• Progress in Medical Physics
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• v.20 no.2
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• pp.88-96
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• 2009

Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

• Progress in Medical Physics
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• v.23 no.4
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• pp.269-278
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• 2012

Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.

• Journal of radiological science and technology
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• v.37 no.4
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• pp.341-348
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• 2014

Wedge filter could use to increase the dose distribution at the hot dose regions. We evaluated dose discrepancy at surface and build region in the infield and outfield that Metal Wedge (MW) and Enhance Dynamic Wedge (EDW) were interact with photon. In this paper, we used Gafchromic EBT3 film that had excellent spatial resolution, composed the water equivalent materials and changed the optical density without development. The set up conditions of linear accelerator were fixed 6 MV photon, 100 cm SSD, $10{\times}10cm^2$ field size and were irradiated 400 cGy at Dmax. The dose distribution and absorbed dose were evaluated when we compared the open field with $15^{\circ}$, $30^{\circ}$, $45^{\circ}$ metal wedge and enhanced dynamic wedge. A $15^{\circ}$ metal wedge could increase the surface and build up region dose than using a $15^{\circ}$ enhanced dynamic wedge. A $30^{\circ}$ metal wedge could decrease the surface and build up region dose than using a $30^{\circ}$ enhanced dynamic wedge. A $45^{\circ}$ metal wedge could decrease by large deviation the surface and build up region dose than using a $15^{\circ}$ enhanced dynamic wedge. The dose of penumbra region at outfield were increased on the thick side but were decreased on the thin side. It could be decrease the surface dose and build up region dose, if the metal wedge filters were properly used to make a good dose distribution and not closed the distance of surface.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.2
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• pp.123-129
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• 2015

Purpose : The goal of this study was to verify and analyze the source position according to the curvature of the universal applicator and 4 different angle applicators when using RALS(Remote After Loading System). Materials and Methods : An interval of 1 cm and 15 second dwell times in each source position were applied for plan. To verify the accuracy of source position, we narrowed the distance between MultiSource container and GAFCHROMIC$^{(R)}$ EBT3 film by 5 cm, 10 cm, 20 cm so that the universal applicator transfer tube had some curvature. Also 4 applicators(Intrauterine tube: $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, Ovoid tube: $65^{\circ}$) were used in the same condition. The differences between desired and actual source position were measured by using Image J. Results : In case of using 4 different angles of applicator with the straight universal applicator transfer tube, the average error was the lowest for $0^{\circ}$ applicator, greatest for $65^{\circ}$ applicator. However, All average errors were within ${\pm}2mm$ recommended in TG-56. When MultiSource container was moved 5 cm, 10 cm, 20 cm towards the EBT3 film, the average errors were beyond ${\pm}2mm$. The first dwell position was relatively located in accuracy, while the second and third dwells were displaced by an increasing magnitude with increasing curvature of the transfer tube. Furthermore, with increasing the angle of applicators, the error of all other dwell positioning was increased. Conclusion : The results of this study showed that both the curvature of universal applicator transfer tube and the angle of applicators affect the source dwell position. It is recommended that using straight universal applicator transfer tubes is followed in all cases, in order to avoid deviations in the delivered source dwell position. Also, It is advisable to verify the actual dwell position, using video camera quality control tool prior to all treatments.

• 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.

• Progress in Medical Physics
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• v.26 no.4
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• pp.223-228
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• 2015

Double-focused micro-Multileaf Collimator (${\mu}MLC$) is able to create radiation fields having sharper dose gradients at the field edges than common MLC. Therefore, ${\mu}MLC$ has been used for the stereotactic radiosurgery (SRS) and Stereotactic Radiotherapy (SRT). We evaluated the dosimetric characteristics of a doublefocused Dynamic-${\mu}MLC$ (DMLC) attached to the Elekta Synergy linear accelerator. For this study, the dosimetric parameters including, Percent Depth Dose (PDD), Leaf leakage and penumbra, have been measured by using of the radiochromic films (GafChromic EBT2), EDGE diode detector and three-dimensional water phantom. All datas were measured on 6 MV x-ray. As a result, The DMLC shows transmission below to 1% and because of double-focused construction of the DMLC, the penumbras of fields with DMLC are independent from the field sizes. In this paper, the resulting dosimetric evaluations proved the applicability of the DMLC attached to the Elekta Synergy linear accelerator.

• Progress in Medical Physics
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• v.20 no.4
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• pp.260-268
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• 2009

In this study, we estimated inhomogeneity correction factor in small field. And, we evaluated accuracy of treatment planning and measurement data which applied inhomogeneity correction factor or not. We developed the Inhomogeneity Correction Phantom (ICP) for insertion of inhomogeneity materials. The inhomogeneity materials were 12 types in each different electron density. This phantom is able to adapt the EBT film and 0.125 cc ion chamber for measurement of dose distribution and point dose. We evaluated comparison of planning and measurement data using ICP. When we applied to inhomogeneity correction factor or not, the average difference was 1.63% and 10.05% in each plan and film measurement data. And, the average difference of dose distribution was 10.09% in each measurement film. And the average difference of point dose was 0.43% and 2.09% in each plan and measurement data. In conclusion, if we did not apply the inhomogeneity correction factor in small field, it shows more great difference in measurement data. The planning system using this study shows good result for correction of inhomogeneity materials. In radiosurgery using small field, we should be correct the inhomogeneity correction factor, more exactly.

• Progress in Medical Physics
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• v.22 no.1
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• pp.3-11
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• 2011

The purpose of this study was to evaluate feasibility of Vertical Multileaf Collimator for determination of irradiation size using Vertical Multileaf Collimator and lead block to determine 4 different irradiation shape in case of Co-60 gamma-ray and 6 MV X-ray. We chose ion chamber, glass dosimeter and EBT chromic film to compare with Vertical Multileaf Collimator results and lead block results. In case of Co-60 gamma-ray and 6 MV X-ray, the central axis point dose normalized at reference field of lead block with ion chamber results for Vertical Multileaf Collimator were estimated higher than lead block about 5.1%, 4.2%. In case of Co-60 gamma-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 2.2%, 7.8%, 7.2%, 4.0% for reference, circle, triangle, cross field, respectively. In case of 6 MV X-ray, the central axis point dose normalized at reference field of lead block with glass dosimeter results for Vertical Multileaf Collimator were estimated higher than lead block about 6.7%, 6.2%, 3.8%, 6.2% for reference, circle, triangle, cross field, respectively. The results of EBT chromic film, Vertical Multileaf Collimator of penumbra size for all irradiation shape was smaller than lead block of those size that 2.0~3.5 mm for Co-60 gamma-ray, 0.5~1.0 mm for 6 MV X-ray. The results from this study, radiation treatment volume that results in shielding block can be minimized. In addition, during radiation treatment for 2, 3-dimensional radiation therapy using a Vertical Multileaf Collimator of this survey can be used to determine variety of irradiation fields.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.31-42
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• 2022

Purpose: This study measures and compares the surface dose values in the virtual target volume using Tomotherapy, Halcyon, and TrueBeam equipment using 6MV-Flattening Filter-Free(FFF) energy. Materials and Methods: CT scan was performed under three conditions of without bolus, 0.5 cm bolus, and 1 cm bolus using an IMRT phantom (IBA, Germany). The Planning Target Volume (PTV) was set at the virtual target depth, and the treatment plan was established at 200 cGy at a time. For surface dosimetry, the Gafchromic EBT3 film was placed in the same section as the treatment planning system and repeated measurements were performed 10 times and then analyzed. Result: As a result of measuring the surface dose for each equipment, without, 0.5 cm, 1 cm bolus is in this order, and the result of Tomotherapy is 115.2±2.0 cGy, 194.4±3.3 cGy, 200.7±2.9 cGy, The result in Halcyon was 104.7±3.0 cGy, 180.1±10.8 cGy, 187.0±10.1 cGy, and the result in TrueBeam was 92.4±3.2 cGy, 148.6±5.7 cGy, 155.8±6.1 cGy, In all three conditions, the same as the treatment planning system, Tomotherapy, Halcyon, TreuBeam was measured highly in that order. Conclusion: Higher surface doses were measured in Tomotherapy and Halcyon compared to TrueBeam equipment. If the characteristics of each equipment are considered according to the treatment site and treatment purpose, it is expected that the treatment efficiency of the patient will increase as well as the treatment satisfaction of the patient.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.137-143
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• 2013

Purpose: We are to find out the difference of calculated dose of treatment planning system (TPS) and measured dose in case of inhomogeneous organ structure. Materials and Methods: Inhomogeneous phantom is made with solid water phantom and cork plate. CT image of inhomogeneous phantom is acquired. Treatment plan is made with TPS (Pinnacle3 9.2. Royal Philips Electronics, Netherlands) and calculated dose of point of interest is acquired. Treatment plan was delivered in the inhomogeneous phantom by ARTISTE (Siemens AG, Germany) measured dose of each point of interest is obtained with Gafchromic EBT2 film (International Specialty Products, US) in the gap between solid water phantom or cork plate. To simulate lung cancer radiation treatment, artificial tumor target of paraffin is inserted in the cork volume of inhomogeneous phantom. Calculated dose and measured dose are acquired as above. Results: In case of inhomogeneous phantom experiment, dose difference of calculated dose and measured dose is about -8.5% at solid water phantom-cork gap and about -7% lower in measured dose at cork-solid water phantom gap. In case of inhomogeneous phantom inserted paraffin target experiment, dose difference is about 5% lower in measured dose at cork-paraffin gap. There is no significant difference at same material gap in both experiments. Conclusion: Radiation dose at the gap between two organs with different electron density is significantly lower than calculated dose with TPS. Therefore, we must be aware of dose calculation error in TPS and great care is suggested in case of radiation treatment planning on inhomogeneous organ structure.