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"[Studi ini telah dilakukan untuk mengetahui karakteristik dari EPID dosimetri yang digunakan sebagai verifikasi pasien IMRT dan VMAT. Penelitian ini dilakukan dengan membandingkan indeks gamma dari hasil verifikasi 5 pasien brain, 5 pasien cervix, 5 pasien kepala dan leher serta 5 pasien paru menggunakan EPID dosimetri dengan MatriXX 2D array pada dua Linac yang berbeda di instalasi radioterapi MRCCC SHS dan Siloam Hospital TBS. Dari penelitian ini dihasilkan nilai indeks gamma untuk kasus IMRT di MRCCC 99.59% ± 0.46 untuk EPID dosimetri dan 99.13% ± 0.75 untuk MatriXX 2D array, sedangkan di Siloam Hospital TBS 99.8% ± 0.20 untuk EPID dosimetri dan 99.71% ± 0.14 untuk MatriXX 2D array. Pada kasus VMAT di MRCCC 97.71% ± 1.27 untuk EPID dosimetri dan 99.50% ± 0.39 untuk MatriXX 2D array, sedangkan di SiloamHospital TBS 97.78% ± 1.45 untuk EPID dosimetri dan 98.66% ± 1.26 untuk MatriXX 2D array. Kesimpulan dari penelitian ini adalah perbedaan antara EPID dosimetri dan MatriXX 2D array di kedua rumah sakit menunjukan nilai kurang dari 1% untuk kasus IMRT dan kurang dari 2% untuk kasus VMAT.

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This work was aimed to study the characteristics of EPID dosimetry in use as patient specific QA for IMRT and VMAT. We compare result of gamma index from patient specific QA with each 5 cases of brain, cervix, head and neck, lung

using EPID dosimetry and MatriXX 2D array in two different linacs at MRCCC SHS and Siloam Hospital TBS. Calculated gamma index from IMRT case in MRCCC SHS ware 99.59% ± 0.46 for EPID dosimetry and 99.13% ± 0.75 for MatriXX 2D array, meanwhile at Siloam Hospital TBS the calculated gamma index were 99.8% ± 0.20 for EPID dosimetry and 99.71% ± 0.14 for MatriXX 2D array.Gamma index from VMAT cases in MRCCC were 97.71% ± 1.27 for EPID dosimetry and 99.50% ± 0.39 for MatriXX 2D array, and in Siloam Hospital TBS the value were 97.78% ± 1.45 for EPID dosimetry and 98.66% ± 1.26 for MatriXX 2D array. We conclude that the difference between EPID dosimetry and Matrixx 2D arrays at two hospitals were less than 1% and less than 2% for IMRT and VMAT cases, respectively. This work was aimed to study the characteristics of EPID dosimetry in use as patient specific QA for IMRT and VMAT. We compare result of gamma index from patient specific QA with each 5 cases of brain, cervix, head and neck, lung using EPID dosimetry and MatriXX 2D array in two different linacs at MRCCC SHS and Siloam Hospital TBS. Calculated gamma index from IMRT case in MRCCC SHS ware 99.59% ± 0.46 for EPID dosimetry and 99.13% ± 0.75 for

MatriXX 2D array, meanwhile at Siloam Hospital TBS the calculated gamma index were 99.8% ± 0.20 for EPID dosimetry and 99.71% ± 0.14 for MatriXX 2D array.Gamma index from VMAT cases in MRCCC were 97.71% ± 1.27 for EPID dosimetry and 99.50% ± 0.39 for MatriXX 2D array, and in Siloam Hospital TBS the value were 97.78% ± 1.45 for EPID dosimetry and 98.66% ± 1.26 for MatriXX 2D array. We conclude that the difference between EPID dosimetry and Matrixx 2D arrays at two hospitals were less than 1% and less than 2% for IMRT and VMAT cases, respectively.;This work was aimed to study the characteristics of EPID dosimetry in use as

patient specific QA for IMRT and VMAT. We compare result of gamma index

from patient specific QA with each 5 cases of brain, cervix, head and neck, lung

using EPID dosimetry and MatriXX 2D array in two different linacs at MRCCC

SHS and Siloam Hospital TBS. Calculated gamma index from IMRT case in

MRCCC SHS ware 99.59% ± 0.46 for EPID dosimetry and 99.13% ± 0.75 for

MatriXX 2D array, meanwhile at Siloam Hospital TBS the calculated gamma

index were 99.8% ± 0.20 for EPID dosimetry and 99.71% ± 0.14 for MatriXX 2D

array.Gamma index from VMAT cases in MRCCC were 97.71% ± 1.27 for EPID

dosimetry and 99.50% ± 0.39 for MatriXX 2D array, and in Siloam Hospital TBS

the value were 97.78% ± 1.45 for EPID dosimetry and 98.66% ± 1.26 forMatriXX

2D array. We conclude that the difference between EPID dosimetry and Matrixx

2D arrays at two hospitals were less than 1% and less than 2% for IMRT and

VMAT cases, respectively., This work was aimed to study the characteristics of EPID dosimetry in use as

patient specific QA for IMRT and VMAT. We compare result of gamma index

from patient specific QA with each 5 cases of brain, cervix, head and neck, lung

using EPID dosimetry and MatriXX 2D array in two different linacs at MRCCC

SHS and Siloam Hospital TBS. Calculated gamma index from IMRT case in

MRCCC SHS ware 99.59% ± 0.46 for EPID dosimetry and 99.13% ± 0.75 for

MatriXX 2D array, meanwhile at Siloam Hospital TBS the calculated gamma

index were 99.8% ± 0.20 for EPID dosimetry and 99.71% ± 0.14 for MatriXX 2D

array.Gamma index from VMAT cases in MRCCC were 97.71% ± 1.27 for EPID

dosimetry and 99.50% ± 0.39 for MatriXX 2D array, and in Siloam Hospital TBS

the value were 97.78% ± 1.45 for EPID dosimetry and 98.66% ± 1.26 forMatriXX

2D array. We conclude that the difference between EPID dosimetry and Matrixx

2D arrays at two hospitals were less than 1% and less than 2% for IMRT and

VMAT cases, respectively.]"

"Verifikasi dosis dilakukan untuk memastikan pemberian dosis ke pasien sesuai dengan dosis yang ditentukan. Beberapa penelitian menunjukkan bahwa verifikasi dosis secara in vivo membawa keuntungan yang lebih daripada verifikasi pre- treatment, karena dapat mendeteksi adanya kesalahan fatal akibat dari perubahan anatomi pasien. Dosimeter yang dipilih sebagai dosimeteri in vivo adalah electronic portal imaging device (EPID). Penelitian ini dilakukan dengan mengevaluasi data sekunder dari hasil penelitian sebelumnya yang dilakukan oleh Ramadhan (Ramadhan, 2019) dengan membandingkan terhadap hasil simulasi secara Monte Carlo. Perangkat yang digunakan untuk simulasi berbasis Monte Carlo adalah PRIMO dan DOSXYZnrc yang secara berurutan digunakan dalam pemodelan linac dan EPID. Pada pemodelan linac diperlukan beam data commissioning (BDC) dari pesawat linac tipe Varian Unique dengan berkas energi foton 6 MV yang digunakan di RSUPN dr. Cipto Mangunkusumo untuk menyamakan keluaran radiasinya. EPID dimodelkan sebagai dosimetri in vivo berdasarkan material dari lapisan penyusunnya dan diuji menggunakan fantom homogen tipe slab (RW3) dengan variasi lapangan 5×5, 10×10, 15×15, dan 20×20 cm2 pada kedalaman 5 cm. Analisis hasil dilakukan dengan melihat nilai indeks gamma, FWHM, beam symmetry, dan beam flatness. Hasil commissioning pesawat linac menunjukkan kesesuaian dengan perbedaan sebesar 4,72% dan 1,29% terhadap dosis profil dan PDD yang diuji pada fantom air 40×40×40 cm3 di lapangan referensi. Hasil analisa parameter berkas yang diuji menunjukkan kesesuaian yang baik dengan nilai rata- rata standar deviasi dari parameter FWHM sebesar 1,63 cm, beam symmetry 3,18 %, dan beam flatness 0,28 %. Nilai faktor koreksi yang diperoleh sebesar 0,20 melalui perbandingan antara pengukuran EPID dan simulasi Monte Carlo.

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Dose verification is carried out to ensure that the dose to the patient is delivered according to the prescribed dose. Several studies have shown that in vivo dose verification provides an advantage over pre-treatment verification, as it can detect fatal errors resulting from changes in patient anatomy. The dosimeter chosen as an in vivo dosimeter is an electronic portal imaging device (EPID). The study was evaluating the secondary data from the results of previous research conducted by Ramadhan (Ramadhan, 2019) by comparing to the results of the Monte Carlo simulation. PRIMO and DOSXYZnrc code are used in linac and EPID modeling, respectively, based on Monte Carlo simulation. A beam data commissioning (BDC) is required from the Varian Unique linac with a 6 MV photon energy beam used at RSUPN dr. Cipto Mangunkusumo to adjust radiation output through the simulation. EPID was modeled as in vivo dosimetry based on the material from the constituent layers and tested using a slab-type homogeneous phantom (RW3) with field variations of 5×5, 10×10, 15×15, and 20×20 cm2 at a depth of 5 cm. The results analysis was performed by looking at the FWHM, beam uniformity, beam flatness, and gamma index value. The results of the commissioning of the linac head showed conformity with a difference of 4,72 % and 1,29 % to the dose profile on the crossline and PDD tested on a water phantom of 40×40×40 cm3 in the reference field. The analysis process of the beam parameters tested showed a good agreement with the average standard deviation of the FWHM parameter of 1.63 mm, beam symmetry of 3,18 %, and beam flatness of 0,28 %. The correction factor value is 0,20 from the comparison between the EPID measurement and the Monte Carlo simulation."