pp.77-86
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• 2016

Purpose : When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) Materials and Methods : VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every $5^{\circ}$ gantry angle in a different filed size($3{\times}3cm^2$, $10{\times}10cm^2$) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the $127^{\circ}$ in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was $0.9g/cm^3$, and in the case of Spine Down Bar, it was $0.7g/cm^3$. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the $170^{\circ}beam$ crossing the Spine Down Bar. Conclusion : To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.273-280
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• 2014

Purpose : To verify the skin dose in Tomotherapy-based radiation treatment according to the change in tumor locations, skin dose was measured by using Gafchromic EBT3 film and compared with the planned doses to find out the gap between them. Materials and Methods : In this study, to measure the skin dose, I'm RT Phantom(IBA Dosimetry, Germany) was utilized. After obtaining the 2.5mm CT images, tumor locations and skin dose measuring points were set by using Pinnacle(ver 9.2, Philips Medical System, USA). The tumor location was decided to be 5mm and 10mm away from surface of the phantom and center. Considering the attenuation of a Tomo-couch, we ensured a symmetric placement between the ceiling and floor directions of the phantom. The measuring point of skin doses was set to have 3mm and 5mm thickness from the surface. Measurement was done 3 times. By employing TomoHD(TomoHD treatment system, Tomotherapy Inc., Madison, Wisconsin, USA), we devised Tomotherapy plans, measured 3 times by inserting Gafchromic EBT3 film into the phantom and compared the measurement with the skin dose treatment plans. Results : The skin doses in the upper part of the phantom, when the tumor was located in the center, were found to be 7.53 cGy and 7.25 cGy in 5mm and 3mm respectively. If placed 5mm away from the skin in the ceiling direction, doses were 18.06 cGy and 16.89 cGy; if 10mm away, 20.37 cGy and 18.27 cGy, respectively. The skin doses in the lower part of the phantom, when the tumor was located in the center, recorded 8.82 cGy and 8.29 cGy in 5mm and 3mm, each; if located 5mm away from the lower part skin, 21.69 cGy and 19.78 cGy were respectively recorded; and if 10mm away, 20.48 cGy and 19.57 cGy were recorded. If the tumor was placed in the center, skin doses were found to increase by 3.2~17.1% whereas if the tumor is 5mm away from the ceiling part, the figure decreased to 2.8~9.0%. To the Tomo-couch direction, skin doses showed an average increase of 11% or over, compared to the planned treatment. Conclusion : This study found gaps between planned skin doses and actual doses in the Tomotherapy treatment planning. Especially to the Tomo-cocuh direction, skin doses were found to be larger than the planned doses. Thus, during the treatment of tumors near the Tomo-couch, doses will need to be more accurately calculated and more efforts to verify skin doses will be required as well.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.27-34
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• 2018

Purpose : To evaluate the effect of carbon couch side rail and vacuum immobilization device in case of lung RPO irradiation. Materials and Methods : The 10, 20, 30 mm thickness of vac-lok's right side were obtained. To measure of doses, glass dosimeters were used and measured reference point is left lung center at the phantom. A, B, C, and D points are left, right, down, and up directions based on the center point. In the state of Side-Rail-Out, place the without vac-lok, with the thickness of 10, 20, and 30 mm vac-lok. After the glass dosimeters was inserted in center, A, B, C, and D points, 100 MU of 6 MV X-ray were irradiated to the referenced center point in the condition of $10{\times}10cm^2$ field size, SAD 100 cm, gantry angle 225, 300 MU/min dose rate. Five measurements were made for each point. In the state of Side-Rail-In, five measurement were made for each point under the same conditions. The average is measured on each of the five Side-Rail-Out and Side-Rail-In measurements. Results : In the presence of side rail, the dose reduction ratio was -11.8 %, -12.3 %, -4.1 %, -12.3 %, -7.3 % for each A, B, C, and D points. In the state of Side-Rail-Out, the dose reduction ratio for the using 10 mm thickness of vac-lok was -0.9 % than without vac-lok. The dose reduction ratio for the using 20 mm thickness of vac-lok was -2.0 %, for the using 30 mm thickness of the vac-lok was -3.0 % than without vac-lok. In the state of Side-Rail-In, the dose reduction ratio for the using 10 mm thickness of vac-lok was -1.0 % than without vac-lok. The dose reduction ratio for the using 20 mm vac-lok was -2.1 %, for the using 30 mm vac-lok was -3.0 % than without vac-lok. Based on the value of no vac-lok dose in the Side-Rail-In state, The dose reduction ratios for the using 10 mm, 20 mm and 30 mm thickness of vac-loks In the Side-Rail-Out that the center point were -12.7 %, -13.7 %, -14.2 % and -12.8 %, -13.8 %, -14.5 % respectively at point A. The dose reduction ratios for the same conditions to the B point were -4.9 %, -6.1 %, -7.1 % and -13.4 %, -14.4 %, -15.5 % respectively at point C. The dose reduction ratios for the same conditions to the D point were -8.4 %, -9.0 %, -10.4 % respectively. Conclusion : The attenuation was caused by presence of side rails and thickness of vac-lok. Pay attention to these attenuation factors, making it a more effective radiation therapy.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.115-121
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• 2013

Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.