• Progress in Medical Physics
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• v.25 no.4
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• pp.255-263
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• 2014

The dosimetry of very small fields is challenging for several reasons including a lack of lateral electronic equilibrium, large dose gradients, and the size of detector in respect to the field size. The objective of this work was to evaluate the suitability of a new commercial synthetic diamond detector, namely, the PTW 60019 microDiamond, for the small field dosimetry in cyberknife photon beams of 6 different collimator size (from 5 mm to 30 mm). Measurements included dose linearity, dose rate dependence, output factors (OF), percentage depth doses (PDD) and off center ratio (OCR). The results were compared to those of pinpoint ionization chamber, diamond detector, microLion liquid Ionization chamber and diode detector. The dose linearity results for the microDiamond detector showed good linearly proportional to dose. The microDiamond detector showed little dose rate dependency throughout the range of 100~600 MU/min, while microLion liquid Ionization chamber showed a significant discrepancy of approximately 5.8%. The OF measured with microDiamond detector agreed within 3.8% with those measured with diode. PDD curves measured with silicon diode and diamond detector agreed well for all the field sizes. In particular, slightly sharper penumbras are obtained by the microDiamond detector, indicating a good spatial resolution. The results obtained confirm that the new PTW 60019 microDiamond detector is suitable candidate for application in small radiation fields dosimetry.

• Radiation Oncology Journal
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• v.21 no.2
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• pp.174-181
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• 2003

Purpose: The target volume for the three field technique in breast cancer include the breast tangential and supraclavicular areas. The techniques rotating the gantry and couch angles, to match these two areas, will geometrically produce mismatching of the posterior edge between the medial and lateral tangential beams. This mismatch was confirmed by film dosimetry and three-dimensional computer planning. The correction methods of this mismatching were studied in this article. Materials and Methods: After the supraclavicular field was simulated using a half beam block and the medial and lateral tangential fields, by the rotation of the couch and gantry, we compared the following two methods to correct the mismatch. The first method was the rotation of coillmator until a line drawn on the posterior edge of tangential beams before the rotation of couch aligned the line drawn on the posterior edge after the rotation. The second method was the rotation of collimator according to the formula developed by the author as follows; Co=$2sin^{-1}${$sin\{theta}\{cdot}sin(C/2)$} (Co: collimator angle, $\theta$: angle between tangential beam and table, C: couch angle) Results: The film dosimetry showed the mismatching of posterior edges of the medial and lateral tangential fields prior to the rotation of collimator, while the posterior edges matched well after the rotation of collimator according to the formula. The three-dimensional computer plan also showed that the posterior edges matched well after the rotation of collimator accordingly. The DVH of the ipsilateral lung with the proper rotation of collimator angle was better than that without the rotation of collimator angle. Conclusion: The mismatching of the posterior edges of the medial and lateral tangential fields can be recognized on the three fileld technique in breast irradiation when the gantry and couch are simultaneously rotated and can be corrected with the proper rotation of the collimator angle. The radiation dose to the ipsilateral lung could be lowered with this technique.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.237-244
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• 1996

Purpose : The accurate dosimetry of independent collimator equipped for 6MV and 15MV X-ray beam was investigated to search for the optimal correction factor. Materials and Methods : The field size factors, beam quality and dose distribution were measured by using 6MV, 15MV X-ray Field size factors were measured from $3{\times}3cm^2$ to $35{\times}35cm^2$ by using 0.6cc ion chamber (NE 2571) at Dmax. Beam qualities were measured at different field sizes, off-axis distances and depths. Isodose distributions at different off-axis distance using $10\times10cm^2$ field were also investigated and compared with symmetric field. Result: 1) Relative field size factors was different along lateral distance with maximum changes in $3.1\%$ for 6MV and $5\%$ for 15MV. But the field size factors of asymmetric fields were identical to the modified central-axis values in symmetric field, which corrected by off-axis ratio at Dmax. 2) The HVL and PDD was decreased by increasing off-axis distance. PDD was also decreased by increasing depth For field size more than $5{\times}cm^2$ and depth less than 15cm, PDD of asymmetric field differs from that of symmetric one ($0.5\~2\%$ for 6MV and $0.4\~1.4\%$ for 15MV). 3) The measured isodose curves demonstrate divergence effects and reduced doses adjacent to the edge close to the flattening filter center was also observed. Conclusion . When asymmetric collimator is used, calculation of MU must be corrected with off-axis and PDD with a caution of underdose in central axis.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.95-101
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• 1985

From July 1979 through March 1985,112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-137. The treatment consisted of 3600rad-5200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-200rad per day. Parametrial boost with 400-800rad was given in 60 patients. 2 intracavitary Cs-137 radiation using TAO applicator were done with 7-10 days interval. Total treatment times were 40-65 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899ra0 with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. $9(8\%)$ had stage $14(12.5\%)$ had stage IIa, $50(44.6\%)$ had stage IIb, $33(29.5\%)$ had stage III, $6(5.4\%)$ had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were $61.8\%$ for the entire group, $84.6\%$ for stage Ib,$77.8\%$ for stage IIa, $56.7\%$ for stage IIb, $60\%$ for stage III, $33.3\%$ for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in $7/18(38.9\%)$ failure (=death) in contrast to 25/94 $(26.5\%)$ failure with dose over 8000rad. RT dose to lateral parametrium (point B) below 6000ra0 yielded 20/63 $(34.9\%)$ failure compared to $10/49(20.4\%)$ failure with dose over 6000rad. Poor survival group of age were between 40-49 years with failure of $14/41(34.1\%)$. There was no increased failure rate below age of 40 with failure of $2111(13.9\%)$. The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.107-114
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• 2012

Purpose: Unlike the existing linear accelerator with photon, proton therapy produces a number of second radiation due to the kinds of nuclide including neutron that is produced from the interaction with matter, and more attention must be paid on the exposure level of radiation workers for this reason. Therefore, thermoluminescence dosimeter (TLD) that is being widely used to measure radiation was utilized to analyze the exposure level of the radiation workers and propose a basic data about the radiation exposure level during the proton therapy. Materials and Methods: The subjects were radiation workers who worked at the proton therapy center of National Cancer Center and TLD Badge was used to compare the measured data of exposure level. In order to check the dispersion of exposure dose on body parts from the second radiation coming out surrounding the beam line of proton, TLD (width and length: 3 mm each) was attached to on the body spots (lateral canthi, neck, nipples, umbilicus, back, wrists) and retained them for 8 working hours, and the average data was obtained after measuring them for 80 hours. Moreover, in order to look into the dispersion of spatial exposure in the treatment room, TLD was attached on the snout, PPS (Patient Positioning System), Pendant, block closet, DIPS (Digital Image Positioning System), Console, doors and measured its exposure dose level during the working hours per day. Results: As a result of measuring exposure level of TLD Badge of radiation workers, quarterly average was 0.174 mSv, yearly average was 0.543 mSv, and after measuring the exposure level of body spots, it showed that the highest exposed body spot was neck and the lowest exposed body spot was back (the middle point of a line connecting both scapula superior angles). Investigation into the spatial exposure according to the workers' movement revealed that the exposure level was highest near the snout and as the distance becomes distant, it went lower. Conclusion: Even a small amount of exposure will eventually increase cumulative dose and exposure dose on a specific body part can bring health risks if one works in a same location for a long period. Therefore, radiation workers must thoroughly manage exposure dose and try their best to minimize it according to ALARA (As Low As Reasonably Achievable) as the International Commission on Radiological Protection (ICRP) recommends.

• Journal of the Korean Society of Radiology
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• v.11 no.2
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• pp.139-144
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• 2017

Percutaneous vertebroplasty (PVP) is increasingly used to treat osteoporotic vertebral fractures, myeloma and osteolytic vertebral metastases. The purpose of this study was to measure the absorbed radiation exposure dose and time during PVP and to assess the possibility of deterministic radiation effects to the operator and patient. The radiation dose and time measure by three pain physicians performed consecutive procedures using the twenty case PVP. Patient's dosimeter placed at the anteroposterior(AP) side was treatment of the vertebra body located in the upper level 2-3 and lateral(LAT) side was flank proximal to C-arm tube of back. Operator's dosimeter placed at the apron outside of upper sternum (thyroid), left chest, lower extremity and apron inside of left chest. Results: Radiation exposure times were $3.6{\pm}0.71min$. Measurements on the Patient radiation dose were AP $121.4{\pm}48.1{\mu}Sv$, LAT side $614.7{\pm}177.1{\mu}Sv$. Operator radiation dose were outside of the lead apron upper sternum $33.7{\pm}7.3{\mu}Sv$, outside of the lead apron chest $49.2{\pm}15.0{\mu}Sv$, outside of the lead apron lower extremity $12.8{\pm}3.8{\mu}Sv$ and inside of the lead apron chest $4.2{\pm}1.4{\mu}Sv$. To escape from the danger of radiation first long distance from the c-arm tube second exposure time reduced second lead apron used fluoroscopy during PVP is more safety patient and operation from the radiation exposure.

• Radiation Oncology Journal
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• v.17 no.3
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• pp.261-267
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• 1999

Purpose : In FSRT (Fractionated stereotactic radiotherapy) planning, we studied the usefulness between multiple arc FSRT and conformal FSRT by comparing tumor shape and DVH (dose volume histogram). Materials and Methods In Chungnam Univ. hospital, we had treated the sixteen patients with FSRT from Aug. 1997 to Dec. 1998. In choosing multiple arc FSRT or conformal FSRT, we had considered If (irregular factor) after calculating tumor volume and surface area. We had considered multiple arc FSRT if tumor shape was similar to sphere or the value of If was less than 1.25, conformal FSRT if tumor shape was very irregular or If was more than 1.3. For evaluation of treatment planning, we had considered the appropriate DVH for tumor volume and for critical organs. Results : The errors between reference point and the coordinates point on AP, Lat radiography were less than 1 mm before treatment. We had planned $3\~$5 arcs for multiple arc FSRT, $5\~6$ports for conformal FSRT. The mean dose distribution of tumor volume of cumulative DVH between multiple arc FSRT and conformal FSRT was 90.6, 85%, respectively. The dose of critical organs irradiated was less than $5\%$ maximum dose of cumulative DVH. Conclusion : We had obtained the similar value between multiple arc FSRT and conformal FSRT, so that we had appropriate treatment planning of FSRT for multiple arc FSRT and conformal FSRT according to tumor shape and size.

• The Journal of Korean Society for Radiation Therapy
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• v.16 no.2
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• pp.81-89
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• 2004

Introduction : The setup error due to the patient and the staff from radiation treatment as the reason which is important the treatment record could be decided is a possibility of effect. The SET-UP ERROR of the patient analyzes the effect of dose distribution and DVH from radiation treatment of the patient. Material & Methode : This test uses human phantom and when C-T scan doing, It rotated the Left direction of the human phantom and it made SET-UP ERROR , Standard plan and 3mm, 5mm, 7mm, 10mm, 15mm, 20mm with to distinguish, it made the C-T scan error. With the result, The SET-UP ERROR got each C-T image Using RTP equipment It used the plan which is used generally from clinical - Box plan, 3Dimension plan( identical angle 5beam plan) Also, ( CTV+1cm margin, CTV+0.5cm margin, CTV+0.3,cm margin = PTV) it distinguished the standard plan and each set-up error plan and The plan used a dose distribution and the DVH and it analyzed Result : The Box4 the plan and 3Dimension plan which it bites it got similar an dose distribution and DVH in 3mm, 5mm From rotation error and Rectilinear movement( $0\%{\sim}2\%$ ). Rotation error and rectilinear error 7mm, 10mm, 15mm, 20mm appeared effect it will go mad to a enough change in treatment ( $2\%{\sim}^11\%$ ) Conclusion : The diminishes the effect of the SET-UP ERROR must reduce move with tension of the patient Also, we are important accessory development and the supply that it reducing of reproducibility and the move

• Progress in Medical Physics
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• v.26 no.4
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• pp.286-293
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• 2015

The purpose of this study was to evaluate the set up accuracy using stereotactic body frame and frameless immobilizer for lung stereotactic body radiation therapy (SBRT). For total 40 lung cancer patients treated by SBRT, 20 patients using stereotactic body frame and other 20 patients using frameless immobilizer were separately enrolled in each group. The setup errors of each group depending on the immobilization methods were compared and analyzed. All patients received the dose of 48~60 Gy for 4 or 5 fractions. Before each treatment, a patient was first localized to the treatment isocenter using room lasers, and further aligned with a series of image guidance procedures; orthogonal kV radiographs, cone-beam CT, orthogonal fluoroscopy. The couch shifts during these procedures were recorded and analyzed for systematic and random errors of each group. Student t-test was performed to evaluate significant difference depending on the immobilization methods. The setup reproducibility was further analyzed using F-test with the random errors excluding the systematic setup errors. In addition, the ITV-PTV margin for each group was calculated. The setup errors for SBF were $0.05{\pm}0.25cm$ in vertical direction, $0.20{\pm}0.38cm$ in longitudinal direction, and $0.02{\pm}0.30cm$ in lateral direction, respectively. However the setup errors for frameless immobilizer showed a significant increase of $-0.24{\pm}0.25cm$ in vertical direction while similar results of $0.06{\pm}0.34cm$, $-0.02{\pm}0.25cm$ in longitudinal and lateral directions. ITV-PTV margins for SBF were 0.67 cm (vertical), 0.99 cm (longitudinal), and 0.83 cm (lateral), respectively. On the other hand, ITV-PTV margins for Frameless immobilizer were 0.75 cm (vertical), 0.96 cm (longitudinal), and 0.72 cm (lateral), indicating less than 1 mm difference for all directions. In conclusion, stereotactic body frame improves reproducibility of patient setup, resulted in 0.1~0.2 cm in both vertical and longitudinal directions. However the improvements are not substantial in clinic considering the effort and time consumption required for SBF setup.

• Journal of Pharmaceutical Investigation
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• v.25 no.3
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• pp.7-20
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• 1995

Taurine, a ${\beta}-amino$ acid, plays an important role as a neuromodulator and is necessary for the normal development of the brain. Since de novo synthesis of taurine in the brain is minimal and in vivo studies suggest that taurine dose not cross the blood-brain barrier, we examined whether the choroid plexus, the blood-cerebrospinal fluid (CSF) barrier, plays a role in taurine transport in the central nervous system. The uptake of $[^3H]-taurine$ into ATP depleted choroid plexus from rabbit was substantially greater in the presence of an inwardly directed $Na^+$ gradient taurine accumulation was negligible. A transient in side-negative potential gradient enhanced the $Na^+-driven$ uptake of taurine into the tissue slices, suggesting that the transport process is electrogenic, $Na^+-driven$ taurine uptake was saturable with an estimated $V_{max}$ of $111\;{\pm}\;20.2\;nmole/g/15\;min$ and a $K_M\;of\;99.8{\pm}29.9\;{\mu}M$. The estimated coupling ratio of $Na^+$ and taurine was $1.80\;{\pm}\;0.122.$ $Na^+-dependent$ taurine uptake was significantly inhibited by ${\beta}-amino$ acids, but not by ${\alpha}-amino$ acids, indicating that the transporter is selective for ${\beta}-amino$ acids. Since it is known that the physiological concentration of taurine in the CSF is lower than that in the plasma, the active transport system we characterized may face the brush border (i.e., CSF facing) side of the choroid plexus and actively transport taurine out of the CSF. Therefore, we examined in vivo elimination of taurine from the CSF in the rat to determine whether elimination kinetics of taurine from the CSF is consistent with the in vitro study. Using a stereotaxic device, cannulaes were placed into the lateral ventricle and the cisterna magna of the rat. Radio-labelled taurine and inulin (a marker of CSF flow) were injected into the lateral ventricle, and the concentrations of the labelled compounds in the CSF were monitored for upto 3 hrs in the cisterna magna. The apparent clearance of taurine from CSF was greater than the estimated CSF flow (p<0.005) indicating that there is a clearance process in addition to the CSF flow. Taurine distribution into the choroid plexus was at least 10 fold higher than that found in other brain areas (e. g., cerebellum, olfactory bulb and cortex). When unlabelled taurine was co-administered with radio-labelled taurine, the apparent clearance of taurine was reduced (p<0.0l), suggesting a saturable disposition of taurine from CSF. Distribution of taurine into the choroid plexus, cerebellum, olfactory bulb and cortex was similarly diminished, indicating that the saturable uptake of taurine into these tissues is responsible for the non-linear disposition. A pharmacokinetic model involving first order elimination and saturable distribution described these data adequately. The Michaelis-Menten rate constant estimated from in vivo elimination study is similar to that obtained in the in vitro uptake experiment. Collectively, our results demonstrate that taurine is transported in the choroid plexus via a $Na^+-dependent,saturable$ and apparently ${\beta}-amino$ acid selective mechanism. This process may be functionally relevant to taurine homeostasis in the brain.