• Title/Summary/Keyword: Hybrid IMRT

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Evaluating efficiency of application the skin flash for left breast IMRT. (왼쪽 유방암 세기변조방사선 치료시 Skin Flash 적용에 대한 유용성 평가)

  • Lim, Kyoung Dal;Seo, Seok Jin;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.49-63
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    • 2018
  • Purpose : The purpose of this study is investigating the changes of treatment plan and comparing skin dose with or without the skin flash. To investigate optimal applications of the skin flash, the changes of skin dose of each plans by various thicknesses of skin flash were measured and analyzed also. Methods and Material : Anthropomorphic phantom was scanned by CT for this study. The 2 fields hybrid IMRT and the 6 fields static IMRT were generated from the Eclipse (ver. 13.7.16, Varian, USA) RTP system. Additional plans were generated from each IMRT plans by changing skin flash thickness to 0.5 cm, 1.0 cm, 1.5 cm, 2.0 cm and 2.5 cm. MU and maximum doses were measured also. The treatment equipment was 6MV of VitalBeam (Varian Medical System, USA). Measuring device was a metal oxide semiconductor field-effect transistor(MOSFET). Measuring points of skin doses are upper (1), middle (2) and lower (3) positions from center of the left breast of the phantom. Other points of skin doses, artificially moved to medial and lateral sides by 0.5 cm, were also measured. Results : The reference value of 2F-hIMRT was 206.7 cGy at 1, 186.7 cGy at 2, and 222 cGy at 3, and reference values of 6F-sIMRT were measured at 192 cGy at 1, 213 cGy at 2, and 215 cGy at 3. In comparison with these reference values, the first measurement point in 2F-hIMRT was 261.3 cGy with a skin flash 2.0 cm and 2.5 cm, and the highest dose difference was 26.1 %diff. and 5.6 %diff, respectively. The third measurement point was 245.3 cGy and 10.5 %diff at the skin flash 2.5 cm. In the 6F-sIMRT, the highest dose difference was observed at 216.3 cGy and 12.7 %diff. when applying the skin flash 2.0 cm for the first measurement point and the dose difference was the largest at the application point of 2.0 cm, not the skin flash 2.5 cm for each measurement point. In cases of medial 0.5 cm shift points of 2F-hIMRT and 6F-sIMRT without skin flash, the measured value was -75.2 %diff. and -70.1 %diff. at 2F, At -14.8, -12.5, and -21.0 %diff. at the 1st, 2nd and 3rd measurement points, respectively. Generally, both treatment plans showed an increase in total MU, maximum dose and %diff as skin flash thickness increased, except for some results. The difference of skin dose using 0.5 cm thickness of skin flash was lowest lesser than 20 % in every conditions. Conclusion : Minimizing the thickness of skin flash by 0.5 cm is considered most ideal because it makes it possible to keep down MUs and lowering maximum doses. In addition, It was found that MUs, maximum doses and differences of skin doses did not increase infinitely as skin flash thickness increase by. If the error margin caused by PTV or other factors is lesser than 1.0 cm, It is considered that there will be many advantages in with the skin flash technique comparing without it.

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Feasibility of MatriXX for Intensity Modulated Radiation Therapy Quality Assurance (세기변조방사선치료의 품질관리를 위한 이온전리함 매트릭스의 유용성 고찰)

  • Kang, Min-Young;Kim, Yoen-Lae;Park, Byung-Moon;Bae, Yong-Ki;Bang, Dong-Wan
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.2
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    • pp.91-97
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    • 2007
  • Purpose: To evaluate the feasibility of a commercial ion chamber array for intensity modulated radiation therapy (IMRT) quality assurance (QA) was performed IMRT patient-specific QA Materials and Methods: A use of IMRT patient-specific QA was examined for nasopharyngeal patient by using 6MV photon beams. The MatriXX (Wellhofer Dosimetrie, Germany) was used for IMRT QA. The case of nasopharyngeal cancer was performed inverse treatment planning. A hybrid dose distribution made on the CT data of MatriXX and solid phantom all of the same gantry angle (0$^\circ$). The measurement was acquired with geometrical condition that equal to hybrid treatment planning. The $\gamma$-index (dose difference 3%, DTA 3 mm) histogram was used for quantitative analysis of dose discrepancies. An absolute dose was compared at the high dose low gradient region. Results: The dose distribution was shown a good agreement by gamma evaluation. A proportion of acceptance criteria was 95.8%, 97.52%, 96.28%, 98.20%, 97.78%, 96.64% and 92.70% for gantry angles were 0$^\circ$, 55$^\circ$, 110$^\circ$, 140$^\circ$, 220$^\circ$, 250$^\circ$ and 305$^\circ$, respectively. The absolute dose in high dose low gradient region was shown reasonable agreement with the RTP calculation within $\pm$3%. Conclusion: The MatriXX offers the dosimetric characteristics required for performing both relative and absolute measurements. If MatriXX use in the clinic, it could be simplified and reduced the IMRT patient-specific QA workload. Therefore, the MatriXX is evaluated as a reliable and convenient dosimeter for IMRT patient-specific QA.

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Verification of Non-Uniform Dose Distribution in Field-In-Field Technique for Breast Tangential Irradiation (유방암 절선조사 시 종속조사면 병합방법의 불균등한 선량분포 확인)

  • Park, Byung-Moon;Bae, Yong-Ki;Kang, Min-Young;Bang, Dong-Wan;Kim, Yon-Lae;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.277-282
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    • 2010
  • The study is to verify non-uniform dose distribution in Field-In-Field (FIF) technique using two-dimensional ionization chamber (MatriXX, Wellhofer Dosimetrie, Germany) for breast tangential irradiation. The MatriXX and an inverse planning system (Eclipse, ver 6.5, Varian, Palo Alto, USA) were used. Hybrid plans were made from the original twenty patients plans. To verify the non-uniform dose distribution in FIF technique, each portal prescribed doses (90 cGy) was delivered to the MatriXX. The measured doses on the MatriXX were compared to the planned doses. The quantitative analyses were done with a commercial analyzing tool (OmniPro IMRT, ver. 1.4, Wellhofer Dosimetrie, Germany). The delivered doses at the normalization points were different to average 1.6% between the calculated and the measured. In analysis of line profiles, there were some differences of 1.3-5.5% (Avg: 2.4%), 0.9-3.9% (Avg: 2.5%) in longitudinal and transverse planes respectively. For the gamma index (criteria: 3 mm, 3%) analyses, there were shown that 90.23-99.69% (avg: 95.11%, std: 2.81) for acceptable range ($\gamma$-index $\geq$ 1) through the twenty patients cases. In conclusion, through our study, we have confirmed the availability of the FIF technique by comparing the calculated with the measured using MatriXX. In the future, various clinical applications of the FIF techniques would be good trials for better treatment results.

A Pilot Research for Real-Time Specific Patient Quality Assurance Using the Hybrid Optimized Vmat Phantom (Hovp) in Volume Modulated Arc Therapy (체적변조회전치료에서 Hybrid Optimized VMAT Phantom (HOVP)을 이용한 실시간 환자 맞춤형 정도관리를 위한 예비연구)

  • Huh, Hyun-Do;Choi, Sang-Hyoun;Kim, Woo-Chul;Kim, Hun-Jeong;Kim, Kum-Bae;Kim, Seong-Hoon;Cho, Sam-Ju;Min, Chul-Kee;Cho, Kwang-Hwan;Lee, Sang-Hoon;Lee, Suk;Shim, Jang-Bo;Shin, Dong-Oh;Ji, Young-Hoon
    • Progress in Medical Physics
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    • v.22 no.4
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    • pp.206-215
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    • 2011
  • The purpose of this was to investigate the measurement of fluence dose map for the specific patient quality assurance. The measurement of fluence map was performed using 2D matrixx detector. The absorbed dose was measured by a glass detector, Gafchromic film and ion chamber in Hybrid Optimized VMAT Phantom (HOVP). For 2D Matrixx, the results of comparison were average passing rate $85.22%{\pm}1.7$ (RT_Target), $89.96%{\pm}2.15$ (LT_Target) and $95.14%{\pm}1.18$ (G4). The dose difference was $11.72%{\pm}0.531$, $-11.47%{\pm}0.991$, $7.81%{\pm}0.857$, $-4.14%{\pm}0.761$ at the G1, G2, G3, G4. In HOVP, the results of comparison for film were average passing rate (3%, 3 mm) $93.64%{\pm}3.87$, $90.82%{\pm}0.99$. We were measured an absolute dose in steep gradient area G1, G2, G3, G4 using the glass detector. The difference between the measurement and calculation are 8.3% (G1), -5.4% (G2), 6.1% (G3), 7.2% (G4). The using an Ion-chamber were an average relative dose error $-1.02%{\pm}0.222$ (Rt_target), $0.96%{\pm}0.294$ (Lt_target). Though we need a more study using a transmission detector. However, a measurement of real-time fluence map will be predicting a dose for real-time specific patient quality assurance in volume modulated arc therapy.