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"ABSTRAKDalam perencanaan terapi teknik lanjut telah diimplementasikan algoritma Anisotropic Analytical Algorithm AAA dan Acuros XB pada perencanaan terapi dengan teknik IMRT dan VMAT. Dalam penelitian ini dimaksudkan untuk memverifikasi simulasi perencanaan terapi dan pemberian dosis IMRT dan VMAT pada kasus kanker prostat dan kanker paru. Verifikasi dosis dilakukan dengan meletakkan TLD 100 LiF rod dan film Gafchromic EBT3 pada fantom Rando Alderson. Evaluasi dosis dilakukan dengan membandingkan analisis dosimetri PTV dan organ at risk menggunakan algoritma Anisotropic Analytical Algorithm AAA dan Acuros XB pada teknik IMRT dan VMAT. Dari hasil penelitian PTV pada kanker prostat algoritma Acuros XB memiliki kualitas perencanaan lebih baik dibandingkan Anisotropic Analytical Algorithm AAA sebesar 1 . Pola yang sama juga diperoleh organ at risk dengan algoritma terbaik diperoleh Acuros XB dengan penyimpangan rata-rata terbesar pada OAR femoral head sebesar 6 . Lebih lanjut PTV pada kanker paru kiri dan kanan memiliki penyimpangan rata-rata lebih kecil pada teknik VMAT. Sementara pada penggunaan algoritma Acuros XB memiliki kualitas perencanaan lebih baik dibandingkan Anisotropic Analytical Algorithm AAA sebesar 0,56 . Pada OAR kasus paru kiri dan kanan tidak terdapat perbedaan yang signifikan dari penggunaan algortima Acuros XB dan Anisotropic Analytical Algorithm AAA dengan rentang deviasi terbesar diperoleh jantung 9.

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ABSTRACTIn the planning of advanced engineering therapy has been implemented Anisotropic Analytical Algorithm AAA and Acuros XB algorithms on therapy planning with IMRT and VMAT techniques. In this study intended to verify the simulation of therapy planning and dosage of IMRT and VMAT in cases of prostate cancer and lung cancer. Dose verification is done by placing TLD 100 LiF rod and Gafchromic EBT3 film on fantom Rando Alderson. Dose evaluation was done by comparing dosimetry analysis of PTV and organ at risk using Anisotropic Analytical Algorithm AAA and Acuros XB algorithm on IMRT and VMAT techniques. From the results of research PTV on prostate cancer algorithm Acuros XB has better planning quality than Anisotropic Analytical Algorithm AAA of 1 . The same pattern is also obtained by the organ at risk with the best algorithm obtained by Acuros XB with the largest mean deviation on femoral head OAR of 6 . Furthermore, PTV in left and right lung cancer has a smaller mean deviation in VMAT technique. While the use of Acuros XB algorithm has better planning quality than Anisotropic Analytical Algorithm AAA of 0.56 . In the left and right lung OAR cases there was no significant difference from the use of the Acuros XB algorithm and the Anisotropic Analytical Algorithm AAA with the largest deviation range obtained by heart 9 . "

"[ABSTRAKTelah dilakukan verifikasi dosis organ target dan jaringan sehat di sekitar target dengan menempatkan TLD Rod LiF100 dan film Gafchromic EBT2 di lubang slab bagian pelvis dari phantom Rando Alderson untuk simulasi kanker prostat. TLD dievaluasi menggunakan TLD Reader Harshaw, sementara Film Gafchromic EBT2 dipindai menggunakan scanner Epson Perfection V700 dengan mode transmisi, red channel dan resolusi 72 dpi. Pengukuran dosis titik dilakukan dengan membandingkan antara dosis yang direncanakan TPS Eclipse ver. 11 dan dosis yang diukur pada target organ target dan organ beresiko menggunakan teknik IMRT dan VMAT. Hasilnya adalah deviasi dosis pada organ target menggunakan teknik IMRT dan VMAT adalah kurang dari 5%. Demikian pula, deviasi dosis pada bladder dan rectum untuk kedua teknik juga kurang dari 5% karena posisinya sangat dekat dengan target volume. Di sisi lain, deviasi dosis di femoral head lebih dari 5% untuk kedua teknik karena lokasinya pada gradien dosis rendah. Selanjutnya, deviasi dosis organ target untuk teknik IMRT cenderung lebih kecil dari teknik VMAT baik untuk TLD dan Film. Perbedaan dosis pada dosis titik organ target antara IMRT dan VMAT kurang dari 1% tetapi terjadi pada dosis yang random untuk organ beresiko. Adapun dosis permukaan pada teknik IMRT cenderung lebih kecil dari teknik VMAT jika kita menggunakan TLD, tetapi dosis pada film EBT2 cenderung sama antara teknik IMRT dan VMAT.

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ABSTRACTHave been done the dose verification of the target and healthy tissues around by placing the TLD Rod LiF100 and EBT2 Gafchromic film at slab hole of pelvic part of the Alderson Rando phantom for prostate cancer simulation. The Exposed TLDs was evaluated using the TLD Reader Harshaw, while Gafchromic Film EBT2 was scanned using Epson Perfection V700 scanner with transmission mode, red channel and resolution 72 dpi. The point dose measurements were compared between planned dose TPS Eclipse ver. 11 and measured dose at target volume organ and organ at risk for IMRT and VMAT techniques. The result is the dose difference at target volume for IMRT and VMAT are less than 5%. Similarly, the dose difference at Bladder and Rectum for both techniques are also less than 5% due to the position of OAR is very close to target volume. On the other hand, the dose difference at Femoral head are more than 5% for both techniques because the location of OAR already in low gradient dose. Furthermore, the difference dose of the target volume for IMRT technique is tends to be smaller than VMAT either for TLD and film detectors. The dose difference at point dose of target volume between IMRT and VMAT techniqe are less than 1% but it occur in random number for organ at risk. More over, the surface dose of IMRT tend to be smaller than VMAT dose if we are using TLDs, but the dose of EBT2 films tend to be similar between IMRT and VMAT techniques, Have been done the dose verification of the target and healthy tissues around by placing the TLD Rod LiF100 and EBT2 Gafchromic film at slab hole of pelvic part of the Alderson Rando phantom for prostate cancer simulation. The Exposed TLDs was evaluated using the TLD Reader Harshaw, while Gafchromic Film EBT2 was scanned using Epson Perfection V700 scanner with transmission mode, red channel and resolution 72 dpi. The point dose measurements were compared between planned dose TPS Eclipse ver. 11 and measured dose at target volume organ and organ at risk for IMRT and VMAT techniques. The result is the dose difference at target volume for IMRT and VMAT are less than 5%. Similarly, the dose difference at Bladder and Rectum for both techniques are also less than 5% due to the position of OAR is very close to target volume. On the other hand, the dose difference at Femoral head are more than 5% for both techniques because the location of OAR already in low gradient dose. Furthermore, the difference dose of the target volume for IMRT technique is tends to be smaller than VMAT either for TLD and film detectors. The dose difference at point dose of target volume between IMRT and VMAT techniqe are less than 1% but it occur in random number for organ at risk. More over, the surface dose of IMRT tend to be smaller than VMAT dose if we are using TLDs, but the dose of EBT2 films tend to be similar between IMRT and VMAT techniques]"

"ABSTRACTNilai indeks gamma yang dihasilkan antara satu perencanaan dengan perencanaan lainnya berbeda. Perbedaan ini mungkin dipengaruhi oleh banyak hal seperti detektor yang digunakan, kasus kanker yang berbeda, dll. Akan tetapi, terdapat passing criteria yang direkomendasikan oleh AAPM TG 119, sehingga seharusnya nilai indeks gamma tidak akan bernilai jauh dari passing criteria yang telah direkomendasikan. Oleh karena itu, pada penelitian ini akan dilakukan evaluasi konsistensi verifikasi yang dilakukan di RS MRCCC Siloam Hospital Semanggi dengan cara melihat perbedaan nilai rata-rata indeks gamma setiap tahunnya selama 8 tahun sejak tahun 2011-2018. Uji statistika juga dilakukan untuk menganalisis perbedaan dan pengaruh antara detektor yang berbeda, kasus kanker yang berbeda, serta teknik penyinaran yang berbeda terhadap nilai indeks gamma yang dihasilkan. Peralatan yang digunakan dalam penelitian ini adalah Pesawat LINAC Varian Clinac iX dengan TPS Eclipse versi 8.6-13, detektor 2D array bilik ionisasi MatriXXEvolution , EPID serta software Portal Dosimetry, Omni Pro I rsquo;mRT dan SPSS. Secara umum, metode penelitian dibagi menjadi beberapa tahap yaitu : pencatatan data pasien, verifikasi perencanaan, evaluasi indeks gamma, uji statistika dan analisis. Uji statistika yang digunakan merupakan uji Kruskal-Wallis, Mann-Whitney dan Wilcoxon. Uji Kruskal Wallis digunakan untuk melihat perbedaan rata-rata nilai indeks gamma setiap tahunnya. Uji Mann Whitney digunakan untuk melihat perbedaan rata-rata nilai indeks gamma antara kanker otak dan kanker prostat serta melihat perbedaan rata-rata nilai indeks gamma yang dihasilkan antara teknik IMRT dan VMAT. Uji Wilcoxon digunakan untuk melihat perbedaan rata-rata nilai indeks gamma detektor MatriXX dan EPID. Hasil penelitian menunjukkan perbedaan yang signifikan secara statistika pada nilai rata-rata indeks gamma antara dua detektor, dua teknik IMRT dan VMAT, serta antara dua kasus kanker yang berbeda, sedangkan nilai rata-rata indeks gamma per tahun tidak signifikan secara statistika. Secara keseluruhan, nilai rata-rata indeks gamma setiap tahunnya konsisten. Oleh karena itu, disimpulkan bahwa verifikasi yang dilakukan di RS MRCCC Siloam selama 8 tahun konsisten secara statistika.

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ABSTRACTThe gamma index value generated between one plan and another is normally different. This can be affected by many factors such as the usage of different detectors, different type of cancer cases, etc. However, there is certain passing criteria recommended by AAPM TG 119, thus the gamma index value ideally should not be much far from the recommended passing criteria. Therefore, this study will evaluate the verification consistency conducted at MRCCC Siloam Hospital Semanggi by looking at the difference between the mean value of gamma index every year for 8 years since 2011 2018. Statistical tests were also performed to analyze differences and effects between different detectors, different cancer cases, and different irradiation techniques on the resulting gamma index values. The equipment used in this research was LINAC Varian Clinac iX with TPS Eclipse version 8.6 13, 2D detector MatrixEvolution ionization array, EPID and Dosimetry Portal software, Omni Pro I 39 mRT and SPSS. In general, the study method is divided into several stages patient data recording, planning verification, gamma index evaluation, statistical test run, and analysis. The statistical test used is Kruskal Wallis, Mann Whitney and Wilcoxon test. The Kruskal Wallis test was used to see the average difference in the gamma index value annually. In addition, Mann Whitney test was used to see the difference in gamma index mean values between brain cancer and prostate cancer and to see the difference in gamma index mean values generated between IMRT and VMAT techniques. Furthermore, Wilcoxon test was used to see the difference in gamma index mean values of MatriXX and EPID detectors. The results showed statistically significant differences on the gamma index mean values between two detectors, two IMRT and VMAT techniques, and between two different cancer cases, while the difference between gamma index mean value per year was not statistically significant. Overall, the average value of the gamma index each year is consistent. Therefore, the verification performed at MRCCC Siloam Hospital for over 8 years is consistent statistically."

"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."

"Penelitian ini bertujuan untuk mengevaluasi penggunaan file log 20-Hz dengan Analytical Anisotropic Algorithm (AAA) dalam perhitungan dosis, dengan tujuan mengurangi beban kerja untuk Patient specific quality assurance (PSQA) dalam rutinitas klinis. Dalam penelitian ini, 19 rencana klinis kepala dan leher menggunakan VMAT dan 15 rencana klinis kepala dan leher menggunakan IMRT dipilih secara acak. Perangkat lunak perhitungan dosis yang digunakan adalah Eclipse, yang menggunakan AAA sebagai algoritma perhitungan dosis sekunder. Selain itu, perangkat lunak TPS Monaco juga digunakan dengan algoritma XVMC sebagai algoritma perhitungan dosis sekunder. File log 20-Hz diubah menjadi paket DICOM RT Plan dan dievaluasi menggunakan Eclipse dan Monaco sebagai sumber untuk on-treatment quality assurance. Evaluasi dilakukan terhadap beberapa metrik PTV (Dmean, D95%, dan D2%) antara RT Plan dan Log-file yang dievaluasi menggunakan kedua algoritma. Namun, untuk rencana IMRT, evaluasi hanya dilakukan menggunakan algoritma AAA. Hasil penelitian menunjukkan adanya korelasi yang kuat pada ketiga metrik PTV antara RT Plan dan Log-file Plan baik pada kasus IMRT maupun VMAT yang dievaluasi menggunakan algoritma AAA. Ketika menggunakan algoritma XVMC, korelasi pada metrik PTV menunjukkan hasil yang kuat namun dengan dua data pencilan . Analisis gamma dilakukan dengan parameter (2%/2mm/30%), (1%/1mm/30%), dan (3%/2mm/10%). Hasil evaluasi GPR pada IMRT menunjukkan hasil yang konsisten dan memenuhi semua kriteria. Hal ini didukung oleh analisis varians yang menunjukkan tidak adanya perbedaan signifikan antara nilai GPR pada ketiga kriteria. Namun, pada hasil evaluasi GPR VMAT, uji t menunjukkan adanya perbedaan signifikan pada satu kriteria, yaitu (1%/1mm/30%). Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa penggunaan file log 20-Hz dan algoritma AAA memiliki potensi untuk mengurangi pengukuran berbasis phantom sebagai metode Patient specific quality assurance (PSQA).

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This study aims to evaluate the use of 20-Hz log-files with the Analytical Anisotropic Algorithm (AAA) for dose calculations, with the goal of reducing the workload for Patient specific quality assurance (PSQA) in clinical routines. For this purpose, a total of 19 clinical head and neck VMAT plans and 15 clinical head and neck IMRT plans were randomly selected. The treatment planning system (TPS) used was Eclipse, which also served as the software for secondary dose calculation using AAA. In addition to Eclipse, the TPS Monaco was also used as software for secondary dose calculation using the XVMC algorithm. The 20-Hz log-files were converted into DICOM RT Plan packages and evaluated in Eclipse and Monaco as sources for on-treatment quality assurance. The evaluation involved comparing several PTV metrics (Dmean, D95%, and D2%) between the RT Plan and the Log-file evaluated with both algorithms. However, for the IMRT plans, the evaluation could only be performed with the AAA algorithm. The results showed a strong correlation in all three PTV metrics between the RT Plan and the Log-file Plan, both for IMRT and VMAT cases evaluated using the AAA algorithm. However, when comparing the PTV metrics using the XVMC algorithm, the results showed a strong correlation, except for two outlier data. Gamma analysis was performed using criteria of (2%/2mm/30%), (1%/1mm/30%), and (3%/2mm/10%). The GPR evaluation results for IMRT showed consistent passing rates for all criteria. This was supported by the analysis of variance, which indicated no significant differences between the GPR values for the three criteria. However, in the GPR evaluation of VMAT, the t-test indicated a significant difference in one criterion, namely (1%/1mm/30%). Therefore, the use of 20-Hz log-files and the AAA algorithm has the potential to reduce phantom-based measurements as part of Patient specific quality assurance (PSQA)."

"Penelitian ini bertujuan untuk membandingkan kualitas dari perencanaan terapi menggunakan conformity index (CI) dan homogeneity index (HI) pada kasus kanker paru-paru. Dengan menggunakan 5 pasien kanker paru-paru yang berada pada paru kanan. Dilakukan evaluasi pengaruh dari dose grid, kalibrasi densitas elektron berdasarkan fan beam dan cone beam CT. Hasil dari penelitian ini menunjukkan pasien dengan volume target berukuran besar memiliki kecenderungan CI yang rendah dan HI yang tinggi. Pada penggunaan variasi grid dose, nilai CI dan HI masing-masing kurang dari 0.02 dan 0.013. Perbedaan perhitungan antara cone beam dan fan beam adalah 10% untuk CI dan 60% untuk HI.

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This research aims to compare the quality of planning by using conformity index (CI) and homogeneity index (HI) for lung cancer cases. We used 5 lung cancer patients which is located in right lung. We evaluated the impact of dose grid, eletron density calibration based on fan beam and cone beam CT.

The results of shows the patient with big size target volume has tendency low CI value and high HI. On the use of grid dose variation, the CI and HI values less than 0.02 dan 0.013, respectively. The differences between the cone beam and fan beam calculation was 10% for CI and 60% for HI."

"ABSTRAKPenelitian yang telah dilakukan ini bertujuan untuk mengevaluasi dan menganalisis kesesuaian dosis teknik IMRT dan VMAT antara distribusi dosis pada TPS dengan distribusi dosis yang terukur oleh dosimeter film gafchromic EBT2, MatriXXEvolution dan EPID pada kasus kanker KNF, paru dan prostat. Percobaan dilakukan menggunakan Pesawat Linac Varian Rapid Arc dengan TPS Eclips yang dimiliki oleh Rumah Sakit MRCCC SHS. Pengolahan data dari ketiga dosimeter tersebut menggunakan software MATLAB, Omni Pro IMRT dan portal dosimetry. Untuk perbandingan dilakukan analisis data sekunder yang telah dilakukan oleh pihak RS MRCCC SHS. Hasil penelitian menunjukkan indeks gamma rata-rata data sekunder pasien masih dalam toleransi dengan nilai >90%. Hasil pengukuran menggunakan film EBT2, MatriXXEvolution dan EPID dengan kriteria gamma 3% / 3mm pada kasus kanker KNF, paru dan prostat menunjukan bahwa indeks gamma yang diperoleh melewati batas toleransi yang diizinkan yaitu lebih dari 90%. Selisih indeks gamma antara dosimetri film gafchromic, MatriXXEvolution dan EPID pada teknik VMAT dan IMRT tidak terlalu jauh, dengan rentang 0,01 – 5,36%. Perbedaan indeks gamma menunjukkan bahwa direkomendasikan pengukuran menggunakan detektor MatriXXEvolution daripada menggunakan film dosimetri EBT2 dan EPID. Selisih persentase rata-rata indek gamma pada teknik IMRT dan VMAT berada pada rentang 0,02 – 5,31%. Selisih antara hasil pengukuran dan data sekunder menggunakan MatriXXEvolution dengan hasil penelitian Miura et al. diperoleh dengan rentang 0 – 6%. Data penelitian ini sangat mendukung penelitian yang telah dilakukan sebelumnya oleh Hussein et al., (2013), Nalbant et al., (2014), Elawady et al, (2014), Pham (2013), Miura et al., (2014).

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ABSTRACTThe purpose of this research was to evaluate and analyze the compatibility dose IMRT and VMAT technique between the dose distribution in the TPS and the dose distributions which measured by the film dosimeter gafchromic EBT2, MatriXXEvolution and EPID in the case of KNF cancer, lung and prostat. The experiments were done by using Varian linac Plane Rapid Arc with TPS Eclips owned by the MRCCC Siloam Hospital Semanggi. The data processed of the three dosimeters were using MATLAB software, Omni Pro IMRT and Dosimetry portal. For the comparative analysis of secondary data has been made by MRCCC SHS. The results showed an average gamma index of secondary data patients within tolerances with values > 90%. The measurement results EBT2 film, MatriXXEvolution and EPID of using criteria gamma 3% / 3mm in the case of NPC cancer, lung and prostate indicates that the gamma index gained over the limit allowed tolerance of more than 90%. Gamma index difference between the film dosimetry gafchromic, MatriXXEvolution and EPID on VMAT and IMRT techniques are not too far away, with a range of 0.01 to 5.36%. Differences show that the gamma index measurement using a MatriXXEvolution better than using EBT dosimetry film 2 and EPID. The difference in the average percentage of gamma index on IMRT and VMAT technique to be in the range of 0.02 to 5.31%. The difference between the measurement results and secondary data using MatriXXEvolution and the results Miura et al. Measurement in the range of 0-6%. Data from this study strongly support previous research by Hussein et al., (2013), Nalbant et al., (2014), Elawady et al, (2014), Pham (2013), Miura et al., (2014)"

"[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.]"