• Journal of the Korea Safety Management & Science
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• v.17 no.4
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• pp.199-206
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• 2015

The purpose of this study was to investigate radiation dose sensitivity due to displacement of human extremities in the water bolus box on radiation therapy. Water bolus box and human thigh with femur bone were constructed in computerized radiation therapy planning system to verify the absorbed dose. Two 6MV X-ray beams were irradiated bilaterally into water bolus box and then radiation dose were calculated each situation at displacement of middle axis of thigh from the center in water bolus box to right and left direction. Absorbed dose of thigh and femur bone increased by the distance of displacement. The maximum dose of thigh even increased 20% over than prescribed dose. This is in contrast to conventional concept of dose distribution in water bolus box. Based on this result, displacement of body site in the water bolus box have to be averted during radiation therapy.

• Journal of radiological science and technology
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• v.44 no.6
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• pp.663-669
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• 2021

The purpose of this study was to evaluate the usefulness of the rice bolus for upper-lower extremity radiation therapy by Tomotherapy. The computed tomography images were obtained for air, water, and rice bolus. The average and standard deviation of the Hounsfield unit (HU) were measured for image evaluation. The conformity index (CI) and homogeneity index (HI) were calculated for dose distribution of the planning target volume (PTV) which was treated by direct mode with gantry angle (90 and 270 angle). The point dose of a total of ten axial planes was measured to confirm the different regions. The mean of HU was -999.72 ± 0.72 at the air. The water and rice bolus were -0.13 ± 1.65 and -170 ± 27.2, respectively. The CI (HI) of PTV was 0.96 (1.36) at the air. 0.95 (1.04) at the water bolus, and 0.95 (1.04) at the rice bolus. The maximum dose for air was 136 cGy which is about 32% higher than 103 cGy for water and 104 cGy for rice bolus. There was a statistical difference for point dose between air and water including rice bolus (p=0.04), however, no statistical difference between water and rice bolus (p=0.579).The rice bolus phantom for extremities radiation therapy could be not only the optimized dose distribution but also the convenience and equipment safety at Tomotherapy. However, additional research will be necessary to more accurately verify the clinical usefulness of rice bolus phantom due to not enough examination.

• Radiation Oncology Journal
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• v.26 no.3
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• pp.189-194
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• 2008

Purpose: We designed a water-based bolus device for radiation therapy in Kaposi's sarcoma. This study evaluated the usefulness of this new device and compared it with the currently used rice-based bolus. Materials and Methods: We fashioned a polystyrene box and cut a hole in order to insert patient's extremities while the patient was in the supine position. We used a vacuum-vinyl based polymer to reduce water leakage. Next, we eliminated air using a vacuum pump and a vacuum valve to reduce the air gap between the water and extremities in the vacuum-vinyl box. We performed CT scans to evaluate the density difference of the fabricated water-based bolus device when the device in which the rice-based bolus was placed directly, the rice-based bolus with polymer-vinyl packed rice, and the water were all put in. We analyzed the density change with the air gap volume using a planning system. In addition, we measured the homogeneity and dose in the low-extremities phantom, attached to six TLD, and wrapped film exposed in parallel-opposite fields with the LINAC under the same conditions as the set-up of the CT-simulator. Results: The density value of the rice-based bolus with the rice put in directly was 14% lower than that of the water-based bolus. Moreover, the value of the other experiments in the rice-based bolus with the polymer-vinyl packed rice showed an 18% reduction in density. The analysis of the EDR2 film revealed that the water-based bolus shows a more homogeneous dose plan, which was superior by $4{\sim}4.4%$ to the rice-base bolus. The mean TLD readings of the rice-based bolus, with the rice put directly into the polystyrene box had a 3.4% higher density value. Moreover, the density value in the case of the rice-based bolus with polymer-vinyl packed rice had a 4.3% higher reading compared to the water-based bolus. Conclusion: Our custom-made water-based bolus device increases the accuracy of the set-up by confirming the treatment field. It also improves the accuracy of the therapy owing to the reduction of the air gap using a vacuum pump and a vacuum valve. This set-up represents a promising alternative device for delivering a homogenous dose to the target volume.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.2
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• pp.105-112
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• 2006

Purpose: To demonstrate that water bolus in the patient surface can decrease the dose inhomogeneity by patient surface large tissue defect when the surface is in an electron-beam field. And We tried to find a easy way to water control. Methods and Materials: To demonstrate the use of water bolus in the irregular surface clinically, the case of a patient with myxofibrosarcoma of the chest wall who was treated with electrons. We obtained dose distribution using missing tissue option of PINACLE 6.2b (ADAC, USA). We fabricate a Mev-green for water bolus in patient with defect of tissue. Then put the water bolus which is vinyl packed water into the designed Mev-green. We peformed CT scan with CT-simulator. Three-dimensional (3D) dose distributions with and without water bolus in the large irregular chest wall were calculated for a representative patient. Resulting dose distributions and dose-volume histograms of water bolus were compared with missing tissue option and non bolus plans. We fabricate a new water control device. Results: Controlled Water bolus markedly decrease the dose heterogeneity, and minimizes normal tissue exposure caused by the surface irregularities of the chest wall mass. In the test case, The non bolus plan has a maximum target dose of 132%. After applying water bolus, the maximum target dose has been reduced substantially to 110.4%. The maximum target dose was reduced by 21.6% using this technique. Conclusion: The results showed that controlled water bolus could significantly improve the dose homogeneity in the PTV for patients treated with electron therapy using water control device. This technique may reduce the incidence of normal organ complications that occur after electron-beam therapy in irregular surface. And our new device shows handiness of water control.

• Journal of radiological science and technology
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• v.43 no.1
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• pp.9-14
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• 2020

Commercial plate bolus is generally used for treatment of surface tumor and required surface dose. We fabricated 3D-printed bolus by using 3D printing technology and usability of 3D-printed bolus was evaluated. RT-structure of contoured plate bolus in the TPS was exported to DICOM files and converted to STL file by using converting program. The 3D-printed bolus was manufactured with rubber-like translucent materials using a 3D printer. The dose distribution calculated in the TPS and compared the characteristics of the plate bolus and the 3D printed bolus. The absolute dose was measured inserting an ion chamber to the depth of 5 cm and 10 cm from the surface of the blue water phantom. HU and ED were measured to compare the material characteristics. 100% dose was distributed at Dmax of 1.5 cm below the surface when was applied without bolus. When the plate bolus and 3D-plate bolus were applied, dose distributed at 0.9 cm and 0.8 cm below the surface of the bolus. After the comparative analysis of the radiation dose at the reference depth, differences in radiation dose of 0.1 ~ 0.3% were found, but there was no difference dose. The usability of the 3D-printed bolus was thus confirmed and it is considered that the 3D-printed bolus can be applied in radiation therapy.

• Journal of the Korean Society of Radiology
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• v.14 no.6
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• pp.741-746
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• 2020

To investigate the radiation dose sensitivity in extremity radiatioin therapy depending on rice cultivar which have different size and shape of grains, plan results are compared that used rice bolus Korean and Thai rice. Phantoms that are each no bolus, Korean rice bolus, Thai rice bolus were used and prescribed 100 cGy to isocenter and checked the point dose of 12 points of interest of each phantoms. The meane dose are 103.57±1.98 cGy in Thai rice bolus using, 104.27±2.12 cGy in Korean rice bolus and 104.99±6.40 cGy in phantom without bolus. Dose distribution of Thai and Korean rice bolus differed significantly in Wilcoxon's Signed Rank test (p=.011). It has been confirmed that that the bolus using Thai rice, which has a small grain size, shows a more even dose distribution.

• Progress in Medical Physics
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• v.35 no.1
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• pp.10-15
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• 2024

Purpose: This study aimed to comprehensively investigate the diverse characteristics of a novel commercial bolus, CLEANBOLUS-WHITE (CBW), to ascertain its suitability for clinical application. Methods: The evaluation of CBW encompassed both physical and biological assessments. Physical parameters such as mass density and shore hardness were measured alongside analyses of element composition. Biological evaluations included assessments for skin irritation and cytotoxicity. Dosimetric properties were examined by calculating surface dose and beam quality using a treatment planning system (TPS). Additionally, doses were measured at maximum and reference depths, and the results were compared with those obtained using a solid water phantom. The effect of air gap on dose measurement was also investigated by comparing measured doses on the RANDO phantom, under the bolus, with doses calculated from the TPS. Results: Biological evaluation confirmed that CBW is non-cytotoxic, nonirritant, and non-sensitizing. The bolus exhibited a mass density of 1.02 g/cm³ and 14 shore 00. Dosimetric evaluations revealed that using the 0.5 cm CBW resulted in less than a 1% difference compared to using the solid water phantom. Furthermore, beam quality calculations in the TPS indicated increased surface dose with the bolus. The air gap effect on dose measurement was deemed negligible, with a difference of approximately 1% between calculated and measured doses, aligning with measurement uncertainty. Conclusions: CBW demonstrates outstanding properties for clinical utilization. The dosimetric evaluation underscores a strong agreement between calculated and measured doses, validating its reliability in both planning and clinical settings.

• Progress in Medical Physics
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• v.32 no.4
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• pp.159-164
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• 2021

Purpose: We investigated the properties of CLEANBOLUS based on silicone with suitable characteristics for clinical use. Methods: We evaluated the characteristics of CLEANBOLUS and compared the results with the commercial product (Super-Flex bolus). Also, we conducted physical evaluations, including shore hardness, element composition, and elongation break. Transparency was investigated through the measured absorbance within the visible region (400-700 nm). Also, dosimetric characteristics were investigated with surface dose and beam quality. Finally, the volume of unwanted air gap was investigated based on computed tomography images for breast, chin, and nose using Super-Flex bolus and CELANBOLUS. Results: CLEANBOLUS showed excellent physical properties for a low shore hardness (000-35) and elongation break (>1,000%). Additionally, it was shown that CLEANBOLUS is more transparent than Super-Flex bolus. Dosimetric results obtained through measurement and calculation have an electron density similar to water in CLEANBOLUS. Finally, CLEANBOLUS showed that the volume of unwanted air gap between the phantom and each bolus is smaller than Super-Flex bolus for breast, chin, and nose. Conclusions: The physical properties of CLEANBOLUS, including excellent adhesive strength and lower shore hardness, reduce unwanted air gaps and ensure accurate dose distribution. Therefore, it would be an alternative to other boluses, thus improving clinical use efficiency.

• The Journal of Korean Society for Radiation Therapy
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• v.3 no.1
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• pp.85-89
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• 1989

Dose distribution was evaluated under vaseline and thin lead used as surface bolus, in case with scattering filter and without, for 9-MeV electron using chambers in water phantom. The results were as follows: 1. The skin dose can be remarkably increased with thin lead bolus than with convensional bolus. 2. The skin dose over $110\%$ in the 0.6mm thin lead bolus compared with the maximum dose in normal irradiation, so skin burn or any other complications may be occured in patients.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.163-170
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• 2014

Purpose : If electron, chosen for superficial oncotherapy, was applied with bolus, it could work as an important factor to a therapy result by showing a drastic change in surface dose. Hence the calculation value and the actual measurement value of surface dose of Treatment Planning System (TPS) according to four variables influencing surface dose when using bolus on an electron therapy were compared and analyzed in this paper. Materials and Methods : Four variables which frequently occur during the actual therapies (A: bolus thickness - 3, 5, 10 mm, B: field size - $6{\time}6$, $10{\time}10$, $15{\time}15cm2$, C: energy - 6, 9, 12 MeV, D: gantry angle - $0^{\circ}$, $15^{\circ}$) were set to compare the actual measurement value with TPS(Pinnacle 9.2, philips, USA). A computed tomography (lightspeed ultra 16, General Electric, USA) was performed using 16 cm-thick solid water phantom without bolus and total 54 beams where A, B, C, and D were combined after creating 3, 5 and 10 mm bolus on TPS were planned for a therapy. At this moment SSD 100 cm, 300 MU was investigated and measured twice repeatedly by placing it on iso-center by using EBT3 film(International Specialty Products, NJ, USA) to compare and analyze the actual measurement value and TPS. Measured film was analyzed with each average value and standard deviation value using digital flat bed scanner (Expression 10000XL, EPSON, USA) and dose density analyzing system (Complete Version 6.1, RIT, USA). Results : For the values according to the thickness of bolus, the actual measured values for 3, 5 and 10 mm were 101.41%, 99.58% and 101.28% higher respectively than the calculation values of TPS and the standard deviations were 0.0219, 0.0115 and 0.0190 respectively. The actual values according to the field size were $6{\time}6$, $10{\time}10$ and $15{\time}15cm2$ which were 99.63%, 101.40% and 101.24% higher respectively than the calculation values and the standard deviations were 0.0138, 0.0176 and 0.0220. The values according to energy were 6, 9, and 12 MeV which were 99.72%, 100.60% and 101.96% higher respectively and the standard deviations were 0.0200, 0.0160 and 0.0164. The actual measurement value according to beam angle were measured 100.45% and 101.07% higher at $0^{\circ}$ and $15^{\circ}$ respectively and standard deviations were 0.0199 and 0.0190 so they were measured 0.62% higher at $15^{\circ}$ than $0^{\circ}$. Conclusion : As a result of analyzing the calculation value of TPS and measurement value according to the used variables in this paper, the values calculated with TPS on 5 mm bolus, $6{\time}6cm2$ field size and low-energy electron at $0^{\circ}$ gantry angle were closer to the measured values, however, it showed a modest difference within the error bound of maximum 2%. If it was beyond the bounds of variables selected in this paper using electron and bolus simultaneously, the actual measurement value could differ from TPS according to each variable, therefore QA for the accurate surface dose would have to be performed.