• Nuclear Engineering and Technology
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• v.55 no.9
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• pp.3140-3149
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• 2023

In theory, the sharp dose falloff at the distal end of a proton beam allows for high conformal dose to the target. However, conformity has not been fully achieved in practice, primarily due to beam range uncertainty, which is approximately 4% and varies slightly across institutions. To address this issue, we developed a new range verification system prototype: a multi-slit prompt-gamma camera (MSPGC). This system features high prompt-gamma detection sensitivity, an advanced range estimation algorithm, and a precise camera positioning system. We evaluated the range measurement precision of the prototype for single spot beams with varying energies, proton quantities, and positions, as well as for spot-scanning proton beams in a simulated SSPT treatment using a phantom. Our results demonstrated high accuracy (<0.4 mm) in range measurement for the tested beam energies and positions. Measurement precision increased significantly with the number of protons, achieving 1% precision with 5 × 10⁸ protons. For spot-scanning proton beams, the prototype ensured more than 5 × 10⁸ protons per spot with a 7 mm or larger spot aggregation, achieving 1% range measurement precision. Based on these findings, we anticipate that the clinical application of the new prototype will reduce range uncertainty (currently approximately 4%) to 1% or less.

• Progress in Medical Physics
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• v.11 no.1
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• pp.39-47
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• 2000

In Stereotactic Radiosurgery (SRS), there are three imaging methods of target localization, such as digital subtraction Angiography (DSA), computed tomography (CT), magnetic resonance imaging (MRI). Especially, DSA and MR images have a distortion effect generated by each modality. In this research, image properties of DSA were studied. A first essential condition in SRS is an accurate information of target locations, since high dose used to treat a patient may give a complication on critical organ and normal tissue. Hut previous localization program did not consider distortion effect which was caused by image intensifier (II) of DSA. A neurosurgeon could not have an accurate information of target locations to operate a patient. In this research, through distortion correction, we tried to calculate accurate target locations. We made a grid phantom to correct distortion, and a target phantom to evaluate localization algorithm. The grid phantom was set on the front of II, and DSA images were obtained. Distortion correction methods consist of two parts: 1. Bilinear transform for geometrical correction and bilinear interpolation for gray level correction. 2. Automatic detection method for calculating locations of grid crosses, fiducial markers, and target balls. Distortion was corrected by applying bilinear transform and bilinear interpolation to anterior-posterior and left-right image, and locations of target and fiducial markers were calculated by the program developed in this study. Localization errors were estimated by comparing target locations calculated in DSA images with absolute locations of target phantom. In the result, the error in average with and without distortion correction is $\pm$0.34 mm and $\pm$0.41 mm respectively. In conclusion, it could be verified that our localization algorithm has an improved accuracy and acceptability to patient treatment.

• Journal of the Korean Society of Radiology
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• v.14 no.6
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• pp.763-772
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• 2020

During X-ray examinations in the DR system, the scattered X-rays physically generated by the patient cause image blurring in poor quality. Although X-rays to increase the contrast of images, this increases the patient's exposure dose and is likely to result in grid induced artifacts. Therefore, the purpose of this study is obtain images similar to those of real-grid with non-grid level conditions using a VGR (Virtual Grid Role) algorithm that serves as a virtual grid. Comparing MTF, SNR and CNR of non-grid and VGR algorithm images obtained with 70% exposure conditions of real-grid images showed that the MTF0.5 differed from 0.265 to 0.350 and the MTF0.1 from 0.412 to 0.467 and the SNR, CNR were also different. In addition, comparing MTF, SNR and CNR of VGR algorithm and real-grid images showed that the MTF0.5 differed from 0.350 to 0.367 and the MTF0.1 from 0.467 to 0.483 and the SNR, CNR by little.

• Progress in Medical Physics
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• v.12 no.2
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• pp.177-184
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• 2001

The goal of radiation treatment is to deliver a prescribed radiation dose to the target volume accurately while minimizing dose to normal tissues. Due to inaccurate placement of field and shielding block and patient's movement, there could be displacement errors between the planed and treatment regions. In order to verify the location of radiation treatment, we in this study developed the registration algorithm of the x-ray simulator images and portal images and quantified the inaccuracy in terms of shift, scale and rotation. The algorithm for registration of pairs of radiation fields consists of the alignment of pairs of radiation images by points matching and field displacement analysis by field boundary matching. In the first step, paired surface landmarks are matched to calculate the transformation parameters (scale, rotation and shift) using the corresponding line pairs which are created by connecting two landmarks of each image. In the next step, portal field boundary is extracted and then the two field boundaries are matched by the $\rho$-$\theta$ technique. Applying the phantom portal images, detection errors were calculated to be less than 2mm in translation, 1$^{\circ}$ in rotation and 1% in scale. In conclusion, we quantitatively analyzed the displacement error of x-ray simulator images and portal images. The present results could contribute to the study of the radiation treatment verification.

• Progress in Medical Physics
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• v.33 no.4
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• pp.150-157
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• 2022

Purpose: Elekta synergy^® was commissioned in the Seoul National University Veterinary Medical Teaching Hospital. Recently, Chung-Ang University Gwang Myeong Hospital commissioned Elekta Versa HD^TM. The beam characteristics of both machines are similar because of the same Agility^TM MLC Model. We compared measured beam data calculated using the Elekta treatment planning system, Monaco^®, for each institute. Methods: Beam of the commissioning Elekta linear accelerator were measured in two independent institutes. After installing the beam model based on the measured beam data into the Monaco^®, Monte Carlo (MC) simulation data were generated, mimicking the beam data in a virtual water phantom. Measured beam data were compared with the calculated data, and their similarity was quantitatively evaluated by the gamma analysis. Results: We compared the percent depth dose (PDD) and off-axis profiles of 6 MV photon and 6 MeV electron beams with MC calculation. With a 3%/3 mm gamma criterion, the photon PDD and profiles showed 100% gamma passing rates except for one inplane profile at 10 cm depth from VMTH. Gamma analysis of the measured photon beam off-axis profiles between the two institutes showed 100% agreement. The electron beams also indicated 100% agreement in PDD distributions. However, the gamma passing rates of the off-axis profiles were 91%-100% with a 3%/3 mm gamma criterion. Conclusions: The beam and their comparison with MC calculation for each institute showed good performance. Although the measuring tools were orthogonal, no significant difference was found.

• 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.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.33-41
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• 2017

Objectives: The aim of this study is to evaluate the reproducibility and usefulness of the images through the fusion of CT(Computed tomography) and MRI(Magnetic resonance imaging) using a self-manufactured phantom. We will also compare and analyze the target dose from acquired images. Materials and Methods: Using a self-manufactured phantom, CT images and MRI images are acquired by 1.5T and 3.0T of different magnetic fields. The reproducibility of the size and volume of the small holes present in the phantom is compared through the image from CT and 1.5T and 3.0T MRI, and dose changes are compared and analyzed on any target. Results: 13 small hole diameters were a maximum 31 mm and a minimum 27.54 mm in the CT scan and the were measured within an average of 29.28 mm 1 % compared to actual size. 1.5 T MRI images showed a maximum 31.65 mm and a minimum 24.3 mm, the average is 28.8 mm, which is within 1 %. 3.0T MRI images showed a maximum 30.2 mm and a minimum 27.92 mm, the average is 29.41 mm, which is within 1.3 %. The dose changes in the target were 95.9-102.1 % in CT images, 93.1-101.4 % in CT-1.5T MRI fusion images, and 96-102 % in CT-3.0T MRI fusion images. Conclusion: CT and MRI are applied with different algorithms for image acquisition. Also, since the organs of the human body have different densities, image distortion may occur during image acquisition. Because these inaccurate images description affects the volume range and dose of the target, accurate volume and location of the target can prevent unnecessary doses from being exposed and errors in treatment planning. Therefore, it should be applied to the treatment plan by taking advantage of the image display algorithm possessed by CT and MRI.

• Progress in Medical Physics
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• v.20 no.4
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• pp.269-276
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• 2009

Radiation treatment techniques using photon beam such as three-dimensional conformal radiation therapy (3D-CRT) as well as intensity modulated radiotherapy treatment (IMRT) demand accurate dose calculation in order to increase target coverage and spare healthy tissue. Both jaw collimator and multi-leaf collimators (MLCs) for photon beams have been used to achieve such goals. In the Pinnacle3 treatment planning system (TPS), which we are using in our clinics, a set of model parameters like jaw collimator transmission factor (JTF) and MLC transmission factor (MLCTF) are determined from the measured data because it is using a model-based photon dose algorithm. However, model parameters obtained by this auto-modeling process can be different from those by direct measurement, which can have a dosimetric effect on the dose distribution. In this paper we estimated JTF and MLCTF obtained by the auto-modeling process in the Pinnacle3 TPS. At first, we obtained JTF and MLCTF by direct measurement, which were the ratio of the output at the reference depth under the closed jaw collimator (MLCs for MLCTF) to that at the same depth with the field size $10{\times}10\;cm^2$ in the water phantom. And then JTF and MLCTF were also obtained by auto-modeling process. And we evaluated the dose difference through phantom and patient study in the 3D-CRT plan. For direct measurement, JTF was 0.001966 for 6 MV and 0.002971 for 10 MV, and MLCTF was 0.01657 for 6 MV and 0.01925 for 10 MV. On the other hand, for auto-modeling process, JTF was 0.001983 for 6 MV and 0.010431 for 10 MV, and MLCTF was 0.00188 for 6 MV and 0.00453 for 10 MV. JTF and MLCTF by direct measurement were very different from those by auto-modeling process and even more reasonable considering each beam quality of 6 MV and 10 MV. These different parameters affect the dose in the low-dose region. Since the wrong estimation of JTF and MLCTF can lead some dosimetric error, comparison of direct measurement and auto-modeling of JTF and MLCTF would be helpful during the beam commissioning.

• Progress in Medical Physics
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• v.15 no.2
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• pp.63-69
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• 2004

HDR brachytherapy administers a large dose of radiation in a short time compare with LDR, and its optimization for treatment is related to several complex factors, such as physical, radiation and optimization algorithms, so there is a need for these to be verified for accurate dose delivery. In our approach, a previous study concerning the phantom for dose verification has been modified, and a new pelvic phantom fabricated for the purpose of localization, including a structure enabling the use of a CT or MRI system. In addition, a comparison study was performed to verify an orthogonal method that is commonly used for brachytherapy localization by comparing target coordinates from a CT system. Since the developed phantom was designed to simulate the clinical setups of cervix cancer, it included an air-filled bladder and a rectum structure shaped sphere and cylinder An N-shaped localizer was used to obtain precision coordinates from both CT and films. Moreover, the IDL 5.5 software program for Windows was used to perform coordinates analysis based on an orthogonal algorithm. The film results showed differences within 1.0 mm of the selected target points compare with the CT coordinates. For these results, a Plato planning system (Nucletron, Netherlands) could be independently verified using this phantom and software. Furthermore, the new phantom and software will be efficient and powerful qualify assurance (QA) tools in the field of brachytherapy QA.

• Journal of Radiation Protection and Research
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• v.20 no.1
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• pp.25-36
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• 1995

The purpose of this research is to develop stereotactic localization and radiation measurement system for the efficient and precise radiosurgery. The algorithm to obtain a 3-D stereotactic coordinates of the target has been developed using a Fisher CT or angio localization. The procedure of stereotactic localization was programmed with PC computer, and consists of three steps: (1) transferring patient images into PC; (2) marking the position of target and reference points of the localizer from the patient image; (3) computing the stereotactic 3-D coordinates of target associated with position information of localizer. Coordinate transformation was quickly done on a real time base. The difference of coordinates computed from between Angio and CT localization method was within 2 mm, which could be generally accepted for the reliability of the localization system developed. We measured dose distribution in small fields of NEC 6 MVX linear accelerator using various detector; ion chamber, film, diode. Specific quantities measured include output factor, percent depth dose (PDD), tissue maximum ratio (TMR), off-axis ratio (OAR). There was small variation of measured data according to the different kinds of detectors used. The overall trends of measured beam data were similar enough to rely on our measurement. The measurement was performed with the use of hand-made spherical water phantom and film for standard arc set-up. We obtained the dose distribution as we expected. In conclusion, PC-based 3-D stereotactic localization system was developed to determine the stereotactic coordinate of the target. A convenient technique for the small field measurement was demonstrated. Those methods will be much helpful for the stereotactic radiosurgery.