• Progress in Medical Physics
• /
• v.22 no.1
• /
• pp.35-41
• /
• 2011

For overall system test, hidden-target test have been used using film which leads to inherent analysis error. The purpose of our study is to quantify this error and to propose gel dosimeter based verification technique for 3-dimensional target point error. The phantom was made for simulation of human head and this has ability to equip 10 gel-dosimeter. $BANGkit^{TM}$ which we are able to manufacture whenever it is needed as well as to easily change the container with different shapes was used as a gel dosimeter. The 10 targets were divided into two groups based on shapes of areas with a planned 50% isodose line. All treatment and analysis was performed three times using Novalis and $BrainSCAN^{TM}$. The target point error is $0.77{\pm}0.15mm$ for 10 targets and directional target point error in each direction is $0.54{\pm}0.23mm$, $0.37{\pm}0.08mm$, $0.33{\pm}0.10mm$ in AP (anterior-posterior), LAT (lateral), and VERT (vertical) direction, respectively. The result of less than 1 mm shows that the treatment was performed through each precise step in treatment procedure. In conclusion, the 3-dimensional target point verification technique can be one of the techniques for overall system test.

• Journal of radiological science and technology
• /
• v.35 no.4
• /
• pp.335-343
• /
• 2012

Intensity-modulated radiotherapy(IMRT) have the ability to provide better dose conformity and sparing of critical normal tissues than three-dimensional radiotherapy(3DCRT). Especially, with the benefit of health insurance in 2011, its use now increasingly in many modern radiotherapy departments. Also the use of linear accelerator with high-energy photon beams over 10 MV is increasing. As is well known, these linacs have the capacity to produce photonueutrons due to photonuclear reactions in materials with a large atomic number such as the target, flattening filters, collimators, and multi-leaf collimators(MLC). MLC-based IMRT treatments increase the monitor units and the probability of production of photoneutrons from photon-induced nuclear reactions. The purpose of this study is to quantitatively evaluate the dose of photoneutrons produced from 3DCRT and IMRT technique for Rando phantom in cervical cancer. We performed the treatment plans with 3DCRT and IMRT technique using Rando phantom for treatment of cervical cancer. An Rando phantom placed on the couch in the supine position was irradiated using 15 MV photon beams. Optically stimulated luminescence dosimeters(OSLD) were attached to 4 different locations (abdomen, chest, head and neck, eyes) and from center of field size and measured 5 times each of locations. Measured neutron dose from IMRT technique increased by 9.0, 8.6, 8.8, and 14 times than 3DCRT technique for abdomen, chest, head and neck, and eyes, respectively. When using IMRT with 15 MV photonbeams, the photoneutrons contributed a significant portion on out-of-field. It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, It is difficult to prevent high energy photon beams to produce the phtoneutrons due to physical properties, if necessary, it is need to provide the additional safe shielding on a linear accelerator and should therefore reduce the out-of-field dose.

• Radiation Oncology Journal
• /
• v.25 no.4
• /
• pp.261-267
• /
• 2007

Purpose: To evaluate the association between radiation pneumonitis and dose-volume histogram parameters and to provide practical guidelines to prevent radiation pneumonitis following radiotherapy administered for breast cancer including internal mammary lymph nodes. Materials and Methods: Twenty patients with early breast cancer who underwent a partial mastectomy were involved in this study. The entire breast, supraclavicular lymph nodes, and internal mammary lymph nodes were irradiated with a dose of 50.4 Gy in 28 fractions. Radiation pneumonitis was assessed by both radiological pulmonary change (RPC) and by evaluation of symptomatic radiation pneumonitis. Dose-volume histogram parameters were compared between patients with grade <2 RPC and those with grade ${\geq}$2 RPC. The parameters were the mean lung dose, V10 (percent lung volume receiving equal to and more than 10 Gy), V20, V30, V40, and normal tissue complication probability (NTCP). Results: Of the 20 patients, 9 (45%) developed grade 2 RPC and 11 (55%) did not develop RPC (grade 0). Only one patient developed grade 1 symptomatic radiation pneumonitis. Univariate analysis showed that among the dose-volume histogram parameters, NTCP was significantly different between the two RPC grade groups (p<0.05). Fisher's exact test indicated that an NTCP value of 45% was appropriate as an RPC threshold level. Conclusion: This study shows that NTCP can be used as a predictor of RPC after radiotherapy of the internal mammary lymph nodes in breast cancer. Clinically, it indicates that an RPC is likely to develop when the NTCP is greater than 45%.

• The Journal of Korean Society for Radiation Therapy
• /
• v.31 no.2
• /
• pp.51-63
• /
• 2019

Purpose: Radiation therapy for breast cancer should consider the change in breast shape due to breathing and swelling. In this study, we evaluate the benefit of using virtual bolus for IMRT of left breast cancer. Materials and methods: 10 patients with early breast cancer who received radiation therapy after breastconserving surgery compared the VMAT and IMRT plans using the virtual bolus method and without using it. The first analysis compared the V95%, HI, CI of treatment volume, Dmean, V5, V20, V30 of ipsilateral lung, and Dmean of heart in VMAT plan made using the virtual bolus method(VMAT_VB) to the plan without using it(VMAT_NoVB) in case there is no change in the breast. In IMRT, the same method was used. The second analysis compared TCP and NTCP based on each treatment plan in case there is 1cm expansion of treatment volume. Result: If there is no change in breast, V95% in VB Plan(VMAT_VB, IMRT_VB) and NoVB Plan(VMAT_NoVB, IMRT_NoVB) is all over 99% on each treatment plan. V95% in VMAT_NoVB and VMAT_VB is 99.80±0.17% and 99.75±0.12%, V95% in IMRT_NoVB and IMRT_VB is 99.67±0.26% and 99.51±0.15%. Difference of HI, CI is within 3%. OAR dose in VB plan is a little high than NoVB plan, and did not exceed guidelines. If there is 1cm change in breast, VMAT_NoVB and IMRT_NoVB are less effective for treatment. But VMAT_VB and IMRT_VB continue similar treatment effect compared in case no variation of breast. Conclusion: This study confirms the benefit of using a virtual bolus during VMAT and IMRT to compensate potential breast shape modification.

• Journal of radiological science and technology
• /
• v.42 no.3
• /
• pp.217-222
• /
• 2019

The purpose of this study is to evaluate the dose distribution by gantry rotation and MLC moving speed on treatment planning system(TPS) and linear accelerator. The dose analyzer phantom(Delta 4) was scanned by CT simulator for treatment planning. The planning target volumes(PTVs) of prostate and pancreas was prescribed 6,500 cGy, 5,000 cGy on VMAT(Volumetric Modulated Arc Therapy) by TPS while MLC speed changed. The analyzer phantom was irradiated linear accelerator using by planned parameters. Dose distribution of PTVs were evaluated by the homogeneity index, conformity index, dose volume histogram of organ at risk(rectum, bladder, spinal cord, kidney). And irradiated dose analysis were evaluated dose distribution and conformity by gamma index. The PTV dose of pancreas was 4,993 cGy during 0.1 cm/deg leaf and gantry that was the most closest prescribed dose(5,000 cGy). The dose of spinal cord, left kidney, and right kidney were accessed the lowest during 0.1 cm/deg, 1.5 cm/deg, 0.3 cm/deg. The PTV dose of prostate was 6,466 cGy during 0.1 cm/deg leaf and gantry that was the most closest prescribed dose(6,500 cGy). The dose of bladder and rectum were accessed the lowest during 0.3 cm/deg, 2.0 cm/deg. For gamma index, pancreas and prostate were analyzed the lowest error 100% at 0.8, 1.0 cm/deg and 99.6% at 0.3, 0.5 cm/deg. We should used the optimal leaf speed according to the gantry rotation if the treatment cases are performed VMAT.

• The Journal of Korean Society for Radiation Therapy
• /
• v.20 no.1
• /
• pp.45-53
• /
• 2008

Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

• Proceedings of the Korea Water Resources Association Conference
• /
• 2007.05a
• /
• pp.825-830
• /
• 2007

사면에서 발생되는 강우유출과정에 기여하는 대공극의 영향은 그 중요성에도 불구하고 잘 알려져 있지 않다. 특히 대공극의 공간적분포특상에 대한 현장측정은 이뤄지지 않았다. 본 연구의 실험지역은 경기도 포천시 광릉수목원에 있는 작은 소유역이다. 이 지역의 정밀한 측량을 하여 수치고도모형(DEM)을 얻었다. 이 수치고도모형을 바탕으로 수치지형분석을 통해 흐름선을 파악하여 총 20지점을 선정하였다. 각 지점에서의 대공극을 통한 수직적인 유동들은 장력침투계를 사용하여 지표면아래 깊이 10cm에서 측정하였다. 공간적 토양의 특성분포를 파악하기 위해 각 지점에서의 체적밀도와 점토함량을 조사하였다. 토양수분의 공간적 분포 특성은 TDR(Time Domain Reflectometry)방식인 TRASE를 이용하여 토양수분 값을 얻었다. 이러한 다양한 공간적 특성들은 대공극발달의 공간적 분포특성을 파악하는 중요자료가 된다. 소유역을 크게 기여사면 면적을 기준으로 상부, 중부, 하부로 나누어 대공극의 유효 공극율과 대공극흐름율을 계산하였다. 상부에서의 유효 대공극율의 평균값과 변동계수는 각각 4.3%, 42.1%이고, 대공극흐름율의 평균값과 변동계수는 각각 45.0%, 26.6%이다. 중부에서는 유효 대공극율의 평균값과 변동계수는 6.8%, 37.3%이고, 대공극흐름율의 평균값과 변동계수는 56.2%, 14.4% 이다. 그리고 하부에서의 유효공극율의 평균값과 변동계수는 12.5%, 58.3% 이고 대공극흐름율의 평균값과 변동계수는 64.5%, 24%이다. 이는 유효 대공극율과 대공극흐름율의 비율은 기여사면 면적이 증가할수록 증가하였다. 이는 대공극을 통한 물 이송 능력이 원두부로 갈수록 증가한다는 것을 보여주고 있다.e, taurine, methionine, phenylalanine은 함량(含量)이 적었다. 5. 일건(日乾)중 총유리아미노산의 변화(變化)는 생시료(生試料)의 경우 2,041.2 mg%였으나 1일(日) 건조(乾燥) 후는 1,784.0 mg%로 감소(減少)하다가 그 이후 계속 증가(增加)하여 20일(日) 건조(乾燥) 후는 5,277.0 mg%였다. 6. 일건(日乾)중 leucine, isoleucine, valine은 대체로 증가(增加)하는 경향(傾向)을 나타내었으나 aspartic acid, proline, taurine은 대체로 감소(減少)하는 경향(傾向)을 나타내었다. 436.59mg%로 가장 많았고 군유산(軍有山) 차엽(茶葉)이 146.94mg%로 가장 적었으며 일반차엽(一般茶葉)의 평균치(平均値)는 264.59mg%, 용장(龍欌) 차엽(茶葉)이 223.10mg%, Yabukita 차엽(茶葉)이 256.49mg%였다. 7) 이상(以上)의 결과(結果)를 종합(綜合)할 때 용장(龍欌) 차엽(茶葉)은 일반차엽(一般茶葉)과 형질(形質) 뿐만 아니라, 성분(成分)도 다르므로 품종(品種)이 다른 수종(樹種)으로 추정(推定)되며 와운(臥雲) 차엽(茶葉)은 일반차엽(一般茶葉)과 형질(形質)은 다르나 성분상(成分上)의 비슷한 점으로 보아 동일계통(同一系統)의 변이(變異)된 대엽종(大葉種)으로 추정(推定)된다.5(${\pm}0.77$0.77) % 의 오차로 크게 감소하였다. 결론: 방사선이 통과하는 경로에 불균질조직인 폐가 존재할 경우에도 불균질조직에 대하여 조직의 밀도를 이용하여 보정하는 방법을 사용하여 투과선량으로부터 종양선량을 계산할 수 있음을 알 수 있었다.X>로 평균$43.26{\m

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.191-197
• /
• 2014

Purpose : This study presents the usefulness assessment of metal artifact reduction for orthopedic implants(O-MAR) to decrease metal artifacts from materials with high density when acquired CT images. Materials and Methods : By CT simulator, original CT images were acquired from Gammex and Rando phantom and those phantoms inserted with high density materials were scanned for other CT images with metal artifacts and then O-MAR was applied to those images, respectively. To evaluate CT images using Gammex phantom, 5 regions of interest(ROIs) were placed at 5 organs and 3 ROIs were set up at points affected by artifacts. The averages of standard deviation(SD) and CT numbers were compared with a plan using original image. For assessment of variations in dose of tissue around materials with high density, the volume of a cylindrical shape was designed at 3 places in images acquired from Rando phantom by Eclipse. With 6 MV, 7-fields, $15{\time}15cm2$ and 100 cGy per fraction, treatment planning was created and the mean dose were compared with a plan using original image. Results : In the test with the Gammex phantom, CT numbers had a few difference at established points and especially 3 points affected by artifacts had most of the same figures. In the case of O-MAR image, the more reduction in SD appeared at all of 8 points than non O-MAR image. In the test using the Rando Phantom, the variations in dose of tissue around high density materials had a few difference between original CT image and CT image with O-MAR. Conclusion : The CT images using O-MAR were acquired clearly at the boundary of tissue around high density materials and applying O-MAR was useful for correcting CT numbers.

• Progress in Medical Physics
• /
• v.22 no.2
• /
• pp.99-105
• /
• 2011

The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

• Radiation Oncology Journal
• /
• v.23 no.2
• /
• pp.92-97
• /
• 2005

Purpose : Reports on the outcome of curative radiotherapy for the primary hepatocellular carcinoma (HCC) are rarely encountered in the literature. in this study, we report our experience of a clinical trial where fractionated stereotactic radiotherapy (SRT) was used in treating a primary HCC. Materials and Methods : A retrospective analysis was peformed on 20 patients who had been histologically diagnosed as HCC and treated by fractionated SRT. The long diameter of tumor measured by CT was $2\~6.5$ cm (average: 3.8 cm). A single dose of radiation used in fractionated SRT was S or 10 Gy: each dose was prescribed based on the planning target volume and normalized to $85\~99\%$ isocenter dose. Patients were treated $3\~5$ times per week for 2 weeks, with each receiving a total dose of 50 Gy (the median dose: 50 Gy). The follow up period was $\~55$ months (the median follow up period: 23 months). Results : The response rate was $50\%$ (12 patients), with 4 patients showing complete response ($20%$), 8 patients showing partial response ($40\%$), and 8 patients showing stable disease ($40\%$). The 1-year and 2-year survival rates were $70.0\%$ and $43.1\%$, respectively, and the median survival time was 20 months. The 1-year and 2-year disease free survival rates were $65\%$ and $32.5\%$, respectively, and the median disease-free survival rate was 19 months. Some acute complications of the treatment were noted as follows: dyspepsia in 12 patients ($60\%$), nausea/emesis in 8 patients ($40\%$), and transient liver function impairment in 6 patients ($30\%$). However, there was no treatment related death. Conclusion : The study indicates that fractionated SRT is a relatively safe and effective method for treating primary HCC. Thus, fractionated SRT may be suggested as a local treatment for HCC of small lesion and containing a single lesion, when the patients are inoperable or operation is refused by the patients. We thought that fractionated SRT is a challenging treatment modality for the HCC.