• Title/Summary/Keyword: 방사선치료실

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Paraaortic node를 포함하는 자궁 경부암 치료시 효율적인 MLC사용에 대한 고찰

  • 최지민;김종식;조현상;박영환
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.122-125
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    • 2001
  • I. 목적 : Primus의 Multi Leaf Collimator는 X측이 29쌍으로 이루어 져 있으며 그중27쌍의 leaf은 1cm이고 2쌍은 6.5cm의 leaf으로 구성되어있다. 이러한 이유로 Paraaortic node를 포함하는 자궁경부암 치료시 현재는 Y가 27cm 이상인 경우는 차폐블럭을 제작하여 치료를 시행하나 차폐 블럭의 제작에 따른 업무의 지연과 차폐 블럭이 무거워져 치료시 환자에게 떨어질 위험을 제거 하기 위해 Asymmetric Field로 Multi Leaf Collimator를 사용한 결과를 보고하고자 한다. II. 재료 및 방법 : 모의 치료(Ximatron, Varian, USA)시 $Y_1$측을 15cm을 기준으로 하여 $Y_2$측을 변경하면서 Field size를 결정한다. ($Y_2$측은 20cm가 최대, 즉 Y측은 35cm까지 적용) 이러한 방법으로 Multi Leaf Collimator를 사용한 환자와 기존의 차폐블럭을 제작하여 치료한 환자와의 업무 개선사항을 확인하기 위하여 실제 공작실 업무 담당자의 블럭 제작 시간과 Beam Shaper를 이 용해 Multi Leaf Collimator를 입력하는 시간을 상호 비교하여 단축된 시간을 조사하였다. III. 결과 : 차폐블럭을 대신해 Multi Leaf Collimator를 이용함으로써 치료실에서 환자에 대한 위험요소(차폐블럭이 무겁다)를 사전에 제거 할 수 있었고 공작실에서 블럭 제작 시간과 LANTIS를 이용해 MLC를 입력하는 시간을 실측 한 결과업무의 시간이 120분에서 5분으로 단축되는 효과가 있었다. 전산화 계획 실에서 선량 계산시 OAR Factor값을 고려하여야 한다. IV. 결론 : Paraaortic node를 포함한 자궁경부암 환자의 차폐부위는 모양이 거의 일직선이기 때문에 Mu]ti Leaf Collimator를 사용하기에 용이 한 치료 부위이다. 하지만 큰 Field size로 인한 불편함이 있었다. 이러한 제 약성을 Asymmetric Field를 이용해서 Multi Leaf Collimator의 사용을 가능하게 하고 차폐 블록의 제작과정과 치료 시에 발생되는 근무자의 업무의 손실을 줄이고 환자에 대한 위험성 을 해결하였다.

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Calculation Formula for Shielding Thickness of Direct Shielded Door installed in Treatment Room using a 6 MV X-ray Beam (6 MV X-선 빔을 사용하는 치료실에 설치되는 직접 차폐식 도어의 차폐 두께 계산식)

  • Park, Cheol Seo;Kim, Jong Eon;Kang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.14 no.5
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    • pp.545-552
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    • 2020
  • The purpose of this study is to derive a lead thickness calculation formula for direct-shielded doors based on NCRP Report No.151 and IAEA Safety Report Series N0.47. After deriving the dose rate calculation formula for the direct shielded door, this formula was substituted for the lead shielding thickness calculation formula to derive the shielding thickness calculation formula at the door. The lead shielding thickness calculated from the derived direct shielded door shielding thickness calculation formula was about 6% lower than that calculated by the NCRP and IAEA secondary barrier shielding thickness calculation methods. This result is interpreted as meaning that the thickness calculation is more conservative from the NCRP and IAEA secondary barrier shielding thickness calculation methods and fits well for secondary beam shielding. In conclusion, it is thought that the formula for calculating lead shielding thickness of the direct shielded door derived in this study can be usefully used in the shield design of the door.

Role of Radiation Therapy for Locally Advanced Gastric Carcinoma Management (재발성 또는 국소진행된 위암의 방사선치료 -35예의 치료성적 분석)

  • Yoon Sei Chul;Oho Yoon Kyeoung;Shinn Kyeong Sub;Bahk Yong Whee;Kim In Chul;Lee Kyung Sik
    • Radiation Oncology Journal
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    • v.6 no.1
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    • pp.41-47
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    • 1988
  • Thirty-five patients with locally advanced gastric carcinoma were treated with combined modalities of external radiation therapy (RT) and 5-FU based chemotherapy at the Division of Radiation Therapy, Department of Radiology, Kangnam 51. Mary's Hospital, Catholic University Medical College from May 1983 to May 1987. The purpose of this retrospective study is for the evaluation of the palliative response to RT. There were 25 men and 10 women. The age ranged from 38 to 80 years (median: 56 years). The pathologic classification showed $14(40\%)$ poorly differentiated, $12 (34\%)$ moderately differentiated, $3(9\%)$ well differentiated adenocarcinomas, 2 mucinous cystadenocarcinomas, 1 signet ring cell and 3 not specified ones. The time intervals from the initial surgicopathologic diagnosis to the starting day of RT was within 1 year for $18 (51\%)$, 1 to 2 years for $8 (23\%)$ and 2 to 3 years for $5 (14\%)$, respectively. The major symptoms to be treated were pain in $30 (80\%)$, mass for $29 (83\%)$, obstruction for $11 (31\%)$ and jaundice for $9 (20\%)$ patients. The response rate (patient number of positive response/total patient number) according to treated radiation doses were observed as follows; $14/16(88\%)$ for $40\~50Gy,\;8/10(80\%)$ for over $50Gy,6/8 (75\%)\;for\;30\~40Gy\;and\;8/10(53\%)\;for\;20\~30 Gy$ in decreasing order. The over ail survival was 3.0 months and that of 5FU+RT, FAM+RT and RT alone groups were 4.6 months, 3.7 months and 2.5 months respectively. Complications induced by RT were nausea and vomiting in $16(46\%)$, diarrhea in $7(20\%)$, leukopenia in $6(17\%)$ and anemia and intercurrent pneumonia in each $3(9\%)$ patients in decreasing order.

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Correlation between Chest Radiographic Findings and Respiratory Indices in Neonates with Respiratory Distress Syndrome (신생아 호흡곤란 증후군에서 흉부방사선 소견과 Respiratory Index와의 관계)

  • Chung, Yong-Hwan;Park, Youn-Jin;Bae, Chong-Woo;Sung, Dong-Wook
    • Clinical and Experimental Pediatrics
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    • v.46 no.7
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    • pp.655-660
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    • 2003
  • Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio($a/APO_2$) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care Unit of Kyunghee University Hospital from 1996 to 2000 were analyzed retrospectively. Chest radiographs taken at the time after birth were classified into four groups according to Bomsel's classification. The $a/APO_2$ and VI values were calculated and compared with the corresponding chest radiographs. Results : Among the 50 cases of RDS examined, three cases were classified into grade I(6%), eight cases into grade II(16%), 20 cases into grade III(40%), and 19 cases into grade IV(38%). The mean $a/APO_2$ of the cases classified into grades I or II was 0.32 and the mean $a/APO_2$ of those classified into grades III and IV was 0.18 and 0.09, respectively. The mean VI was 0.049 for the cases classified into grades I or II and 0.076 and 0.161 for those classified into grades III and IV, respectively. Conclusion : The severity of RDS according to chest X-ray findings correlate to the values of respiratory indices, $a/APO_2$ and VI.

Evaluation of the Positional Accuracy of the Delivered Beams from the Target: A Phantom Study (방사선 치료에서 치료 표적과 조사 빔의 일치 정도 평가: 팬텀 연구)

  • Kang, Sei-Kwon;Cho, Byung-Chul;Cheong, Kwang-Ho;Ju, Ra-Hyeong;Kim, Su-Ssan;Kim, Kyoung-Ju;Choi, Sang-Gyu;Bae, Hoon-Sik;Lee, Re-Na;Oh, Do-Hoon
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.192-200
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    • 2006
  • We evaluated the positional accuracy of the delivered beams to the target in a phantom by simulating the whole process of the radiation treatments Including CT scanning, planning and beam exposures with MLCs. For this purpose, a phantom was made to calibrate the alignment between the CT and the attached laser system. A new, convenient method was also devised to align the setup lasers in the treatment room. Film was used for the Identification of the delivered beam and analyzed with a homemade computer program. The positional differences between the target and the beam centers varied with the couch rotations. The accelerator we used showed a maximum discrepancy of 2.0 mm at the table angle of $295^{\circ}$. The same measurements based on the new isocenter from the Winston-Lutz test resulted in the maximum of 1.35 mm for all rotation angles. The evaluation of the differences between the target and the beam centers is useful for the treatment planning.

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Derivation of a Verification Formula for the Dose Rate Contributing to the Maze Door of the 6 MV Treatment Room (6 MV 치료실의 미로 도어에 기여하는 선량률의 검증식 유도)

  • Park, Cheol Seo;Kim, Jong Eon;Kang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.15 no.1
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    • pp.85-91
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    • 2021
  • The purpose of this study is to derive an equation to verify the accuracy of the dose rate for each component calculated at the measurement point outside the maze door when designing the maze door of 6 MV X-ray beam. Based on the component-specific dose rate calculation formula for the measurement point outside the maze door described in NCRP Report 151 and IAEA Safety Report Series 47, the dose rate calculation formula for each component when applying the values of the drawing-based parameters and the dose rate calculation formula for each component when applying the values of conservative parameters are derived. From the two dose rate calculation formulas for each component, the dose rate verification formula for each component at the measurement point outside the maze door was derived. The resulting dose rate verification formula for each component at the measurement point outside the maze door can be compared and analyzed whether the dose rate for each component at the measurement point outside the maze door calculated by the designer falls within the range of the dose rate obtained from the derived dose rate verification formula for each component. This verification formula is considered to be practically useful in verifying the accuracy of the dose rate for each component calculated by the designer.

Treatment Outcome and Analysis of the Prognostic Factors of High Grade Glioma Treated by Postoperative Radiotherapy (고악성도 신경아교종의 수술 후 방사선 치료 성적과 예후인자 분석)

  • Lee, Sun-Min;Park, Young-Je;Yoon, Won-Sup;Lee, Suk;Yang, Dae-Sik;Jeong, Yong-Gu;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.117-124
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    • 2010
  • Purpose: To analyze the postoperative radiotherapy results and prognostic factors in patients with WHO grade 3 and 4 gliomas. Materials and Methods: A total of 99 patients with malignant gliomas who underwent postoperative radiotherapy between 1988 and 2007 were enrolled in this study. Total resections, subtotal resections ($\geq$50%), partial resections (<50%), and biopsies were performed in 16, 38, 22, and 23 patients, respectively. In total there were 32, 63 and 4 WHO grade 3, 4, and unspecified high grade gliomas, respectively. The biologically equivalent dose was in the range of 18.6 to $83.3\;Gy_{10}$ (median dose, $72.2\;Gy_{10}$). We retrospectively analyzed survival rate, patterns of failure, prognostic factors, and adverse effects. Results: The median follow-up time was 11 months and there were 54 patients (54.5%) with local failure. The one and 2-year survival rates were 56.6% and 29.3%, respectively, and the median survival duration was 13 months. The one and 2-year progression-free survival rates (PFS) were 31.3% and 18.2%, respectively, and the median PFS was 7 months. The prognostic factors for overall survival were age (p=0.0001), surgical extents (subtotal resection, p=0.023; partial resection, p=0.009; biopsy only, p=0.002), and enhancement of tumor in postoperative imaging study (p=0.049). The factors affecting PFS were age (p=0.036), tumor enhancement of the postoperative imaging study (p=0.006). There were 3 patients with grade 3 and 4 side effects during and after radiotherapy. Conclusions: In addition to age and surgical extents, tumor enhancement of the postoperative imaging study was included in the prognostic factors. The most common relapse patterns were local failures and hence, additional studies are needed to improve local control rates.

Radiation Therapy for Pituitary Adenoma -Changes in Endocrine Function after Treatment- (뇌하수체선종의 방사선치료후 혈중 호르몬치의 변화)

  • Yoon Sei Chul;Jang Hong Suck;Kim Song Hwan;Shinn Kyung Sub;Bahk Yong Whee;Son Ho Young;Kang Joon Ki
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.185-195
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    • 1991
  • Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

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Medical Radiation Exposure Dose of Workers in the Private Study of the Job Function (의료기관 방사선 종사자의 직무별 개인피폭선량에 관한 연구)

  • Kang, Chun-Goo;Oh, Ki-Baek;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.3-12
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    • 2011
  • Purpose: With increasing medical use of radiation and radioactive isotopes, there is a need to better manage the risk of radiation exposure. This study aims to grasp and analyze the individual radiation exposure situations of radiation-related workers in a medical facility by specific job, in order to instill awareness of radiation danger and to assist in safety and radiation exposure management for such workers. Materials and Methods: From January 1, 2010 December 31, 2010, medical practitioners working in the radiation is classified as a regular personal radiation dosimetry, and subsequently one year 540 people managed investigation department to target workers, dose sectional area, working period, identify the job function-related tasks for a deep dose, respectively, the annual average radiation dose were analyzed. Frequency analysis methods include ANOVA was performed. Results: Medical radiation workers in the department an annual radiation dose of Nuclear and 4.57 mSv a was highest, dose zone-specific distribution of nuclear medicine and in the 5.01~19.05 mSv in the high dose area distribution showed departmental radiation four of the annual radiation dose of Nuclear and 7.14 mSv showed the highest radiation dose. More work an average annual radiation dose according to the job function related to the synthesis of Cyclotron to 17.47 mSv work showed the highest radiation dose, Gamma camera Cinema Room 7.24 mSv, PET/CT Cinema Room service is 7.60 mSv, 2.04 mSv in order of intervention high, were analyzed. Working period, according to domain-specific average annual dose of radiation dose from 10 to 14 in oral and maxillofacial radiology practitioners as high as 1.01~3.00 mSv average dose showed the Department of Radiology, 1-4 years, 5-9 years, respectively, 1.01 workers~8.00 mSv in the range of the most high-dose region showed the distribution, nuclear medicine, and the 1-4 years, 5-9 years 3.01~19.05 mSv, respectively, workers of the highest dose showed the distribution of the area in the range of 10 to 14 years, Workers at 15-19 3.01~15.00 mSv, respectively in the range of the high-dose region were distributed. Conclusion: These results suggest that medical radiation workers working in Nuclear Medicine radiation safety management of the majority of the current were carried out in the effectiveness, depending on job characteristics has been found that many differences. However, this requires efforts to minimize radiation exposure, and systematic training for them and for reasonable radiation exposure management system is needed.

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Implementation of Radiotherapy Educational Contents Using Virtual Reality (가상현실 기술을 활용한 방사선치료 교육 콘텐츠 제작 구현)

  • Kwon, Soon-Mu;Shim, Jae-Goo;Chon, Kwon-Su
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.409-415
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    • 2018
  • The development of smart devices has brought about significant changes in daily life and one of the most significant changes is the virtual reality zone. Virtual reality is a technology that creates the illusion that a 3D high-resolution image has already been created using a display device just like it does in itself. Unrealized subjects are forced to rely on audiovisual materials, resulting in a decline in the concentration of practices and the quality of classes. It used virtual reality to develop effective teaching materials for radiology students. In order to produce a video clip bridge using virtual reality, a radiology clinic was selected to conduct two exposures from July to September 2017. The video was produced taking into account the radiology and work flow chart and filming was carried out in two separate locations : in the computerized tomography unit and in the LINAC room. Prior to filming the scenario and the filming route were checked in advance to facilitate editing of the video. Modeling and mapping was performed in a PC environment using the Window XP operating system. Using two leading virtual reality camera Gopro Hero, CC pixels were produced using a 4K UHD, Adobe, followed by an 8 megapixel resolution of $3,840{\times}2,160/4,096{\times}2,160$. Total regeneration time was performed in about 5 minutes during the production of using virtual reality to prevent vomiting and dizziness. Currently developed virtual reality radiation and educational contents are being used to secure the market and extend the promotion process to be used by various institutions. The researchers will investigate the satisfaction level of radiation and educational contents using virtual reality and carry out supplementary tasks depending on the results.