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We developed and evaluated an algorithm to calculate the target radiation dose in cancer patients by measuring the transmitted dose during 3D conformal radiation treatment (3D-CRT) treatment. The patient target doses were calculated from the transit dose, which was measured using a glass dosimeter positioned 150 cm from the source. The accuracy of the transit dose algorithm was evaluated using a solid water phantom for five patient treatment plans. We performed transit dose- based patient dose verification during the actual treatment of 34 patients who underwent 3D-CRT. These included 17 patients with breast cancer, 11 with pelvic cancer, and 6 with other cancers. In the solid water phantom study, the difference between the transit dosimetry algorithm with the treatment planning system (TPS) and the measurement was 0:10 1:93%. In the clinical study, this difference was 0:94 4:13% for the patients with 17 breast cancers, 0:11 3:50% for the eight with rectal cancer, 0:51 5:10% for the four with bone cancer, and 0:91 3:69% for the other five. These results suggest that transit-dosimetry-based in-room patient dose verification is a useful application for 3D-CRT. We expect that this technique will be widely applicable for patient safety in the treatment room through improvements in the transit dosimetry algorithm for complicated treatment techniques (including intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT)).
This study describes the development of a simple method to assess inter-fractional deviations of delivered proton beams in treatment rooms. To monitor the treatment beam, we measured the field-by-field beam fluences by attaching the EBT3 film to the snout, followed by a simple constancy check based on comparisons between the reference beam fluences (acquired during the pre-treatment quality assurance process) and the test beam fluences (acquired during treatment). The feasibility of the proposed treatment beam-monitoring system was confirmed by evaluating 12 treatment fields for each of six patients (brain, liver, prostate, lung, cranial and spinal area, and head and neck). The constancy of the treatment beams was verified by using a gamma index analysis to compare three measurements per field with the reference beam fluence. On the basis of the 3%/3 mm criterion, the average gamma-index passing rates for all measurements were over 99.6%. These results suggest that the constancy of fractional proton beams delivered to patients in treatment rooms can be verified with EBT3 film-based proton-beam monitoring system that can be easily attached to the treatment nozzle and is cost effective.
Quality assurance (QA) is required when performing pencil-beam scanning proton therapy, but the eciency of QA is degraded in proportion to the energy of the protons. We developed a method to assess the preferred energy range and distal fall-off by combining multiple Bragg peaks to increase the eciency of QA. Beams of 70, 110, 150, 190, and 230 MeV for exposure were planned using a treatment planning system. The Bragg curves for therapeutic proton beams were modeled using three different fitting function models, allowing the feasibility of a simple modeling of the Bragg curve to be investigated. The planned beams were exposed and measured using a multi-layered ionization chamber. Software developed using a Python tool could detect five Bragg peaks from the integrated curves that were fitted based on polynomial, cubic spline and Landau distributions. This software could calculate the range and distal fall-off of the five fitted peaks. For the verification of the accuracy of this method, the calculated results were compared with the range and distal fall- off obtained by exposing and analyzing five single-energy beams individually. Comparisons of the Bragg peaks for the five energies exposed individually with the results obtained by exposing them all at once showed that the ranges of the energy beams when using the polynomial fitting and the cubic spline modes were 0.16 mm and 0.10 mm longer, respectively, while the distal fall-offs were 0.14 mm and 0.06 mm shorter, respectively. When using the Landau distribution fitting, the range was 0.06 mm longer and the distal fall-off was 0.04 mm shorter. Analyses of the ranges and distal fall-offs of the five energy beams exposed at once with single-beam loading by using the method developed in this study showed no significant differences from the results obtained by exposing the energy beams individually. Thus, range verification QA by using the proposed method is not only suitable for single-proton beams with multiple energies but also reduces the measurement time.
We have developed an analytic software that can easily analyze the spot position and width of proton beam therapy nozzles in a periodic quality assurance. The developed software consists of an image processing method that conducts an analysis using center-of-spot geometry and a Gaussian fitting method that conducts an analysis through Gaussian fitting. By using the software, an analysis of 210 proton spots with energies 150, 190, and 230 MeV showed a deviation of approximately 3% from the mean. The software we developed to analyze proton spot positions and widths provides an accurate analysis and reduces the time for analysis.
Personal dosimeters are used to measure the amount of radiation exposure in individual radiation workers. We aimed to replace existing personal dosimeters and evaluate a real-time scintillator-based dosimeter by monitoring its radiation dose and checking the location exposed to radiation in the workspace. The developed dosimeter measured the radiation dose based on a scintillating fiber (SF) bundle, and comprised a silicon photomultiplier (SiPM), ultra-wide-band (UWB)-based location detecting system, and Bluetooth system. The SF bundle was exposed to radiation-emitted light, and the photons were amplified and converted to electrical signals through the SiPM. These signals were transferred to the user through the Bluetooth system and monitored. To evaluate the feasibility of this mechanism as a dosimeter, we performed characteristic tests, such as dose linearity, dependence on dose rate, energy, exposed angle, and location coordinate mapping. Also, the dose distribution formed in circles around the iso-center was measured to confirm the feasibility of monitoring the exposure dose and location and to enable the radiation worker to move freely in a workspace. We confirmed dose linearity, independence from energy and angle, and accuracy of location monitoring in our device. The user's locations were measured with a difference of − 6 cm and − 4.8 cm on the x- and the y-axes, respectively. The measured doses on our developed dosimeter were 62.7, 32.3, 21.0, and 15.4 mSv at distances of 50, 100, 150, and 200 cm from the iso-center. In other words, all measured doses at several points showed an error within 5% as compared to doses provided by the conventional pocket dosimeter. These results show that the developed SF-based dosimeter is advantageous in monitoring the exposure dose and location in real time, and has significant potential as a new personal dosimeter for radiation workers.
The amount of potentially lethal damage repair (PLDR) is a significant factor in the process of modeling the survival curves of cells irradiated with fractionated carbon beams. Because the amount of PLDR generally depends on the features of the cells and the linear energy transfer (LET), the amount of PLDR of cells irradiated with fractionated carbon beams shows distinct differences from that of cells irradiated with X-rays. This study considered a new parameter dependent on the correlation between the PLDR trait (T) of the cells over a time interval (Δ) at the fractionated carbon beam irradiation. The survival curves of the cells irradiated with fractionated carbon beams n times were predicted using the ζ and the Ψ values from the delay assay. This study aims to overcome the barriers of traditional methods by developing a new survival curve model with new parameters based on an analysis of the PLDR traits of cells over time interval in fractionated carbon beam irradiation and to suggest a model that produces results significantly closer to the experimental data.
김진성(Jin Sung Kim), 윤명근(Myonggeun Yoon), 박성용(Sung Yong Park), 신정석(Jung Suk Shin), 신은혁(Eunhyuk Shin), 주상규(Sang-Gyu Ju), 한영이(Youngyih Han), 안용찬(Yong-Chan Ahn) 대한방사선종양학회 2009 Radiation Oncology Journal Vol.27 No.4
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목 적: 방사선치료 관련 연구를 수행함에 있어서 선량 체적 히스토그램(dose volume histogram, DVH)을 분석하는 것이 필수적이나 상용 방사선치료계획시스템에서 수행할 수 없다. 본 연구는 이러한 선량 체적 히스토그램의 정보를 쉽게 분석할 수 있도록 소프트웨어를 제작하였다. 대상 및 방법: 방사선치료계획 시스템에서 치료계획 후에 환자의 DVH 데이터를 텍스트로 저장하여 이를 이용해서 DVH 상에서의 필요한 특정 값들(Vx, Dx)을 지정하여 획득할 수 있도록 하였고, Niemierko의 generalized equivalent uniform dose (EUD), Lyman-Kutcher-Burman 모델을 이용한 normal tissue complication probability (NTCP) 및 방사선치료의 2차 암유발 위험도 인자인 organ equivalent dose (OED)를 계산하는 프로그램을 개발하였다. 결 과: 환자의 데이터를 가지고 실제 방사선치료계획 시스템 상에서의 Vx, Dx와 NTCP 비교를 통해 개발된 프로그램의 계산 알고리즘을 검증하였고 0.1% 내의 오차를 보였으며 EUD 및 OED도 성공적으로 계산되었다. 결 론: 선량 체적 히스토그램을 분석하는 프로그램을 개발하였으며 다양한 방사선치료 관련 연구에 활용할 수 있을것으로 예상된다. Purpose: To provide a simple research tool that may be used to analyze a dose volume histogram from different radiation therapy planning systems for NTCP (Normal Tissue Complication Probability), OED (Organ Equivalent Dose) and so on. Materials and Metohds: A high-level computing language was chosen to implement Niemierko's EUD, Lyman-Kutcher-Burman model's NTCP, and OED. The requirements for treatment planning analysis were defined and the procedure, using a developed GUI based program, was described with figures. The calculated data, including volume at a dose, dose at a volume, EUD, and NTCP were evaluated by a commercial radiation therapy planning system, Pinnacle (Philips, Madison, WI, USA) for comparison. Results: The volume at a special dose and a dose absorbed in a volume on a dose volume histogram were successfully extracted using DVH data of several radiation planning systems. EUD, NTCP and OED were successfully calculated using DVH data and some required parameters in the literature. Conclusion: A simple DVH analyzer program was developed and has proven to be a useful research tool for radiation therapy.
방사선치료안전보고시스템(ROSIS)을 기반으로 방사선치료 중 발생하는 사고의 경향성 및 유형별 빈도를 살펴보고 빈발사고의 유형과 발생원인, 발견 방법에 따라 향후 사고 유발인자 제어방법 연구의 발전방향을 살펴보고자 한다. 이에 따라 본 연구에서는 2003년부터 2013년까지 최근 11년간 1163건에 달하는 ROSIS 사고 자료에 대하여 분석을 수행하였다. 분석을 위하여 치료법, 발견 시점, 발견 방법, 발견자의 직종 등으로 규격화한 후, 각 항목별로 분류 및 백분율화 하였다. 근접사고(Near Miss)를 포함한 1163건의 사고 사례에 대하여 외부방사선치료가 97%이고 근접방사선치료가 2%로 조사되었으며 그 외 기타로 1%가 분류되었다. 계획 선량이 잘못 전달된 사례가 44% (497건)에 달했고 이중 대부분을 차지하는 429건(86%)이 3회 분할치료이전에 발견되었고 13건의 경우는 11회 분할치료 이후에 발견된 것으로 조사되었다. 또한, 발견 시점은 다양하게 분포되는 것으로 조사되었는데, 약 42%가 환자 치료 중에 발견되었고 29%는 차트 검사 중에 발견되었다. 방사선 사고 발견빈도가 가장 높은 직업군은 치료실에서 근무하는 방사선사(53%)인 것으로 조사되었다. 1163건의 사고 사례 중에서 환자치료 이전에 오류를 발견한 경우가 24% (273건)로 조사 되어 대부분의 사고(70%, 813건)는 사고가 발생한 이후에 발견된 것으로 조사되었다. ROSIS 분석을 통해 획득한 이러한 경향은 한국의 경우에서도 크게 다르지 않을 것으로 사료되므로 사고 예방과 조기 발견을 위한 보다 다양하고 체계적인 연구가 필요할 것으로 예상된다. In this study, we examine the trends and types of incidents frequently occur during radiation therapy by using the data from the radiation oncology safety information system (ROSIS), according to discovery method explores the development direction of future research accident cause factor control method. This study was carried out analysis of incident data in ROSIS nearly 1163 cases in last 11 years from 2003 to 2013. We categorized into treatment methods, found the time, discoverer of occupations and finding ways to analyze the data. Then, we calculate the percentage and the classification for each item. About 1163 cases of incident cases including the near miss cases, external radiation therapy, brachytherapy and other were 97%, 2% and 1%. In the case was improperly planned dose delivery was 44% (497 cases) which 429 cases (86%) was found before 3 fractions and 13 cases were found after 11 fractions. The investigation was found to be distributed in various a found times. Approximately 42% of found time was during treatment and 29% of patients were found the problem during inspection chart. Occupation to discover the most radiation accidents was the radiation therapist (53%) who works in treatment room. Among 1163 incidence cases, 24% cases were found the accident before the treatment, therefore most of accident were found after of during the treatment (70%, 813 cases). This trend is acquired through ROSIS analysis, is expected to be not significantly different in the case of Korea, so it is necessary more diverse and systematic research for the prevention and early detection by using the ROSIS data.