Kyo-Tae Kim

Development and evaluation of multi-energy PbO dosimeter for quality assurance of image-guide radiation therapy devices

In radiation therapy, accurate radiotherapy treatment plan (RTP) reproduction is necessary to optimize the clinical results. Thus, attempts have recently been made to ensure high RTP reproducibility using image-guide radiation therapy (IGRT) technology. However, the clinical use of digital X-ray equipment requires extended quality assurance (QA) for those devices, since the IGRT device quality determines the precision of intensity-modulated radiation therapy. The study described in this paper was focused on developing a multi-energy PbO dosimeter for IGRT device QA. The Schottky-type polycrystalline PbO dosimeter with a Au/PbO/ITO structure was evaluated by comparing its response coincidence, dose linearity, measurement reproducibility, linear attenuation coefficient, and percent depth dose with those of Si diode and standard ionization chamber dosimeters.

Feasibility study of a lead monoxide-based dosimeter for quality assurance in radiotherapy

Lately, cancer has been treated using high-energy radiation, and this requires highly reliable treatment plans. Therefore, a dosimeter with excellent performance, which is capable of precise dose measurement, is critical. In current clinical practices, an ionization chamber and diode utilizing the ionization reaction mechanism are widely used. Several studies have been carried out to determine optimal materials for the detector in a dosimeter to enable diagnostic imaging. Recently, studies with lead monoxide, which was shown to have low drift current and high resolving power at a high bias, were reported with the dosimeter exhibiting a fast response time against incident photons. This research aims to investigate the feasibility of a lead monoxide-based dosimeter for QA (quality assurance) in radiotherapy. In this paper, we report that the manufactured dosimeter shows similar linearity to a silicon diode and demonstrates similar characteristics in terms of PDD (percent depth dose) results for the thimble ionization chamber. Based on these results, it is demonstrated that the lead monoxide-based dosimeter complies with radiotherapy QA requirements, namely rapid response time, dose linearity, dose rate independence. Thus, we expect the lead monoxide-based dosimeter to be used commercially in the future.

Feasibility Study of Phosphor Screen Containing Nano-Scale Anti-Reflection Layer for Improved Optical Properties in Indirect X-ray Detector

With increasingly strict regulations regarding patient exposure, research on digital radiography technology has recently focused on indirect methods that can produce high-quality images for a low radiation dose. In particular, medical imaging systems based on indirect methods universally use rare-earth metal phosphors, because of their high atomic number and excellent luminescence efficiency. Thus, various studies aiming to improve the luminescence efficiency of phosphors have been conducted. Despite this research, however, the current luminescence efficiencies are insufficient. Here, we report a basic study aiming to develop a phosphor screen containing a three-quarter-wave optical-thickness layer to improve the light transmission efficiency. Specifically, the fabrication and measurement of a Gd2O2S:Tb phosphor screen containing a single three-quarter-wave optical-thickness layer is presented. The screen is fabricated via a screen-printing and spin-coating method. Based on histograms of the degree of luminescence and the pixel values, we demonstrate that the light transmission efficiency is improved by the three-quarter-wave optical-thickness layer. Note that analysis of the full width at half maximum of the pixel value distribution reveals the possibility of resolution loss when obtaining medical images. Overall, the results of this study confirm that the light transmission efficiency can be improved through use of a single-layer anti-reflection coating. However, because the emission spectrum of the Gd2O2S:Tb screen is in the 480-600-nm band, it is necessary to expand the areas exhibiting the lowest reflectance to the wavelengths at the edge of this band. Thus, further study should be conducted to optimize the optical thickness.

Feasibility study of a photoconductor based dosimeter for quality assurance in radiotherapy

With the recent market entries of new types of linear accelerators (LINACs) with a multi leaf collimator (MLC) mounted on them, high-precision radiosurgery applying a LINAC to measure high-dose radiation on the target region has been gaining popularity. Systematic and accurate quality assurance (QA) is of vital important for high-precision radiosurgery because of its increased risk of side effects including life-threatening ones such as overexposure of healthy tissues to high-dose radiation beams concentrated on small areas. Therefore, accurate dose and dose-distribution measurements are crucial in the treatment procedure. The accurate measurement of the properties of beams concentrated on small areas requires high-precision dosimeters capable of high-resolution output and dose mapping as well as accurate dosimetry in penumbra regions. In general, the properties of beams concentrated on small areas are measured using thermos luminescent dosimeters (TLD), diode detectors, ion chambers, diamond detectors, or films, and many papers have presented the advantages and disadvantages of each of these detectors for dosimetry. In this study, a solid-state photoconductor dosimeter was developed, and its clinical usability was tested by comparing its relative dosimetric performance with that of a conventional ion chamber. As materials best-suited for radiation dosimeters, four candidates namely lead (II) iodide (PbI2), lead (II) oxide (PbO), mercury (II) iodide (HgI2), and HgI2/ titanium dioxide (TiO2) composite, the performances of which were proved in previous studies, were used. The electrical properties of each candidate material were examined using the sedimentation method, one of the particle-in-binder (PIB) methods, and unit-cell-type prototypes were fabricated. The unit-cell samples thus prepared were cut into specimens of area 1 × 1 cm2 with 400-μ m thickness. The electrical properties of each sample, such as sensitivity, dark current, output current, rising time, falling time, and response delay, were then measured, in addition to the consistency, reproducibility and linearity of each unit-cell. According to the measurement results, HgI2/TiO2 composite outperformed the other candidate materials. A radiation dosimeter with a chamber-type structure was fabricated in this study using a LINAC under accelerating voltages of 6, and 15 MV and compared with a commercial ion chamber. Percent depth dose (PDD) and beam profile were measured on a water phantom at a fixed area of 10 × 10 cm2 by using the fabricated chamber-type dosimeter, and the values were compared with those measured by a commercial ion chamber. Additionally, a homogeneous phantom was fabricated, and the exposure doses of the center points were measured according to a real treatment plan, followed by a comparison of the measured values as relative values. In this paper, we report that the manufactured dosimeter shows similar characteristics in terms of PDD and beam profile and results for the conventional ion chamber. Based on these results, it is demonstrated that the HgI2/TiO2-based dosimeter complies with radiotherapy QA requirements, namely Superior detection characteristics, consistency, dose linearity, reproducibility. Thus, we expect the HgI2/TiO2-based dosimeter to be used commercially in the future.

Feasibility study of a lead(II) iodide-based dosimeter for quality assurance in therapeutic radiology

The most widely used form of radiotherapy to treat tumors uses a linear accelerator, and the apparatus requires regular quality assurance (QA). QA for a linear accelerator demands accuracy throughout, from mock treatment and treatment planning, up to treatment itself. Therefore, verifying a radiation dose is essential to ensure that the radiation is being applied as planned. In current clinical practice, ionization chambers and diodes are used for QA. However, using conventional gaseous ionization chambers presents drawbacks such as complex analytical procedures, difficult measurement procedures, and slow response time. In this study, we discuss the potential of a lead(II) iodide (PbI2)-based radiation dosimeter for radiotherapy QA. PbI2 is a semiconductor material suited to measurements of X-rays and gamma rays, because of its excellent response properties to radiation signals. Our results show that the PbI2-based dosimeter offers outstanding linearity and reproducibility, as well as dose-independent characteristics. In addition, percentage depth dose (PDD) measurements indicate that the error at a fixed reference depth Dmax was 0.3%, very similar to the measurement results obtained using ionization chambers. Based on these results, we confirm that the PbI2-based dosimeter has all the properties required for radiotherapy: stable dose detection, dose linearity, and rapid response time. Based on the evidence of this experimental verification, we believe that the PbI2-based dosimeter could be used commercially in various fields for precise measurements of radiation doses in the human body and for measuring the dose required for stereotactic radiosurgery or localized radiosurgery.

Development and evaluation of polycrystalline cadmium telluride dosimeters for accurate quality assurance in radiation therapy

For quality assurance in radiation therapy, several types of dosimeters are used such as ionization chambers, radiographic films, thermo-luminescent dosimeter (TLD), and semiconductor dosimeters. Among them, semiconductor dosimeters are particularly useful for in vivo dosimeters or high dose gradient area such as the penumbra region because they are more sensitive and smaller in size compared to typical dosimeters. In this study, we developed and evaluated Cadmium Telluride (CdTe) dosimeters, one of the most promising semiconductor dosimeters due to their high quantum efficiency and charge collection efficiency. Such CdTe dosimeters include single crystal form and polycrystalline form depending upon the fabrication process. Both types of CdTe dosimeters are commercially available, but only the polycrystalline form is suitable for radiation dosimeters, since it is less affected by volumetric effect and energy dependence. To develop and evaluate polycrystalline CdTe dosimeters, polycrystalline CdTe films were prepared by thermal evaporation. After that, CdTeO3 layer, thin oxide layer, was deposited on top of the CdTe film by RF sputtering to improve charge carrier transport properties and to reduce leakage current. Also, the CdTeO3 layer which acts as a passivation layer help the dosimeter to reduce their sensitivity changes with repeated use due to radiation damage. Finally, the top and bottom electrodes, In/Ti and Pt, were used to have Schottky contact. Subsequently, the electrical properties under high energy photon beams from linear accelerator (LINAC), such as response coincidence, dose linearity, dose rate dependence, reproducibility, and percentage depth dose, were measured to evaluate polycrystalline CdTe dosimeters. In addition, we compared the experimental data of the dosimeter fabricated in this study with those of the silicon diode dosimeter and Thimble ionization chamber which widely used in routine dosimetry system and dose measurements for radiation therapy.

Decrease in bispectral index prior to cardiovascular collapse during Caesarean sections

We report a case of significant reduction in bispectral index (BIS) associated with suspected amniotic fluid embolism (AFE) that occurred prior to change in haemodynamic variables. The patient was a 29‐year‐old nulliparous, who was admitted for Caesarean section under general anaesthesia in the 33rd week of pregnancy. After the baby was born, the BIS value suddenly decreased to 0, with suppression ratio of 100. One minute later, saturation decreased abruptly to 85%, end‐tidal carbon dioxide (EtCO2) decreased to 5u2009mmHg, peak inspiratory pressure increased to 35u2009cmu2009H2O, and non‐invasive blood pressure (BP) failed to obtain a reading. After administration of vasoactive drugs, the systolic BP was maintained at 100u2009mmHg or higher, the BIS value rose to 10–20, and the EtCO2 increased to 24–33u2009mmHg. In this case, the BIS monitoring may provide an earlier warning of impending cardiovascular collapse in the case of AFE.