• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.108-115
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• 2022

Background: This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT). Methods: The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and Brain-LAB) between June 2019 and March 2021. We analyzed the multileaf collimator DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm-1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm). Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1% (95.5%-100%) and 97.5% (92.3%-99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm-0.9%/0.9 mm). Conclusion: This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

• Progress in Medical Physics
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• v.10 no.1
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• pp.17-22
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• 1999

INJ-I, INJ-E, PFN, BMI, and PRF were selected among the various factors which constitute a digital linear accelerator to find effects on the dose distribution by changing current and voltage within the permitted scale which Mevatron automatically maintained. We measured the absorbed dose using an ion chamber, analyzed the waveform of beam output using an oscilloscope, and measured symmetry and flatness using a dosimetry system. An RFA plus (Scanditronix, Sweden) device was used as a dosimetry system. Then an 0.6cc ion chamber (PR06C, USA), an electrometer (Capintec192, USA), and an oscilloscope (Tektronix, USA) were employed to measure the changes on the dose distribution characteristics by changing the beam-tuning parameters. When the currents and the voltages of INJ-I, INJ-E, PFN, BMI, and PRF were modified, we were able to see the notable change on the dose rate by examining the change of the output pulse using the oscilloscope and by measuring them using the ion chamber. However, the results of energy and flatness graph from RF A plus were almost identical. The factors had fine differences: INJ-I, INJ-E, PFN, BMI, and PRF had 0.01∼0.02% differences in D10/D20, 0.1∼0.2 % differences in symmetry, and 0.1∼0.4% differences in flatness. Since Mevatron controlled itself automatically to keep the reference value of the factor, it was not able to see large differences in the dose distribution. There were fine differences on the dose rate distribution when the voltage and the currents of the digitized factors were modified Nonetheless, a basic operational management information was achieved.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.53-58
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• 1991

From February 1987 through July 1990, the seventeen cases of inoperable intracranial arteriovenous malformation (AVM) were treated using 6 MV linear accelerator at the Division of Therapautic Radiology, Kang Nam 51. Mary's Hospital. Of seventeen cases, fourteen were male and three were female. Ages ranged from 10 to 51 years (median age of 25 years). The main symtoms were headache, epilepsy and hemiparesis in decreasing order of frequency. The middle cerebral artery is the most common origin of the feeding vessel $(41.2\%)$. Four were treated by conventionally fractionated radiation therapy (CRT, thirteen were treated by stereotactic radiosurgery (RS). duration or follow-up in CRT and RS group were 4 to 43 months (median 33 months) and 3 to 12 months (median 13 months), respectively. When the response was assessed by radiologic follow-up study, two of four CRT group showed minimal response. Of thirteen cases of RS group, two $(15.4\%)$ showed complete response, five $(38\%)$ partial response, two $(15.4\%)$ minimal response and four $(30.7\%)$ no response by the same assessment. There was no statistical significance in terms of follow-up period (p=0.22), size of lesion (p=0.82) and treated dose (p=0.05). Further accumulation of experience is recommended with proper case selection and sufficient follow-up period.

• Progress in Medical Physics
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• v.6 no.2
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• pp.13-19
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• 1995

The behavior of the correction factor associated with the collimator opening(head-scatter factor) were investigated for the 6MV x-ray beams of medical linear accelerator. The primary photon fluence was measured in air quasi-small fied size. Consideration in this study was given to the effect of head scatter factor with quasi-small fied size, the upper and lower collimator jaw scatter collection factors of quasi-small field (4-10cm) were measured with ion chamber. In general, the wedge factors which are used clinical practics are ignored of dependency on field sizes and depth. In wedge factors for each wedge filter were measured at various depth by using 6MV X-ray. In this present we inverstigated systematically the depth and field sizes dependency to determine the absorbed dose more accurately. Head scatter(upper-lower collimator jaw)appears to be (1) a small effect, less than 5％ over the range of clinical field sizes (2) generated primarily at the flattening filter and therefored influenced most by the upper collimator setting.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.537-543
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• 2020

The elderly population in the modern society is growing rapidly due to advance medical technology and minimally invasive surgery. Therefore, as the tendency to use medical device is increasing, pathogenic infection is a concern. Therefore, the first aim of modern medicine is infection prevention in medical place. Recently, patient implants are increasing using 3D printing. Hydroxyapatite is used as a representative material. And, there haven't had currently absorbed dose standard for sterilization of hydroxyapatite discs. Escherichia coli and Streptococcus mutans contaminated on the surface of hydroxyapatite discs were irradiated at each absorbed dose of 0, 0.5, 1.0, 3.0, 5.0 kGy using Gamma-ray of cobalt and Electron-beam of linear accelerator. Then, the number of bacteria was measured in the sample by the decimal dilution method. After sterilization, a non-parametric testing method was performed to compare the survival of Escherichia coli and Streptococcus mutans. As a result, Escherichia coli was sterilized at 1 kGy or more and Streptococcus mutans at 3 kGy or more on absorbed dose. It is considered possible to perform sterilization at a lower value than the recommended absorbed dose of radiation sterilization.

• Progress in Medical Physics
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• v.29 no.2
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• pp.66-72
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• 2018

The proper position of a multi-leaf collimator (MLC) is essential for the quality of intensity-modulated radiation therapy (IMRT) and volumetric modulated arc radiotherapy (VMAT) dose delivery. Task Group (TG) 142 provides a quality assurance (QA) procedure for MLC position. Our study investigated the QA validation of the mechanical leaf gap measurement and the maintenance procedure. Two $VitalBeam^{TM}$ systems were evaluated to validate the acceptance of an MLC position. The dosimetric leaf gaps (DLGs) were measured for 6 MV, 6 MVFFF, 10 MV, and 15 MV photon beams. A solid water phantom was irradiated using $10{\times}10cm^2$ field size at source-to-surface distance (SSD) of 90 cm and depth of 10 cm. The portal dose image prediction (PDIP) calculation was implemented on a treatment planning system (TPS) called $Eclipse^{TM}$. A total of 20 VMAT plans were used to confirm the accuracy of dose distribution measured by an electronic portal imaging device (EPID) and those predicted by VMAT plans. The measured leaf gaps were 0.30 mm and 0.35 mm for VitalBeam 1 and 2, respectively. The DLG values decreased by an average of 6.9% and 5.9% after mechanical MLC adjustment. Although the passing rates increased slightly, by 1.5% (relative) and 1.2% (absolute) in arc 1, the average passing rates were still within the good dose delivery level (>95%). Our study shows the existence of a mechanical leaf gap error caused by a degenerated MLC motor. This can be recovered by reinitialization of MLC position on the machine control panel. Consequently, the QA procedure should be performed regularly to protect the MLC system.

• Progress in Medical Physics
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• v.32 no.4
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• pp.116-121
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• 2021

Purpose: To investigate the effects of dose rate on intensity-modulated radiation therapy (IMRT) quality assurance (QA). Methods: We performed gamma tests using portal dose image prediction and log files of a multileaf collimator. Thirty treatment plans were randomly selected for the IMRT QA plan, and three verification plans for each treatment plan were generated with different dose rates (200, 400, and 600 monitor units [MU]/min). These verification plans were delivered to an electronic portal imager attached to a Varian medical linear accelerator, which recorded and compared with the planned dose. Root-mean-square (RMS) error values of the log files were also compared. Results: With an increase in dose rate, the 2%/2-mm gamma passing rate decreased from 90.9% to 85.5%, indicating that a higher dose rate was associated with lower radiation delivery accuracy. Accordingly, the average RMS error value increased from 0.0170 to 0.0381 cm as dose rate increased. In contrast, the radiation delivery time reduced from 3.83 to 1.49 minutes as the dose rate increased from 200 to 600 MU/min. Conclusions: Our results indicated that radiation delivery accuracy was lower at higher dose rates; however, the accuracy was still clinically acceptable at dose rates of up to 600 MU/min.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3747-3750
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• 2013

Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.925-932
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• 2019

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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7743-7748
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• 2013

Background: To study the pattern of patient load, personnel and equipment resources from 30-years experience in Southern Thailand. Materials and Methods: This retrospective study collected secondary data from the Division of Therapeutic Radiology and Oncology and the Songklanagarind Hospital Tumor Registry database, Faculty of Medicine, Prince of Songkla University, during the period of 1982-2012. Results: The number of new patients who had radiation treatment gradually increased from 121 in 1982 to 2,178 in 2011. Shortages of all kinds of personnel were demonstrated as compared to the recommendations, especially in radiotherapy technicians. In 2011, Southern Thailand, with two radiotherapy centers, had 0.44 megavoltage radiotherapy machines (cobalt or linear accelerator) per million of population. This number is suboptimal, but could be managed cost-effectively by prolonging machine operating times during personnel shortages. Conclusions: This study identified a discrepancy between workload and resources in one medical school radiotherapy center in Southern Thailand. This information is crucial for future strategic planning both regionally and nationally.