• Korean Journal of Digital Imaging in Medicine
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• v.12 no.1
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• pp.65-69
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• 2010

High energy electron beams were to concentrically dose inside a tumor and more energy is a shape decreased of dose. Therefore, it is useful to radiation therapy of a tumor. Also high energy electron beams ionized into collision with a atom in structure material of tissue and it has big changes to dose distribution by multiple scattering. The study had to establish characteristic of electron beams from interaction of electron beams and materials. Experiment method was to measure dependence of electron beam central axis for depth dose curve, field flatness and symmetry and field size dependence. The results were able to evaluate data for a datum pint of electron beam. Also radiotherapy has to be considered for not only energy pencil of lines but characteristic, electron guide and isodose curves distribution.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.1
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• pp.15-24
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• 2013

Purpose: In Asan Medical Center, Two parallel opposite beams are employed for total body irradiation. Patients are required to be in supine position where two arms are attached to mid axillary line. Normally, physical compensators are required to compensate the large dose difference for different parts of body due to the different thicknesses compared to the umbilicus separation. There was the maximum dose difference up to 30% in lung and chest wall compared to the prescription dose. In order to resolve the dose discrepancy occurring on different body regions, the feasibility of using Fieid-in-Field Technique is investigated in this study. Materials and Methods: CT scan was performed to The RANDO Phantom with fabricated two arms and sent to Eclipse treatment planning system (version 10.0, Varian, USA). Conventional plan with physical lead compensator and new plan using Field-in-Field Technique were established on TPS. AAA (Anisotropic Analytical Algorithm) dose calculation algorithm was employed for two parallel opposite beams attenuation. Results: The dose difference between two methods was compared with the prescription dose. The dose distribution of chest and anterior chest wall uncovered by patient arms was 114~124% for physical lead compensator while Field-in-Field Technique gave 106~107% of the dose distribution. In-vivo dosimetry result using TLD showed that the dose distribution to the same region was 110~117% for conventional physical compensator and 104~107% for Field-in-Field Technique. Conclusion: In this study, the feasibility of using FIF technique has been investigated with fabricated arms attached Rando phantom. The dose difference was up to 17% due to the attached arms. It is shown that the dose homogeneity is within ${\pm}10%$ with the CT based 3-dimensional 4 step FIF technique. The in-vivo dosimetry result using TLD was showed that 95~107% dose distribution compared to prescription dose. It is considered that CT based 3-dimensional Field-in-Field Technique for the total body irradiation gives much homogeneous dose distribution for different body parts than the conventional physical compensator method and might be useful to evaluate the dose on each part of patient body.

• Radiation Oncology Journal
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• v.5 no.2
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• pp.141-148
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• 1987

The ultimate goal of radiotherapy is to result in complete local control of tumor while sparing the surrounding normal tissues as much as possible. Since the development of CT in 1970s, patient's anatomical normal tissues and the site and extent of infiltration of tumor were identified almost accurately. In addition, the isodose distribution of delivered radiation to target tumor was shown in each cross-section. In the treatment planning of head and neck cancers, CT-reconstruction provided almost 3-dimensinonal inter-relationship between tumor and normal tissues. The utilization of imaging system of the CT scanner made it possible to illustrate in superposition the patient structure image, the radiation beams, and the isodose distributions. Thus it was possible to deliver radiation enough to control the local disease, and to avoid unnecessary administration of radiation to normal tissue such as spinal cord. CT-reconstructed image in axial, sagittal, and coronal planes suggested 3-dimensional radiotherapy treatment planning be possible and practical instead of conventional 2-dimensional planning at coronal plane.

• Journal of Radiation Protection and Research
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• v.28 no.3
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• pp.225-231
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• 2003

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.

• Radiation Oncology Journal
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• v.21 no.3
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• pp.238-244
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• 2003

Purpose: The Planning of High-Dose-Rate (HDR) brachytherapy treatments are becoming individualized and more dependent on the treatment planning system. Therefore, computer software has been developed to perform independent point dose calculations with the integration of an isodose distribution curve display into the patient anatomy images. Meterials and Methods: As primary input data, the program takes patients'planning data including the source dwell positions, dwell times and the doses at reference points, computed by an HDR treatment planning system (TPS). Dosimetric calculations were peformed in a $10\times12\times10\;Cm^3$ grid space using the Interstitial Collaborative Working Group (ICWG) formalism and an anisotropy table for the HDR Iridium-192 source. The computed doses at the reference points were automatically compared with the relevant results of the TPS. The MR and simulation film images were then imported and the isodose distributions on the axial, sagittal and coronal planes intersecting the point selected by a user were superimposed on the imported images and then displayed. The accuracy of the software was tested in three benchmark plans peformed by Gamma-Med 12i TPS (MDS Nordion, Germany). Nine patients'plans generated by Plato (Nucletron Corporation, The Netherlands) were verified by the developed software. Results: The absolute doses computed by the developed software agreed with the commercial TPS results within an accuracy of $2.8\%$ in the benchmark plans. The isodose distribution plots showed excellent agreements with the exception of the tip legion of the source's longitudinal axis where a slight deviation was observed. In clinical plans, the secondary dose calculations had, on average, about a $3.4\%$ deviation from the TPS plans. Conclusion: The accurate validation of complicate treatment plans is possible with the developed software and the qualify of the HDR treatment plan can be improved with the isodose display integrated into the patient anatomy information.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.13-19
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• 2011

Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.1-9
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• 2003

I. Purpose The multileaf collimator(MLC) has many advantages, but use of the MLC increased effective penumbra and isodose undulation in dose distribution compared with that of an alloy block. In this work, we introduced the HD-270 MLC, which can improve the above disadvantages of MLC, and reported its feasibility study. II. Method and Materials The HD-270 MLC is a technique which combines the use of the existing Siemens multileaf collimator(3D MLC) with patient translation perpendicular to the leaf plane. The technique produces a smoothed isodose distribution with the reduced isodose undulation and effective penumbra. To assess the efficacy of the HD-270 technique and determine the appropriate resolution, a polygonal shaped MLC field was made to produce field edge angles from 0 degree to 75 degree with a step of 15 degree. Each HD-270 group was generated according to the allowed resolution, i. e., 5, 3, and 2mm. The experiment was carried out on Primus, a Siemens linear accelerator configured with HD-270 MLC. The total 60 MU of 6 MV photon beam was delivered to X-Omat film(Kodak, USA) at a SAD of 100 cm and 1.5 cm depth in solid water phantom. Exposed films were scanned by Lumiscan75(LUMISYS) and analyzed using RIT113 software(Radiological Imaging Technology Inc., USA). To test the mechanical accuracy of table movement, the transverse, longitudinal, and vertical positions were controlled by a consol with ${\pm}5\;mm,\;{\pm}4\;mm,\;{\pm}3\;mm,\;and\;{\pm}2\;mm$ steps, and then measured using a dial gauge with an accuracy of 0.001 inch. During the experiments, the table loaded with about 50Kg human phantom to simulate the real treatment situation. III. Results The effective penumbra and isodose undulation became larger with increase the resolution and field edge angle. The accuracy of the table movement on each direction is good within the ${\pm}1\;mm$. IV. Conclusion Clinical use of the MLC can be increased by using of the HD-270 MLC which complements to the disadvantages of the MLC.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.129-132
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• 2002

The practical virtual compensator, which uses a dynamic multi-leaf collimator (dMLC) and three-dimensional radiation therapy planning (3D RTP) system, was designed. And the feasibility study of the virtual compensator was done to verify that the virtual compensator acts a role as the replacement of the physical compensator. Design procedure consists of three steps. The first step is to generate the isodose distributions from the 3D RTP system (Render Plan, Elekta). Then isodose line pattern was used as the compensator pattern. Pre-determined compensating ratio was applied to generate the fluence map for the compensator design. The second step is to generate the leaf sequence file with Ma's algorithm in the respect of optimum MU-efficiency. All the procedure was done with home-made software. The last step is the QA procedure which performs the comparison of the dose distributions which are produced from the irradiation with the virtual compensator and from the calculation by 3D RTP. In this study, a phantom was fabricated for the verification of properness of the designed compensator. It is consisted of the styrofoam part which mimics irregular shaped contour or the missing tissues and the mini water phantom. Inhomogeneous dose distribution due to the styrofoam missing tissue could be calculated with the RTP system. The film dosimetry in the phantom with and without the compensator showed significant improvement of the dose distributions. The virtual compensator designed in this study was proved to be a replacement of the physical compensator in the practical point of view.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.305-311
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• 1989

Fletcher-Suit colpostat has an internal structure to reduce dose to bladder and rectum. Some programs were developed to calculate dose at any point in water in three dimension around the colpostat containing Cs-137 tube, to find the shielding effect to dose by the internal structure, and to draw isodose curves and iso-shielding effect curves. Computer was an IBM compatible AT with EGA card and language was MS-Basic V6.0, Material, shape and geometry of the strucure, tube and colpostat were considered in algorithm for calculation of dose. Dose rates per unit mg. Ra. eq. in water calculated by a program were stored in auxiliary memory devices and retrieved in another programs. Isodose curves on medial side shrinked. Dose distribution was not symmetric about a transverse axis bisecting the colpostat. Reduction of dose was more excessive on top side than on bottom. Iso-shielding effect curve showed that the shielding effect was higher on top side than on bottom, and that there was shielding effect over almost all area of medial side. Such results were related to both shifted position of tube in the colpostat and asymmetric distribution of active source in the tube. Maximum of shielding effect was $49\%$ on top side and $44\%$ on bottom side. The direction of iso-shielding effect curve was generally radial from the center of active source. In treatment planning using Fletcher-Suit colpostat, the internal structure should be considered to find precise doses to bladder and rectum, etc.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.129-137
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• 1984

In brachytherapy, it is important to determine the positions of the radiation sources which are inserted into a patient and to estimate the dose resulting from the treatment. Calculation of the dose distribution throughout an implant is so laborious that it is rarely done by manual methods except for model cases. It is possible to calculate isodose distributions and tumor doses for individual patients by the use of a microcomputer. In this program, the dose rate and dose distributions are calculated by numerical integration of point source and the localization of radiation sources are obtained from two radiographs at right angles taken by a simulator developed for the treatment planning. By using microcomputer for brachytherapy, we obtained the result as following 1. Dose calculation and irradiation time for tumor could be calculated under one or five seconds after input data. 2. It was same value under$\pm2\%$ error between dose calculation by computer program and measurement dose. 3. It took about five minutes to reconstruct completely dose distribution for intracavitary irradiation. 4. Calculating by computer made remarkly reduction of dose errors compared with Quimby's calculation in interstitial radiation implantation. 5. It could calculate the biological isoffect dose for high and low dose rate activities.