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"Telah dilakukan penelitian yang bertujuan untuk mengimplementasikan film Gafchromic XR-RV3 untuk verifikasi dosis radioterapi pada IMRT dan VMAT. Evaluasi dosis pada target ditentukan dengan meletakkan film Gafchromic XRRV3 dan EBT2 padqa slab fantom Rando Alderson. Percobaan dilakukan dengan menggunakan Varian Clinac Trilogy, Inc. Proses simulasi terlebih dahulu dilakukan pada fantom Rando Alderson bagian thorax dan pelvis di CT simulator Phillips, Inc. Dua kasus perencanaan IMRT dan VMAT dibuat menggunakan TPS Eclipse ver. 10. Film Gafchromic yang telah dipapar kemudian dipindai menggunakan scanner Epson Perfection V700 ke dalam format tagged image file (.TIFF) dengan 72 dpi dan RGB 48 bit yang kemudian dianalisis menggunakan algoritma in-house yang telah dikembangkan oleh penelitian sebelumnya. Dalam penelitian ini dilakukan perbandingan pengukuran distribusi dosis pada film Gafchromic XR-RV3 dan EBT2 untuk mendapatkan dosis rata-rata dalam bentuk kurva histogram. Hasil penelitian ini memiliki persentase kesalahan terhadap dosis preskripsi pada kasus kanker prostat sebesar -4.85% pada film Gafchromic EBT2 dan -1.94% pada film Gafchromic XR-RV3 dengan teknik penyinaran IMRT, sedangkan untuk teknik penyinaran VMAT sebesar -4.48% pada film Gafchromic EBT2 dan -7.47% pada film Gafchromic XR-RV3. Di sisi lain, persentase kesalahan terhadap dosis preskripsi pada kasus kanker paru-paru dengan teknik penyinaran IMRT adalah 14.47% pada film Gafchromic EBT2 dan -4.37% pada film Gafchromic XR-RV3, sedangkan untuk teknik penyinaran VMAT sebesar 51.64% pada film Gafchromic EBT2 dan -28.07% pada film Gafchromic XR-RV3.

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The research aims to implement Gafchromic XR-RV3 films in order to verify the dose of radiotherapy on IMRT and VMAT. The evaluation of targeted dose is determined by putting films of Gafchromic XR-RV3 and EBT2 on Rando Alderson slab fantom. The experiment was performed with Varian Clinac Trilogy, Inc. The simulation process was initially conducted on thorax and pelvis on Phillips Inc.’s CT Simulator. Two cases of IMRT and VMAT plans were made using Eclipse TPS ver. 10. Exposed Gafchromic films then scanned using Epson Perfection V700 into (.TIF) format in 72 dpi and RGB 48 bit which was analyzed by in-house algorithm that had been developed on a previous research. The comparison between EBT2 and XR-RV3 Gafchromic films were used to obtain average dose in the form of histogram curve. The percentage of errors in the case of prostate cancer toward the planned dose were -4.85% in EBT2 Gafchromic films and -1.94% in the XR-RV3 Gafchromic films on IMRT technique, whereas for VMAT were -4.48% on EBT2 Gafchromic films and -7.47% on XR-RV3 Gafchromic films. On the other hand, the percentage of errors in the case of lung cancer toward the planned dose with IMRT technique were 14.47% on EBT2 Gafchromic films and -4.37% on XR-RV3 Gafchromic films, while for VMAT were 51.64% on EBT2 Gafchromic films and -28.07% on XR-RV3 Gafchromic films."

"Penelitian ini bertujuan untuk mempelajari karakteristik dosimetri dari film gafchromic XR-RV3 yang memiliki sensitifitas terhadap rentang dosis 1 cGy hingga 30 Gy serta membandingkannya dengan film EBT2 dengan rentang dosis 1 cGy hingga 40 Gy untuk verifikasi dosis pada Radioterapi. Karakteristik film seperti respon terhadap dosis tinggi, pengaruh energi serta orientasi film menjadi fokus penelitian. Pengukuran dilakukan menggunakan energi Megavoltage x-rays (6 MV dan 10 MV), dan Cobalt 60 yang sudah dikalibrasi sesuai dengan protokol dosimetri IAEA TRS-398. Respon film pada masing-masing energi diukur pada rentang dosis 50 cGy hingga 10 Gy. Pemindaian pada masing-masing film menggunakan EPSON Perfection V700 flatbed scanner, mode transmisi untuk film EBT2 dan mode refleksi untuk film XR-RV3, 48 bit color, dan resolusi spasial 75 dpi. Data yang diperoleh dianalisa menggunakan software FilmQA Pro, ROI berukuran 3 x 3 cm2 pada bagian tengah dari film untuk memperoleh nilai pixel rata-rata. Untuk masing-masing nilai pixel yang diperoleh dari masing-masing film selanjutnya ditentukan nilai rata-rata net Optical Density (netOD). Respon bacaan film EBT2 dan XR-RV3 pada rentang energi yang berbeda menunjukkan pengaruh energi yang rendah dengan deviasi rata – rata sebesar ±1%. Hasil perbandingan karakteristik respon bacaan film EBT2 dan XR-RV3 untuk masing-masing modalitas energi berbeda menunjukkan deviasi sebesar ±3%. Pengujian respon bacaan film XR-RV3 pada sisi orientasi yang berbeda tidak menunjukkan perbedaan yang signifikan dengan deviasi rata – rata sebesar 0.2%. Hasil evaluasi profil berkas menggunakan film XR-RV3 menunjukkan jumlah noise (disturbance) yang lebih banyak dibandingkan dengan EBT2. Pengukuran nilai simetris dan kerataan berkas pada rentang energi Cobalt-60 menunjukkan penyimpangan yang cukup besar pada posisi film horizontal terhadap sumbu utama berkas yaitu diatas 30%. Pengujian sensitifitas respon bacaan film XR-RV3 pada dosis tinggi dan dosis rendah menunjukkan hasil yang lebih baik dibandingkan dengan film EBT2.

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The purpose of this study is to compare the dosimetry characterization of XR-RV3 film with its sensitivity to dose levels from 1 cGy to 30 Gy and EBT2 film with its sensitivity to dose levels from 1 cGy to 40 Gy for dose verification in radiation therapy. The characteristics of film such as response at high dose levels, energy dependence and side orientation dependence to scanner were the main focus of this study. The film response to each energy (foton 6 MV, 10 MV and Cobalt-60) was measured over the dose levels from 50 cGy to 10 Gy and the output source were calibrated following IAEA TRS-398 Dosimetry Protocol. Each film piece was scanned using EPSON Perfection V700 flatbed scanner, 48-bit color, 75 dpi spatial resolution, Transmission mode for EBT2 film and Reflection mode for XR-RV3 film. The data were analyzed using FilmQA Pro Software and for each scanned image, a ROI size 3 x 3 cm2 at the field center was selected to obtain the mean pixel value. Furthermore, the pixel value from each film were calculated to find the average of net Optical Density (netOD). From this study, the result revealed that there was no significant difference in characteristics response between XR-RV3 and EBT2 film with standar deviation of ±3%. The energy dependence of XR-RV3 and EBT2 film was found to be relatively small within measurement uncertainties ±1%. The dependence of XR-RV3 film side orientation is negligibly small with the standard deviation of 0.2%. The result of beam profile dosimetry evaluation using XR-RV3 showed more amount of noise or disturbance than EBT2 film. The measurement of beam symmetry and beam flatness on energy range of Cobalt-60, showed a significant error of film in horizontal position at central axis beam that was above 30%. In addition, the sensitivity of response XR-RV3 film at high and low dose shown better result than EBT2 film."

"Pada prosedur kardiologi intervensional pasien akan menerima radiasi primer berintensitas tinggi dari berkas utama sinar-X, sehingga dosis yang didapatkan cukup besar. Dengan demikian, perlu adanya studi distribusi dosis untuk melihat bagaimana penyebaran dosis pada organ-organ tubuh, dengan menggunakam film Gachromic XR-RV3 dan TLD 100 jenis rod yang telah diletakkan di dalam fantom Rando berbentuk manusia (wanita dewasa) sebagai pengganti pasien dengan parameter eksposi : kV rata-rata = 90 kV, laju frame = 15 fps, kuat arus = 6,2 mA dengan ukuran FPD = 15 cm x 15 cm. Distribusi laju dosis terbesar berada pada radius 0 cm sampai dengan 5 cm dari pusat lapangan, kemudian turun drastis pada radius 7,5 cm dan sudah tidak terdeteksi nilai laju dosis radius 10 cm. Untuk nilai laju dosis terbesar terdapat pada bagian pusat lapangan yaitu sebesar 6,345 ±0,097 mGy/min. Pada pengukuran laju dosis di beberapa Organ at Risk (OAR) dengan menggunakan Film Gafchromic XR-RV3 dan TLD 100 rod sebagai dosimeter didapatkan laju dosis pada Film Gachromic XR-RV3 dan TLD 100 rod dengan nilai terbesar terdapat pada organ jantung bagian tengah berturut-turut yaitu 2,742±0.029 mGy/min dan 2,791±0.161 mGy/min. Perbedaan nilai laju dosis antara Film Gachromic XR-RV3 dengan TLD 100 rod berkisar antara 0,53 % sampai dengan 13,80%.

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In interventional cardiology procedures patients will receive primary radiation of high intensity X-rays beam, so that dose received by the patient is relatively high. Thus, the dose distribution studies needed to see how the spread of the dose to the organs of the body, using Gachromic XR - RV3 film and TLD 100 type rod that has been placed in phantom Rando (adult women) as a replacement for a patient with parameters: average kV = 90 kV, frame rate = 15 fps, electric currents = 6.2 mA with FPD size = 15 cm x 15 cm. The distribution of the largest dose rate is at a radius of 0 cm to 5 cm from the center of the field, then dropped away at a radius of 7.5 cm and had no detectable dose rate value at radius of 10 cm. For the largest dose rate values are at the center of the field is about 6.345 ± 0.097 mGy / min. In the measurement of the dose rate in some organs at risk ( OAR ) using Gafchromic XR - RV3 film and TLD 100 rod obtained dose rate at Gachromic XR-RV3 film and TLD 100 rod with the largest value found in the central part of the heart organ ie 0.029 ± 2.742 mGy / min and 2.791 ± 0.161 mGy / min, respectively. The difference between the value of the dose rate Gachromic XR-RV3 film with TLD 100 rod ranged from 0.53% to 13.80%."

"[ABSTRAKDosimeter film Radiochromic XR-RV3 merupakan salah satu tipe dosimeter yangdapat digunakan untuk mengukur dosis pasien pada prosedur kateterisasi jantungdengan fluoroskopi sebagai pemandu. Namun, perlu dipastikan pengaruhkeberadaan film Radiochromic XR-RV3 terhadap kualitas citra. Penelitian inimenggunakan fantom Kat Ped sebagai representasi jantung dewasa danmembandingkan secara kuantitatif kualitas citra fantom yang dieksposi denganmenggunakan film dan tanpa menggunakan film GafChromic XR-RV3. Kuantitasikualitas citra yang digunakan sebagai pembanding adalah Signal to noise ratio(SNR) dan resolusi kontras tinggi. Signal to noise ratio (SNR) yang diperolehdianalisa menggunakan statistik t-test dengan confidence level 95%. Hasil analisamenunjukkan tidak terdapat perbedaan SNR yang signifikan dengan menggunakanfilm dan tanpa menggunakan film pada mode fluoroskopi low dose, normal dosedan high dose dengan diskrepansi SNR <10%. Pada mode cine 15 fps low dan 15fps normal, terdapat kenaikan SNR dengan menggunakan film dengan diskrepansi<13% sedangkan pada mode cine 15 fps boost dan 25 fps coronary tidak terdapatperbedaan signifikan SNR dengan diskrepansi rerata < 7%. Pada high contrastanalisa t-test untuk kedua mode fluoroscopy dan Cine tidak menunjukkan adanyaperbedaan signifikan dengan hasil non rejected pada confidence level 95%.ABSTRACTRadiochromic XR-RV3 film dosimeter is a type of dosimeter that can be used tomeasure patient dose on cardiac catheterization procedure with fluoroscopy as aguide. However, it is necessary to ensure the effect of Radiochromic XR-RV3 filmto image quality. This study used a Kat Ped phantom as a representation of theadult heart and quantitatively compare the image quality by using a phantom thatexposed with film and without using film GafChromic XR-RV3. Quantitation ofimage quality used for comparison is the signal to noise ratio (SNR) and highcontrast resolution. Signal to noise ratio (SNR) obtained statistically analyzedusing t-test with 95% confidence level. The analysis results showed no significantdifference in SNR using film and without using film on a low dose mode, thenormal dose, and high dose flouroscopy with SNR discrepancy <10%. In the cinemode of 15 fps low and 15 fps normal, there is an increased SNR by using filmwith discrepancy <13%, while in the cine mode of 15 fps boost and 25 fpscoronary there are no significant differences with mean SNR discrepancy <7%. Athigh contrast t-test analysis for both Fluoroscopy and Cine mode, result showed nosignificant difference with the results of non-rejected at the 95 % confidence level., Radiochromic XR-RV3 film dosimeter is a type of dosimeter that can be used tomeasure patient dose on cardiac catheterization procedure with fluoroscopy as aguide. However, it is necessary to ensure the effect of Radiochromic XR-RV3 filmto image quality. This study used a Kat Ped phantom as a representation of theadult heart and quantitatively compare the image quality by using a phantom thatexposed with film and without using film GafChromic XR-RV3. Quantitation ofimage quality used for comparison is the signal to noise ratio (SNR) and highcontrast resolution. Signal to noise ratio (SNR) obtained statistically analyzedusing t-test with 95% confidence level. The analysis results showed no significantdifference in SNR using film and without using film on a low dose mode, thenormal dose, and high dose flouroscopy with SNR discrepancy <10%. In the cinemode of 15 fps low and 15 fps normal, there is an increased SNR by using filmwith discrepancy <13%, while in the cine mode of 15 fps boost and 25 fpscoronary there are no significant differences with mean SNR discrepancy <7%. Athigh contrast t-test analysis for both Fluoroscopy and Cine mode, result showed nosignificant difference with the results of non-rejected at the 95 % confidence level.]"

"Gerak tumor akibat pernapasan pasien merupakan masalah yang signifikan dalam pengobatan radioterapi kanker paru-paru, khususnya teknik radioterapi modern Intensity Modulated Radiotherapy (IMRT) dan Volumetric Modulated Arc Therapy (VMAT). Interaksi gerakan antara gerak target tumor dan MLC (interplay effect) memiliki keterbatasan dalam hal modulasi intensitas radiasi, probabilitasnya hanya sebagian kecil Planning Target Volume (PTV) menerima dosis radiasi sesuai perencanaan dosis Treatment Planning System (TPS) pada waktu tertentu.Penelitian ini melakukan verifikasi dosimetri antara dosis yang direncanakan TPS dan dosis yang diterima volume tumor, akibat adanya interplay effect pada teknik IMRT dan VMAT. Penelitian menggunakan fantom toraks dinamik in-house dengan target tumor bergerak translasi arah superior-inferior dengan variasi amplitudo dan periode gerak tumor sebesar 9,3 mm dan 2,3 sekon, 20 mm dan 3,44 sekon, 30 mm dan 4,22 sekon. Pengukuran dosis titik dengan meletakkan dosimeter TLD-100 LiF:Mg,Ti dan Film Gafchromic EBT2 pada titik tengah target tumor dan organ at risk spinal cord. Penyinaran teknik IMRT menggunakan 7-field dan teknik VMAT menggunakan Rapidarc partial double arc dengan dosis preskripsi (95%) sebesar 200 cGy per fraksi.Hasil penelitian menunjukkan bahwa kehadiran gerak target tumor paru-paru menyebabkan efek dosimetri yang tidak diinginkan berupa underdosage dalam volume tumor. Deviasi dosis rata-rata pada target tumor antara perencanaan dosis TPS dan hasil pengukuran pada teknik IMRT dengan target tumor bergerak statis, bergerak 9,3 mm, bergerak 20 mm, bergerak 30 mm berturut-turut sebesar 0,3% sampai 0,5%, -2,7% sampai -3,0%, -3,7% sampai -4,6%, dan -6,0% sampai -6,6%, sedangkan deviasi dosis pada teknik VMAT berturut-turut sebesar 0,2% sampai 0,9%, -1,6% sampai -1,9%, -2,9% sampai -3,1%, dan -5,0% sampai -5,3%. Hal berbeda, deviasi dosis untuk organ at risk spinal cord pada teknik IMRT berturutturut sebesar -5,6% sampai -1,0%, -6,8% sampai -6,9%, -3,7% sampai -5,9%, dan 0,7% sampai 1,0%, sedangkan deviasi dosis pada teknik VMAT berturut-turut sebesar -1,4% sampai -3,1%, -3,0% sampai -6,3%, -1,6% sampai -4,2%, dan 0,1% sampai 0,9%. Kenaikan amplitudo gerak target tumor menyebabkan dosis yang diterima volume tumor menurun. Namun sebaliknya, adanya kenaikan amplitudo gerak target tumor menyebabkan dosis yang diterima organ at risk spinal cord meningkat.

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Tumor motion due to patient's respiratory is a significant problem in radiotherapy treatment of lung cancer, especially in modern radiotherapy treatment of Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT). The interplay effect is the effect that may occur as the motion of Linac (primarily the MLC) and motion of the tumor target interferes. At delivery dose treatment, a small part of Planning Target Volume (PTV) does not recover dose according to Treatment Planning System (TPS) Prescription.

This investigation was carried out through dosimetry verification between TPS and actual dose by tumor volume due to the interplay effect in IMRT and VMAT treatment. Tumor target of in-house dynamic thorax phantom was designed in linier sinusoidal motion toward superior-inferior direction with amplitude and period variation of tumor motion of 9,3 mm and 2,3s, 20 mm and 3,44s, 30 mm and 4,22s respectively. For point dose measurement, TLD-100 LiF:Mg,Ti and gafchromic EBT2 film detectors were took placed at midpoint of tumor target and spinal cord. IMRT treatment irradiation was applied by 7-fields and VMAT treatment by partial double arc, with prescription dose (95%) of 200 cGy per fraction.

The results showed that the occurrence of lung tumor target motion causes underdosage dosimetry effect in tumor volume. Mean dose deviation of tumor target between TPS and measurement in IMRT treatment by tumor target moves at condition of static, 9,3 mm, 20 mm and 30 mm were 0,3% to 0,5%, -2,7% to -3,0%, -3,7% to -4,6%, and -6,0% to -6,6% respectively while dose deviation in VMAT treatment were 0,2% to 0,9%, -1,6% to -1,9%, -2,9% to -3,1%, and -5,0% to -5,3% respectively. On the other hand, mean dose deviation of spinal cord in IMRT treatment were -5,6% to -1,0%, -6,8% to -6,9%, -3,7% to -5,9%, and 0,7% to 1,0% respectively and in VMAT treatment were -1,4% to -3,1%, -3,0% to -6,3%, -1,6% to -4,2%, and 0,1% to 0,9% respectively. The increment amplitude of tumor target motion reduced dose received by tumor volume and conversely, increased dose received by spinal cord."

"ABSTRAKTujuan penelitian ini mengevaluasi perencanaan terapi radiasi kasus nasofaring dengan teknik Intensity Modulated Radiation Therapy IMRT dan Volumetric Modulated Arc Therapy VMAT menggunakan algoritma Analytical Anisotropic Algorithm AAA dan Acuros External Beam AXB versi 13.0.01. Penelitian dibagi menjadi tiga yaitu 1 analisa dose volume histogram DVH di TPS, 2 verifikasi dosis fantom slab memakai film Gafchromic EBT3 dan bilik ionisasi CC13, dan 3 verifikasi fantom rando memakai film Gafchromic EBT3 dan Thermoluniscence Dosimeter TLD . Analisa DVH menghasilkan penyimpangan AXBDm dan AXBDw terhadap AAA pada PTVtulang sebesar -1.5 dan 2.0 , sedangkan pada organ sehat inner ear dan mandibula penyimpangan AXBDm dan AXBDw sebesar 8 . Conformity index AXBDm untuk IMRT dan VMAT adalah 0.58 dan 0.61, sedangkan homogeneity index AAA adalah 0.06 dan 0.05. Deviasi pengukuran dengan slab homogen dan inhomogen menunjukkan Acuros lebih kecil bacaan deviasinya dibandingkan AAA, dengan nilai deviasi 0.10 - 7.78 . Verifikasi dosis titik dengan fantom rando menunjukkan hasil yang acak, nilai deviasi menunjukkan pola yang tidak bisa diprediksi terhadap algoritma mana yang akan menghasilkan deviasi lebih kecil. Pengukuran nilai gamma dengan kriteria 7 /4mm dihasilkan passing rate gamma index untuk IMRT pada AAA, AXBDm, dan AXBDw sebesar 52.7 , 90.7 , dan 63.66 , sedangkan VMAT sebesar 61.51 , 90.09, dan 92.67 .

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ABSTRACTThe purpose of this study to evaluate the radiation therapy planning techniques nasopharyngeal case with Intensity Modulated Radiation Therapy IMRT and Volumetric Modulated Arc Therapy VMAT using algorithm Anisotropic Analytical Algorithm AAA and Acuros External Beam AXB version 13.0.01. The study was divided into three 1 the analysis of dose volume histogram DVH at TPS, 2 verification dose in slab phantom using film Gafchromic EBT3 and ionization chamber CC13, and 3 verification dose in rando phantom use film Gafchromic EBT3 and Thermoluminiscence Dosimeter TLD . DVH analysis resulted in deviations AXBDm and AXBDw to AAA on PTVbone amount 1.5 and 2.0 , whereas in healthy organs mandibula and inner ear and deviation of AXBDm to AXBDw up to 8 . Conformity index AXBDm for IMRT and VMAT is 0.58 and 0.61, while AAA homogeneity index is 0.06 and 0.05. Deviation measurements with homogeneous slab and inhomogen Acuros readings indicate the deviation compared to AAA, with a deviation 0 10 7.78 . . Point dose verification with fantom rando shows random results. Gamma value measurement criteria of 7 4mm generated gamma passing rate index for IMRT for AAA, AXBDm, and AXBDw was.7 , 90.7 and 63.66 , while VMAT was 61.51 , 90.09, and 92.67 ."

"Penelitian ini bertujuan untuk memverifikasi dosis radiasi radioterapi pada kasus kanker payudara dan kanker nasofaring (KNF). Percobaan dilakukan dengan menggunakan Linac Varian Trilogy radiasi foton berenergi 6 MV. Detektor yang digunakan dalam penelitian ini adalah film gafchromic, MatriXX 2D array, TLD, dan EPID. Film gafchromic dan TLD ditempatkan dalam phantom rando untuk mengevaluasi distribusi dosis pada volume target, sedangkan untuk mendapatkan hasil registrasi film gafchromic dan MatriXX 2D array ditempatkan dalam Multi Cube, dan dilakukan juga penyinaran pada EPID. Hasil perbedaan distribusi dosis teknik IMRT dan VMAT antara film dengan dosis preskripsi TPS pada KNF PTV70 adalah 6,87% dan 8,55%, pada KNF PTV50 adalah 14,43% dan 4,65%, sedangkan pada kanker payudara 11,98% dan 12,10%. Perbedaan nilai dosis antara TLD dengan dosis preskripsi TPS teknik IMRT dan VMAT pada KNF PTV50 sebesar 1,76% dan 1,60%, dan pada kanker payudara sebesar 7,06% dan 3,36%. Selisih perbedaan nilai gamma indeks teknik IMRT dan VMAT pada KNF sebesar -0,09% dan -1,65% antara film dan MatriXX, dan 5,13% dan 1,43% antara film dengan EPID. Pada kanker payudara selisih perbedaan nilai gamma indeks teknik IMRT dan VMAT sebesar 0,51% dan 0,19% antara film dengan MatriXX, dan 2,28% dan 4,38% antara film dengan EPID. Verifikasi dosis radioterapi dan registrasi citra pada kasus kanker payudara dan KNF dapat dilakukan menggunakan film gafchromic, TLD, MatriXX 2D array, dan EPID.

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This study was aimed to verify the radiation dose in the case of breast cancer and nasopharyngeal carcinoma (NPC). The experiments were performed using a Varian Trilogy Linac at 6 MV photon radiation and gafchromic films, Matrixx 2D Array, TLD, and EPID detectors. Gafchromic films and TLD were inserted into rando phantom to measures the dose on target volume and organ at risk. In order to evaluated the gamma index, gafchromic films and Matrixx 2D array were placed in the Multi Cube, and was irradiated with EPID in position. Results of the dose distribution differences on IMRT and VMAT between film and TPS on NPC PTV70 was 6.87% and 8.55%, the NPC PTV50 was 14.43% and 4.65%, and for breast cancer was 11,98% and 12,10%. The dose differences between TLD and TPS on IMRT and VMAT for NPC PTV50 was 1.76% and 1.60%, and the breast cancer was 7.06% and 3.36%. Gamma index differences on IMRT and VMAT technique on NPC was -0.09% and -1.65% between film and MatriXX, and 5.13% and 1.43% between films and EPID. In breast cancer the gamma index differences on IMRT and VMAT was 0.51% and 0.19% between films and MatriXX, and 2.28% and 4.38% between films and EPID. Radiotherapy dose verification and image registration for breast cancer and NPC was done using gafchromic film, TLD, MatriXX 2D array, and EPID."

"ABSTRAKPenelitian ini bertujuan untuk memverifikasi distribusi dosis pada teknik 3D-CRT dan IMRT dengan menggunakan dosimeter TLD rod dan film gafchromic EBT3 pada kasus payudara yang telah dibuat di TPS berdasarkan data klinis di Siloam Hospital TB Simatupang. Penelitian ini dilakukan menggunakan Linac Trilogy dengan TPS menggunakan modul Eclipse versi 11 yang memproduksi berkas foton dengan radiasi 6 dan 10 MV. Film EBT3 dengan ukuran 4 4 cm2 diiradiasi menggunakan energi 6 MV dalam variasi dosis 0 - 260 cGy. Penelitian ini menggunakan lapangan radiasi 10 10 cm2. Film dipindai menggunakan flatbed scanner Epson V700 dalam evaluasi pixel value. Perhitungan dan plot antara netOD dan dosis untuk mendapatkan kurva kalibrasi yang digunakan untuk memperoleh dosis pengukuran pada pasien. TLD rod dengan ukuran 3 mm diiradiasi dengan energi 6 MV dalam dosis 200 cGy. TLD dibaca menggunakan TLD reader Harshaw dalam bentuk muatan coulomb. Perhitungan dan plot antara muatan dan dosis akan mendapatkan faktor kalibrasi yang digunakan untuk memperoleh dosis pengukuran pada pasien. TLD dan film EBT3 ditempelkan pada 5 titik di masker yang digunakan pasien dimana titik 1 daerah trakea, titik 2 daerah aksila, titik 3 daerah mammaria interna, titik 4 daerah nipple, dan titik 5 mammae inferior. Hasil perbedaan dosis menunjukkan penggunaan film gafchromic EBT3 pada verifikasi dosis titik kasus kanker payudara lebih baik daripada TLD rod pada teknik 3D-CRT dan teknik IMRT. Perbedaan dosis antara TPS dan film EBT3 dalam rentang 0,66 sampai dengan 5,67 teknik 3D-CRT dan -0,67 sampai dengan -7,57 teknik IMRT . Perbedaan dosis antara TPS dan TLD rod dalam rentang -2,63 sampai dengan 29,14 teknik 3D-CRT dan -16,41 sampai dengan -46,84 teknik IMRT . Uji statistika menunjukkan korelasi kuat 1,00 tetapi tidak signifikan sig < 0,05 serta terdapat perbedaan dosis titik rata-rata yang signifikan antara film EBT3 dan TLD rod pada kelompok pasien sebelum dan setelah dilakukan operasi. Tidak terdapat perbedaan dosis titik rata-rata antara kelompok sebelum dan setelah dilakukan operasi baik teknik 3D-CRT maupun IMRT dan tidak terdapat perbedaan dosis titik rata-rata antara teknik 3D-CRT dan IMRT.

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ABSTRACTThe aim of thisresearch is to verify dose distribution in 3D CRT and IMRT by using TLD rod dosimeter and Gafchromic EBT3 films on breast cases that have been made in TPS based on clinical data at Siloam Hospital TB Simatupang.This research was conducted using Linac Trilogy with TPS using Eclipse module version 11 which produces photon beam with radiation of 6 and 10 MV.EBT3 films of size 4 4 cm2 were irradiated using 6MV photon beams in dose variation of 0 260 cGy. Radiation field of size 10 10 cm2 was used in this research. The irradiated EBT3 film was scanned using Epson V700 flatbed scanner to evaluate the pixel value. The calculation and plot between netOD and dose was used to get the calibration curve which will be used to obtain dose measurement for patients. TLD rod of size 3 mm was irradiated using 6 MV in dose variation of 200 cGy. TLD was read by using HarshawTLD reader in coulomb. The calculation and plot between netOD and dose will generate calibration factor used to get dose measurement for patients. TLD and EBT3 film were taped to 5 points in the mask used by patients where 1 point is the OAR trachea and 4 points is the PTV50. The results of dose difference at PTV50 with point orientation.TLD and EBT3 film were taped to 5 points in the mask used by patients wherethe first point is in the OAR trachea , the second point is in the axilla, the third point is in the mammaria interna, the fourth point is in the nipple, and the fifth point is in the mammae inferior. The result of differences in dose shows the use of gafchromic EBT3 film in dose verification on breast cancer is better than TLD rod in 3D CRT technique and IMRT technique. The dose difference between TPS and EBT3 film ranged from 0.66 to 5.67 3D CRT technique and 0.67 to 7.57 IMRT technique . The dose difference between TPS and TLD rod is in the range 2.63 to 29.14 3D CRT technique and 16.41 up to 46.84 IMRT technique . The statistical test showed a strong correlation 1.00 but insignificant sig "

"[ABSTRAKFilm gafchromic EBT2 dan EBT3 cocok digunakan untuk jaminan kualitas (QA) pada treatment planning systems (TPS) dan linear accelerator (LINAC) serta verifikasi radioterapi teknik IMRT dan VMAT. Namun generasi selanjutnya dari film gafchromic EBT yaitu EBT2 dan EBT3 ketika dilakukan scanning (pemindaian) menggunakan scanner flatbed masih terdapat artefak geometris yang dahulunya juga ditemukan pada film EBT sehingga memerlukan penanggulangan dan koreksi yang sesuai. Pada penelitian ini menggunakan scanner flatbed Epson expression 10000XL, Epson perfection V700 dan Mikrotek 1000XL plus yang dapat menangkap warna dengan rinci dan presisi. Perangkat lunak yang digunakan dalam koreksi ini adalah FilmQA Pro 2015. Hasil yang diperoleh yaitu Koefisien A dan B diterapkan untuk variasi posisi lateral terhadap nilai tanggapan di lokasi yang bersamaan, sehingga pengkoreksian tanggapan artifak lateral dapat dilakukan. Pada dosis maksimum nilai koreksinya <0,5% dan pada kasus <0.2%. Pada pengukuran ulang untuk setiap film, standar deviasi yang diperoleh untuk setiap film sekitar 0.19%. Pengujian dosimetri channel tunggal (merah) sebelum dan sesudah koreksi pada kasus IMRT didapatkan hampir 91% dari piksel memenuhi 3% / 3mm kriteria gamma keseluruhan dengan ambang batas dosis > 10%. Untuk pengujian kasus VMAT, film di scan dengan posisi di pusat scanner dan posisi ektrim tepi scanner, maka pengukuran di channel warna merah 4% lebih tinggi dibandingkan channel warna hijau dan biru. Rata-rata konsistensi pengukuran dosis selama daerah terkena dosis > 100 cGy adalah sekitar 21,8 cGy dan di daerah yang paling dekat dengan tepi scan window sekitar 10 mm dengan perbedaan dosis 35 cGy. Setelah dilakukan koreksi, rata-rata konsistensi dosis pada tiga channel di sekitar daerah terpapar sekitar 5,1 cGy. Perbedaan dosis antar channel sekitar 9 cGy. Hasil ini menunjukkan koreksi respon artefak lateral memang perlu dilakukan. Respon yang diukur tergantung pada posisi film pada pemindai dan dosis yang diberikan. Pengukuran pada channel warna merah menunjukkan sensitivitas yang lebih besar pada dosis rendah, sedangkan respon pada channel hijau atau biru memberikan perpanjangan jangkauan dinamis dari film ke dosis tinggi. Metode triple-channel dosimetri telah terbukti memiliki keuntungan signifikan atas single channel dosimetry dengan akurasi dosimetri yang baik.

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ABSTRACT

The film of gafchromic EBT2 and EBT3 are appropriate for quality assurance (QA) to the radiotherapy technics verification of IMRT and VMAT. In the next generations of EBT which are EBT2 and EBT3, are still attained the geometrical artifacts once scanning by flatbed scanner which is used to be found on EBT film in order to need an overcome ways and an appropriate correction. This research used a flatbed scanner EPSON expression 10000XL, EPSON perfection V700 and Microtech 1000XL plus and FilmQA Pro 2015 as a software for correcting it. The result shows that coefficient A and B were applied for lateral correction artifacts responses can be made. On the maximum dose, it has correction value as much as <0,5% and in case was <0.2%. The deviation standard was approximately 0,19% on re-measure for each film. Prior to the dosimetry measurement of single channel (red) and subsequent to the correction IMRT has got almost 91% of pixel which met with gamma criteria, 3% / 3mm, with dose threshold 10% TH. In the measurement of VMAT‟s case, film scanned on the center of scanner and the extreme position of the scanner edge. Thus, measurement in the red channel was 4% higher than green and blue channel. The average of dose measurement consistency during area exposed to doses > 100 cGy is approximately 21,8 cGy and the closest area with the edge of scan window is around 10 mm at difference doses 35 cGy. After correction, the average of doses consistency was 5,1 cGy on the three channel where exposed. The distinction of doses was approximately 9 cGy among channels. This result stated that the correction of artifacts lateral response is needed to carry on. The method of triple-channel dosimetry has the significant advantage on single-channel dosimetry with a good consistency. Through escalation dose and variation of lateral position, the distinct response would be increased on single-channel which is red channel. The measurement on red channel reveals the highest sensitivity on the slight dose. Whereas, a green or blue channel response provides a dynamic range extension of film to a high dose. Thus, the method of dosimetry triple-channel has the significant contribution of single-channel evidently with a good dosimetric accuracy., The film of gafchromic EBT2 and EBT3 are appropriate for quality assurance (QA) to the radiotherapy technics verification of IMRT and VMAT. In the next generations of EBT which are EBT2 and EBT3, are still attained the geometrical artifacts once scanning by flatbed scanner which is used to be found on EBT film in order to need an overcome ways and an appropriate correction. This research used a flatbed scanner EPSON expression 10000XL, EPSON perfection V700 and Microtech 1000XL plus and FilmQA Pro 2015 as a software for correcting it. The result shows that coefficient A and B were applied for lateral correction artifacts responses can be made. On the maximum dose, it has correction value as much as <0,5% and in case was <0.2%. The deviation standard was approximately 0,19% on re-measure for each film. Prior to the dosimetry measurement of single channel (red) and subsequent to the correction IMRT has got almost 91% of pixel which met with gamma criteria, 3% / 3mm, with dose threshold 10% TH. In the measurement of VMAT‟s case, film scanned on the center of scanner and the extreme position of the scanner edge. Thus, measurement in the red channel was 4% higher than green and blue channel. The average of dose measurement consistency during area exposed to doses > 100 cGy is approximately 21,8 cGy and the closest area with the edge of scan window is around 10 mm at difference doses 35 cGy. After correction, the average of doses consistency was 5,1 cGy on the three channel where exposed. The distinction of doses was approximately 9 cGy among channels. This result stated that the correction of artifacts lateral response is needed to carry on. The method of triple-channel dosimetry has the significant advantage on single-channel dosimetry with a good consistency. Through escalation dose and variation of lateral position, the distinct response would be increased on single-channel which is red channel. The measurement on red channel reveals the highest sensitivity on the slight dose. Whereas, a green or blue channel response provides a dynamic range extension of film to a high dose. Thus, the method of dosimetry triple-channel has the significant contribution of single-channel evidently with a good dosimetric accuracy.]"