• Progress in Medical Physics
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• v.30 no.4
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• pp.128-138
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• 2019

Purpose: Segmental analysis of volumetric modulated arc therapy (VMAT) is not clinically used for compositional error source evaluation. Instead, dose verification is routinely used for plan-specific quality assurance (QA). While this approach identifies the resultant error, it does not specify which machine parameter was responsible for the error. In this research study, we adopted an approach for the segmental analysis of VMAT as a part of machine QA of linear accelerator (LINAC). Methods: Two portal dose QA plans were generated for VMAT QA: a) for full arc and b) for the arc, which was segmented in 12 subsegments. We investigated the multileaf collimator (MLC) position and dosimetric accuracy in the full and segmented arc delivery schemes. A MATLAB program was used to calculate the MLC position error from the data in the dynalog file. The Gamma passing rate (GPR) and the measured to planned dose difference (DD) in each pixel of the electronic portal imaging device was the measurement for dosimetric accuracy. The eclipse treatment planning system and a MATLAB program were used to calculate the dosimetric accuracy. Results: The maximum root-mean-square error of the MLC positions were <1 mm. The GPR was within the range of 98%-99.7% and was similar in both types of VMAT delivery. In general, the DD was <5 calibration units in both full arcs. A similar DD distribution was found for continuous arc and segmented arcs sums. Exceedingly high DD were not observed in any of the arc segment delivery schemes. The LINAC performance was acceptable regarding the execution of the VMAT QA plan. Conclusions: The segmental analysis proposed in this study is expected to be useful for the prediction of the delivery of the VMAT in relation to the gantry angle. We thus recommend the use of segmental analysis of VMAT as part of the regular QA.

• Journal of Radiation Protection and Research
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• v.43 no.3
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• pp.107-113
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• 2018

Background: The purpose of our study was to compare the dosimetric advantages of Flattening filter free (FFF) beams for trigeminal neuralgia patients using 4 mm conical collimators over previously treated patients with 6 MV SRS beam. Materials and Methods: A retrospective study was conducted for 5 TN patients who had been previously treated at our institution using frame-based, LINAC-based stereotactic radiosurgery (SRS) on Novalis Tx using 6 MV SRS beam were replanned on 6X FFF beams on Edge Linear accelerator with same beam angles and dose constraints using 4 mm conical collimator. The total number of monitor units along with the beam on time was compared for both Edge and Novalis Tx by redelivering the plans in QA mode of LINAC to compare the delivery efficiency. Plan quality was evaluated by homogeneity index (HI) and Paddick gradient index (GI) for each plan. We also analyzed the doses to brainstem and organ at risks (OARs). Results and Discussion: A 28% beam-on time reduction was achieved using 6X FFF when compared with 6X SRS beam of Novalis Tx. A sharp dose fall off with gradient index value of $3.4{\pm}0.27$ for 4 mm Varian conical collimator while $4.17{\pm}0.20$ with BrainLab cone. Among the 5 patients treated with a 4 mm cone, average maximum brainstem dose was 10.24 Gy for Edge using 6X FFF and 14.28 Gy for Novalis Tx using 6X SRS beam. Conclusion: The use of FFF beams improves delivery efficiency and conical collimator reduces dose to OAR's for TN radiosurgery. Further investigation is warranted with larger sample patient data.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.2
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• pp.123-130
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• 2008

Purpose: To provide practical education, most universities should be equipped with medical appliances in need. As compensatory measures, Gimcheon College has produced in-house dummy linac and dummy accessories, we are going to report efficiency and its usage. Materials and Methods: Dummy linear accelerator (DLINAC-001) has the same mechanical functions as rotation of gantry and collimation in linear accelerator. In addition, to maximize practical education, we have produced and utilized in-house custom blocks, wedge filters, electron cones and head rests. Results: The in-house produced linear accelerator with the same mechanical functions as the linear accelerator, DLINAC-001 can be effectively used in practicing diverse medical instruments. Conclusion: We have produced dummy linear accelerators and dummy accessories and utilized them in practice classes, which can provide the students with clinical training in diverse fields. Consequently, the students exposed to the maximized educational effectiveness can be easily equipped with the practical competence required in real clinical fields.

• Radiation Oncology Journal
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• v.11 no.1
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• pp.167-174
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• 1993

Recently, stereotactic radiosurgery plan is required with the information of 3-D image and dose distribution. A project has been doing if developing LINAC based stereotactic radiosurgery since April 1991. The purpose of this research is to develop 3-D radiosurgery planning system using personal computer. The procedure of this research is based on two steps. The first step is to develop 3-D localization system, which input the image information of the patient, coordinate transformation, the position and shape of target, and patient contour into computer system using CT image and stereotactic frame. The second step is to develop 3-D dose planning system, which compute dose distribution on image plane, display on high resolution monitor both isodose distribution and patient image simultaneously and develop menu-driven planning system. This prototype of radiosurgery planning system was applied recently for several clinical cases. It was shown that our planning system is fast, accurate and efficient while making it possible to handle various kinds of image modalities such as angiography, CT and MRI. It makes it possible to develop general 3-D planning system using beam's eye view or CT simulation in radiation therapy in future.

• The Journal of Korean Society for Radiation Therapy
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• v.6 no.1
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• pp.21-30
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• 1994

To analyze the states of operation of radiotherapy facilities in the period from 1979 to 1992 and to get the base for efficient operation and maintenance of the radiotherapy facilities. Data on the records of annual number of patients operated by each facility; span of suspension of operation, the cost and span of repairing, and parts of oui-of-order in the period from 1979 to 1992 were analyzed. We made a comparative analysis of average annual number of patients, annual span of the suspension of operation, annual cost ratio of repair, span of repairing per break down, and total number of broken parts. We could get following annual number of patients(day), span of the suspension of span ($\%$)(day). annual cost ratio fo repair($\%$), span of repairing per break down(Min-Max, day), and number of broken parts from this analysis. 1. Cobalt unit (Picker C-9) : 10,389(43), 0.4(0.83) 0.07, 1hr-2, 3 2. Linac(Clinac 6/100) : 11,492(50), 4.0(9.57), 0.98, 1hr-30, 12 3. Linac(Clinac 18) : 9.115(44), 12.7(30.5), 3.54, 1hr-108. 41 4. Simulator(Picker Ther-X) : 2,017(9), 0.51(1.3), 0.24, 1hr-2, 7 5. RTP(Capentec Cap-plan) : 528(2), 0.4(0.93), - hrs, - The conclusion obtained from statistical analysis above are as follows. 1. The rate of operation of Cobalt unit($99.6\%$) was higher that of Linear Accelerators ($87.3\%$). The rates operation of Simulator and RTP computer were very close to that of Cobalt unit. 2. In order to raise up the working ratio of accelerator. it is desirable that we keep our engineer to learn a sufficient technical skill and the equipment agent to stock sufficient spare parts. 3. In order to maintain Linear Accelerator efficiently, it is desirable to have annually $2.3\%$ of the purchase price of equiment for repairing.

• Nuclear Engineering and Technology
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• v.48 no.2
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• pp.525-532
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• 2016

High-energy linear accelerators are increasingly used in the medical field. However, the unwanted photo-neutrons can also be contributed to the dose delivered to the patients during their treatments. In this study, neutron fluxes were measured in a solid water phantom placed at the isocenter 1-m distance from the head of an18-MV linac using the foil activation method. The produced activities were measured with a calibrated well-type Ge detector. From the measured fluxes, the total neutron fluence was found to be $(1.17{\pm}0.06){\times}10^7n/cm^2$ per Gy at the phantom surface in a $20{\times}20cm^2$ X-ray field size. The maximum photo-neutron dose was measured to be $0.67{\pm}0.04$ mSv/Gy at $d_{max}=5cm$ depth in the phantom at isocenter. The present results are compared with those obtained for different field sizes of $10{\times}10cm^2$, $15{\times}15cm^2$, and $20{\times}20cm^2$ from 10-, 15-, and 18-MV linacs. Additionally, ambient neutron dose equivalents were determined at different locations in the room and they were found to be negligibly low. The results indicate that the photo-neutron dose at the patient position is not a negligible fraction of the therapeutic photon dose. Thus, there is a need for reduction of the contaminated neutron dose by taking some additional measures, for instance, neutron absorbing-protective materials might be used as aprons during the treatment.

• Nuclear Engineering and Technology
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• v.51 no.1
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• pp.176-189
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• 2019

This paper presents a feasibility study for producing the medical isotope $^{99m}Tc$ using the hazardous and currently wasted radioisotope $^{99}Tc$. This can be achieved with the nuclear resonance fluorescence (NRF) phenomenon, which has recently been made applicable due to high-intensity laser Compton scattering (LCS) photons. In this work, 21 NRF energy states of $^{99}Tc$ have been identified as potential contributors to the photo-production of $^{99m}Tc$ and their NRF cross-sections are evaluated by using the single particle estimate model and the ENSDF data library. The evaluated cross sections are scaled using known measurement data for improved accuracy. The maximum LCS photon energy is adjusted in a way to cover all the significant excited states that may contribute to $^{99m}Tc$ generation. An energy recovery LINAC system is considered as the LCS photon source and the LCS gamma spectrum is optimized by adjusting the electron energy to maximize $^{99m}Tc$ photo-production. The NRF reaction rate for $^{99m}Tc$ is first optimized without considering the photon attenuations such as photo-atomic interactions and self-shielding due to the NRF resonance itself. The change in energy spectrum and intensity due to the photo-atomic reactions has been quantified using the MCNP6 code and then the NRF self-shielding effect was considered to obtain the spectrums that include all the attenuation factors. Simulations show that when a $^{99}Tc$ target is irradiated at an intensity of the order $10^{17}{\gamma}/s$ for 30 h, 2.01 Ci of $^{99m}Tc$ can be produced.

• Progress in Medical Physics
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• v.31 no.4
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• pp.145-152
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• 2020

Purpose: In ionization-chamber dosimetry for high-dose-rate electron beams-above 20 mGy/pulse-the ion-recombination correction methods recommended by the International Atomic Energy Agency (IAEA) and the American Association of Physicists in Medicine (AAPM) are not appropriate, because they overestimate the correction factor. In this study, we suggest a practical ion-recombination correction method, based on Boag's improved model, and apply it to reference dosimetry for electron beams of about 100 mGy/pulse generated from an electron linear accelerator (LINAC). Methods: This study employed a theoretical model of the ion-collection efficiency developed by Boag and physical parameters used by Laitano et al. We recalculated the ion-recombination correction factors using two-voltage analysis and obtained an empirical fitting formula to represent the results. Next, we compared the calculated correction factors with published results for the same calculation conditions. Additionally, we performed dosimetry for electron beams from a 6 MeV electron LINAC using an Advanced Markus^® ionization chamber to determine the reference dose in water at the source-to-surface distance (SSD)=100 cm, using the correction factors obtained in this study. Results: The values of the correction factors obtained in this work are in good agreement with the published data. The measured dose-per-pulse for electron beams at the depth of maximum dose for SSD=100 cm was 115 mGy/pulse, with a standard uncertainty of 2.4%. In contrast, the k_s values determined using the IAEA and AAPM methods are, respectively, 8.9% and 8.2% higher than our results. Conclusions: The new method based on Boag's improved model provides a practical method of determining the ion-recombination correction factors for high dose-per-pulse radiation beams up to about 120 mGy/pulse. This method can be applied to electron beams with even higher dose-per-pulse, subject to independent verification.

• Progress in Medical Physics
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• v.34 no.4
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• pp.48-54
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• 2023

Purpose: In this study, the dosimetric characteristics of lung stereotactic body radiotherapy (SBRT) plans using the new Halcyon system were analyzed to assess its suitability. Methods: We compared the key dosimetric parameters calculated for the Halcyon SBRT plans with those of a conventional C-arm linear accelerator (LINAC) equipped with a high-definition multileaf collimator (HD-MLC)-Trilogy Tx. A total of 10 patients with non-small-cell lung cancer were selected, and all SBRT plans were generated using the RapidArc technique. Results: Trilogy Tx exhibited significant superiority over Halcyon in terms of target dose coverage (conformity index, homogeneity index, D_{0.1 cc}, and D_95%) and dose spillage (gradient). Trilogy Tx was more efficient than Halcyon in the lung SBRT beam delivery process in terms of the total number of monitor units, modulation factor, and beam-on time. However, it was feasible to achieve a dose distribution that met SBRT plan requirements using Halcyon, with no significant differences in satisfying organs at risk dose constraints between both plans. Conclusions: Results confirm that Halcyon is a viable alternative for performing lung SBRT in the absence of a LINAC equipped with HD-MLC. However, extra consideration should be taken in determining whether to use Halcyon when the planning target volume setting is enormous, as in the case of significant tumor motions.

• Progress in Medical Physics
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• v.34 no.3
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• pp.33-39
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• 2023

Purpose: FLASH radiotherapy (RT) using ultra-high dose rate (>40 Gy/s) radiation is being studied worldwide. However, experimental studies such as preclinical studies using small animals are difficult to perform due to the limited availability of irradiation devices and methods for generating a FLASH beam. In this paper, we report the initial dosimetry results of a prototype electron linear accelerator (LINAC)-based irradiation system to perform ultra-high dose rate (UHDR) preclinical experiments. Methods: The present study used the prototype electron LINAC developed by the Research Center of Dongnam Institute of Radiological and Medical Sciences (DIRAMS) in Korea. We investigated the beam current dependence of the depth dose to determine the optimal beam current for preclinical experiments. The dose rate in the UHDR region was measured by film dosimetry. Results: Depth dose measurements showed that the optimal beam current for preclinical experiments was approximately 33 mA, corresponding to a mean energy of 4.4 MeV. Additionally, the average dose rates of 80.4 Gy/s and 162.0 Gy/s at a source-to-phantom surface distance of 30 cm were obtained at pulse repetition frequencies of 100 Hz and 200 Hz, respectively. The dose per pulse and instantaneous dose rate were estimated to be approximately 0.80 Gy and 3.8×10⁵ Gy/s, respectively. Conclusions: Film dosimetry verified the appropriate dose rates to perform FLASH RT preclinical studies using the developed electron-beam irradiator. However, further research on the development of innovative beam monitoring systems and stabilization of the accelerator beam is required.