• The Journal of Korean Society for Radiation Therapy
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• v.28 no.1
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• pp.57-64
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• 2016

Purpose : To evaluate the results of absorbed and effective doses using CBCT and 4D-CBCT settings for lung cancer. Materials and Methods : This experimental study. Measurements were performed using a Anderson rando phantom with OSLD(optically stimulated luminescent dosimeters). It was performed computed tomography(Lightspeed GE, USA) in order to express the major organs of the human body. Measurements were obtained a mean value is repeated three times each. Evaluations of effective dose and absorbed dose were performed the CL-IX-Thorax mode and Truebeam-Thorax mode CBCT. Additionally, compared Truebeam-Thorax mode CBCT with Truebeam-Thorax mode 4D-CBCT(Four-dimensional Cone Beam Computed Tomography) Results : Average absorbed dose in the CBCT of CL-IX was measured in lung 2.505cGy, heart 2.595cGy, liver 2.145cGy, stomach 1.934cGy, skin 2.233cGy, in case of Truebeam, It was measured lung 1.725cGy, heart 2.034cGy, liver 1.616cGy, stomach 1.470cGy, skin 1.445cGy. In case of 4D-CBCT, It was measured lung 3.849cGy, heart 4.578cGy, liver 3.497cGy, stomach 3.179cGy, skin 3.319cGy Average effective dose, considered tissue weighting and radiation weighting, in the CBCT of CL-IX was measured lung 2.164mSv, heart 2.241mSVv, liver 0.136mSv, stomach 1.668mSv, skin 0.009mSv, in case of Turebeam, it was measured lung 1.725mSv, heart 1.757mSv, liver 0.102mSv, stomach 1.270mSv, skin 0.005mSv, In case of 4D-CBCT, It was measured lung 3.326mSv, heart 3.952mSv, liver 0.223mSv, stomach 2.747mSv, skin 0.013mSv Conclusion : As a result, absorbed dose and effective Dose in the CL-IX than Truebeam was higher about 1.3 times and in the 4D-CBCT Truebeam than CBCT of Truebeam was higher about 2.2times However, a large movement of the patient and respiratory gated radiotherapy may be more accurate treatment in 4D-CBCT. Therefore, it will be appropriate to selectively used.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.167-173
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• 2003

Purpose: The purpose of this study was to evaluate whether a GafChromic film applied to stereotactic radiosurgery with a linear accelerator could provide information on the value for acceptance testing and quality control on the absolute dose and relative dose measurements and/or calculation of treatment planning system. Materials and methods: A spherical acrylic phantom, simulating a patient's head, was constructed from three points. The absolute and relative dose distributions could be measured by inserting a GafChromic film into the phantom. We tested the use of a calibrated GafChromic film (MD-55-2, Nuclear Associate, USA) for measuring the optical density. These measurements were achieved by irradiating the films with a dose of 0-112 Gy employing 6 MV photon. To verify the accuracy of the prescribed dose delivery to a target isocenter using a five arc beams (irradiated in 3 Gy per one beam) setup, calculated by the Linapel planning system the absolute dose and relative dose distribution using a GafChromic film were measured. All the irradiated films were digitized with a Lumiscan 75 laser digitizer and processed with the RIT113 film dosimetry system. Results: We verified the linearity of the Optical Density of a MD-55-2 GafChromic film, and measured the depth dose profile of the beam. The absolute dose delivered to the target was close to the prescribed dose of Linapel within an accuracy for the GafChromic film dosimetry (of $\pm$3$\%$), with a measurement uncertainty of $\pm$1 mm for the 50$\~$90$\%$ isodose lines. Conclusion: Our results have shown that the absolute dose and relative dose distribution curves obtained from a GafChromic film can provide information on the value for acceptance. To conclude the GafChromic flim is a convenient and useful dosimetry tool for linac based radiosurgery.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Journal of the Korean Society of Radiology
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• v.14 no.1
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• pp.23-29
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• 2020

The standard uptake values (SUVs) strongly depend on positron emission tomographs (PETs) and image reconstruction methods. Various image reconstruction algorithms in GE Discovery MIDR (DMIDR) and Discovery Ste (DSte) installed at Department of Nuclear Medicine, Seoul Samsung Medical Center were applied to measure the SUVs in an anthropomorphic torso phantom. The measured SUVs in the heart, liver, and background were compared to the actual SUVs. Applied image reconstruction algorithms were VPFX-S (TOF+PSF), QCFX-S-350 (Q.Clear+TOF+PSF), QCFX-S-50, VPHD-S (OSEM+PSF) for DMIDR, and VUE Point (OSEM) and FORE-FBP for DSte. To reduce the radiation exposure to radiation technologists, only the small amount of radiation source ¹⁸F-FDG was mixed with the distilled water: 2.28 MBq in the 52.5 ml heart, 20.3 MBq in the 1,290 ml liver and 45.7 MBq for the 9,590 ml in the background region. SUV values in the heart with the algorithms of VPFX-S, QCFX-S-350, QCFX-S-50, VPHD-S, VUE Point, and FOR-FBP were 27.1, 28.0, 27.1, 26.5, 8.0, and 7.4 with the expected SUV of 5.9, and in the background 4.2, 4.1, 4.2, 4.1, 1.1, and 1.2 with the expected SUV of 0.8, respectively. Although the SUVs in each region were different for the six reconstruction algorithms in two PET/CTs, the SUV ratios between heart and background were found to be relatively consistent; 6.5, 6.8, 6.5, 6.5, 7.3, and 6.2 for the six reconstruction algorithms with the expected ratio of 7.8, respectively. Mean SNRs (Signal to Noise Ratios) in the heart were 8.3, 12.8, 8.3, 8.4, 17.2, and 16.6, respectively. In conclusion, the performance of PETs may be checked by using with the SUV ratios between two regions and a relatively small amount of radioactivity.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.299-306
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• 2009

Purpose : To compare radiation dose for coronary CT angiography (CTA) obtained with 6 examination protocols such as a retrospectively ECG gated helical scan, a prospectively ECG gated sequential scan, low kVp technique, and cardiac dose modulation technique. Materials and Methods : Coronary CTA was performed by using 6 current clinical protocols to evaluate effective dose and organ dose in primary beam area with anthropomorphic female phantom and glass dosimetric system in 64 channel multi-detector CT. After acquiring topograms of frontal and lateral projection with 80 kVp and 10 mA, main coronary scan was done with 0.35 sec tube rotation time, 40 mm collimation ($0.625\;mm{\times}64\;ea$), small scan field of view (32 cm diameter), 105 mm scan length. Heart beat rate of phantom was maintained 60 bpm in ECG gating. In constant mAs technique 120 kVp, 600 mA was used, and 100 kVp for low kVp technique. In a retrospectively ECG gated helical CT technique 0.22 pitch was used, peak mA (600 mA) was adopted in range of $40{\sim}80%$ of R-R interval and 120mA(80% reduction) in others with cardiac dose modulation. And 210 mAs was used without cardiac dose modulation. In a prospectively ECG gated sequential CT technique data were acquired at 75% R-R interval (middle diastolic phase in cardiac cycle), and 120 msec additional padding of the tube-on time was used. For effective dose calculation region specific conversion factor of dose length product in thorax was used, which was recommended by EUR 16262. Results : The mean effective dose for conventional coronary CTA without cardiac dose modulation in a retrospectively ECG gated helical scan was 17.8 mSv, and mean organ dose of heart was 103.8 mGy. With low kVp and cardiac dose modulation the mean effective dose showed 54.5% reduction, and heart dose showed 52.3% reduction, compared with that of conventional coronary CTA. And at the sequential scan(SnapShot pulse mode) under prospective ECG gating the mean effective dose was 4.9 mSv, this represents an 72.5% reduction compared with that of conventional coronary CTA. And heart dose was 33.8 mGy, this represents 67.4% reduction. In the sequential scan technique under prospective ECG gating with low kVp the mean effective dose was 3.0 mSv, this represents an 83.2% reduction compared with that of conventional coronary CTA. And heart dose was 17.7 mGy, this represents an 82.9% reduction. Conclusion : In coronary CTA at retrospectively ECG gated helical scan, cardiac dose modulation technique using low kVp reduced dose to 50% above compared with the conventional helical scan. And the prospectively ECG gated sequential scan offers substantially reduced dose compared with the traditional retrospectively ECG gated helical scan.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.86-90
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• 2012

Purpose: Quantification of myocardial blood flow (MBF) using dynamic PET imaging has the potential to assess coronary artery disease. Rb-82 plays a key role in the clinical assessment of myocardial perfusion using PET. However, MBF could be overestimated due to the underestimation of left ventricular input function in the beginning of the acquisition when the scanner has non-linearity between count rate and activity concentration due to the scanner dead-time. Therefore, in this study, we evaluated the count rate linearity as a function of the activity concentration in PET data acquired in list mode. Materials & methods: A cylindrical phantom (diameter, 12 cm length, 10.5 cm) filled with 296 MBq F-18 solution and 800 mL of water was used to estimate the linearity of the Biograph 40 True Point PET/CT scanner. PET data was acquired with 10 min per frame of 1 bed duration in list mode for different activity concentration levels in 7 half-lives. The images were reconstructed by OSEM and FBP algorithms. Prompt, net true and random counts of PET data according to the activity concentration were measured. Total and background counts were measured by drawing ROI on the phantom images and linearity was measured using background correction. Results: The prompt count rates in list mode were linearly increased proportionally to the activity concentration. At a low activity concentration (<30 kBq/mL), the prompt net true and random count rates were increased with the activity concentration. At a high activity concentration (>30 kBq/mL), the increasing rate of the prompt net true rates was slightly decreased while the increasing rate of random counts was increased. There was no difference in the image intensity linearity between OSEM and FBP algorithms. Conclusion: The Biograph 40 True Point PET/CT scanner showed good linearity of count rate even at a high activity concentration (~370 kBq/mL).The result indicates that the scanner is useful for the quantitative analysis of data in heart dynamic studies using Rb-82, N-13, O-15 and F-18.

• Progress in Medical Physics
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• v.19 no.4
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• pp.201-208
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• 2008

Physical evaluations provide the basis for an objective and quantitative analysis of the image quality. Nonetheless, there are limitations in using physical evaluations to judge the utility of the image quality if the observer's subjectivity plays a key role despite its imprecise and variable nature. This study proposes a new method for objective and quantitative evaluation of image quality to compensate for the demerits of both physical and subjective image quality and combine the merits of them. The images of chest phantom were acquired from four digital radiography systems on clinic sites. The physical image quality was derived from an image analysis algorithm in terms of the contrast-to-noise ratio (CNR) of the low-contrast objects in three regions (lung, heart, and diaphragm) of a digital chest phantom radiograph. For image analysis, various image processing techniques were used such as segmentation, and registration, etc. The subjective image quality was assessed by the ability of the human observer to detect low-contrast objects. Fuzzy integral was used to integrate them. The findings of this study showed that the physical evaluation did not agree with the subjective evaluation. The system with the better performance in physical measurement showed the worse result in subjective evaluation compared to the other system. The proposed protocol is an integral evaluation method of image quality, which includes the properties of both physical and subjective measurement. It may be used as a useful tool in image evaluation of various modalities.

• Journal of the Korean Society of Radiology
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• v.4 no.1
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• pp.25-30
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• 2010

The objective of this study was to compare the resolution and density appropriate to diagnosis in chest PA radiography. In comparing the resolution, we radiographed with conventional radiography, computed radiography(CR) and digital radiography(DR) using the linear resolution phantom(Nuclear Associates-Carle Place. N.Y.). 2 radiologists and 3 radiological technologists read the resolution value by the blind test. DR, conventional radiography and CR measured 3.95, 3.58, 3.48 resolution value respectively. In analysing the density, we chose the fifty normal chest CR and DR and conventional film. We estimated the density using by densitometer(X-rite company-Model 301) in seven regions(lung field, lung field margine, mediastinum I, mediastinum II, heart shadow I, heart shadow II, diaphragm) of chest film. We adapted to analysis the Japanese chest X-ray evaluating method and table. It was scored 0(farthest density value) to 2(nearest density value). DR scored 2 at mediastinum I, mediastinum II, heart shadow I, heart shadow II and diaphragm. On the contrary with, CR scored 2 at lung field and lung field margine. Consequently, DR superior than CR and conventional radiography film compairing density and resolution. It was due to small pixel size and post processing algorithm with digital radiography.

• Korean Journal of Digital Imaging in Medicine
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• v.2 no.1
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• pp.74-82
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• 1996

This paper were studied the evaluation in compare with the conventional and AMBER of analog images, PACS and CR of digital images which were collected every ten sampling chest images with the J.J.Vucicuh chest evaluated chart, and were measured the chest phantom surface dose and the density of several part in chest images. The evaluated numbers were total 22 persons who were 6 persons of the M.D., 6 of the radiotechnological professors and 10 of the radiotechnologists. The obtained results summarized as following : 1. Approaching the optimum standard density of the several part in chest images drew near at the lung round region density in PACS images, the sternum region density in CR and AMBER images, the heart region density in CR AMBER images, the diaphram region density in AMBER and conventional images. 2. The evaluation measured surface dose were appeared orderly lesser dose at the AMBER images (spine 21 mR, lung 2mR, heart 12mR, apex 6mR) than the conventional images(32 mR), CR images(38mR) and PACS images(81mR). 3. The anatomical physical evaluation marks were taken the highest points at CR images(88.3), and orderly PACS images(82), AMBER images(79.2) and conventional images(65.2). 4. It is exposured with lesser surface dose at the analog images, but analog images leaves much room for image quality improvement, and digital images demand for lesser exposure surface dose, although excellent image quality.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.249-260
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• 2007

Purpose: In order to enhance the quality of IMRT as employed in Korea, we developed a remote monitoring system. The feasibility of the system was evaluated by conducting a pilot study. Materials and Methods: The remote monitoring system consisted of a head and neck phantom and a user manual. The phantom contains a target and three OARs (organs at risk) that can be detected on CT images. TLD capsules were inserted at the center of the target and at the OARs. Two film slits for GafchromicEBT film were located on the axial and saggital planes. The user manual contained an IMRT planning guide and instructions for IMRT planning and the delivery process. After the manual and phantom were sent to four institutions, IMRT was planed and delivered. Predicted doses were compared with measured doses. Dose distribution along the two straight lines that intersected at the center of the axial film was measured and compared with the profiles predicted by the plan. Results: The measurements at the target agreed with the predicted dose within a 3% deviation. Doses at the OARs that represented the thyroid glands showed larger deviations (minimum 3.3% and maximum 19.8%). The deviation at OARs that represented the spiral cord was $0.7{\sim}1.4%$. The percentage of dose distributions that showed more than a 5% of deviation on the lines was $7{\sim}27%$ and $7{\sim}14%$ along the horizontal and vertical lines, respectively. Conculsion: Remote monitoring of IMRT using the developed system was feasible. With remote monitoring, the deviation at the target is expected to be small while the deviation at the OARs can be very large. Therefore, a method that is able to investigate the cause of a large deviation needs to be developed. In addition, a more clinically relevant measure for the two-dimensional dose comparison and pass/fail criteria need to be further developed.