• 대한디지털의료영상학회논문지
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• 제12권1호
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• pp.59-64
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• 2010

We examined the accuracy and efficiency of phantom by applying the designed phantom in order to check daily quality assurance easily by objective criteria and to confirm daily quality assurance of linear accelerator, simulator, and CT-simulator. The results of 10 weeks of linear accelerator output dose using American Association of Physicists in Medicine(AAPM) daily quality assurance guide were measured within ${\pm}1%$ of error. Mechanical check of laser alignment, optical distance indicator(ODI), CT scanner laser and alignment of gantry lasers with the center of imaging plane were measured within ${\pm}1mm$. Daily average working time for daily quality assurance of radiation therapy equipments was 38 minutes. The designed phantom was easy to install and daily quality assurance was possible with only one installation. The aspects reproducibility and efficiency as well as accuracy of quality assurance were excellent.

• Nuclear Medicine and Molecular Imaging
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• 제42권2호
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• pp.137-144
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• 2008

Positron emission tomography-computed tomography (PET/CT) provides both functional and anatomical images of high quality non-invasively with better precision in localization than PET alone. Increase in the use of PET/CT, coupled with increasing concerns about the quality of medical services accrued the demands for accurate evaluation of system performance and quality assurance. Thus, well designed programs for performance evaluation and quality assurance are needed. Widely used protocols for performance evaluation of PET are the methods proposed by National Electrical Manufacturers Association (NEMA) in 1994 and 2001. In addition, in order to maintain high quality of PET/CT images, quality assurance programs including periodic (daily, monthly, and yearly). Therefore, in this article, the methods and present state of performance evaluation and quality assurance of PET/CT are reviewed.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• 한국의학물리학회지:의학물리
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• 제21권1호
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• pp.99-112
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• 2010

국내에서 방사선치료를 위한 선형가속기 품질관리 프로토콜은 많이 개발되어 왔지만 선형가속기를 기반으로 하는 방사선수술장비의 품질관리 프로토콜 개발은 현재까지 거의 이루어져 있지 않고 있다. 이에 본 연구는 선형가속기 기반 일체형 방사선수술장비인 노발리스의 정확도 및 정밀도를 유지하기 위하여 일간, 주간, 월간, 연간에 주기적으로 시행하여야 하는 노발리스 품질관리 프로토콜을 개발 하고 품질관리 상태의 종합적 확인을 할 수 있는 해부학적 팬텀을 제작하였다. 이를 위하여 국내외의 선형가속기를 이용하는 방사선수술 품질관리 프로토콜의 수집 및 분석을 통해 필수적인 품질관리항목과 각 항목의 허용치를 정하였다. 노발리스 품질관리 항목은 기계적 정확도 부분과 방사선 전달 부분의 2가지로 분리하고 기계적 정확도 부분은 방사선발생 장치부, 보조장치부, 그리고 미세다엽 시준기부의 3가지 부분으로 방사선 전달부분은 치료 중심점 평가와 선량학적 평가의 2가지 부분으로 나누어 작성하였다. 최종적으로 노발리스 품질관리 유지를 위하여 시행하여야 하는 일간, 주간, 월간, 연간의 노발리스 품질관리 항목 표를 완성하였다. 완성된 노발리스 품질관리항목 표는 노발리스가 방사선수술에 적합한 정확도 및 정밀도를 유지하는데 필요한 지표로서 기여 할 수 있을 것이라 생각된다.

• 한국의학물리학회지:의학물리
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• 제28권4호
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• pp.197-206
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• 2017

We develop guidelines for the quality assurance of radiation treatment planning systems (TPS) by comparing and reviewing recommendations from major countries and organizations, as well as by analyzing the AAPM, ESTRO, and IAEA TPS quality assurance guidelines. We establish quality assurance items for acceptance testing, commissioning, periodic testing, system management, and security, and propose methods to perform each item within acceptable standards. Acceptance includes tests of hardware and network environments, data transmission, software, and benchmarking as specified by the system supplier, and apply the IAEA classification criteria. Commissioning includes dosimetric and non-dosimetric items for assessing TPS performance by applying the AAPM classification criteria and the latest technical items from the IAEA. Periodic quality assurance tests include daily, weekly, monthly, yearly, and occasional items by applying the AAPM classification criteria. System management and security items include the state and network connectivity of TPS, periodic data backup, and data access security. The guidelines for TPS quality assurance proposed in this study will help to improve the safety and quality of radiotherapy by preventing incidents related to radiotherapy.

• 한국의학물리학회지:의학물리
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• 제23권2호
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• pp.123-126
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• 2012

혈액조사기의 정기적 정도관리를 위하여 일일, 월간 및 년간점검 항목을 개발하였다. 일일점검은 육안으로 기본적 작동을 점검하고, 월간과 년간점검은 자체 제작한 기구(유리선량계 지그)를 사용하여 조사 콘테이너에 대한 선량평가를 수행하도록 하였다. 본 연구에서 도출한 항목들은 임상적 차원에서 실용적이라고 평가한다.

• Journal of Radiation Protection and Research
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• 제44권1호
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• pp.43-52
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• 2019

Background: The mid-term performance of clinical linear accelerator (LINAC) during volumetric modulated arc therapy (VMAT) treatment period is not performed in clinical practice and usually replaced with one-time plan quality assurance (QA). In this research we aim to monitor daily reproducibility of VMAT delivery from tracking individual leaf movement error and dosimetric error to evaluate the mid-term quality of the machine used. Materials and Methods: First, multileaf collimator (MLC) information was imported into MATLAB program to determine which of the MLC leaves in the leaf bank had the maximum RMS position error (maxRMS). We estimated where the maximum positional errors (maxPE) of the chosen leaf occur along its path length and tracked its daily variations over the entire treatment period. Secondly, picture information of dosimetric error from portal dosimetry was imported into MATLAB where representative high gamma index region (HGR) was determined as HGR with length of > 1 cm and their centers were daily tracked. Results and Discussion: The maxPEs in the brain and tongue cases were distributed broader than in other cases, but all data were found located within ${\pm}0.5mm$. From first day to last day all of five cases show the similar visual pattern of HGRs and Centers of the longest HGRs remained within ${\pm}1mm$ of that in first day. These findings prove excellent mid-term performance of the LINAC used in VMAT treatments over a full course of treatment. Conclusion: Tracking the daily location changes of leaf movement and dosimetric error can be a good indicator of predicting the daily quality like stability and reproducibility of beam delivering in VMAT treatment.

• Journal of Radiation Protection and Research
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• 제44권1호
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• pp.32-42
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• 2019

Background: There have been much efforts to develop the proper and realistic machine Quality Assurance (QA) reflecting on real Volumetric Modulated Arc Therapy (VMAT) plan. In this work we propose and test a special VMAT plan of plan-class specific (pcsr) QA, as a machine QA so that it might be a good solution to supplement weak point of present machine QA to make it more realistic for VMAT treatment. Materials and Methods: We divided human body into 5 treatment sites: brain, head and neck, chest, abdomen, and pelvis. One plan for each treatment site was selected from real VMAT cases and contours were mapped into the computational human phantom where the same plan as real VMAT plan was created and called plan-class specific reference (pcsr) QA plan. We delivered this pcsr QA plan on a daily basis over the full research period and tracked how much MLC movement and dosimetric error occurred in regular delivery. Several real patients under treatments were also tracked to test the usefulness of pcsr QA through comparisons between them. We used dynalog file viewer (DFV) and Dynalog file to analyze position and speed of individual MLC leaf. The gamma pass rate from portal dosimetry for different gamma criteria was analyzed to evaluate analyze dosimetric accuracy. Results and Discussion: The maxRMS of MLC position error for all plans were all within the tolerance limit of < 0.35 cm and the positional variation of maxPEs for both pcsr and real plans were observed very stable over the research session. Daily variations of maxRMS of MLC speed error and gamma pass rate for real VMAT plans were observed very comparable to those in their pcsr plans in good acceptable fluctuation. Conclusion: We believe that the newly proposed pcsr QA would be useful and helpful to predict the mid-term quality of real VMAT treatment delivery.

• 핵의학기술
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• 제21권1호
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• pp.29-33
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• 2017

QA 과정을 통해 30개의 정규화 보정값을 얻고, 1개의 기준 데이터 설정 후 29개의 정규화 보정값과 비교하였다. 또한 각 정규화 보정값을 PET raw data 에 적용시켜 재구성된 영상을 동일한 ROI를 그려 SUV 와 count 로 비교평가 하였다. 30개의 정규화 보정값은 차이가 발생하지 않았으며, 각각의 정규화 보정값을 적용시킨 PET 영상도 크게 차이가 없었다. 핵의학 영상은 정량분석을 위해 불감시간 보정 및 광자의 감쇠 및 산란 등 물리적 현상에 대한 보정이 필요하고, 정규화 보정 또한 무시할 수 없는 보정 과정이다. 따라서 이런 과정을 통해 PET 장비의 균일성이 유지되고 여러 디텍터의 효율도 균등해야 영상의 왜곡을 방지할 수 있고, 질 좋은 영상을 만드는데 꼭 필요한 과정이므로 매일 QA 과정이 필요하다고 사료된다.

• 한국의학물리학회지:의학물리
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• 제14권3호
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• pp.151-160
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• 2003

삼차원 입체조형방사선치료나 세기조절방사선치료와 같은 다엽시준기(Multileaf Collmator, MLC)를 이용하는 보다 복잡한 방사선 치료 기술은 다엽시준기의 위치 및 운동의 검증의 중요성을 증가시키고 있다. 이러한 다엽시준기의 검증은 신뢰성과 그동안 축척된 경험적 검증능력으로 인하여 주로 필름을 가지고 수행되어왔다. 그러나 전자포탈영상장치(Electornic Portal Imaging Device, EPID)의 사용의 편이성과 디지털 영상 제공 능력은 낮은 임상편이성, 효율성, 비용대 수익률에도 불구하고 정기적인 정도확립(Quality Assurance, QA)에 현실적인 필름의 대체재로 관심을 모아왔다. 본 연구에서는 EPI를 활용한 다엽시준기의 정기적인, 특히 일간 정도확립법을 개발하였다. 정기적 정도확립을 위한 전자포탈영상(Electronic Portal Imaing, EPI)의 적용가능성에 대한 검증은 방사선 조사시 동시에 획득된 필름과 다엽시준기의 제어장치에 입력한 다엽시준기의 처방과의 비교를 통해 수행되었다. 특별히 설계된 두가지 형태의 시험형(test pattern)이 영상 획득 및 비교에 적용되었다. 정성적인 온라인 육안 검증과 함께 윤곽 검출 알고리듬을 이용한 정량적인 오프라인 분석이 검증 절차에 이용되었다. 결론적으로, 본 연구에서 개발된 EPI를 이용한 다엽시준기의 일간 정도확립법은 필름의 정확도를 가지고 편리하게 수행될 수 있었다.