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Evaluation of useful treatment which uses dual-energy when curing lung-cancer patient with stereotactic body radiation therapy (폐암 환자의 정위적방사선 치료 시 이중 에너지를 이용한 치료 방법의 유용성 평가)

  • Jang, Hyeong Jun;Lee, Yeong Gyu;Kim, Yeong Jae;Park, Yeong Gyu
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.87-99
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    • 2016
  • Purpose : This study will evaluate the clinical utility by applying clinical schematic that uses monoenergy or dual energy as according to the location of tumors to the stereotactic radiotherapy to compare the change in actual dose given to the real tumor and the dose that locates adjacent to the tumor. Materials and Methods : CT images from a total of 10 patients were obtained and the clinical planning were planned based on the volumetric modulated arc therapy on monoenergy and dual energy. To analyze the change factor in the tumor, Comformity Index(CI) and Homogeneity Index(HI) and maximum dose quantity were each calculated and comparing the dose distribution on normal tissues, $V_{10}$ and $V_5$, first ~ fourth ribs closest to the tumor ($1^{st}{\sim}4^{th}$ Rib), Spinal Cord, Esophagus and Trachea were selected. Also, in order to confirm the accuracy on which the planned dose distribution is really measured, the 2-dimensional ion chamber array was used to measure the dose distribution. Results : As of the tumor factor, CI and HI showed a number close to 1 when the two energies were used. As of the maximum dose, the front chest wall showed 2% and the dorsal tumor showed equivalent value. As of normal tissue, the front chest wall tumors were reduced by 4%, 5% when both energies were used in the adjacent rib and as of trachea, reduced by 11%, 17%. As of the dose in the lung, as of $V_{10}$, it reduced by 1.5%, $V_5$ by 1%. As of the rear chest wall, when both energies were used, the ribs adjacent to the tumors showed 6%, 1%, 4%, 12% reduction, and in the lung dose distribution, $V_{10}$ reduced by 3%, and $V_5$ reduced by 3.1%. The dose measurement in all energies were in accordance to the results of Gamma Index 3mm/3%. Conclusion : It is considered that rather than using monoenergy, utilizing double energy in the clinical setting can be more effectively applied to the superficial tumors.

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Comparison Study of Image Quality of Direct and Indirect Conversion Digital Mammography System (직접 및 간접변환 방식의 디지털 유방 X선 촬영시스템의 영상화질 비교 연구)

  • Park, Hye-Suk;Oh, Yu-Na;Jo, Hee-Jeong;Kim, Sang-Tae;Choi, Yu-Na;Kim, Hee-Joung
    • Progress in Medical Physics
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    • v.21 no.3
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    • pp.239-245
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    • 2010
  • The purpose of this study is to comprehensively compare and evaluate the characteristics of image quality for digital mammography systems which use a direct and indirect conversion detector. Three key metrics of image quality were evaluated for the direct and indirect conversion detector, the modulation transfer function (MTF), normalized noise power spectrum (NNPS), and detective quantum efficiency (DQE), which describe the resolution, noise, and signal to noise performance, respectively. DQE was calculated by using a edge phantom for MTF determination according to IEC 62220-1-2 regulation. The contrast to noise ratio (CNR) was evaluated according to guidelines offered by the Korean Institute for Accreditation of Medical Image (KIAMI). As a result, the higher MTF and DQE was measured with direct conversion detector compared to indirect conversion detector all over spatial frequency. When the average glandular dose (AGD) was the same, direct conversion detector showed higher CNR value. The direct conversion detector which has higher DQE value all over spatial frequency would provide the potential benefits for both improved image quality and lower patient dose in digital mammography system.

Characteristics of Tidal Flow Simulation of Real Tide in West-South Coastal Waters of Korea (실조석에 의한 한국 서남해 연안역에서 해수유동의 재현특성)

  • Jeong, Seung-Myong;Park, Il-Heum
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.26 no.5
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    • pp.531-541
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    • 2020
  • In this study, a computed tide of a real tide was introduced to improve the numerical solutions for tides and tidal flow simulations. The real tide was defined considering the nodal modulation amplitude, phase correction factor, astronomical argument, and tidal harmonic constants of all the constituents. The numerical simulation was performed using the real tide parameters for the west-south coastal waters of Korea, where the observation data for tides, tidal currents, waves, and winds over two seasons exist. The tidal flow simulation of the real tide was simulated successfully. The correlation coefficient between the observed and calculated values was 1.0, which indicated both accurate amplitude and phase. The U- and V-components of the tidal current obtained for the real tide had average valid correlations of 0.83 and 0.936, respectively. The speed error for the residual current was 0.006 m/s on the average, which indicated an insignificant difference, and the directional behavior of the residual current was very similar. In addition, the velocity error was attributed to various weather effects, such as high waves and wind storms. Therefore, this model is expected to improve current solutions provided that weathering forces, such as waves and winds, are considered.

Contactless Electroreflectance Spectroscopy of In0.5(Ga1-xAlx)0.5P/GaAs Double Heterostructures (In0.5(Ga1-xAlx)0.5P/GaAs 이중 이종접합 구조의 Contactless Electroreflectance에 관한 연구)

  • Kim, Jeong-Hwa;Jo, Hyun-Jun;Bae, In-Ho
    • Journal of the Korean Vacuum Society
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    • v.19 no.2
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    • pp.134-140
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    • 2010
  • We have investigated the contactless electroreflectance (CER) properties of $In_{0.5}(Ga_{1-x}Al_x)_{0.5}P$/GaAs double heterostructures grown by metal-organic chemical vapour deposition (MOCVD). The CER measurements on the sample were studied as a function of temperature, modulation voltage ($V_{ac}$), and dc bias voltage ($V_{bias}$). Five signals observed at room temperature are related to the GaAs, $In_{0.5}Ga_{0.5}P$, $In_{0.5}(Ga_{0.73}Al_{0.27})_{0.5}P$, $In_{0.5}(Ga_{0.5}Al_{0.5})_{0.5}P$, and $In_{0.5}(Ga_{0.2}Al_{0.8})_{0.5}P$ transitions, respectively. From the temperature dependence of CER spectrum, the Varshni coefficients and broadening parameters were determined and discussed. In addition, we found that the behavior of the CER amplitude for the reverse bias is larger than that of the forward.

Evaluating efficiency of application the skin flash for left breast IMRT. (왼쪽 유방암 세기변조방사선 치료시 Skin Flash 적용에 대한 유용성 평가)

  • Lim, Kyoung Dal;Seo, Seok Jin;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.49-63
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    • 2018
  • Purpose : The purpose of this study is investigating the changes of treatment plan and comparing skin dose with or without the skin flash. To investigate optimal applications of the skin flash, the changes of skin dose of each plans by various thicknesses of skin flash were measured and analyzed also. Methods and Material : Anthropomorphic phantom was scanned by CT for this study. The 2 fields hybrid IMRT and the 6 fields static IMRT were generated from the Eclipse (ver. 13.7.16, Varian, USA) RTP system. Additional plans were generated from each IMRT plans by changing skin flash thickness to 0.5 cm, 1.0 cm, 1.5 cm, 2.0 cm and 2.5 cm. MU and maximum doses were measured also. The treatment equipment was 6MV of VitalBeam (Varian Medical System, USA). Measuring device was a metal oxide semiconductor field-effect transistor(MOSFET). Measuring points of skin doses are upper (1), middle (2) and lower (3) positions from center of the left breast of the phantom. Other points of skin doses, artificially moved to medial and lateral sides by 0.5 cm, were also measured. Results : The reference value of 2F-hIMRT was 206.7 cGy at 1, 186.7 cGy at 2, and 222 cGy at 3, and reference values of 6F-sIMRT were measured at 192 cGy at 1, 213 cGy at 2, and 215 cGy at 3. In comparison with these reference values, the first measurement point in 2F-hIMRT was 261.3 cGy with a skin flash 2.0 cm and 2.5 cm, and the highest dose difference was 26.1 %diff. and 5.6 %diff, respectively. The third measurement point was 245.3 cGy and 10.5 %diff at the skin flash 2.5 cm. In the 6F-sIMRT, the highest dose difference was observed at 216.3 cGy and 12.7 %diff. when applying the skin flash 2.0 cm for the first measurement point and the dose difference was the largest at the application point of 2.0 cm, not the skin flash 2.5 cm for each measurement point. In cases of medial 0.5 cm shift points of 2F-hIMRT and 6F-sIMRT without skin flash, the measured value was -75.2 %diff. and -70.1 %diff. at 2F, At -14.8, -12.5, and -21.0 %diff. at the 1st, 2nd and 3rd measurement points, respectively. Generally, both treatment plans showed an increase in total MU, maximum dose and %diff as skin flash thickness increased, except for some results. The difference of skin dose using 0.5 cm thickness of skin flash was lowest lesser than 20 % in every conditions. Conclusion : Minimizing the thickness of skin flash by 0.5 cm is considered most ideal because it makes it possible to keep down MUs and lowering maximum doses. In addition, It was found that MUs, maximum doses and differences of skin doses did not increase infinitely as skin flash thickness increase by. If the error margin caused by PTV or other factors is lesser than 1.0 cm, It is considered that there will be many advantages in with the skin flash technique comparing without it.

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Evaluation of Tangential Fields Technique Using TOMO Direct Radiation Therapy after Breast Partial Mastectomy (유방 부분 절제술 후 방사선 치료 시 TOMO Direct를 이용한 접선 조사의 선량적 유용성에 관한 고찰)

  • Kim, Mi-Jung;Kim, Joo-Ho;Kim, Hun-Kyum;Cho, Kang-Chul;Chun, Byeong-Chul;Cho, Jeong-Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.59-66
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    • 2011
  • Purpose: Investigation of the clinical use of tangential fields technique using TOMO direct in comparison to conventional LINAC based radiation therapy after breast partial mastectomy. Materials and Methods: Treatment plans were created for 3 left-sided breast cancer patients who had radiation therapy after breast partial mastectomy by using wedged tangential fields technique, field in field technique (FIF), TOMO Direct, TOMO Direct intensity modulated radiation therapy (IMRT) under the normalized prescription condition ($D_{90%}$: 50.4 Gy/28 fx within CTV). Dose volume histogram (DVH) and isodose curve were used to evaluate the dose to the clinical target volume (CTV), organ at risk (OAR). We compared and analyzed dosimetric parameters of CTV and OAR. Dosimetric parameters of CTV are $D_{99}$, $D_{95}$, Dose homogeneity index (DHI: $D_{10}/D_{90}$) and $V_{105}$, $V_{110}$. And dosimetric parameters of OAR are $V_{10}$, $V_{20}$, $V_{30}$, $V_{40}$ of the heart and $V_{10}$, $V_{20}$, $V_{30}$ of left lung. Results: Dosimetric results of CTV, the average value of $D_{99}$, $D_{95}$ were $47.7{\pm}1.1Gy$, $49.4{\pm}0.1Gy$ from wedged tangential fields technique (W) and FIF (F) were $47.1{\pm}0.6Gy$, $49.2{\pm}0.4Gy$. And it was $49.2{\pm}0.4$ vs. $48.6{\pm}0.8Gy$, $49.9{\pm}0.4$ vs. $49.5{\pm}0.3Gy$ Gy for the TOMO Direct (D) and TOMO Direct IMRT (I). The average value of dose homogeneity index was W: $1.1{\pm}0.02$, F: $1.07{\pm}0.02$, D: $1.03{\pm}0.001$, I: $1.05{\pm}0.02$. When we compared the average value of $V_{105}$, $V_{110}$ using each technique, it was the highest as $34.6{\pm}9.3%$, $7.5{\pm}7.9%$ for wedged tangential fields technique and the value dropped for FIF as $16.5{\pm}14.8%$, $2.1{\pm}3.5%$, TOMO direct IMRT as $7.5{\pm}8.3%$, $0.1{\pm}0.1%$ and the TOMO direct showed the lowest values for both as 0%. Dosimetric results of OAR was no significant difference among each technique. Conclusion: TOMO direct provides improved target dose homogeneity over wedged tangential field technique. It is no increase the amount of normal tissue volumes receiving low doses, as oppose to IMRT or Helical TOMO IMRT. Also, it simply performs treatment plan procedure than FIF. TOMO Direct is a clinical useful technique for breast cancer patients after partial mastectomy.

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Analysis of the Causes of Subfrontal Recurrence in Medulloblastoma and Its Salvage Treatment (수모세포종의 방사선치료 후 전두엽하방 재발된 환자에서 원인 분석 및 구제 치료)

  • Cho Jae Ho;Koom Woong Sub;Lee Chang Geol;Kim Kyoung Ju;Shim Su Jung;Bak Jino;Jeong Kyoungkeun;Kim Tae_Gon;Kim Dong Seok;Choi oong-Uhn;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.22 no.3
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    • pp.165-176
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    • 2004
  • Purpose: Firstly, to analyze facto in terms of radiation treatment that might potentially cause subfrontal relapse in two patients who had been treated by craniospinal irradiation (CSI) for medulloblastoma, Secondly, to explore an effective salvage treatment for these relapses. Materials and Methods: Two patients who had high-risk disease (T3bMl, T3bM3) were treated with combined chemoradiotherapy CT-simulation based radiation-treatment planning (RTP) was peformed. One patient who experienced relapse at 16 months after CSI was treated with salvage surgery followed by a 30.6 Gy IMRT (intensity modulated radiotherapy). The other patient whose tumor relapsed at 12 months after CSI was treated by surgery alone for the recurrence. To investigate factors that might potentially cause subfrontal relapse, we evaluated thoroughly the charts and treatment planning process including portal films, and tried to find out a method to give help for placing blocks appropriately between subfrotal-cribrifrom plate region and both eyes. To salvage subfrontal relapse in a patient, re-irradiation was planned after subtotal tumor removal. We have decided to treat this patient with IMRT because of the proximity of critical normal tissues and large burden of re-irradiation. With seven beam directions, the prescribed mean dose to PTV was 30.6 Gy (1.8 Gy fraction) and the doses to the optic nerves and eyes were limited to 25 Gy and 10 Gy, respectively. Results: Review of radiotherapy Portals clearly indicated that the subfrontal-cribriform plate region was excluded from the therapy beam by eye blocks in both cases, resulting in cold spot within the target volume, When the whole brain was rendered in 3-D after organ drawing in each slice, it was easier to judge appropriateness of the blocks in port film. IMRT planning showed excellent dose distributions (Mean doses to PTV, right and left optic nerves, right and left eyes: 31.1 Gy, 14.7 Gy, 13.9 Gy, 6.9 Gy, and 5.5 Gy, respectively. Maximum dose to PTV: 36 Gy). The patient who received IMRT is still alive with no evidence of recurrence and any neurologic complications for 1 year. Conclusion: To prevent recurrence of medulloblastoma in subfrontal-cribriform plate region, we need to pay close attention to the placement of eye blocks during the treatment. Once subfrontal recurrence has happened, IMRT may be a good choice for re-irradiation as a salvage treatment to maximize the differences of dose distributions between the normal tissues and target volume.

Survey of Technical Parameters for Pediatric Chest X-ray Imaging by Using Effective DQE and Dose (유효검출양자효율과 선량을 이용한 소아 흉부 X-선 영상의 기술적인 인자에 관한 조사)

  • Park, Hye-Suk;Kim, Ye-Seul;Kim, Sang-Tae;Park, Ok-Seob;Jeon, Chang-Woo;Kim, Hee-Joung
    • Progress in Medical Physics
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    • v.22 no.4
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    • pp.163-171
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    • 2011
  • The purpose of this study was to investigate the effect of various technical parameters for the dose optimization in pediatric chest radiological examinations by evaluating effective dose and effective detective quantum efficiency (eDQE) including the scatter radiation from the object, the blur caused by the focal spot, geometric magnification and detector characteristics. For the tube voltages ranging from 40 to 90 kVp in 10 kVp increments at the FDD of 100, 110, 120, 150, 180 cm, the eDQE was evaluated at the same effective dose. The results showed that the eDQE was largest at 60 kVp when compares the eDQE at different tube voltage. Especially, the eDQE was considerably higher without the use of an anti-scatter grid on equivalent effective dose. This indicates that the reducing the scatter radiation did not compensate for the loss of absorbed effective photons in the grid. When the grid is not used the eDQE increased with increasing FDD because of the greater effective modulation transfer function (eMTF). However, most of major hospitals in Korea employed a short FDD of 100 cm with an anti-scatter grid for the chest radiological examination of a 15 month old infant. As a result, the entrance surface air kerma (ESAK) values for the hospitals of this survey exceeded the Korean DRL (diagnostic reference level) of $100{\mu}Gy$. Therefore, appropriate technical parameters should be established to perform pediatric chest examinations on children of different ages. The results of this study may serve as a baseline to establish detailed reference level of pediatric dose for different ages.

Effects of Nodus Nelumbinis Rhizomatis Extracts on Sociopsychological Stress in Mice (연근(蓮根) 추출물이 생쥐의 사회.심리적 스트레스에 미치는 영향)

  • Kim, Su-Yeon;Kim, Eun-Jeong;Lee, Dong-Won;Won, Ho-Young
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.2
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    • pp.149-158
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    • 2004
  • 만성적이거나 반복적인 스트레스는 우울중이나 심신병 등의 발병 기전과 밀접한 관련이 있다. 전기적 자극(electric foot shock), 한랭 자극, 속박(immobilization), 투쟁(fighting), 에테르 노출 등과 같은 심한 스트레스 자극이 뇌 조직의 시상 및 시상하부, 편도체 등에서의 노르아드레날린(noradrenalin) 방출을 유의 하게 감소시키는 동시에 혈청 corticosterone을 증가시키는 것으로 알려져 있다. 한의학에서는 스트레스 인자에 대한 신체반응을 기(氣)의 변화로 인식하고 있고, 이러한 자극요인들은 신체에 대하여 병적 요인을 제공하여 제반 질환을 야기한다. 또한 질병 발생에 대한 근거로 정기(正氣)와 사기(邪氣)의 상호 관계 위주로 인식하는데, 내부의 기(氣)의 변조(變調)는 질병의 발생을 야기하는 기초가 된다. 실험에 사용된 연근(蓮根)은 연꽃과에 속한 수생초본인 연꽃의 뿌리부분으로 우(藕) 또는 우절(藕節)이라는 명칭으로 불리기도 한다. 성미(性味)는 감(甘) 삽(澁) 평(平) 무독(無毒)하고 폐(肺) 위(胃) 간경(肝經)으로 들어가며 수렴지혈(收斂止血) 화어(化瘀)의 효능이 있어 토혈(吐血) 객혈(喀血) 뇨혈(尿血) 편혈(便血) 등의 각종 출혈 증상에 사용되어져 왔다. 최근 연꽃의 부위별 추출물이 흰쥐의 지질 과산화 생성을 효과적으로 억제하는 것으로 보고되고 있어 연근(蓮根)에 대한 다양한 약리 효능의 검색이 필요할 것으로 생각되며 연꽃의 씨앗인 연자육(蓮子肉)이 양심안신(養心安神)의 효능이 있어 스트레스성 질환에 많이 응용되고 있는 것에 착안하여 본 연구를 착수하였다. 실험 동물은 ICR계 마우스를 이용하였으며, 사회 심리적 스트레스는 옆쪽 cage에서 다른 마우스의 신체에 가해지는 전기 충격을 하루 1시간 동안 지켜보게 하는 것으로 유발하였으며 이 상태에서 약물을 투여한 그룹을 실험군, 그렇지 않은 그룹을 대조군으로 하였다. 정상군은 아무런 자극 없이 하루 1시간 동안 일정 공간에 가두어 두는 것으로 하였다. 실험 결과 사회 심리적 스트레스를 받은 경우에 아무런 처치를 하지 않은 대조군에 비해 연근 추출물을 100mg/kg/day 용량으로 5 일간 투여한 실험군에서 혈청 중 corticosterone 함량이 유의하게 감소하였으므로 매우 효과적으로 스트레스를 해소하였음을 알 수 있다. 뇌세포 중에서 신경전달물질로 분비되는 노르아드레날린의 분비량은 전반적으로 증가되는 경향을 나타내었으나 유의성은 없었다. 신체적 또는 사회 심리적 스트레스가 간 조직 내 지질의 과산화를 유발하는 것으로 나타났으며 연근 추출물이 이 결과에는 영향을 주지 못하였다. 사회 심리적 스트레스로 인하여 간 조직 내 지질과산화 정도가 증가하였으므로 혈청 내 ALT 함량도 따라 증가할 것으로 추정되었으며 이에 대한 연근 추출물 경구 투여가 간 조직을 보호할 수 있는지를 확인하기 위해 분리한 혈청으로부터 ALT 함량을 측정한 결과 대조군에 비하여 유의한 감소를 나타내었다. 또한 연근 추출물이 혈청 내 지질 과산화물의 생성을 억제할 수 있다면 질병의 예방과 치료에 효과적일 것으로 추정할 수 있으므로 그 생성량을 측정하여 보았으나 대조군과의 차이가 나타나지 않았다. 이상의 결과들을 종합하여 보면 스트레스가 부하된 5일 동안 연근(蓮根) 추출물을 함께 투여한 결과 혈청 corticosterone 함량을 유의하게 감소시켰고 뇌 조직내 noradrenaline 함량을 증가시키는 경향을 나타내어 스트레스 해소에 도움이 될 수 있음을 시사하였다. 또한 혈청 내 ALT 함량을 유의하게 감소시켜 스트레스로 인해 발생하는 간 기능의 손상도 어느 정도 억제시키는 것을 확인할 수 있었는데 앞으로 연근(蓮根)의 이러한 작용에 대한 보다 자세한 연구들이 필요한 것으로 생각된다.

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A study on the effect of collimator angle on PAN-Pelvis volumetric modulated arc therapy (VMAT) including junction (접합부를 포함한 PAN-전골반암 VMAT 치료 계획 시 콜리메이터 각도의 영향에 관한 고찰)

  • Kim, Hyeon Yeong;Chang, Nam Jun;Jung, Hae Youn;Jeong, Yun Ju;Won, Hui Su;Seok, Jin Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.61-71
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    • 2020
  • Purpose: To investigate the effect of collimator angle on plan quality of PAN-Pelvis Multi-isocenter VMAT plan, dose reproducibility at the junction and impact on set-up error at the junction. Material and method: 10 adult patients with whole pelvis cancer including PAN were selected for the study. Using Trubeam STx equipped with HD MLC, we changed the collimator angle to 20°, 30°, and 45° except 10° which was the default collimator angle in the Eclipse(version 13.7) and all other treatment conditions were set to be the same for each patient and four plans were established also. To evaluate these plans, PTV coverage, coverage index(CVI) and homogeneity index (HI) were compared and clinical indicators for each treatment sites in normal tissues were analyzed. To evaluate dose reproducibility at the junction, the absolute dose was measured using a Falmer type ionization chamber and dose changes at the junction were evaluated by moving the position of the isocenter in and out 1~3mm and setting up the virtual volume at the junction. Result: CVI mean value was PTV-45 0.985±0.004, PTV-55 0.998±0.003 at 45° and HI mean value was PTV-45 1.140±0.074, and PTV-55 1.031±0.074 at 45° which were closest to 1. V20Gy of the kidneys decreased by 9.66% and average dose of bladder and V30 decreased by 1.88% and 2.16% at 45° compared to 10° for the critical organs. The dose value at the junction of the plan and the actual measured were within 0.3% and within tolerance. At the junction, due to set-up error the maximum dose increased to 14.56%, 9.88%, 8.03%, and 7.05%, at 10°, 20°, 30°, 45°, and the minimum dose decreased to 13.18%, 10.91%, 8.42%, and 4.53%, at 10°, 20°, 30°, 45° Conclusion: In terms of CVI, HI of PTV and critical organ protection, overall improved values were shown as the collimator angle increased. The impact on set-up error at the junction by collimator angle decreased as the angle increased and it will help improve the anxiety about the set up error. In conclusion, the collimator angle should be recognized as a factor that can affect the quality of the multi-isocenter VMAT plan and the dose at the junction, and be careful in setting the collimator angle in the treatment plan.