Due to the Co-60 source size, the penumbra in Co-60 teletheraphy poses a serious problem, even if the extended collimators are used, Here an empirical formula for the calculation of integral absorbed dose in the penumbra region was derived. Through a numerical calculation, the penumbra effect on integral absorbed dose was investigated. The longer the source-to-skin distance, the larger the integral absorbed dose of penumbra region, and the larger the source diameter, the larger the integral absorbed dose of penumbra region. It was also found that in some case the integral absorbed dose in penumbra region becomes several times larger than the integral absorbed dose of treatment region itself if the source-to-skin distance becomes greater. Therefore, one must consider the penumbra effect in Co-60 teletherapy.
Purpose: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. Materials and Methods: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. Results: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The $V_{20Gy}$ of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. Conclusion: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.
Lim Do Hoon;Lee Myung Za;Chun Ha Chung;Kim Dae Yong
Radiation Oncology Journal
/
v.19
no.2
/
pp.199-204
/
2001
Purpoe : To find the optimal values of total arc degree to protect the normal brain tissue from high dose radiation in stereotactic radiotherapy planning. Methods and Materials : With Xknife-3 planning system & 4 MV linear accelerator, the authors planned under various values of parameters. One isocenter, 12, 20, 30, 40, 50, and 60 mm of collimator diameters, $100^{\circ},\;200^{\circ},\;300^{\circ},\;400^{\circ}C,\;500^{\circ},\;600^{\circ}$ or total arc degrees, and $30^{\circ}\;or\;45^{\circ}$ or arc intervals were used. After the completion of planning, the plans were compared each other using $V_{50}$ (the volume of normal brain that is delivered high dose radiation) and integral biologically effective dose. Results : At $30^{\circ}$ of arc interval, the values of $V_{50}$ had the decreased pattern with the increase of total arc degree in any collimator diameter. At 45 arc interval, up to $400^{\circ}$ of total arc degree, the values of $ V_{50}$ decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. At $30^{\circ}$ of arc interval, integral biologically effective dose showed the decreased pattern with the increase of total arc degree in any collimator diameter. At $45^{\circ}$ arc interval with less than 40 mm collimator diameter, the integral biologically effective dose decreased with the increase of total arc degree, but with n and n mm or collimator diameters, up to $400^{\circ}$ or total arc degree, integral biologically effective dose decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. Conclusion : In the stereotactic radiotherapy planning for brain lesions, planning with $400^{\circ}$ of total arc degree is optimal. Especially, when the larger collimator more than 50 mm diameter should be used, the uses of $500^{\circ}\;and\;600^{\circ}$ of total arc degrees make the increase of$V_{50}$ and integral biologically effective dose. Therefore stereotactic radiotherapy planning using $400^{\circ}$ of total arc degree can increase the therapeutic ratio and produce the effective outcome in the management of personal and mechanical sources in radiotherapy department.
We can and must improve the diagnostic images using available knowledge and technology. At the same time we must strive to reduce the patient's integral and entrance radiation dose. Reducing the integral dose to the patient during the radiologic procedure is a primary concern of the patient, especially the pediatric patient, the radiologist and the technologist. A 100cm focal film distance generally is used for most over-table radiography. The early x-ray tubes and screen film combinations required long exposures, which often resulted in motion artifacts. But nowaday, we have the generators and x-ray tubes that can deliver the energy necessary in a very short time and the receptors that can record the information just as rapidly. And, we performed this studies to evaluate the patient exposure dose and the image quality by increasing focal film distance in diagnostic radiography. There are many factors which affected to exposure factor, but we studied to verify of FFD increase, only. Effect of increasing the focal film distance to a 140 cm distance was tested as follows; 1. The focal film distances were set at 100, 120, and 140cm. 2. A 18cm acryl(tissue equivalent) phantom was placed on the table top. 3. An Capintec 192 electrometer with PM 05 ion chamber was placed at the entrance surface of the phantom, and exposure were made at each focal film distances. 4. The procedure was repeated in the same manner as above except the ion chamber was placed beneath the phantom at the film plane. 5. Exit exposure were normalize to 8mR for each portions of the experiment. Based on the success of the empirical measurements, a detailed mathematical analysis of the dose reduction was performed using the percent depth dose data. The results of this study can be summerized as followings ; 1) Increasing FFD from 100 cm to 140 cm, we would create a situation that would have a significant effect on the overall quality of radiograph and achive the 17.42% reduction of entrance dose and the 18.95% reduction of integral dose that the patient receives. 2) Thickness of Al step wedge for equal film density increased with the long distance. 3) Increasing FFD, Magnification of image was lowered. 4) Resolution of image also increased with the FFD. As the results described above, we strongly recommend using the long FFD to provide better information for our patients and profession in abdomen radiographic studies.
The use of high dose rate remote afterloading system for the treatment of intraluminal lesions necessitates the need for a more accurate of dose distributions around the high intensity brachytherapy sources, doses are often prescribed to a distance of few centimeters from the linear source, and in this range the dose distribution is very difficult to assess. Accurated and optimized dose calculation with stable numerical algorithms by PC level computer was required to treatment intraluminal lesions by high dose rate brachytherapy system. The exposure rate from sources was calculated with Sievert integral and dose rate in tissue was calculated with Meisberger equation, An algorithm for generating a treatment plan with optimized dose distribution was developed for high dose rate intraluminal radiotherapy. The treatment volume becomes the locus of the constrained target surface points that is the specified radial distance from the source dwelling positions. The treatment target volume may be alternately outlined on an x-ray film of the implant dummy sources. The routine used a linear programming formulism to compute which dwell time at each position to irradiate the constrained dose rate at the target surface points while minimizing the total volume integrated dose to the patient. The exposure rate and the dose distribution to be confirmed the result of calculation with algorithm were measured with film dosimetry, TLD and small size ion chambers.
In this paper, we developed optical dosimetry system with a plastic scintillator, a commercial 50 mm, f1.8 lens, and a commercial high-sensitivity CMOS (complementary metal-oxide semiconductor) camera. And, the correction processors of vignetting, geometrical distortion and scaling were established. Using the developed system, we can measured a percent depth dose, a beam profile and a dose linearity for 6 MV medical LINAC (Linear Accelerator). As results, the optically measured percent depth dose was well matched with the measured percent depth dose by ion-chamber within 2% tolerance. And the determined flatness was 2.8%. We concluded that the optical dosimetry system was sufficient for application of absorbed dose monitoring during radiation therapy.
Park, Byoung Suk;Ahn, Jong Ho;Kwon, Dong Yeol;Seo, Jeong Min;Song, Ki Weon
The Journal of Korean Society for Radiation Therapy
/
v.25
no.1
/
pp.9-14
/
2013
Purpose: High-energy radiotherapy with 10 MV or higher develops photoneutron through photonuclear reaction. Photoneutron has higher radiation weighting factor than X-ray, thus low dose can greatly affect the human body. An accurate dosimetric calculation and consultation are needed. This study compared and analyzed the dose change of photoneutron in terms of space according to the size of photon beam energy and treatment methods. Materials and Methods: To measure the dose change of photoneutron by the size of photon beam energy, patients with the same therapy area were recruited and conventional plans with 10 MV and 15 MV were each made. To measure the difference between the two treatment methods, 10 MV conventional plan and 10 MV IMRT plan was made. A detector was placed at the point which was 100 cm away from the photon beam isocenter, which was placed in the center of $^3He$ proportional counter, and the photoneutron dose was measured. $^3He$ proportional counter was placed 50 cm longitudinally superior to and inferior to the couch with the central point as the standard to measure the dose change by position changes. A commercial program was used for dose change analysis. Results: The average integral dose by energy size was $220.27{\mu}Sv$ and $526.61{\mu}Sv$ in 10 MV and 15 MV conventional RT, respectively. The average dose increased 2.39 times in 15 MV conventional RT. The average photoneutron integral dose in conventional RT and IMRT with the same energy was $220.27{\mu}Sv$ and $308.27{\mu}Sv$ each; the dose in IMRT increased 1.40 times. The average photoneutron integral dose by measurement location resulted significantly higher in point 2 than 3 in conventional RT, 7.1% higher in 10 MV, and 3.0% higher in 15 MV. Conclusion: When high energy radiotherapy, it should consider energy selection, treatment method and patient position to reduce unnecessary dose by photoneutron. Also, the dose data of photoneutron needs to be systematized to find methods to apply computerization programs. This is considered to decrease secondary cancer probabilities and side effects due to radiation therapy and to minimize unnecessary dose for the patients.
Gayen, Sanjib;Kombathula, Sri Harsha;Manna, Sumanta;Varshney, Sonal;Pareek, Puneet
Radiation Oncology Journal
/
v.38
no.2
/
pp.138-147
/
2020
Purpose: To evaluate the dosimetric variations in patients of head and neck cancer treated with definitive or adjuvant radiotherapy using optimized non-coplanar (ncVMAT) beams with coplanar (cVMAT) beams using volumetric arc therapy. Materials and Methods: Twenty-two patients of head and neck cancer that had received radiotherapy using VMAT in our department were retrospectively analyzed. Each of the patients was planned using coplanar and non-coplanar orientations using an optimized couch angle and fluences. We analyzed the Conformity Index (CIRTOG), Dose Homogeneity Index (DHI), Heterogeneity Index (HIRTOG), low dose volume, target and organs-at-risk coverage in both the plans without changing planning optimization parameters. Results: The prescription dose ranged from 60 Gy to 70 Gy. Using ncVMAT, CIRTOG, DHI and HIRTOG, and tumor coverage (ID95%) had improved, low dose spillage volume in the body V5Gy was increased and V10Gy was reduced. Integral dose and intensity-modulated radiation therapy factor had increased in ncVMAT. In the case of non-coplanar beam arrangements, maximum dose (Dmax) of right and left humeral head were reduced significantly whereas apex of the right and left lung mean dose were increased. Conclusion: The use of ncVMAT produced better target coverage and sparing of the shoulder and soft tissue of the neck as well as the critical organ compared with the cVMAT in patients of head and neck malignancy.
Chang, Nam Joon;Seok, Jin Yong;Won, Hui Su;Hong, Joo Wan;Choi, Ji Hun;Park, Jin Hong
The Journal of Korean Society for Radiation Therapy
/
v.25
no.1
/
pp.1-8
/
2013
Purpose: A selection of proper energy in treatment planning is very important because of having different dose distribution in body as photon energy. In generally, the low energy photon has been used in intensity-modulated radiation therapy (IMRT) for head and neck (H&N) cancer. The aim of this study was to evaluate the effect of partially used high energy photon at posterior oblique fields on IMRT plan for H&N cancer. Materials and Methods: The study was carried out on 10 patients (nasopharyngeal cancer 5, tonsilar cancer 5) treated with IMRT in Seoul National University Bundang Hospital. CT images were acquired 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). Two plans were generated under same planing objectives, dose volume constraints, and eight fields setting: (1) The low energy plan (LEP) created using 6 MV beam alone, (2) the partially used high energy plan (PHEP) created partially using 15 MV beam at two posterior oblique fields with deeper penetration depths, while 6 MV beam was used at the rest of fields. The plans for LEP and PHEP were compared in terms of coverage, conformity index (CI) and homogeneity index (HI) for planning target volume (PTV). For organs at risk (OARs), $D_{mean}$ and $D_{50%}$ were analyzed on both parotid glands and $D_{max}$, $D_{1%}$ for spinal cord were analyzed. Integral dose (ID) and total monitor unit (MU) were compared as addition parameters. For the comparing dose to normal tissue of posterior neck, the posterior-normal tissue volume (P-NTV) was set on the patients respectively. The $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ for P-NTV were evaluated by using dose volume histogram (DVH). Results: The dose distributions were similar with regard to coverage, CI and HI for PTV between the LEP and PHEP. No evident difference was observed in the spinal cord. However, the $D_{mean}$, $D_{50%}$ for both parotid gland were slightly reduced by 0.6%, 0.7% in PHEP. The ID was reduced by 1.1% in PHEP, and total MU for PHEP was 1.8% lower than that for LEP. In the P-NTV, the $D_{mean}$, $V_{20Gy}$ and $V_{25Gy}$ of the PHEP were 1.6%, 1.8% and 2.9% lower than those of LEP. Conclusion: Dose to some OARs and a normal tissue, total monitor unit were reduced in IMRT plan with partially used high energy photon. Although these reduction are unclear how have a clinical benefit to patient, application of the partially used high energy photon could improve the overall plan quality of IMRT for head and neck cancer.
Up-front irradiation technique as 3-dimensional conformation, or intensity modulation has kept large proportion of brain tumors from being complicated with acute radiation reactions in the normal tissue during or shortly after radiotherapy. For years, we've cannot help but counting on 2-D vertex beam technique to reduce acute reactions in the brain tumor patients because we're not equipped with 3-dimensional planning system. We analyzed its advantages and limitations in the clinical application. From 1998 to 2001, vertex or oblique vertex beams were applied to 35 patients with primary brain tumor and 25 among them were eligible for this analysis. Vertex(V) plans were optimized on the reconstructed coronal planes. As the control, we took the bilateral opposed techniques(BL) otherwise being applied. We compared the volumes included in 105% to 50% isodose lines of each plan. We also measured the radiation dose at various extracranial sites with TLD. With vertex techniques, we reduced the irradiated volumes of contralateral hemisphere and prevented middle ear effusion at contralateral side. But the low dose volume increased outside 100%; the ratio of V to BL in irradiated volume included in 100%, 80%, 50% was 0.55+/-0.10, 0.61+/-0.10, and 1.22+/-0.21, respectively. The hot area within 100% isodose line almost disappeared with vertex plan; the ratio of V to BL in irradiated volume included in 103%, 105%, 108% was 0.14+/-0.14, 0.05./-0.17, 0.00, respectively. The dose distribution within 100% isodose line became more homogeneous; the ratio of volume included in 103% and 105% to 100% was 0.62+/-0.14 and 0.26+/-0.16 in BL whereas was 0.16+/-0.16 and 0.02+/-0.04 in V. With the vertex techniques, extracranial dose increased up to $1{\sim}3%$ of maximum dose in the head and neck region except submandibular area where dose ranged 1 to 21%. From this data, vertex beam technique was quite effective in reduction of unnecessary irradiation to the contralateral hemispheres, integral dose, obtaining dose homogeneity in the clinical target. But it was associated with volume increment of low dose area in the brain and irradiation toward the head and neck region otherwise being not irradiated at all. Thus, this 2-D vertex technique can be a useful quasi-conformal method before getting 3-D apparatus.
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