• Title/Summary/Keyword: 단층치료

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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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body fat thresholds in computed tomography image processing (전산화 단층촬영 영상처리의 체지방 문턱치)

  • 김승환;이건형;이수열;박선희;표현봉;조준식;권순태
    • Proceedings of the Korean Information Science Society Conference
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    • 1998.10c
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    • pp.438-440
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    • 1998
  • 본 논문에서는 복부의 전산화 단층촬영 영상으로부터 체지방의 양을 측정하기 위한 영상처리에서 사용되는 문턱치의 자동 설정 방법을 제안한다. 체지방의 정량적 측정은 비만과 관련된 진단 및 치료에 있어서 중요하다. 기존의 비만도 측정은 체중과 신장의 비, 허리와 둔부 둘레의 비, 손으로 잡히는 복부의 두께 등 단순한 측정방법을 사용하여 실제 지방의 양을 제대로 반영하지 못하는 단점이 있다. 이러한 단점을 보완하기 위하여 최근에 전산화 단층촬영 영상으로부터 영상처리를 통하여 직접 지방의 양을 측정하려는 시도가 있다. 전산화 단층촬영 영상을 이용하면 지방의 양을 정량적으로 측정할 수 있고 피하지방과 복강내지방 등 특정부위의 체지방의 양을 측정할 수 있다. 전산화 단층촬영은 밀도에 비례하는 하운스필드 단위 값으로 구성된 영상을 제공한다. 일반적으로 체지방은 하운스필드 단위 값이 -150에서 -50사이인 것으로 알려져 있다. 그러나, 체지방의 문턱치는 사람에 따라 다르고, 또한 같은 사람에 대해서도 촬영 부위에 따라 다르다. 본 논문에서는 이러한 차이를 히스토그램을 통하여 보이고 히스토그램의 가우시안 함수 근사로부터 체지방의 문턱치를 자동으로 설정하는 방법을 제안한다.

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Pretreatment prognostic Factors in Early Stage Caricinoma of the Uterine Cervix (초기 자궁 경부암에서 치료전 예후 인자)

  • Kim, Mi-Sook;Hua, Sung-Whan
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.59-67
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    • 1992
  • From March 1979 through December 1986, 124 patients with early stage carcinoma of the uterine cervix received curative radiation therapy. According to FIGO classification, 35 patients were stage IB and 89 were stge II A. In stage IB, five year locoregional control, five year disease free survival, and five year overall survival was $79.0\%$, $76.4\%$ and $81.8\%$, respectively. In stage II A, five year locoregional control, five year disease free survival, and five year overall survival were $78.0\%$, $66.8\%$, and $72.1\%$, respectively. To identify prognostic factors, pretreatment parameters including age, ECOG performance status, number of pregnancies, history of diabetes mellitus and hypertension, histology, size and shape of primary tumor, CT findings and blood parameters were retrospectively analyzed in terms of locoregional control, disease free survival and overall survival using univariate analysis and multivariate analysis. In univariate analysis, tumor size on physicai examination and rectal invasion on CT significantly affected locoregional control, disease free survival and overall survival. Parametrial involvement on CT was a significant prognostic factor on locoregional control and disease free survival. Hemoglobin level affected disease free survival and overall survival. Histology and age were significant prognostic factors on locoregional control. In multivariate analysis excluding CT finding, tumor size on physical examination was a significant factor in terms of locoregioal control and overall survival. Hemoglobin level was significant in terms of disease free survival. In multivariate analysis including CT, histology was a prognostic factor on locoregional control and disease free survival. Hemoglobin level and rectal invasion on CT were significant factors on locoregional control.

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Comparison of 2D and 3D Brachytherapy Planning for Cervical Cancer (자궁경부암 근접방사선치료 시 2차원, 3차원 치료계획 비교평가)

  • Kim, Jung Hoon
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.303-309
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    • 2017
  • To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to $2cm^3$ of bladder to less than 7.5 Gy, and $2cm^3$ of rectum to less than 5Gy. In one patient of 10 patients, $D_{2cm3}$ of rectal dose was over 5Gy and 6patients at $D_{2cm3}$ of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

Efficiency Evaluation of CT Simulator QA Phantom (전산화 단층촬영 모의치료기 정도관리 팬텀의 유용성 평가)

  • Hwang, Se-Ha;Min, Je-Sun;Lee, Jae-Hee;Park, Heung-Deuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.89-95
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    • 2009
  • Purpose: The purpose is to evaluate efficiency of the CT simulator QA phantom manufactured for daily QA. Materials and Methods: We made holes ($1{\times}100{\times}1\;mm$) to verify accuracy between image and real measurement in polystyrene phantom and made 1 mm holes to verify table movement accuracy at superior and inferior 100 mm to the center of the phantom and inserted radiopacity material. To evaluate laser alignment, we made cross mark on the right and left side at phantom and to evaluate CT number accuracy we made 3 cylindrical holes and inserted equivalence material of bone, water, air in them. After CT scanning the phantom, We evaluated accuracy between image and real measurement, accuracy of table movement, laser, and CT number using exposed image. Results: It was measured that the accuracy between image and real measurement was ${\pm}0.3\;mm$, table movement accuracy was ${\pm}0.3\;mm$, laser accuracy was ${\pm}0.5\;mm$ from 7th January to 7th March in 2008 as within the reference point ${\pm}1\;mm$. In the CT number accuracy of bone was ${\pm}10\;HU$, air was ${\pm}5\;HU$, water was ${\pm}5\;HU$ as within the reference point is ${\pm}10\;HU$. Conclusion: We was able to perform CT simulator QA and laser equipment QA more conveniently and fast using manufactured phantom at the same time. We will be able to make more accurate treatment plan that added to QA procedures using images at previous daily QA.

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Treatment of giant iatrogenic pseudoaneurysm of the femoral artery (대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료)

  • Kang, Wu-Seong;Park, Chan-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.423-428
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    • 2019
  • The role of angioembolization has increased because of increases in nonoperative treatment for traumatic splenic injury. We report here a case of successful treatment of iatrogenic pseudoaneurysm of the femoral artery by thrombin injection with coil embolization. A 55-year-old female was admitted to our hospital because of blunt trauma. Computed tomography (CT) revealed a grade V splenic injury with contrast extravasation; therefore, angioembolization was performed. Three days after admission, follow-up CT scan revealed rebleeding from the spleen, and repeat angioembolization was performed. Seven days after admission, an approximately $7.0cm{\times}4.0cm-sized$ pseudoaneurysm was found on follow-up CT scan and there was no bleeding from the spleen. Although thrombin was injected into the aneurysmal sac, there was still inflow of blood, as observed on color-doppler ultrasound. Therefore, coil embolization to the neck of the aneurysm was performed. On angiography, there was no contrast filling into the sac. The size of the pseudoaneurysmal sac had decreased on follow-up CT scan, and the patient was discharged to home without complications. We successfully treated a giant pseudoaneurysm of the femoral artery using thrombin and coil embolization.

Characteristics of CCD Based Optical CT Scanner for Therapeutic Radiation Dosimetry (치료방사선량평가를 위한 CCD 기반 광학컴퓨터단층촬영 스캐너의 특성)

  • Lee, Jae Choon;Kim, Ae Ran;Ji, Young Hoon;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.27 no.2
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    • pp.72-78
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    • 2016
  • A CCD camera and an LED light source were combined to fabricate a compact optical CT scanner for the therapeutic radiation dose evaluation of a polymer gel dosimeter. After the collimated beam emitted by the LED passed through aquarium, gel phantom, and telecentric lens, an image was collected by the CCD camera and reconstructed using MATLAB. By using a stepping motor and LabVIEW, the gel dosimeter was rotated at every $0.72^{\circ}$, and the time for collecting 500 slice images per a revolution was within 20 min. At a spatial frequency of 4.5 lp/mm of the optical CT scanner, the modulation transfer function value was 72%. The linear correlation coefficient of the optical CT scanner for the polymer gel dosimeter was 0.987.

Analysis of Pretreatment Prognostic Factors in Locally Advanced Carcinoma of the Uterine Cervix (국소진행된 자궁경부암에 있어서의 예후인자 분석)

  • Oh, Do-Hoon;Ha, Sung-Whan;Lee, Moo-Song
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.69-76
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    • 1992
  • To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1986. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was $58\%$, $51\%$, and $27\%$ in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was $57\%$, $40\%$, and $25\%$ for each stage respectively. Five year overall survival was $67\%$, $51\%$, and $33\%$ in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than $10\;g\%$, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography (IVP), pelvic lymph node (LN) status on CT, and pelvic sidewall invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. in terms of overall survival, the size.

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