• Title/Summary/Keyword: 치료계획시스템

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Evaluation of Every Other Day - Cone Beam Computed Tomography in Image Guided Radiation Therapy for Prostate Cancer (전립선암의 영상유도방사선치료 시 격일 콘빔 CT 적용의 유용성 평가)

  • Park, Byoung Suk;Ahn, Jong Ho;Kim, Jong Sik;Song, Ki Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.289-295
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    • 2014
  • Purpose : Cone Beam Computed Tomography(CBCT) in Image Guided Radiation Therapy(IGRT), Set-up error can be reduced but exposure dose of the patient due to CBCT will increase. Through this study, we are to evaluate by making a scenario with the implementation period of CBCT as every other day. Materials and Methods : Of prostate cancer patients, 9 patients who got a Intensity Modulated Radiation Therapy(IMRT) with CBCT in IGRT were analyzed. Based on values corrected by analyzing set-up error by using CBCT every day during actual treatment, we created a scenario that conducts CBCT every other day. After applying set-up error values of the day not performing CBCT in the scenario to the treatment planning system(Pinnacle 9.2, Philips, USA) by moving them from the treatment iso-center during actual treatment, we established re-treatment plan under the same conditions as actual treatment. Based on this, the dose distribution of normal organs and Planning Target Volume(PTV) was compared and analyzed. Results : In the scenario that performs CBCT every other day based on set-up error values when conducting CBCT every day, average X-axis : $0.2{\pm}0.73mm$, Y-axis : $0.1{\pm}0.58mm$, Z-axis : $-1.3{\pm}1.17mm$ difference was shown. This was applied to the treatment planning to establish re-treatment plan and dose distribution was evaluated and as a result, Dmean : -0.17 Gy, D99% : -0.71 Gy of PTV difference was shown in comparison with the result obtained when carrying out CBCT every day. As for normal organs, V66 : 1.55% of rectal wall, V66 : -0.76% of bladder difference was shown. Conclusion : In case of a CBCT perform every other day could reduce exposure dose and additional treatment time. And it is thought to be able to consider the application depending on the condition of the patient because the difference in the dose distribution of normal organs, PTV is not large.

Application of digital implant system on implant treatment with "all-on-4" concept (디지털 임플란트 시스템을 전용한 "All-on-4" 개념의 임플란트 보철 증례)

  • Kim, Yong-Jun;Jeong, Seung-Mi;Kim, Kyeong-Hee;Fang, Jeong-Whan;Kim, Dae-Hwan;Choi, Byung-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.88-94
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    • 2018
  • Recently, digital implant systems are expanding its influence in dental area. Due to technical improvement, they jumped over their limits nowadays. We can use these newest systems to treat edentulous patient, from implant surgery to fabrication of prosthesis. In this case, The patient was a fifty years old female. She had a full edentulous ridge on mandible and wanted to reconstruct occlusion with using implants. We planned to use digital implant system with "all-on-4" concept on mandible and produced surgical guide for flapless implant surgery. After the surgery, we tried to fabricate full arch prosthesis just using a digital devices and confirmed satisfying result.

Implant surgery and prosthodontic treatment of Temporomandibular disorder patient combined SERAFIN clear aligner system : Clinical case report (세라핀 투명교정 시스템을 활용한 교합 장애 및 치아 결손 증례의 치료)

  • Won-Gun, Chang
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.31 no.1
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    • pp.11-18
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    • 2022
  • Adult patients who need implant and prosthodontic treatment often need treatment to improve the existing occlusion through orthodontic treatment for long-term stable treatment results. However, due to non-aesthetic and uncomfortable orthodontic treatment with orthodontic brackets and wires, many adult patients give up treatment even though they know the need for it. Recently, as digital dentistry has affected all areas of dentistry, clear aligner orthodontic systems have begun to be widely used, and their use is increasing in adults and old-aged people due to the esthetic advantage and convenient oral care. SERAFIN clear aligner system developed in Korea has been developed with the aim of implementing a functional occlusion harmony and is used not only for partial orthodontic treatment but also comprehensive orthodontic treatment. This patient presentation is shown the treatment using SERAFIN clear aligner system for the treatment of patient with TMD, severe extrusion of maxillary second molars, and extracted teeth.

Robust Plan Generation and Dynamic Execution for Intelligent Web Service (지능적인 웹서비스를 위한 강건한 계획 생성과 동적 실행 방법)

  • Hwang, Gyeong-Sun;Lee, Seung-Hui;Lee, Geon-Myeong
    • Proceedings of the Korean Institute of Intelligent Systems Conference
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    • 2007.04a
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    • pp.320-323
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    • 2007
  • 웹 서비스와 같은 분산된 환경에서, 특정 서비스를 수행하기 위해서는 원격의 컴퓨터나 사이트상에서 다중 에이전트들의 협업을 통해 이루어진다. 이때 서비스는 여러 에이전트들의 복잡한 행위들에 의해 구성된다. 또한 지능적인 서비스를 위해서는 에이전트들의 상태정보, 목적정보, 그리고 계획정보 등을 이용한다. 특히 계획정보는 에이전트들이 일련의 행위들로 구성된다. 하지만 계획수립을 위한, 기존 연구들 대부분은 정적으로 기술된 서비스 명세와 초기상태 정보를 이용하여 특정 목표를 만족시키는 단일 계획 생성 방법을 연구해왔다. 따라서 계획수립이 실행 도중에 기대하지 않은 네트워크 장애나 방해 등으로 서비스 수행을 실패하는 경우, 그 계획은 무효가 되고 다시 계획을 생성 해야만 한다. 그러나 다시 계획을 생성하기 위해서는 많은 시간을 소비하게 될 뿐만 아니라 태스크 중복이 불가피하므로 매우 비효율적이다. 이 논문에서는 강건한 계획수립과 그 계획을 실행하기 위한 효과적인 방법을 제안한다. 즉, 계획수립의 재생성을 피하기 위한 방법으로 단일 계획수립 대신에 실행 가능한 다중 계획들로 표현된 강건한 계획을 생성하는 것이다. 강건한 계획의 행위들이 실행되는 동안, 각 단계마다 실행 가능한 행위를 선택한 후, 그 행위를 실행한다. 그러나 선택된 행위가 실행결과를 낼 수 없을 경우, 대체 가능한 서브 계획 경로를 선택하여 실행한다. 강건한 계획을 표현하기 위해 페트리 넷 기반의 방법을 제안한다. 강건한 계획 생성 방법에서는 이용 가능한 모든 계획들을 입력으로 사용한다. 그 계획수립 방법은 HTN 계획수립기로 잘 알려진 JSHOP2 계획수립기내에 구현하였다. 계획 실행 방법으로는 주어진 강건한 계획에 대하여 행위들이 직접 실행하수 있도록 한다.며 용량에 의존하는 양상을 보였다. $H_2O_2$에 의해 유발(誘發)된 DNA의 손상은 catalase와 deferoxamine에 의해 억제되었지만 DPPD는 억제시키지 못했다. 배기음(排氣飮)은 $H_2O_2$에 의해 유발(誘發)된 ATP의 소실을 회복시켰다. 이러한 실험결과 $H_2O_2$에 의해 유발(誘發)된 세포(細胞)의 손상(損傷)은 지질(脂質)의 과산화(過酸化)와는 다른 독립적인 기전에 의해 일어남을 나타낸다. 결론 : 이러한 결과들로 볼 때 Caco-2 세포(細胞)에서 배기음(排氣飮)이 항산화작용(亢酸化作用)보다는 다른 기전을 통하여 Caco-2 세포안에서 산화제(酸化劑)에 의해 유발(誘發)된 세포(細胞)의 사망(死亡)와 DNA의 손상(損傷)을 방지할 수 있다는 것을 가리킨다. 따라서 본 연구(硏究)는 배기음(排氣飮)이 반응성산소기(反應性酸素基)에 의해 매개된 인체(人體) 위장관질환(胃腸管疾患)의 치료(治療)에 사용할 수 있을 가능성(可能性)이 있음을 제시하고 있다.에 이를 이용하여 유가배양시 기질을 공급하는 공정변수로 사용하였다 [8]. 생물학적인 폐수처리장치인 활성 슬러지법에서 미생물의 활성을 측정하는 방법은 아직 그다지 개발되어있지 않다. 본 연구에서는 슬러지의 주 구성원이 미생물인 점에 착안하여 침전시 슬러지층과 상등액의 온도차를 측정하여 대사열량의 발생량을 측정하고 슬러지의 활성을 측정할 수 있는 방법을 개발하였다.enin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는

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The evaluation of image guide system in case of rectal cancer (직장암 치료시 영상유도 시스템의 유용성 평가)

  • Jang, Sewuk;Ahn, Seungkwon;Lee, Sangkyoo;Kim, Jooho;Lee, Wonju;Cho, Jeonghee
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.1
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    • pp.85-92
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    • 2017
  • purpose: Image Guide System offers therapy precise, especially Intensity Modulated Radiation Therapy. However, organs at pelvis have variation and uncertainties each therapy. it brings IG system for verifying patient's position. In this study, analysis the variation at pelvis during rectal cancer radiation therapy. Moreover design the patient re-setup technique and apply to patients. Material and Method: 40 rectal cancer patient who have radiation therapy. The 530 image which acquired from IG system are analyzed. The bone structure, bladder, gas in the rectum, small bowel, soft tissue, weigh loss are evaluated by the criterion. The criterion are classified by best, good, bad and figure out the ratio with count. The re-setup proceed in case of one or over the two get the bad criterion and figure out the ratio of re-setup results: The ideal of therapy ratio is 19.2 % each criterion. And the good for therapy ratio is 54.9 %, the cases of bad for therapy is 25.8 %. The bad cases are have therapy after re-setup with post process. conclusion: Each pre-treatment image that acquired IG system has different results despite of same patients. The 25.8 % need to re-setup in order to unsuitable therapy. It is implies that the IG system is necessary establishing precise treatment plan like IMRT especially rectal cancer.

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Effect of CT Contrast Media on Radiation Therapy Planning (Head & Neck Cancer and Prostate Cancer) (CT조영제가 방사선치료계획(두경부, 전립선)에 미치는 영향)

  • Jang, Jaeuk;Han, Manseok;Kim, Minjeong;Kang, Hyeonsoo
    • Journal of the Korean Magnetics Society
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    • v.26 no.5
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    • pp.173-178
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    • 2016
  • This study is to evaluate the effect of a Contrast Media (CM) on dose calculations and clinical significance in Radiation (Electromagnetic wave) Therapy (RT) plans for head & neck (H&N) and prostate cancer. Pinnacle 8.0 system was used to measure the change of Electron Density (ED) of the tissue for CM. To determine the effect of dose calculation due to CM, we did the RT planning for 30 patients. To compare the ED and dose calculations of RT plans, 3D CRT and IMRT plans were do with pinnacle and Tomotherapy planning system. Mean difference of ED between enhanced and unenhanced CT was less than 4%: H&N Target Volume (TV) 2.1%, parotid 1.9%, SMG 3.6%, tongue 0.9%, spinal cord 0.3%, esophagus 2.6%, mandible 0.1% and prostate TV 0.7%, lymph node 1.1%, bladder 1.2%, rectum 1.5%, small bowel 1.2%, colon 0.6%, penile bulb 0.8%, femoral head -0.2%. The dose difference between RT plan using CM and without CM showed an increase of dose in TV. The rate of increase was less than 2.5% (3D CRT: H&N 0.69~2.51%, prostate 0.04~1.14%, IMRT: H&N 0.58~1.31%, prostate 0.36~1.04%). RT plans using a CM has the insignificant effect on the organs and TV, so this error is allowable clinically. However, the much more accurate plan is possible as to image fusion (CM and without CM images) to ROI contour and when dose calculation, use the without CM image. Using the fusion of 'ROI import' perform calculations on without CM, it will be able to reduce the error (1~3%) caused by the CM.

Analyses of the indispensible Indices in Evaluating Gamma Knife Radiosurgery Treatment Plans (감마나이프 방사선수술 치료계획의 평가에 필수불가결한 지표들의 분석)

  • Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.303-312
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    • 2017
  • The central goal of Gamma Knife radiosurgery(GKRS) is to maximize the conformity of the prescription isodose surface, and to minimize the radiation effect of the normal tissue surrounding the target volume. There are the various kinds of indices related with the quality of treatment plans such as conformity index, coverage, selectivity, beam-on time, gradient index(GI), and conformity/gradient index(CGI). As the best treatment plan evaluation tool, we must check by all means conformity index, GI, and CGI among them. Specially, GI and CGI related with complication of healthy normal tissue is more indispensible than conformity index. Then author calculated and statistically analysed CGI, the newly defined conformity/gradient index as well as GI being applied widely using the treatment planning system Leksell GammaPlan(LGP) and the verification method Variable Ellipsoid Modeling Technique(VEMT). In the study 10 patients with intracranial lesion treated by GKRS were included. Author computed the indices from LGP and VEMT requiring only four parameters: the prescribed isodose volume, the volume with dose > 30%, the target volume, and the volume of half the prescription isodose. All data were analyzed by paired t-test, which is statistical method used to compare two different measurement techniques. No statistical significance in GI at 10 cases was observed between LGP and VEMT. Differences in GI ranged from -0.14 to 0.01. The newly defined gradient index calculated by two methods LGP and VEMT was not statistically significant either. Author did not find out the statistical difference for the prescribed isodose volume between LGP and VEMT. CGI as the evaluation index for determining the best treatment plan is not significant statistically also. Differences in CGI ranged from -4 to 3. Similarly newly defined Conformity/Gradient index for GKRS was also estimated as the metric for the evaluation of the treatment plans through statistical analysis. Statistical analyses demonstrated that VEMT was in excellent agreement with LGP when considering GI, new gradient index, CGI, and new CGI for evaluating the best plans of GKRS. Due to the application of the fast and easy evaluation tool through LGP and VEMT author hopes CGI and newly defined CGI as well as gradient indices will be widely used.

The Feasibility Study of MRI-based Radiotherapy Treatment Planning Using Look Up Table (Look Up Table을 이용한 자기공명영상 기반 방사선 치료계획의 타당성 분석 연구)

  • Kim, Shin-Wook;Shin, Hun-Joo;Lee, Young-Kyu;Seo, Jae-Hyuk;Lee, Gi-Woong;Park, Hyeong-Wook;Lee, Jae-Choon;Kim, Ae-Ran;Kim, Ji-Na;Kim, Myong-Ho;Kay, Chul-Seung;Jang, Hong-Seok;Kang, Young-Nam
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.237-242
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    • 2013
  • In the intracranial regions, an accurate delineation of the target volume has been difficult with only the CT data due to poor soft tissue contrast of CT images. Therefore, the magnetic resonance images (MRI) for the delineation of the target volumes were widely used. To calculate dose distributions with MRI-based RTP, the electron density (ED) mapping concept from the diagnostic CT images and the pseudo CT concept from the MRI were introduced. In this study, the look up table (LUT) from the fifteen patients' diagnostic brain MRI images was created to verify the feasibility of MRI-based RTP. The dose distributions from the MRI-based calculations were compared to the original CT-based calculation. One MRI set has ED information from LUT (lMRI). Another set was generated with voxel values assigned with a homogeneous density of water (wMRI). A simple plan with a single anterior 6MV one portal was applied to the CT, lMRI, and wMRI. Depending on the patient's target geometry for the 3D conformal plan, 6MV photon beams and from two to five gantry portals were used. The differences of the dose distribution and DVH between the lMRI based and CT-based plan were smaller than the wMRI-based plan. The dose difference of wMRI vs. lMRI was measured as 91 cGy vs. 57 cGy at maximum dose, 74 cGt vs. 42 cGy at mean dose, and 94 cGy vs. 53 at minimum dose. The differences of maximum dose, minimum dose, and mean dose of the wMRI-based plan were lower than the lMRI-based plan, because the air cavity was not calculated in the wMRI-based plan. These results prove the feasibility of the lMRI-based planning for brain tumor radiation therapy.

Effect of Dose Rate Variation on Dose Distribution in IMRT with a Dynamic Multileaf Collimator (동적다엽콜리메이터를 이용한 세기변조방사선 치료 시 선량분포상의 선량률 변화에 따른 효과)

  • Lim, Kyoung-Dal;Jae, Young-Wan;Yoon, Il-Kyu;Lee, Jae-Hee;Yoo, Suk-Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.1-10
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    • 2012
  • Purpose: To evaluate dose distribution differences when the dose rates are randomly changed in intensity-modulated radiation therapy using a dynamic multileafcollimator. Materials and Methods: Two IMRT treatment plans including small-field and large-field plans were made using a commercial treatment planning system (Eclipse, Varian, Palo Alto, CA). Each plan had three sub-plans according to various dose rates of 100, 400, and 600 MU/min. A chamber array (2D-Array Seven729, PTW-Freiburg) was positioned between solid water phantom slabs to give measurement depth of 5 cm and backscattering depth of 5 cm. Beam deliveries were performed on the array detector using a 6 MV beam of a linear accelerator (Clinac 21EX, Varian, Palo Alto, CA) equipped with 120-leaf MLC (Millenium 120, Varian). At first, the beam was delivered with same dose rates as planned to obtain reference values. After the standard measurements, dose rates were then changed as follows: 1) for plans with 100 MU/min, dose rate was varied to 200, 300, 400, 500 and 600 MU/min, 2) for plans with 400 MU/min, dose rate was varied to 100, 200, 300, 500 and 600 MU/min, 3) for plans with 600 MU/min, dose rate was varied to 100, 200, 300, 400 and 500 MU/min. Finally, using an analysis software (Verisoft 3.1, PTW-Freiburg), the dose difference and distribution between the reference and dose-rate-varied measurements was evaluated. Results: For the small field plan, the local dose differences were -0.8, -1.1, -1.3, -1.5, and -1.6% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +0.9, +0.3, +0.1, -0.2, and -0.2% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.4, +0.8, +0.5, +0.3, and +0.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). On the other hand, for the large field plan, the pass-rate differences were -1.3, -1.6, -1.8, -2.0, and -2.4% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +2.0, +1.8, +0.5, -1.2, and -1.6% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.5, +1.9, +1.7, +1.9, and +1.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). In short, the dose difference of dose-rate variation was measured to the -2.4~+2.0%. Conclusion: Using the Varian linear accelerator with 120 MLC, the IMRT dose distribution is differed a little <(${\pm}3%$) even though the dose-rate is changed.

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Evaluation of Scattered Dose to the Contralateral Breast by Separating Effect of Medial Tangential Field and Lateral Tangential Field: A Comparison of Common Primary Breast Irradiation Techniques (유방암 접선조사 치료 방법에 대한 반대쪽 유방에서의 산란선량 평가)

  • Ban, Tae-Joon;Jeon, Soo-Dong;Kwak, Jung-Won;Baek, Geum-Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.2
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    • pp.183-188
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    • 2012
  • Purpose: The concern of improving the quality of life and reducing side effects related to cancer treatment has been a subject of interest in recent years with advances in cancer treatment techniques and increasing survival time. This study is an analysis of differing scattered dose to the contralateral breast using common different treatment techniques. Materials and Methods: Eclipse 10.0 (Varian, USA) based $30^{\circ}$ EDW (Enhanced dynamic wedge) plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FiF (field in field) plan were established using CT image of breast phantom which in our hospital. Each treatment plan were designed to exposure 400 cGy using CL-6EX (VARIAN, USA) and we measured scattered dose at 1 cm, 3 cm, 5 cm, 9 cm away from medial side of the phantom at 1 cm depth using ionization chamber (FC 65G, IBA). We carried out measurement by separating effect of medial tangential field and lateral tangential field and analyze. Results: The evaluation of scattered dose to contralateral breast, $30^{\circ}$ EDW plan, $15^{\circ}$ wedge plan, $30^{\circ}$ wedge plan, Open beam plan, FIF plan showed 6.55%, 4.72%, 2.79%, 2.33%, 1.87% about prescription dose of each treatment plan. The result of scattered dose measurement by separating effect of medial tangential field and lateral tangential field results were 4.94%, 3.33%, 1.55%, 1.17%, 0.77% about prescription dose at medial tangential field and 1.61%, 1.40%, 1.24%, 1.16%, 1.10% at lateral tangential field along with measured distance. Conclusion: In our experiment, FiF treatment technique generates minimum of scattered dose to contralateral breast which come from mainly phantom scatter factor. Whereas $30^{\circ}$ wedge plan generates maximum of scattered doses to contralateral breast and 3.3% of them was scattered from gantry head. The description of treatment planning system showed a loss of precision for a relatively low scatter dose region. Scattered dose out of Treatment radiation field is relatively lower than prescription dose but, in decision of radiation therapy, it cannot be ignored that doses to contralateral breast are related with probability of secondary cancer.

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