• Progress in Medical Physics
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• v.21 no.3
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• pp.304-310
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• 2010

Less execution of the electron arc treatment could in large part be attributed to the lack of an adequate planning system. Unlike most linear accelerators providing the electron arc mode, no commercial planning systems for the electron arc plan are available at this time. In this work, with the expectation that an easily accessible planning system could promote electron arc therapy, a commercial planning system was commissioned and evaluated for the electron arc plan. For the electron arc plan with use of a Varian 21-EX, Pinnacle3 (ver. 7.4f), with an electron pencil beam algorithm, was commissioned in which the arc consisted of multiple static fields with a fixed beam opening. Film dosimetry and point measurements were executed for the evaluation of the computation. Beam modeling was not satisfactory with the calculation of lateral profiles. Contrary to good agreement within 1% of the calculated and measured depth profiles, the calculated lateral profiles showed underestimation compared with measurements, such that the distance-to-agreement (DTA) was 5.1 mm at a 50% dose level for 6 MeV and 6.7 mm for 12 MeV with similar results for the measured depths. Point and film measurements for the humanoid phantom revealed that the delivered dose was more than the calculation by approximately 10%. The electron arc plan, based on the pencil beam algorithm, provides qualitative information for the dose distribution. Dose verification before the treatment should be mandatory.

• Progress in Medical Physics
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• v.9 no.3
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• pp.163-173
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• 1998

Nuclear medicine emission computed tomography(ECT) can be very useful to diagnose early stage of neuronal diseases and to measure theraputic results objectively, if we can quantitate energy metabolism, blood flow, biochemical processes, or dopamine receptor and transporter using ECT. However, physical factors including attenuation, scatter, partial volume effect, noise, and reconstruction algorithm make it very difficult to quantitate independent of type of SPECT. In this study, we quantitated the effects of attenuation and scatter using brain SPECT and three-dimensional brain phantom with and without applying their correction methods. Dual energy window method was applied for scatter correction. The photopeak energy window and scatter energy window were set to 140ke${\pm}$10% and 119ke${\pm}$6% and 100% of scatter window data were subtracted from the photopeak window prior to reconstruction. The projection data were reconstructed using Butterworth filter with cutoff frequency of 0.95cycles/cm and order of 10. Attenuation correction was done by Chang's method with attenuation coefficients of 0.12/cm and 0.15/cm for the reconstruction data without scatter correction and with scatter correction, respectively. For quantitation, regions of interest (ROIs) were drawn on the three slices selected at the level of the basal ganglia. Without scatter correction, the ratios of ROI average values between basal ganglia and background with attenuation correction and without attenuation correction were 2.2 and 2.1, respectively. However, the ratios between basal ganglia and background were very similar for with and without attenuation correction. With scatter correction, the ratios of ROI average values between basal ganglia and background with attenuation correction and without attenuation correction were 2.69 and 2.64, respectively. These results indicate that the attenuation correction is necessary for the quantitation. When true ratios between basal ganglia and background were 6.58, 4.68, 1.86, the measured ratios with scatter and attenuation correction were 76%, 80%, 82% of their true ratios, respectively. The approximate 20% underestimation could be partially due to the effect of partial volume and reconstruction algorithm which we have not investigated in this study, and partially due to imperfect scatter and attenuation correction methods that we have applied in consideration of clinical applications.

• Progress in Medical Physics
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• v.23 no.3
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• pp.188-198
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• 2012

This study aims to evaluate the accuracy of the collapsed cone convolution (CCC) algorithm for dose calculation in a treatment planning system (TPS), CorePLAN$^{TM}$. We implemented beam models for various setup conditions in TPS and calculated radiation dose using CCC algorithm for 6 MV and 15 MV photon beam in $50{\times}50{\times}50cm^3$ water phantom. Field sizes were $4{\times}4cm^2$, $6{\times}6cm^2$, $10{\times}10cm^2$, $20{\times}20cm^2$, $30{\times}30cm^2$ and $40{\times}40cm^2$ and each case was classified as open beam cases and wedged beam cases, respectively. Generated beam models were evaluated by comparing calculated data and measured data of percent depth dose (PDD) and lateral profile. As a result, PDD showed good agreement within approximately 2% in open beam cases and 3% in wedged beam cases except for build-up region and lateral profile also correspond within approximately 1% in field and 4% in penumbra region. On the other hand, the discrepancies were found approximately 4% in wedged beam cases. This study has demonstrated the accuracy of beam model-based CCC algorithm in CorePLAN$^{TM}$ and the most of results from this study were acceptable according to international standards. Although, the area with large dose difference shown in this study was not significant region in clinical field, the result of our study would open the possibility to apply CorePLAN$^{TM}$ into clinical field.

• Progress in Medical Physics
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• v.23 no.3
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• pp.145-153
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• 2012

In this study, we quantify the residual motion artifact in 4D-CT scan using the dynamic lung phantom which could simulate respiratory target motion and suggest a simple one-dimension theoretical model to explain and characterize the source of motion artifacts in 4DCT scanning. We set-up regular 1D sine motion and adjusted three level of amplitude (10, 20, 30 mm) with fixed period (4s). The 4DCT scans are acquired in helical mode and phase information provided by the belt type respiratory monitoring system. The images were sorted into ten phase bins ranging from 0% to 90%. The reconstructed images were subsequently imported into the Treatment Planning System (CorePLAN, SC&J) for target delineation using a fixed contour window and dimensions of the three targets are measured along the direction of motion. Target dimension of each phase image have same changing trend. The error is minimum at 50% phase in all case (10, 20, 30 mm) and we found that ${\Delta}S$ (target dimension change) of 10, 20 and 30 mm amplitude were 0 (0%), 0.1 (5%), 0.1 (5%) cm respectively compare to the static image of target diameter (2 cm). while the error is maximum at 30% and 80% phase ${\Delta}S$ of 10, 20 and 30 mm amplitude were 0.2 (10%), 0.7 (35%), 0.9 (45%) cm respectively. Based on these result, we try to analysis the residual motion artifact in 4D-CT scan using a simple one-dimension theoretical model and also we developed a simulation program. Our results explain the effect of residual motion on each phase target displacement and also shown that residual motion artifact was affected that the target velocity at each phase. In this study, we focus on provides a more intuitive understanding about the residual motion artifact and try to explain the relationship motion parameters of the scanner, treatment couch and tumor. In conclusion, our results could help to decide the appropriate reconstruction phase and CT parameters which reduce the residual motion artifact in 4DCT.

• Progress in Medical Physics
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• v.20 no.2
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• pp.72-79
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• 2009

Scatter correction for I-131 plays a very important role to improve image quality and quantitation. I-131 has multiple and higher energy gamma-ray emissions. Image quality and quantitative accuracy in I-131 imaging are degraded by object scatter as well as scatter and septal penetration in the collimator. The purpose of this study was to estimate scatter and septal penetration and investigate two scatter correction methods using Monte Carlo simulation. The gamma camera system simulated in this study was a FORTE system (Phillips, Nederland) with high energy, general-purpose, parallel hole collimator. We simulated for two types of high energy collimators. One is composed of lead, and the other is composed of artificially high Z number and high density. We simulated energy spectrum using a point source in air. We estimated both full width at half maximum (FWHM) and full width at tenth maximum (FWTM) using line spread function (LSF) in cylindrical water phantom. We applied two scatter correction methods, triple energy window scatter correction (TEW) and extended triple energy window scatter correction (ETEW). The TEW method is a pixel-by pixel based correction which is easy to implement clinically. The ETEW is a modification of the TEW which corrects for scatter by using abutted scatter rejection window, which can overestimate or the underestimate scatter. The both FWHM and FWTM were estimated as 41.2 mm and 206.5 mm for lead collimator, respectively. The FWHM and FWTM were estimated as 27.3 mm and 45.6 mm for artificially high Z and high density collimator, respectively. ETEW showed that the estimation of scatter components was close to the true scatter components. In conclusion, correction for septal penetration and scatter is important to improve image quality and quantitative accuracy in I-131 imaging. The ETEW method in scatter correction appeared to be useful in I-131 imaging.

• Progress in Medical Physics
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• v.20 no.2
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• pp.97-105
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• 2009

Absorbed dose to water based protocols recommended that plane-parallel chambers be calibrated against calibrated cylindrical chambers in a high energy electron beam with $R_{50}$>7 $g/cm^2$ (E${\gtrsim}$16 MeV). However, such high-energy electron beams are not available at all radiotherapy centers. In this study, we are compared the absorbed dose to water determined according to cross-calibration method in a high energy electron beam of 16 MeV and in electron beam energies of 12 MeV below the cross-calibration quality remark. Absorbed dose were performed for PTW 30013, Wellhofer FC65G Farmer type cylindrical chamber and for PTW 34001, Wellhofer PPC40 Roos type plane-parallel chamber. The cylindrical and the plane-parallel chamber to be calibrated are compared by alternately positioning each at reference depth, $Z_{ret}=0.6R_{50}-0.1$ in water phantom. The $D_W$ of plane-parallel chamber are derived using across-calibration method at high-energy electron beams of 16, 20 MeV. Then a good agreement is obtained the $D_W$ of plane-parallel chamber in 12 MeV. The agreement between 20 MeV and 12 MeV are within 0.2% for IAEA TRS-398.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.51-58
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• 2011

Purpose: In this study, we tried to check the usefulness of two Linear Accelerators, Clinac IX and 21EX (Varian, Palo Alto, CA), which are equipped in Ajou Medical Center. From 2008 to 2010, we evaluated the error range of Absolute Dose based on the daily output, which was measured by CHECKMATE$^{TM}$ (Sun Nuclear, Melbourne, FL). Materials and Methods: For Daily Q.A, photon beams of two linear accelerators, 21EX and IX (6 MV and 10 MV, respectively) were measured daily by using CHECKMATE$^{TM}$ just before the treatment began, while the absolute dose was measured biweekly by using water phantom. We analyzed the data of measured values from the daily Q.A and the absolute dose from 2008 to 2010 for 21EX, and from 2009 to 2010 for IX. We utilized Excel 2007 (Microsoft, USA) to evaluate Average, Standard deviation and Confidence level of the data. Furthermore, in order to check the measured values of CHECKMATE$^{TM}$ and the significance of absolute dose, each error value was compared and analyzed. Results: During the observation period, the output of two equipment's absolute dose increased in process of time and in both 6 MV and 10 MV, there was a similar increasing trend. In addition, the error rate of the measured value of CHECKMATE$^{TM}$ and the value of absolute dose were under 0.34, which means that there is a similarity relationship between the two measured values. After checking that the measured value of CHECKMATE$^{TM}$ increased, We measured the absolute dose to adjust that. When the error range was close to 2~3%, the number of changing the output was four for 21EX and three for IX. Conclusion: As a result of measuring and analyzing the daily output changes for two years by using CHECKMATE$^{TM}$, we could find that there is a significance between the output which we should obey during Q.A, and the measured value of absolute dose within the error tolerance of 2~3%. Thus, the use of CHECKMATE$^{TM}$ can be positively considered for more efficient and reliable daily output verification of linear accelerator. It can also be a good standard for other medical centers to understand the trends of linear accelerator and to refer to for the correction of each output.

• Progress in Medical Physics
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• v.26 no.3
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• pp.143-152
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• 2015

In this study, we aim to design the architecture of the kV imaging system for tumor tracking in the dual-head gantry system and analyze its accuracy by simulations. We established mathematical formulas and algorithms to track the tumor position with the two-pair kV imaging systems when they are in the non-orthogonal positions. The algorithms have been designed in the homogeneous coordinate framework and the position of the source and the detector coordinates are used to estimate the tumor position. 4D XCAT (4D extended cardiac-torso) software was used in the simulation to identify the influence of the angle between the two-pair kV imaging systems and the resolution of the detectors to the accuracy in the position estimation. A metal marker fiducial has been inserted in a numerical human phantom of XCAT and the kV projections were acquired at various angles and resolutions using CT projection software of the XCAT. As a result, a positional accuracy of less than about 1mm was achieved when the resolution of the detector is higher than 1.5 mm/pixel and the angle between the kV imaging systems is approximately between $90^{\circ}$ and $50^{\circ}$. When the resolution is lower than 1.5 mm/pixel, the positional errors were higher than 1mm and the error fluctuation by the angles was greater. The resolution of the detector was critical in the positional accuracy for the tumor tracking and determines the range for the acceptable angle range between the kV imaging systems. Also, we found that the positional accuracy analysis method using XCAT developed in this study is highly useful and will be a invaluable tool for further refined design of the kV imaging systems for tumor tracking systems.

• Progress in Medical Physics
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• v.23 no.1
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• pp.26-32
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• 2012

The magnification technique has recently become popular in bone radiography, mammography and other diagnostic examination. However, because of the finite size of X-ray focal spot, the magnification influences various imaging properties with resolution, noise and contrast. The purpose of study is to investigate the influence of magnification and focal spot size on digital imaging system using eDQE (effective detective quantum efficiency). Effective DQE is a metric reflecting overall system response including focal spot blur, magnification, scatter and grid response. The adult chest phantom employed in the Food and Drug Administration (FDA) was used to derive eDQE from eMTF (effective modulation transfer function), eNPS (effective noise power spectrum), scatter fraction and transmission fraction. According to results, spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.76, 2.21, 1.78, 1.49 and 1.26 lp/mm respectively using small focal spot. The spatial frequencies that eMTF is 10% with the magnification factor of 1.2, 1.4, 1.6, 1.8 and 2.0 are 2.21, 1.66, 1.25, 0.93 and 0.73 lp/mm respectively using large focal spot. The eMTFs and eDQEs decreases with increasing magnification factor. Although there are no significant differences with focal spot size on eDQE (0), the eDQEs drops more sharply with large focal spot than small focal spot. The magnification imaging can enlarge the small size lesion and improve the contrast due to decrease of effective noise and scatter with air-gap effect. The enlargement of the image size can be helpful for visual detection of small image. However, focal spot blurring caused by finite size of focal spot shows more significant impact on spatial resolution than the improvement of other metrics resulted by magnification effect. Based on these results, appropriate magnification factor and focal spot size should be established to perform magnification imaging with digital radiography system.

• Progress in Medical Physics
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• v.26 no.4
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• pp.193-200
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• 2015

The aim of this study is to present commissioning results of the ViewRay system. We verified safety functions of the ViewRay system. For imaging system, we acquired signal to noise ratio (SNR) and image uniformity. In addition, we checked spatial integrity of the image. Couch movement accuracy and coincidence of isocenters (radiation therapy system, imaging system and virtual isocneter) was verified. Accuracy of MLC positioing was checked. We performed reference dosimetry according to American Association of Physicists in Medicine (AAPM) Task Group 51 (TG-51) in water phantom for head 1 and 3. The deviations between measurements and calculation of percent depth dose (PDD) and output factor were evaluated. Finally, we performed gamma evaluations with a total of 8 IMRT plans as an end-to-end (E2E) test of the system. Every safety system of ViewRay operated properly. The values of SNR and Uniformity met the tolerance level. Every point within 10 cm and 17.5 cm radii about the isocenter showed deviations less than 1 mm and 2 mm, respectively. The average couch movement errors in transverse (x), longitudinal (y) and vertical (z) directions were 0.2 mm, 0.1 mm and 0.2 mm, respectively. The deviations between radiation isocenter and virtual isocenter in x, y and z directions were 0 mm, 0 mm and 0.3 mm, respectively. Those between virtual isocenter and imaging isocenter were 0.6 mm, 0.5 mm and 0.2 mm, respectively. The average MLC positioning errors were less than 0.6 mm. The deviations of output, PDDs between mesured vs. BJR supplement 25, PDDs between measured and calculated and output factors of each head were less than 0.5%, 1%, 1% and 2%, respectively. For E2E test, average gamma passing rate with 3%/3 mm criterion was $99.9%{\pm}0.1%$.