• The Journal of Korean Society for Radiation Therapy
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• v.16 no.1
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• pp.1-9
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• 2004

Purpose : The aim of this study is to investigate the properties of small field size and to measure the penumbra and central axis depth dose varying to the jaw setting and off axis distance for indicate this data to small field sizes radiation therapy. Material and methods : The percentage depth dose, beam profile and central axis output dose was measured by farmer type ion chamber and pinpoint chamber using Primart linac with 6MV energy. Beam quality and penumbra variations according to the central axis shift, from center to every 2cm outside increment, and field size, from $1{\times}1cm$ to $10{\times}10cm$ was investigated and compared with that of the standard geometrical condition's results Results : The differences of measured values between two ion chamber was about $37\%$ at 10cm depth with $1{\times}1cm$ field sizes but as field size increased this differences was diminished gradually. Measured data from various off axis distance with the different asymmetric collimations are not changed significantly but as size decreased the dose variation was increased and at $1{\times}1cm$ field size dose difference among off axis distance was as much as $13\%$, and as shallower the measured depth the central axis dose variations among the OAD was increased, penumbra was not changed noticeably depending on off axis distance but the percentage of penumbra from its initial field sizes was strongly dependant on field sizes and penumbra occupation rates of its own field sizes ranging from $6\%$ at $10{\times}10cm$ to $50\%$ at $1{\times}1cm$ field size. Conclusion : For imrt treatment, there are several numbers of different gentry angles with beams of nonuniform fluences are required and several complex factors involved. Among them the characteristics of beam output varying to the geometrical setting and design of collimators are of important to attaining a good treatment results. As mentioned in results the differences of measured values are changed significantly depends on ion chamber volume, depths and field size. For providing quality radiation treatment, especially at small field size, those factor's should have considering deliberately.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.1
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• pp.107-114
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• 2014

Purpose : The purpose of this study is evaluation for the applicability of O-MAR(Metal artifact Reduction for Orthopedic Implants)(ver. 3.6.0, Philips, Netherlands) in head & neck radiation treatment planning CT with metal artifact created by dental implant. Materials and Methods : All of the in this study's CT images were scanned by Brilliance Big Bore CT(Philips, Netherlands) at 120kVp, 2mm sliced and Metal artifact reduced by O-MAR. To compare the original and reconstructed CT images worked on RTPS(Eclipse ver 10.0.42, Varian, USA). In order to test the basic performance of the O-MAR, The phantom was made to create metal artifact by dental implant and other phantoms used for without artifact images. To measure a difference of HU in with artifact images and without artifact images, homogeneous phantom and inhomogeneous phantoms were used with cerrobend rods. Each of images were compared a difference of HU in ROIs. And also, 1 case of patient's original CT image applied O-MAR and density corrected CT were evaluated for dose distributions with SNC Patient(Sun Nuclear Co., USA). Results : In cases of head&neck phantom, the difference of dose distibution is appeared 99.8% gamma passing rate(criteria 2 mm / 2%) between original and CT images applied O-MAR. And 98.5% appeared in patient case, among original CT, O-MAR and density corrected CT. The difference of total dose distribution is less than 2% that appeared both phantom and patient case study. Though the dose deviations are little, there are still matters to discuss that the dose deviations are concentrated so locally. In this study, The quality of all images applied O-MAR was improved. Unexpectedly, Increase of max. HU was founded in air cavity of the O-MAR images compare to cavity of the original images and wrong corrections were appeared, too. Conclusion : The result of study assuming restrained case of O-MAR adapted to near skin and low density area, it appeared image distortion and artifact correction simultaneously. In O-MAR CT, air cavity area even turned tissue HU by wrong correction was founded, too. Consequentially, It seems O-MAR algorithm is not perfect to distinguish air cavity and photon starvation artifact. Nevertheless, the differences of HU and dose distribution are not a huge that is not suitable for clinical use. And there are more advantages in clinic for improved quality of CT images and DRRs, precision of contouring OARs or tumors and correcting artifact area. So original and O-MAR CT must be used together in clinic for more accurate treatment plan.

• Radiation Oncology Journal
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• v.22 no.4
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• pp.316-324
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• 2004

Purpose : In radiotherapy of tumors in liver, enough planning target volume (PTV) margins are necessary to compensate breathing-related movement of tumor volumes. To overcome the problems, this study aims to obtain patients' body movements by using a moving phantom and an ultrasonic sensor, and to develop respiration sating techniques that can adjust patients' beds by using reversed values of the data obtained. Materials and Methods : The phantom made to measure patients' body movements is composed of a microprocessor (BS II, 20 MHz, 8K Byte), a sensor (Ultra-Sonic, range $3\~3$ m), host computer (RS232C) and stepping motor (torque 2.3 Kg) etc., and the program to control and operate it was developed. The program allows the phantom to move within the maximum range of 2 cm, its movements and corrections to take place In order, and x, y and z to move successively. After the moving phantom was adjusted by entering random movement data (three dimensional data form with distance of 2 cm), and the phantom movements were acquired using the ultra sonic sensor, the two data were compared and analyzed. And then, after the movements by respiration were acquired by using guinea pigs, the real-time respiration gating techniques were drawn by operating the phantom with the reversed values of the data. Results : The result of analyzing the acquisition-correction delay time the three types of data values and about each value separately shows that the data values coincided with one another within $1\%$ and that the acquisition-correction delay time was obtained real-time $(2.34{\times}10^{-4}sec)$. Conclusion : This study successfully confirms the clinic application possibility of respiration gating techniques by using a moving phantom and an ultrasonic sensor. With ongoing development of additional analysis system, which can be used in real-time set-up reproducibility analysis, it may be beneficially used in radiotherapy of moving tumors.

• Journal of the Korean Society of Radiology
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• v.15 no.6
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• pp.781-788
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• 2021

Due to the high sensitivity to radiation, excessive exposure needs to be prevented by accurately measuring the dose irradiated to the skin during radiation therapy. Although clinical trials use dosimeters such as film, OSLD, TLD, glass dosimeter, etc. to measure skin dose, these dosimeters have difficulty in accurate dosimetry on skin curves. In this study, to solve these problems, we developed a skin dosimeter that can be attached according to human flexion and evaluated its response characteristics. For the manufacture of the dosimeter, lead oxide (PbO) with high atomic number (Z_Pb: 82, Z_O: 8) and density (9.53 g/cm³) and silicon binders that can bend according to human flexion were used. In the case of a dosimeter made of PbO material, the performance degradation has been prevented by using parylene and others due to the presence of degradation due to oxidation, but the previously used parylene is affected by bending, so a new form of passive layer was produced and applied to the skin dosimeter. The characteristic evaluation of the skin dosimeter was evaluated by analyzing SEM, reproducibility, and linearity. Through SEM analysis, bending was evaluated, reproducibility and linearity at 6 MeV energy were evaluated, and applicability was assessed with a skin dosimeter. As a result of observing the dosimeter surface through SEM analysis, the parylene passive layer PbO dosimeter with the positive layer raised to the parylene produced cracks on the surface when bent. On the other hand, no crack was observed in the silicon passive layer PbO dosimeter, which was raised to silicon passive layer. In the reproducibility measurement results, the RSD of the silicon passive layer PbO dosimeter was 1.47% which satisfied the evaluation criteria RSD 1.5% and the linearity evaluation results showed the R² value of 0.9990, which satisfied the evaluation criteria R² 9990. The silicon passive layer PbO dosimeter was evaluated to be applicable to skin dosimeters by demonstrating high signal stability, precision, and accuracy in reproducibility and linearity, without cracking due to bending.

• Radiation Oncology Journal
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• v.20 no.2
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• pp.155-164
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• 2002

Purpose : A ginkgo biloba extract (GBE) has been known as a hypoxic cell radiosensitizer. Its mechanisms of action are increase of the red blood cell deformability, decrease the blood viscosity, and decrease the hypoxic cell fraction in the tumor. The aims of this study were to estimate the effect of GBE on fractionated radiotherapy and to clarify the mechanism of action of the GBE by estimating the blood flow in tumor and normal muscle. Materials and Methods : Fibrosarcoma (FSall) growing in a C3H mouse leg muscle was used as the tumor model. When the tumor size reached 7 mm in diameter, the GBE was given intraperitoneally at 1 and 25 hours prior to irradiation. The tumor growth delay was measured according to the various doses of radiation (3, 6, 9, 12 Gy and 15 Gy) and to the fractionation (single and fractionated irradiation) with and without the GBE injection. The radiation dose to the tumor the response relationships and the enhancement ratio of the GBE were measured. In addition, the blood flow of a normal muscle and a tumor was compared by laser Doppler flowmetry according to the GBE treatment. Results : When the GBE was used with single fraction irradiation with doses ranging from 3 to 12 Gy, GBE increased the tumor growth delay significantly (p<0.05) and the enhancement ratio of the GBE was 1.16. In fractionated irradiation with 3 Gy per day, the relationships between the radiation dose (D) and the tumor growth delay (TGD) were TGD $(days)=0.26{\times}D$ (Gy)+0.13 in the radiation alone group, and the TGD $(days)=0.30{\times}D$ (Gy)+0.13 in the radiation with GBE group. As a result, the enhancement ratio was 1.19 ($95\%$ confidence interval; $1.13\~1.27$). Laser Doppler flowmetry was used to measure the blood flow. The mean blood flow was higher in the muscle (7.78 mL/100 g/min in tumor and the 10.15 mL/100 g/min in muscle, p=0.005) and the low blood flow fraction (less than 2 mL/100 g/min) was higher in the tumor $(0.5\%\;vs.\;5.2\%,\;p=0.005)$. The blood flow was not changed with the GBE in normal muscle, but was increased by $23.5\%$ ( p=0.0004) in the tumor. Conclusion : Based on these results, it can be concluded that the GBE enhanced the radiation effect significantly when used with fractionated radiotherapy as well as with single fraction irradiation. Furthermore, the GBE increased the blood flow of the tumor selectively.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.137-144
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• 2005

To find the personal radiation dose of radiological technologists, a survey was conducted to 623 radiological technologists who had been working at 44 general hospitals in Korea's 16 cities and provinces from 1998 to 2002. A total of 2,624 cases about personal radiological dose that were collected were analyzed by region, year and hospital, the results of which look as follows : 1. The average radiation dose per capita by region and year for the 5 years was 1.61 mSv. By region, Daegu showed the highest amount 4.74 mSv, followed by Gangwon 4.65 mSv and Gyeonggi 2.15 mSv. The lowest amount was recorded in Chungbuk 0.91 mSv, Jeju 0.94 mSv and Busan 0.97 mSv in order. By year, 2000 appeared to be the year showing the highest amount of radiation dose 1.80 mSv, followed by 2002 1.77 mSv, 1999 1.55 mSv, 2001 1.50 mSv and 1998 1.36 mSv. 2. In 1998, Gangwon featured the highest amount of radiological dose per capita 3.28 mSv, followed by Gwangju 2.51 mSv and Daejeon 2.25 mSv, while Jeju 0.86mSv and Chungbuk 0.85 mSv belonged to the area where the radiation dose remained less than 1.0 mSv In 1999, Gangwon also topped the list with 5.67 mSv, followed by Daegu with 4.35 mSv and Gyeonggi with 2.48 mSv. In the same year, the radiation dose was kept below 1.0 mSv. in Ulsan 0.98 mSv, Gyeongbuk 0.95 mSv and Jeju 0.91 mSv. 3. In 2000, Gangwon was again at the top of the list with 5.73 mSv. Ulsan turned out to have less than 1.0 mSv of radiation dose in the years 1998 and 1999 consecutively, whereas the amount increased relatively high to 5.20 mSv. Chungbuk remained below the level of 1.0 mSv with 0.79 mSv. 4. In 2001, Daegu recorded the highest amount of radiation dose among those ever analyzed for 5 years with 9.05 mSv, followed by Gangwon with 4.01 mSv. The area with less than 1.0 mSv included Gyeongbuk 0.99 mSv and Jeonbuk 0.92 mSv. In 2002, Gangwon also led the list with 4.65 mSv while Incheon 0.88 mSv, Jeonbuk 0.96 mSv and Jeju 0.68 mSv belonged to the regions with less than 1.0 mSv of radiation dose. 5. By hospital, KMH in Daegu showed the record high amount of average radiation dose during the period of 5 years 6.82 mSv, followed by GAH 5.88 mSv in Gangwon and CAH 3.66 mSv in Seoul. YSH in Jeonnam 0.36 mSv comes first in the order of the hospitals with least amount of radiation dose, followed by GNH in Gyeongnam 0.39 mSv and DKH in Chungnam 0.51 mSv. There is a limit to the present study in that a focus is laid on the radiological technologists who are working at the 3rd referral hospitals which are regarded to be stable in terms of working conditions while radiological technologists who are working at small-sized hospitals are excluded from the survey. Besides, there are also cases in which hospitals with less than 5 years since establishment are included in the survey and the radiological technologists who have worked for less than 5 years at a hospital are also put to survey. We can't exclude the possibility, either, of assumption that the difference of personal average radiological dose by region, hospital and year might be ascribed to the different working conditions and facilities by medical institutions. It seems therefore desirable to develop standardized instruments to measure working environment objectively and to invent device to compare and analyze them by region and hospital more accurately in the future.

• Radiation Oncology Journal
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• v.23 no.2
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• pp.61-70
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• 2005

Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.73-82
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• 2022

Purpose: The purpose of this study is to evaluate the effectiveness of reducing the absorbed dose to the ovaries and the quality of the CBCT image when using the Halcyon^TM Fast kV CBCT of cervical cancer patients of child-bearing age who performed ovarian transposition Materials and Methods : Contouring of the cervix and ovaries required for measurement was performed on the computed tomography images of the human phantom (Alderson Rando Phantom, USA), and three Optically Stimulated Luminescence Dosimeter(OSLD) were attached to the selected organ cross-section, respectively. In order to measure the absorbed dose to the cervix and ovaries in the Truebeam^TM pelvis mode (Hereinafter referred to as TP), The Halcyon^TM Pelvis mode (Hereinafter referred to as HP) and The Halcyon^TM Pelvis Fast mode (Hereinafter referred to as HPF), An image was taken with a scan range of 17.5 cm and also taken an image that reduced the Scan range to 12.5cm. A total of 10 cumulative doses were summed, It was replaced with a value of 23 Fx, the number of cervical cancer treatments, and compared In additon, uniformity, low contrast visibility, spatial resolution, and geometric distortion were compared and analyzed using Catphan 504 phantom to compare CBCT image quality between equipment. Each factor was repeatedly measured three times, and the average value was obtained by analysing with the Doselab (Mobius Medical Systems, LP. Versions: 6.8) program. Results: As a result of measuring absorbed dose by CBCT with OSLD, TP and HP did not obtain significant results under the same conditions. The mode showing the greatest reduction value was HPF versus TP. In HPF, the absorbed dose was reduced by 39.8% in the cervix and 19.8% in the ovary compared to the TP in the scan range of 17.5 cm. the scan range was reduced to 12.5 cm, absorbed dose was reduced by 34.2% in the cervix and 50.5% in the ovary. In addition, result of evaluating the quality of the image used in the above experiment, it complied with the equipment manufacturer's standards with Geometric Distortion within 1mm (SBRT standard), Uniformity HU, LCV within 2.0%, Spatial Resolution more than 3 lp/mm. Conclusion: According to the results of this experiment, Halcyon^TM can select more various conditions than Truebeam^TM in treatment of fertility woman who have undergone ovarian Transposition , because it is important to reduce the radiation dose by CBCT during radiation therapy. So finally we recommend Halcyon^TM Fast kV CBCT which maintains image quality even at low mAs. However, it is consider that the additional exposure to low doses can be reduced by controlling the imaging range for patients who have undergone ovarian transposition in other treatment machines.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.1-5
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• 2006

Purpose: IMRT quality assurance(Q.A) is consist of the absolute dosimetry using ionization chamber and relative dosimetry using the film. We have in general used 0.015 cc ionization chamber, because small size and measure the point dose. But this ionization chamber is too small to give an accurate measurement value. In this study, we have examined the degree of calculated to measured dose difference in intensity modulated radiotherapy(IMRT) based on the observed/expected ratio using various kinds of ion chambers, which were used for absolute dosimetry. Materials and Methods: we peformed the 6 cases of IMRT sliding-window method for head and neck cases. Radiation was delivered by using a Clinac 21EX unit(Varian, USA) generating a 6 MV x-ray beam, which is equipped with an integrated multileaf collimator. The dose rate for IMRT treatment is set to 300 MU/min. The ion chamber was located 5cm below the surface of phantom giving 100cm as a source-axis distance(SAD). The various types of ion chambers were used including 0.015cc(pin point type 31014, PTW. Germany), 0.125 cc(micro type 31002, PTW, Germany) and 0.6 cc(famer type 30002, PTW, Germany). The measurement point was carefully chosen to be located at low-gradient area. Results: The experimental results show that the average differences between plan value and measured value are ${\pm}0.91%$ for 0.015 cc pin point chamber, ${\pm}0.52%$ for 0.125 cc micro type chamber and ${\pm}0.76%$ for farmer type 0.6cc chamber. The 0.125 cc micro type chamber is appropriate size for dose measure in IMRT. Conclusion: IMRT Q.A is the important procedure. Based on the various types of ion chamber measurements, we have demonstrated that the dose discrepancy between calculated dose distribution and measured dose distribution for IMRT plans is dependent on the size of ion chambers. The reason is small size ionization chamber have the high signal-to-noise ratio and big size ionization chamber is not located accurate measurement point. Therefore our results suggest the 0.125 cc farmer type chamber is appropriate size for dose measure in IMRT.

• Journal of Radiation Protection and Research
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• v.35 no.4
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• pp.151-156
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• 2010

The types of test items which were recorded in this test report of quality control domestic $^{18}F$-FDG radiopharmaceutical which consisted of 13 different types: appearance, half-life, radioactive heterokaryosis, radiochemical Confirmation (measure of Rf value), radiochemical Purity, Ethanol, Acetonitrile, Kryptofix, Aluminium, pH, Endotoxin, aseptic test, and radioactivity${\cdot}$ml-1. The record was fully recorded in 'appearance', 'radioactive heterokaryosis', 'pH', 'Endotoxin', and 'aseptic test'. In 'half-life', 'radiochemical Confirmation (measure of Rf value), 'radiochemical Purity', 'Ethanol', 'Acetonitrile', 'Kryptofix', 'Aluminium', 'radioactivity${\cdot}$ml-1', there were differences in records of each manufacturing business on radioactive medicine and medical supplies. The result of the test showed all 13 items of quality control test were 100% suitable on the basis of recorded data. There were more radiopharmaceutical made in the laboratory than in hospitals and businesses and in for result of suitability test, the laboratory showed higher suitability than did the hospitals or businesses. Domestically, there are differences of the test report items in the safety of radiopharmaceutical of each facility, and since it is not standardized, supplements are needed. To submit standardized test reports of quality guarantee in radiopharmaceutical, GMP of U.S. and CE Mark of Europe should be referred as well as receiving advice from professionals to standardize as suitable domestic standard.