• Progress in Medical Physics
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• v.20 no.4
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• pp.290-297
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• 2009

In case of radiation treatment using small field high-energy photon beams, an accurate dosimetry is a challenging task because of dosimetrically unfavorable phenomena such as dramatic changes of the dose at the field boundaries, dis-equilibrium of the electrons, and non-uniformity between the detector and the phantom materials. In this study, the absorbed dose in the phantom was measured by using an ion chamber and a diode detector widely used in clinics. $GAFCHROMIC^{(R)}$ EBT films composed of water equivalent materials was also evaluated as a small field detector and compared with ionchamber and diode detectors. The output factors at 10 cm depth of a solid phantom located 100 cm from the 6 MV linear accelerator (Varian, 6 EX) source were measured for 6 field sizes ($5{\times}5\;cm^2$, $2{\times}2\;cm^2$, $1.5{\times}1.5\;cm^2$, $1{\times}1\;cm^2$, $0.7{\times}0.7\;cm^2$ and $0.5{\times}0.5\;cm^2$). As a result, from $5{\times}5\;cm^2$ to $1.5{\times}1.5\;cm^2$ field sizes, absorbed doses from three detectors were accurately identified within 1%. Wheres, the ion chamber underestimated dose compared to other detectors in the field sizes less than $1{\times}1\;cm^2$. In order to correct the observed underestimation, a convolution method was employed to eliminate the volume averaging effect of an ion chamber. Finally, in $1{\times}1\;cm^2$ field the absorbed dose with a diode detector was about 3% higher than that with the EBT film while the dose with the ion chamber after volume correction was 1% lower. For $0.5{\times}0.5\;cm^2$ field, the dose with the diode detector was 1% larger than that with the EBT film while dose with volume corrected ionization chamber was 7% lower. In conclusion, the possibility of $GAFCHROMIC^{(R)}$ EBT film as an small field dosimeter was tested and further investigation will be proceed using Monte Calro simulation.

• Progress in Medical Physics
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• v.33 no.4
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• pp.80-87
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• 2022

Purpose: Proton therapy has different relative biological effectiveness (RBE) compared with X-ray treatment, which is the standard in radiation therapy, and the fixed RBE value of 1.1 is widely used. However, RBE depends on a charged particle's linear energy transfer (LET); therefore, measuring LET is important. We have developed a LET measurement method using the inefficiency characteristic of an EBT3 film on a proton beam's Bragg peak (BP) region. Methods: A Gafchromic EBT3 film was used to measure the proton beam LET. It measured the dose at a 10-cm pristine BP proton beam in water to determine the quenching factor of the EBT3 film as a reference beam condition. Monte Carlo (MC) calculations of dose-averaged LET (LET_d) were used to determine the quenching factor and validation. The dose-averaged LETs at the 12-, 16-, and 20-cm pristine BP proton beam in water were calculated with the quenching factor. Results: Using the passive scattering proton beam nozzle of the National Cancer Center in Korea, the LET_d was measured for each beam range. The quenching factor was determined to be 26.15 with 0.3% uncertainty under the reference beam condition. The dose-averaged LETs were measured for each test beam condition. Conclusions: We developed a method for measuring the proton beam LET using an EBT3 film. This study showed that the magnitude of the quenching effect can be estimated using only one beam range, and the quenching factor determined under the reference condition can be applied to any therapeutic proton beam range.

• The Journal of Korean Society for Radiation Therapy
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• v.22 no.2
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• pp.113-122
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• 2010

Purpose: To evaluate the accuracy of a target position at static and dynamic state by using Dynamic phantom for the difference between tumor's actual movement during respiratory gated radiation therapy and skin movement measured by RPM (Real-time Position Management). Materials and Methods: It self-produced Dynamic phantom that moves two-dimensionally to measure a tumor moved by breath. After putting marker block on dynamic phantom, it analyzed the amplitude and status change depending on respiratory time setup in advance by using RPM. It places marker block on dynamic phantom based on this result, inserts Gafchromic EBT film into the target, and investigates 5 Gy respectively at static and dynamic state. And it scanned investigated Gafchromic EBT film and analyzed dose distribution by using automatic calculation. Results: As a result of an analysis of Gafchromic EBT film's radiation amount at static and dynamic state, it could be known that dose distribution involving 90% is distributed within margin of error of 3 mm. Conclusion: As a result of an analysis of dose distribution's change depending on patient's respiratory cycle during respiratory gated radiation therapy, it is expected that the treatment would be possible within recommended margin of error at ICRP 60.

• Progress in Medical Physics
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• v.29 no.2
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• pp.53-58
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• 2018

This paper evaluates patient-specific quality assurance (PSQA) in the treatment of small and multiple tumors by the CyberKnife system with fixed collimators, using an ion chamber and EBT3 films. We selected 49 patients with single or multiple brain tumors, and the treatment plans include one to four targets with total volumes ranging from 0.12 cc to 3.74 cc. All PSQA deliveries were performed with a stereotactic dose verification phantom. The A16 microchamber (Standard Imaging, WI, USA) and Gafchromic EBT3 film (Ashland ISP Advanced Materials, NJ, USA) were inserted into the phantom to measure the point dose of the target and the dose distribution, respectively. The film was scanned 1 hr after irradiation by a film digitizer scanner and analyzed using RIT software (Radiological Imaging Technology, CO, USA). The acceptance criteria was <5% for the point dose measurement and >90% gamma passing rate using 3%/3 mm and relative dose difference, respectively. The point dose errors between the calculated and measured dose by the ion chamber were in the range of -17.5% to 8.03%. The mean point dose differences for 5 mm, 7.5 mm, and 10 mm fixed cone size was -11.1%, -4.1%, and -1.5%, respectively. The mean gamma passing rates for all cases was 96.1%. Although the maximum dose distribution of multiple targets was not shown in the film, gamma distribution showed that dose verification for multiple tumors can be performed. The use of the microchamber and EBT3 film made it possible to verify the dosimetric and mechanical accuracy of small and multiple targets. In particular, the correction factors should be applied to small fixed collimators less than 10 mm.

• Progress in Medical Physics
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• v.29 no.4
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• pp.164-172
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• 2018

We evaluated the performance of various detectors for small-field dosimetry with field sizes defined by a high-definition (HD) multileaf collimator (MLC) system. For small-field dosimetry, diodes referred to as "RAZOR detectors," MOSFET detectors, and Gafchromic EBT3 films were used in this study. For field sizes less than $1{\times}1cm^2$, percent depth doses (PDDs) and lateral profiles were measured by diodes, MOSFET detectors, and films, and absolute dosimetry measurements were conducted with MOSFET detectors. For comparison purposes, the same measurements were carried out with a field size of $10{\times}10cm^2$. The dose distributions were calculated by the treatment planning system Eclipse. A comparison of the measurements with calculations yielded the percentage differences. With field sizes less than $1{\times}1cm^2$, it was shown that most of the percentage difference values were within 5% for 6-MV and 15-MV photon beams with the use of diodes. The measured lateral profiles were well matched with those calculated by Eclipse as the field sizes increased. Except for the depths of 0.5 cm and 20 cm, there was agreement in terms of the absolute dosimetry within 10% when MOSFET detectors were used. There was good agreement between the calculations and measurements conducted using diodes and EBT films. Both diode detectors and EBT3 films were found to be appropriate options for relative measurements of PDDs and for lateral profiles.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.355-362
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• 2014

Purpose : When head&neck cancer radiation therapy, thermoplastic mask is applied for patients with fixed. The purpose of this study is to evaluate usefulness of thermoplastic mask for SRS in tomotherapy by conparison with the conventional mask. Materials and Methods : Typical mask(conventional mask, C-mask) and mask for SRS are used to fix body phantom(rando phantom) on the same iso centerline, then simulation is performed. Tomotherapy plan for orbit and salivary glands is made by treatment planning system(TPS). A thick portion and a thin portion located near the treatment target relative to the mask S-mask are defined as region of interest for surface dose dosimetry. Surface dose variation depending on the type of mask was analyzed by measuring the TPS and EBT film. Results : Surface dose variation due to the type of mask from the TPS is showed in orbit and salivary glands 0.65~2.53 Gy, 0.85~1.84 Gy, respectively. In case of EBT film, -0.2~3.46 Gy, 1.04~3.02 Gy. When applied to the S-mask, in TPS and Gafchromic EBT3 film, substrantially 4.26%, 5.82% showed maximum changing trend, respectively. Conclusion : To apply S-mask for tomotherapy, surface dose is changed, but the amount is insignificant and be useful when treatment target is close critical organs because decrease inter and intra fractional variation.

• Journal of the Korean Magnetics Society
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• v.26 no.3
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• pp.99-104
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• 2016

For patients receiving chemotherapy and radiation therapy treatment progresses as vomiting, nausea, weight of the patient because of a loss of appetite it is reduced. The patient's weight and the distance from the skin and the treatment site is expected to be closer, thereby reducing the change in the skin because of this dose. This study tests using a loose see the difference between the volume change appears as the weight of the patient using the same phantom and the phantom body of the patient. To using the same as the position EBT film is attached to the skin of the treatment site and was adjusted to the thickness of the Bolus. And using a computerized treatment planning only tomotherapy equipment was passed under the conditions according to the thickness of the radiation dose. To baseline for accurate reproduction position using the MVCT was applied to treated with verification. By passing a total of three dose reduced the error, it was a measure of the film by using a dedicated scanner, EBT VIDAR scanner. Got an increase in the skin dose is displayed each time the thickness of the bolus reduced, in a bolus was completely removed with the highest value. If the changes appeared dose was greater weight loss patients to chemotherapy and therefore bolus thickness variation considering the weight loss of the patient when applying the tomotherapy of nasopharynx cancer was found that the increase in skin dose be increased. This large patient before treatment due to weight loss over the image verification is considered to be established should consider how to re-create your mask and treatment plan for fixing it.

• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.239-246
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• 2021

Portal Dosimetry was verified using EPID to secure the clinical application and reliability of the existing research dose evaluation. The dose distribution of Geant4 was compared with the measured value by 360° rotational irradiation with a 2.5 cm cone for stereotactic brain surgery. To confirm the dose distribution of patients with brain metastasis, the dose distribution investigated by inserting a Gafchromic EBT film into the parietal phantom and the dose distribution obtained from the parietal phantom using VMAT are compared and applied to actual patients. As a result of the analysis, it was confirmed that the accuracy of the beam center and the center of the couch coincide accurately with an error within 1mm as a result of QA through a pin ball. In addition, it was confirmed that the EBT3 film has excellent linearity in the range of 0 to 10 Gy according to various dose irradiation. In the same setting as the two cervical phantoms, we confirm that the implementation and simulation results calculations of dose calculations based on Geant4 using photon beams match the experimental data within the treatment planning volume (PTV). Therefore, volume modulated arc treatment (VMAT) 360° rotational irradiation was performed, and the result of iso-dose distribution analysis by rotational irradiation confirmed that it is appropriate to include a virtual tumor.

• The Journal of Korean Society for Radiation Therapy
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• v.26 no.2
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• pp.273-280
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• 2014

Purpose : To verify the skin dose in Tomotherapy-based radiation treatment according to the change in tumor locations, skin dose was measured by using Gafchromic EBT3 film and compared with the planned doses to find out the gap between them. Materials and Methods : In this study, to measure the skin dose, I'm RT Phantom(IBA Dosimetry, Germany) was utilized. After obtaining the 2.5mm CT images, tumor locations and skin dose measuring points were set by using Pinnacle(ver 9.2, Philips Medical System, USA). The tumor location was decided to be 5mm and 10mm away from surface of the phantom and center. Considering the attenuation of a Tomo-couch, we ensured a symmetric placement between the ceiling and floor directions of the phantom. The measuring point of skin doses was set to have 3mm and 5mm thickness from the surface. Measurement was done 3 times. By employing TomoHD(TomoHD treatment system, Tomotherapy Inc., Madison, Wisconsin, USA), we devised Tomotherapy plans, measured 3 times by inserting Gafchromic EBT3 film into the phantom and compared the measurement with the skin dose treatment plans. Results : The skin doses in the upper part of the phantom, when the tumor was located in the center, were found to be 7.53 cGy and 7.25 cGy in 5mm and 3mm respectively. If placed 5mm away from the skin in the ceiling direction, doses were 18.06 cGy and 16.89 cGy; if 10mm away, 20.37 cGy and 18.27 cGy, respectively. The skin doses in the lower part of the phantom, when the tumor was located in the center, recorded 8.82 cGy and 8.29 cGy in 5mm and 3mm, each; if located 5mm away from the lower part skin, 21.69 cGy and 19.78 cGy were respectively recorded; and if 10mm away, 20.48 cGy and 19.57 cGy were recorded. If the tumor was placed in the center, skin doses were found to increase by 3.2~17.1% whereas if the tumor is 5mm away from the ceiling part, the figure decreased to 2.8~9.0%. To the Tomo-couch direction, skin doses showed an average increase of 11% or over, compared to the planned treatment. Conclusion : This study found gaps between planned skin doses and actual doses in the Tomotherapy treatment planning. Especially to the Tomo-cocuh direction, skin doses were found to be larger than the planned doses. Thus, during the treatment of tumors near the Tomo-couch, doses will need to be more accurately calculated and more efforts to verify skin doses will be required as well.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.13-22
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• 2021

Objective : High precision and accuracy are expected in gamma knife radiosurgery treatment. Because of the requirement of clinically applying complex radiation and dose gradients together with a rapid radiation decline, a dedicated quality assurance program is required to maintain the radiation dosimetry and geometric accuracy and to reduce all associated risk factors. This study investigates the validity of Leksell Gamma plan (LGP)10.1.1 system of 5th generation Gamma Knife Perfexion as modified variable ellipsoid modeling technique (VEMT) method. Methods : To verify LGP10.1.1 system, we compare the treatment plan program system of the Gamma Knife Perfexion, that is, the LGP, with the calculated value of the proposed modified VEMT program. To verify a modified VEMT method, we compare the distributions of the dose of Gamma Knife Perfexion measured by Gafchromic EBT3 and EBT-XD films. For verification, the center of an 80 mm radius solid water phantom is placed in the center of all sectors positioned at 16 mm, 4 mm and 8 mm; that is, the dose distribution is similar to the method used in the x, y, and z directions by the VEMT. The dose distribution in the axial direction is compared and analyzed based on Full-Width-of-Half-Maximum (FWHM) evaluation. Results : The dose profile distribution was evaluated by FWHM, and it showed an average difference of 0.104 mm for the LGP value and 0.130 mm for the EBT-XD film. Conclusion : The modified VEMT yielded consistent results in the two processes. The use of the modified VEMT as a verification tool can enable the system to stably test and operate the Gamma Knife Perfexion treatment planning system.