• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.59-64
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• 2002

Purpose : In radiotherapy, various materials are used to located in treatment field unintentionally. It increases the dose delivered to the skin by interactions of the X-ray within the materials and occurs unwanted skin reaction.(due to the dose build-up effect) This aim of the this study is to measure the increase in skin dose when 13 materials are located in treatment field. Methods : Photon beam measurements were made using an plane-parallel chamber (Markus, PTW-Freiburg) in a polystyrene phantom. skin dose were measured using various overlaying 13 materials. a fixed geometry of a $10{\times}10cm$ field, a SSD=100cm and photon energy 4MV on Varian CLINAC 600C accelerator were used for all measurements. Results : There is an increase in skin dose for all materials($16.4{\sim}160.1\%$). As a percentage of maximum dose, the lowest skin dose were measured for the underwear with silk($43.2\%$) and the highest were measured for the 100m1 fluid-bag($96.6\%$) Conclusion : There is a significant increase in skin dose with 13 materials in the treatment field. a significant increase in skin dose can occur which could produce unwanted skin reaction. considerations for placement of 13 materials to be outside the treatment field whenever possible should be used to keep skin dose to a minimum level.

• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.215-221
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• 2023

Proton treatment may deliver a larger dose to a patient's skin than traditional photon therapy, especially when a range shifter (RS) is inserted in the beam path. This study investigated the effects of an RS on skin dose while considering RS with different thicknesses, airgaps and materials. First, the physical model of the scanning nozzle with RS was established in the TOol for PArticle Simulation (TOPAS) code, and the effects of the RS on the skin dose were studied. Second, the variations in the skin dose and isocenter beam size were examined by reducing the air gap. Finally, the effects of different RS materials, such as polymethylmethacrylate (PMMA), Lexan, polyethylene and polystyrene, on the skin dose were analysed. The results demonstrated that the current RS design had a negligible effect on the skin dose, whereas the RS significantly impacted the isocenter beam size. The skin dose was increased considerably when the RS was placed close to the phantom. Moreover, the magnitude of the increase was related to the thickness of the inserted RS. Meanwhile, the results also revealed that the secondary proton primarily contributed to the increased skin dose.

• Nuclear Engineering and Technology
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• v.49 no.7
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• pp.1495-1504
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• 2017

In a previous study, a set of polygon-mesh (PM)-based skin models including a $50-{\mu}m-thick$ radiosensitive target layer were constructed and used to calculate skin dose coefficients (DCs) for idealized external beams of electrons. The results showed that the calculated skin DCs were significantly different from the International Commission on Radiological Protection (ICRP) Publication 116 skin DCs calculated using voxel-type ICRP reference phantoms that do not include the thin target layer. The difference was as large as 7,700 times for electron energies less than 1 MeV, which raises a significant issue that should be addressed subsequently. In the present study, therefore, as an extension of the initial, previous study, skin DCs for three other particles (photons, protons, and helium ions) were calculated by using the PM-based skin models and the calculated values were compared with the ICRP-116 skin DCs. The analysis of our results showed that for the photon exposures, the calculated values were generally in good agreement with the ICRP-116 values. For the charged particles, by contrast, there was a significant difference between the PM-model-calculated skin DCs and the ICRP-116 values. Specifically, the ICRP-116 skin DCs were smaller than those calculated by the PM models-which is to say that they were under-estimated-by up to ~16 times for both protons and helium ions. These differences in skin dose also significantly affected the calculation of the effective dose (E) values, which is reasonable, considering that the skin dose is the major factor determining effective dose calculation for charged particles. The results of the current study generally show that the ICRP-116 DCs for skin dose and effective dose are not reliable for charged particles.

• The Journal of the Korea Contents Association
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• v.12 no.6
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• pp.346-352
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• 2012

Radiation dose estimation on the newborn and infants during radiation examinations, unlike for the adults, is not actively being progressed. Therefore, as an index to present exposure dose during radiation examinations on newborn and infants, entrance skin dose was measured, and the result was compared with results of monte carlo simulation to raise reproducibility of entrance skin dose measurement, and it was proved that various geometry implementation was possible. The resulting values through monte carlo simulation was estimated using normalization factors for entrance skin dose to calibrate radiation dose and then normalized to a unit X ray radiation field size. Average entrance skin dose per one time exposure was $78.41{\mu}Gy$ and the percentage error between measurement by dosimeter and by monte carlo simulation was found to be -4.77%. Entrance skin dose assessment by monte carlo simulation provides possible alternative method in difficult entrance skin dose estimation for the newborn and infants who visit hospital for actual diagnosis.

• Progress in Medical Physics
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• v.18 no.3
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• pp.167-171
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• 2007

In the case of radiotherapy following breast conservation therapy for breast cancer patients, the characteristic of skin dose was investigated in the treatment of intensity modulated radiation therapy (IMRT) for breast cancer patients by comparing and analysing entrance skin dose irradiated during radiotherapy using tangential technique radiotherpy, and IMRT. The calculation dose irradiated to breast skin was compared with TLD measurement dose in treatment planning by performing the two methods of radiotherapy using tangential technique, and IMRT in treatment planning equipment. The skin absorbed dose was measured to pass a nipple by spacing of 1 cm distance from center to edge of body. In the radiotherapy of tangential technique, for the irradiation of 180 cGy to PTV, the calculation dose was ranged from 103.5 cGy to 155.2 cGy, measurement dose was ranged from 107.5 cGy to 156.2 cGy, and skin dose in the center was maximum 1.45 times more irradiated than that in the edge. In the IMRT, for the irradiation of 180 cGy to PTV, the calculation dose was ranged 9.8 cGy at 80.2 cGy, measurement dose was ranged 8.9 cGy at 77.2 cGy, and skin dose in the center was maximum 0.23 times less irradiated than that in the edge. IMRT was more effective for skin radiation risks because radiation dose irradiated to skin in IMRT was much less than that in radiotherapy of tangential field technique.

• Radiation Oncology Journal
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• v.14 no.4
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• pp.339-345
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• 1996

Purpose : This study was performed for adequate irradiating tumor area when 6 MV linear accerelator photon was used to treat the head and neck tumor. The skin surface dose and maximum build-up region was measured by using a spoiler which was located between skin surface and collimator. Methods : A spoiler was made of tissue equivalent material and the skin surface dose and maximum build-up region was measured varing with field size, thickness of spoiler and interval between skin and collimator. The results of skin surface dose and maximum build-up dose was represented as a build-up ratio and it was compared with dose distribution by using a bolus. Results : The skin surface dose was increased with appling spoiler and decreased by distance of the skin-spoiler separation. The maxium build-up region was 1.5 cm below the skin surface and it was markedly decreased near the skin surface. By using a 1.0-cm thickness spoiler, Dmax moved to 5, 10.2, 12.3 13.9 and 14.8 mm from the skin surface by separation of the spoiler from the skin 0, 5, 10, 15. 20 cm, respectively. Conclusion : The skin surface dose was increased and maximum build-up region was moved to the surface by using a spoiler. Therefore spoiler was useful in treating by high energy photon in the head and neck tumor.

• Progress in Medical Physics
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• v.30 no.1
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• pp.1-6
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• 2019

Purpose: This study conducts a comparative evaluation of the skin dose in CyberKnife (CK) and Helical Tomotherapy (HT) to predict the accurate dose of radiation and minimize skin burns in head-and-neck stereotactic body radiotherapy. Materials and Methods: Arbitrarily-defined planning target volume (PTV) close to the skin was drawn on the planning computed tomography acquired from a head-and-neck phantom with 19 optically stimulated luminescent dosimeters (OSLDs) attached to the surface (3 OSLDs were positioned at the skin close to PTV and 16 OSLDs were near sideburns and forehead, away from PTV). The calculation doses were obtained from the MultiPlan 5.1.2 treatment planning system using raytracing (RT), finite size pencil beam (FSPB), and Monte Carlo (MC) algorithms for CK. For HT, the skin dose was estimated via convolution superposition (CS) algorithm from the Tomotherapy planning station 5.0.2.5. The prescribed dose was 8 Gy for 95% coverage of the PTV. Results and Conclusions: The mean differences between calculation and measurement values were $-1.2{\pm}3.1%$, $2.5{\pm}7.9%$, $-2.8{\pm}3.8%$, $-6.6{\pm}8.8%$, and $-1.4{\pm}1.8%$ in CS, RT, RT with contour correction (CC), FSPB, and MC, respectively. FSPB showed a dose error comparable to RT. CS and RT with CC led to a small error as compared to FSPB and RT. Considering OSLDs close to PTV, MC minimized the uncertainty of skin dose as compared to other algorithms.

• The Journal of Korean Society for Radiation Therapy
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• v.7 no.1
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• pp.176-184
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• 1995

It is very useful benefits to use the megavoltage photon beams in deep site tumor radiotherapy for skin sparing effects. But, In some cases of head and mock tumors, it is often necessary to use spoiler for rapid buildup on skin region. A spoiler with tissue equivalent material to be moved between the patients and the collimator can increase or control the skin dose and buildup region due to position and thickness of the spoiler was measured. Then, the effect of spoiler on skin dose and build up region in protruded tumor of head and neck was evaluated quantitatively. The measurements were abtained with PTW 2334 chamber (Markus type) on a polystylene phantom for 6MV x-ray from an accelerator.

• Imaging Science in Dentistry
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• v.35 no.4
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• pp.203-205
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• 2005

Purpose: This study was aimed to compare skin entrance dose of digital radiography with that of film radiography and to show the dose reduction achievement with digital systems at 11 dental schools in Korea. Materials and Methods: Forty six intraoral radiographic systems in 11 dental schools were included in this study. Digital sensors were used in 33 systems and film was used in 13 systems. Researchers and the volunteer visited 11 dental schools in Korea. Researchers asked the radiologic technician (s) at each school to set the exposure parameters and aiming the x-ray tube for the periapical view of the mandibular molar of the volunteer. The skin entrance doses were measured at the same exposure parameters and distance by the technician for each system with a dosimeter (Multi-O-Meter : Unfors instruments, Billdal, Sweden). Results: The median dose was $491.2{\mu}Gy$ for digital radiography and $1,205.0{\mu}Gy$ for film radiography. The skin entrance dose in digital radiography was significantly lower than that of film radiography (p<0.05). Conclusion: Fifty-nine percent skin entrance dose reduction with digital periapical radiography was achieved over the film radiography in Korean dental schools.

• The Journal of Korean Society for Radiation Therapy
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• v.33
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• pp.55-62
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• 2021

Purpose: This study aims to contribute to the reduction of complications of breast cancer radiation therapy by analyzing skin dose differences due to Set-up error. Materials and Method: Pseudo breast was produced using a 3D printer, applied to the phantom, and images were acquired through CT. Treatment plan was carried out that the PTV, which contains 95% of the prescription dose, could be more than 95% of the volume, so that Dmax did not exceed 107% of the prescription dose. The Set-up error was evaluated by applying ±1mm/±3mm/±5mm to the X-axis, Y-axis, and Z-axis. Results: The dose-variation in skin due to Set-up error was approximately 106% to 123% compared to prescription dose, and the highest dose in skin was 49.24 Gy at 5mm Set-up error in the lateral direction of the X-axis. More than 107% of the prescription dose was the widest at 6.87 cc in skin lateral. Conclusions: If a Set-up error occurs during left breast cancer VMAT, a great difference in skin dose was shown in the lateral direction of the X-axis. If more effort is made to align the X-axis of the breast treated during CBCT registration, the dose-variation of skin will be reduced.