[Accuracy of absorbed dose calculation and measurement of scatter factors with different depth of mini-phantoms using a pinpoint ionization chamber].

The output factor of high-energy X-ray machines varies with collimation. According to Khan's theory, collimator and phantom scatter factors contribute to total scatter factor. For precise X-ray irradiation, the two factors need to be taken into consideration. To obtain proper factors, we made two original polystyrene cylindrical mini-phantoms. These phantoms are both 4 cm in diameter and have a pinpoint ion chamber placed at a depth of 5 cm and 10 cm, respectively. Using a 6 MV X-ray machine, collimator scatter factors were calculated for various field arrangements (i.e., field sizes ranging from 4 cm x 4 cm to 40 cm x 40 cm at isocenter). To determine if calculated values were appropriate, we measured point doses of 20 X-ray irradiation patterns using a Farmer-type ion chamber with a water equivalent phantom at depths of 5 cm and 10 cm, respectively. Two hundred MUs were irradiated to the above-mentioned depths for each field. Based on the measured doses, variations were obtained for four calculation methods. Accounting for 1) secondary collimator (jaw) setting, 2) blocked field (multi-leaf collimator) setting, 3) Khan's theory using a 5 cm mini-phantom, and 4) Khan's theory using a 10 cm mini-phantom. Dose variations in each method of calculation were as follows: 1) +0.3 to +10.2% (mean, +2.0 to +3.2%) , 2) -2.3 to 0.0% (mean, -0.8 to -0.6%), 3) 0.0 to +1.5% (mean, +0.1 to +0.3%), 4) 0.0 to +1.4% (mean, -0.1 to +0.1%).

[Gated Radiotherapy]

Recent external radiotherapy requires precise localization of the target because advance in diagnostic imaging has made it possible to visualize a tiny tumor which would be curable with focused high dose irradiation. However, tumors in respiratory and bowel organs have been difficult to be given the high dose because of 1 to 3 cm movement during delivery of irradiation. Respiratory-gating techniques have been used with medical linear accelerators and particle therapy machines. Real-time tumor-tracking radiotherapy has been realized using fluoroscopic x-rays, internal gold-markers, and pattern recognition technology. Advantage and disadvantage of each gating technique have been realized. Active breath control method would be a cost-effective way of precise treatment without gating. More work is required to find the relationship between abdominal wall and internal movement of the tumor in many respiratory-gating radiotherapy and between the internal markers and target volume in real-time tracking radiotherapy.