• Korean Journal of Heritage: History & Science
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• v.57 no.3
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• pp.24-35
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• 2024

Recently, research using deep learning technologies such as artificial intelligence, convolutional neural networks, etc. has been actively conducted in various fields including healthcare, manufacturing, autonomous driving, and security, and is having a significant influence on society. In line with this trend, the present study attempted to apply deep learning to the classification of archaeological artifacts, specifically ancient Korean roof-end tiles. Using 100 images of roof-end tiles from each of the Goguryeo, Baekje, and Silla dynasties, for a total of 300 base images, a dataset was formed and expanded to 1,200 images using data augmentation techniques. After building a model using transfer learning from the pre-trained EfficientNetB0 model and conducting five-fold cross-validation, an average training accuracy of 98.06% and validation accuracy of 97.08% were achieved. Furthermore, when model performance was evaluated with a test dataset of 240 images, it could classify the roof-end tile images from the three dynasties with a minimum accuracy of 91%. In particular, with a learning rate of 0.0001, the model exhibited the highest performance, with accuracy of 92.92%, precision of 92.96%, recall of 92.92%, and F1 score of 92.93%. This optimal result was obtained by preventing overfitting and underfitting issues using various learning rate settings and finding the optimal hyperparameters. The study's findings confirm the potential for applying deep learning technologies to the classification of Korean archaeological materials, which is significant. Additionally, it was confirmed that the existing ImageNet dataset and parameters could be positively applied to the analysis of archaeological data. This approach could lead to the creation of various models for future archaeological database accumulation, the use of artifacts in museums, and classification and organization of artifacts.

• Radiation Oncology Journal
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• v.19 no.2
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• pp.127-135
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• 2001

Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

• Journal of Korean Home Economics Education Association
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• v.30 no.4
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• pp.141-164
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• 2018

The purpose of this study was to investigate the stress perception, dietary habits, lifestyle and snack intake behaviors of students to help dietary education of high school students in Jeonnam area. The data were collected from high school students in Jeonnam area and 503 questionnaires were used for analysis. The main results of this study are as follows. First, the mean scores of high school students' perception of stress were 2.92 points for male students and 3.07 points for female students, and female students were statistically significantly higher than male students(p<.01). Stress perceptions showed significant differences in school stress(p<.001) and family stress(p<.05) according to gender, and female students gained more stressed than male students. Second, the dietary habits and lifestyle characteristics of high school students by gender showed significant difference between male students and female students at the one meal time(p<.001), the amount of meal(p<.05), the tendency of eating habits(p<.001), the salty taste of food(p<.05), the exercise frequency per week(p<.001) and the exercise time per day(p<.001), respectively. One meal time was shorter for male students than for female students, and the amount of meals was more suitable amount for female students than male students. Also, male students ate more regularly than female students and female students preferred more stimulating foods than male students. Male students ate slightly bland salty taste, and female students ate standard salty taste. The exercise frequency per week and the exercise time per day were more in male students than in female students. Third, the snack intake characteristics of high school students by gender showed significantly different between male students and female students at the cost of snack per day(p<.01), the time to eat snacks(p<.01) and the favorite snacks(p<.001), respectively. The cost of snack per day was higher for female students than for male students in case of less than 4,000 won. The time for eating snack showed that 'Irregularly' was high for male students and 'In the evening after lunch' was high for female students. The favorite snacks were cookies, candies and chocolates for male and female students. Forth, the dietary habits and lifestyle characteristics of high school students by stress level showed significantly different at the frequency of daily meals(p<.05), the tendency of eating habits(p<.01) and the salty taste of food(p<.05), respectively. The frequency of daily meals was more than four times in case of the 'High stress' and 'Low stress' groups. The tendency of eating habit was low in regular meal rate in 'High stress' group. Fifth, the snack intake characteristics of high school students by stress level showed significantly different in the frequency of snacks per day(p<.05) and the favorite taste of snacks(p<.05). In case of the frequency of daily snack intake, 'More than 4 times' was highest in 'High stress' group and 'Low stress' group. The favorite taste of snacks showed that the spicy taste was highest in the 'High stress' group and the 'Low stress' group.

• Korean Journal of Soil Science and Fertilizer
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• v.43 no.2
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• pp.230-236
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• 2010

Jeju Island is a volanic island which is located about 96 km south of Korean Peninsula. Volcanic ejecta, and volcaniclastic materials are widespread as soil parent materials throughout the island. Soils on the island have the characteristics of typical volcanic ash soils. This study was conducted to reclassify Jeju series based on the second edition of Soil Taxonomy and to discuss the formation of Jeju series in Jeju Island. Morphological properties of typifying pedon of Jeju series were investigated, and physico-chemical properties were analyzed according to Soil survey laboratory methods manual. The typifying pedon has dark brown (10YR 3/3) silt clay loam A horizon (0~22 cm), strong brown (7.5YR 4/6) silty clay BAt horizon (22~43 cm), brown (7.5YR 4/4) silty clay Bt1 horizon (43~80 cm), brown (7.5YR 4/6) silty clay loamBt2 horizon (80~105 cm), and brown (10YR 5/4) silty clay loam Bt3 horizon (105~150 cm). It is developed in elevated lava plain, and are derived from basalt, and pyroclastic materials. The typifying pedon contains 1.3~2.1% oxalate extractable (Al + 1/2 Fe), less than 85%phosphate retention, and higher bulk density than 0.90 Mg $m^{-3}$. That can not be classified as Andisol. But it has an argillic horizon from a depth of 22 to 150 cm, and a base saturation (sum of cations) of less than 35% at 125 cm below the upper boundary of the argillic horizon. That can be classified as Ultisol, not as Andisol. Its has 0.9% or more organic carbon in the upper 15 cm of the argillic horizon, and can be classified as Humult. It dose not have fragipan, kandic horizon, sombric horizon, plinthite, etc. in the given depths, and key out as Haplohumult. A hoizon (0~22 cm) has a fine-earth fraction with both a bulk density of 1.0 Mg $cm^{-3}$ or less, and Al plus 1/2 Fe percentages (by ammonium oxalate) totaling more than 1.0. Thus, it keys out as Andic Haplohumult. It has 35% or more clay at the particle-size control section, and has thermic soil temperature regime. Jeju series can be classified as fine, mixed, themic family of Andic Haplohumults, not as ashy, thermic family of Typic Hapludands. In the western, and northern coastal areas which have a relatively dry climate in Jeju Island, non Andisols are widely distributed. Mean annual precipitation increase 110 mm, and mean annual temperature decrease $0.8^{\circ}C$ with increasing elevation of 100m. In the western, and northern mid-mountaineous areas Andisols, and non Andisols are distributed simultaneously. Jeju series distributed mainly in the western and northern mid-mountaineous areas are developed as Ultisols with Andic subgroup.

• Radiation Oncology Journal
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• v.14 no.3
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• pp.221-228
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• 1996

Purpose : We tried to evaluate the clinical characteristics, the treatment methods, the results of treatments, and the Patterns of failure in ovarian dysgerminoma retrospectively According to the results we would like to suggest the proper management guideline of stage la ovarian dysgerminoma patients who want to maintain fertility. Materials and Methods : Between 1975 and 1990, 34 patients with ovarian dysgerminoma were treated at the Yonsei University Hospital. The case records of these patients have been reviewed for presenting symptoms, treatment methods, local control and survival following treatment. Excluded from analysis were five patients with mixed ovarian germ cell tumors and gonadoblastomas (46,XY) Treatment results of the twenty nine patients were analysed by each treatment modality. Twenty one patients were treated with surgery and postoperative adjuvant radiotherapy (group 2). The other eight patients were treated with operation alone (group 2). The median age of twenty-nine patients was 23 years with a range of 8 to 39 years. Presenting symptoms were abdominal mass (20) pelvic discomfort or pain (5) et al. Radiotherapy was performed by 10MV LINAC or Co-60 teletherapy unit. The total radiation dose of the whole abdomen was 20-25 Gy/3weeks, 1-1.5 Gy/fraction with a boost to the whole pelvis 10-15 Gy/l-2weeks 1.8-2.0 Gy/fraction. Advanced stage disease (stage II or stage III) patients received prophylactic mediastinal and supraclavicular irradiation to a dose of 16-26 Gy. Median duration of follow-up of living patients was 80 months (range 13-201 months). Results : All of the twenty one patients of group 1 were alive without disease ($100\%$). Among the eight patients who were not treated with radiotherapy (group 2), six patients developed local recurrence. Four Patients referred with recurrent disease were treated with salvage radiotherapy. Three of four patients were salvaged and one Patient who had recurrent intra-abdominal disease died of progressed carcinomatosis at 11 months after salvage radiotherapy. The other two patients with recurrence were salvaged with chemotherapy (1 patient) or re-operation (1 Patient). Twenty eight patients remained alive without disease at last follow up, so the 5 year local control rate and 5 year overall survival rate for all groups were $96.6\%$ (28/29), respectively. Among thirteen patients with stage la unilateral tumors seven patients were treated with postoperative radiotherapy and the other six patients were treated with unilateral salpingo-oophorectomy alone. Five patients who did not received radiotherapy developed local failure but all of the recurrent ovarian dysgerminomas were salvaged with radiotherapy, chemotherapy or re-operation. So all the 13 patients with stage la ovarian dysgerminoma were free of disease from 20-201 months (median 80 months). Conclusion : The authors consider external irradiation to be an effective treatment as a complement to surgery in ovarian dysgerminoma. For those patients with disease presenting in stage la tumors who wish to maintain fertility, unilateral salpingo-oophorectomy alone may be curative and spare ovarian function considering excellent salvage rate of recurrent ovarian dysgerminoma in present study.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.2
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• pp.81-89
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• 2011

The results of tracking the symbolism of plants in the introduction factors of Sokhwa(folk painting) are as the following. 1. The term Sokhwa(俗畵) is not only a type of painting with a strong local customs, but also carries a symbolic meaning and was discovered in "Donggukisanggukjip" of Lee, Gyu-Bo(1268~1241) in the Goryo era as well as the various usage in the "Sok Dongmunseon" in the early Chosun era, "Sasukjaejip" of Gang, Hee-mang(1424~1483), "Ilseongrok(1786)" in the late Chosun era, "Jajeo(自著)" of Yoo, Han-joon(1732~1811), and "Ojuyeonmunjangjeonsango(五洲衍文長箋散稿)" of Lee, Gyu-gyung(1788~?). Especially, according to the Jebyungjoksokhwa allegation〈題屛簇俗畵辯證說〉in the Seohwa of the Insa Edition of Ojuyeonmunjangjeonsango, there is a record that the "people called them Sokhwa." 2. Contemporarily, the Korean Sokhwa underwent the prehistoric age that primitively reflected the natural perspective on agricultural culture, the period of Three States that expressed the philosophy of the eternal spirits and reflected the view on the universe in colored pictures, the Goryo Era that religiously expressed the abstract shapes and supernatural patterns in spacein symbolism, and the Chosun Era that established the traditional Korean identity of natural perspective, aesthetic values and symbolism in a complex integration in the popular culture over time. 3. The materials that were analyzed in 1,009 pieces of Korean Sokhwa showed 35 species of plants, 37 species of animals, 6 types of natural objects and other 5 types with a total of 83 types. 4. The shape aesthetics according to the aesthetic analysis of the plants in Sokhwa reflect the primitive world view of Yin/yang and the Five Elements in the peony paintings and dynamic refinement and biological harmonies in the maehwado; the composition aesthetics show complex multi-perspective composition with a strong noteworthiness in the bookshelf paintings, a strong contrast of colors with reverse perspective drawing in the battlefield paintings, and the symmetric beauty of simple orderly patterns in nature and artificial objects with straight and oblique lines are shown in the leisurely reading paintings. In terms of color aesthetics, the five colors of directions - east, west, south, north and the center - or the five basic colors - red, blue, yellow, white and black - are often utilized in ritual or religious manners or symbolically substitute the relative relationships with natural laws. 5. The introduction methods in the Korean Sokhwa exceed the simple imitation of the natural shapes and have been sublimated to the symbolism that is related to nature based on the colloquial artistic characteristics with the suspicion of the essence in the universe. Therefore, the symbolism of the plants and animals in the Korean Sokhwas is a symbolic recognition system, not a scientific recognition system with a free and unique expression with a complex interaction among religious, philosophical, ecological and ideological aspects, as a identity of the group culture of Koreans where the past and the future coexist in the present. This is why the Koran Sokhwa or the folk paintings can be called a cultural identity and can also be interpreted as a natural and folk meaningful scenic factor that has naturally integrated into our cultural lifestyle. However, the Sokhwa(folk paintings) that had been closely related to our lifestyle drastically lost its meaning and emotions through the transitions over time. As the living lifestyle predominantly became the apartment culture and in the historical situations where the confusion of the identity has deepened, the aesthetic and the symbolic values of the Sokhwa folk paintings have the appropriateness to be transmitted as the symbolic assets that protect our spiritual affluence and establish our identity.

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.5-19
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• 1998

Introduction: Direct histologic and bacteriologic examination of a representative specimen of lung tissue is the only certain method of providing an accurate diagnosis in various pulmonary diseases including diffuse pulmonary diseases. The purpose of national survey was to define the indication, incidence, effectiveness, safety and complication of open and thoracoscopic lung biopsy in korea. Methods: A multicenter registry of 37 university or general hospitals equipped more than 400 patient's bed were retrospectively collected and analyzed for 3 years from the January 1994 to December 1996 using the same registry protocol. Results: 1) There were 511 cases from the 37 hospitals during 3 years. The mean age was 50.2 years(${\pm}15.1$ years) and men was more prevalent than women(54.9% vs 45.9%). 2) The open lung biopsy was performed in 313 cases(62%) and thoracoscopic lung biopsy was performed in 192 cases(38%). The incidence of lung biopsy was more higher in diffuse lung disease(305 cases, 59.7%) than in localized lung disease(206 cases, 40.3%) 3) The duration after abnormalities was found in chest X-ray until lung biopsy was 82.4 days(open lung biopsy: 72.8 days, thoracoscopic lung biopsy: 99.4 days). The bronchoscopy was performed in 272 cases(53.2%), bronchoalveolar lavage was performed in 123 cases(24.1%) and percutaneous lung biopsy was performed in 72 cases(14.1%) before open or thoracoscopic lung biopsy. 4) There were 230 cases(45.0%) of interstitial lung disease, 133 cases(26.0%) of thoracic malignancies, 118 cases(23.1%) of infectious lung disease including tuberculosis and 30 cases (5.9 %) of other lung diseases including congenital anomalies. No significant differences were noted in diagnostic rate and disease characteristics between open lung biopsy and thoracoscopic lung biopsy. 5) The final diagnosis through an open or thoracoscopic lung biopsy was as same as the presumptive diagnosis before the biopsy in 302 cases(59.2%). The identical diagnostic rate was 66.5% in interstitial lung diseases, 58.7% in thoracic malignancies, 32.7% in lung infections, 55.1 % in pulmonary tuberculosis, 62.5% in other lung diseases including congenital anomalies. 6) One days after lung biopsy, $PaCO_2$ was increased from the prebiopsy level of $38.9{\pm}5.8mmHg$ to the $40.2{\pm}7.1mmHg$(P<0.05) and $PaO_2/FiO_2$ was decreased from the prebiopsy level of $380.3{\pm}109.3mmHg$ to the $339.2{\pm}138.2mmHg$(P=0.01). 7) There was a 10.1 % of complication after lung biopsy. The complication rate in open lung biopsy was much higher than in thoracoscopic lung biopsy(12.4% vs 5.8%, P<0.05). The incidence of complication was pneumothorax(23 cases, 4.6%), hemothorax(7 cases, 1.4%), death(6 cases, 1.2%) and others(15 cases, 2.9%). 8) The 5 cases of death due to lung biopsy were associated with open lung biopsy and one fatal case did not describe the method of lung biopsy. The underlying disease was 3 cases of thoracic malignancies(2 cases of bronchoalveolar cell cancer and one malignant mesothelioma), 2 cases of metastatic lung cancer, and one interstitial lung disease. The duration between open lung biopsy and death was $15.5{\pm}9.9$ days. 9) Despite the lung biopsy, 19 cases (3.7%) could not diagnosed. These findings were caused by biopsy was taken other than target lesion(5 cases), too small size to interpretate(3 cases), pathologic inability(11 cases). 10) The contribution of open or thoracoscopic lung biopsy to the final diagnosis was defininitely helpful(334 cases, 66.5%), moderately helpful(140 cases, 27.9%), not helpful or impossible to judge(28 cases, 5.6%). Overall, open or thoracoscopic lung biopsy were helpful to diagnose the lung lesion in 94.4 % of total cases. Conclusions: The open or thoracoscopic lung biopsy were relatively safe and reliable diagnostic method of lung lesion which could not diagnosed by other diagnostic approaches such as bronchoscopy. We recommend the thoracoscopic lung biopsy when the patients were in critical condition because the thoracoscopic biopsy was more safe and have equal diagnostic results compared with the open lung biopsy.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.74-80
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• 2015

Purpose Breast lymphoscintigraphy is an important technique to present for body surface precisely, which shows a lymph node metastasis of malignant tumors at an early stage and is performed before and after surgery in patients with breast cancer. In this study, we evaluated several methods of body outline imaging to present exact location of lesions, as well as compared respective exposure doses. Materials and Methods RANDO phantom and SYMBIA T-16 were used for obtaining imaging. A lesion and an injection site were created by inserting a point source of 0.11 MBq on the axillary sentinel lymph node and 37 MBq on the right breast, respectively. The first method for acquiring the image was used by drawing the body surface of phantom for 30 sec using $Na^{99m}TcO_4$ as a point source. The second, the image was acquired with $^{57}Co$ flood source for 30 seconds on the rear side and the left side of the phantom, the image as the third method was obtained using a syringe filled with 37 MBq of $Na^{99m}TcO_4$ in 10 ml of saline, and as the fourth, we used a photon energy and scatter energy of $^{99m}Tc$ emitting from phantom without any addition radiation exposure. Finally, the image was fused the scout image and the basal image of SPECT/CT using MATLAB$^{(R)}$ program. Anterior and lateral images were acquired for 3 min, and radiation exposure was measured by the personal exposure dosimeter. We conducted preference of 10 images from nuclear medicine doctors by the survey. Results TBR values of anterior and right image in the first to fifth method were 334.9 and 117.2 ($1^{st}$), 266.1 and 124.4 ($2^{nd}$), 117.4 and 99.6 ($3^{rd}$), 3.2 and 7.6 ($4^{th}$), and 565.6 and 141.8 ($5^{th}$). And also exposure doses of these method were 2, 2, 2, 0, and $30{\mu}Sv$, respectively. Among five methods, the fifth method showed the highest TBR value as well as exposure dose, where as the fourth method showed the lowest TBR value and exposure dose. As a result, the last method ($5^{th}$) is the best method and the fourth method is the worst method in this study. Conclusion Scout method of SPECT/CT can be useful that provides the best values of TBR and the best score of survey result. Even though personal exposure dose when patients take scout of SPECT/CT was higher than another scan, it was slight level comparison to 1 mSv as the dose limit to non-radiation workers. If the scout is possible to less than 80 kV, exposure dose can be reduced, and also useful lesion localization provided.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.14-20
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• 2016

Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

• Radiation Oncology Journal
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• v.20 no.1
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• pp.41-52
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• 2002

Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.