• Title/Summary/Keyword: 치료계획장치

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Evaluation of the Positional Uncertainty of a Liver Tumor using 4-Dimensional Computed Tomography and Gated Orthogonal Kilovolt Setup Images (사차원전산화단층촬영과 호흡연동 직각 Kilovolt 준비 영상을 이용한 간 종양의 움직임 분석)

  • Ju, Sang-Gyu;Hong, Chae-Seon;Park, Hee-Chul;Ahn, Jong-Ho;Shin, Eun-Hyuk;Shin, Jung-Suk;Kim, Jin-Sung;Han, Young-Yih;Lim, Do-Hoon;Choi, Doo-Ho
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.155-165
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    • 2010
  • Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

The Development of Air-kerma Strength Calculation Algorithm in Terms of the Absorbed Dose to Water for HDR Ir-192 Source (기준점에서의 물 흡수선량을 이용한 Ir-192 선원의 공기커마 세기 계산을 위한 알고리즘 개발)

  • Huh, Hyun-Do;Kim, Woo-Chul;Loh, John-Jk;Lee, Suk;Lee, Sang-Hoon;Cho, Sam-Ju;Shin, Dong-Oh;Choi, Jin-Ho;Kwon, Soo-Il;Kim, Seong-Hoon
    • Progress in Medical Physics
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    • v.17 no.4
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    • pp.232-237
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    • 2006
  • The aim of this study was to develop the calculation algorithm of source strength of Ir-192 source In terms of the absorbed dose to water instead of an apparent activity (Ci). For this work the Multi Purpose Brachytherapy Phantom(MPBP) was developed, which was designed to locate the source and the chamber precisely at a specific position Inside the water phantom. The reference point of measurement was set at the 5 cm distance along the transverse axis of the source. For a brachytherapy source calibration, the absorbed dose to water calibration factor ($N_{D.W.Q}$) of an lonization chamber were determined and then apply standard protocols of absorbed dose to water. The calibration factor ($N_{D.W.Q}$) of the ion chamber (TM30013, PTW, Germany) was determined using the EGSnrcCPP Monte Carlo Code. The calculated calibration factor ($N_{D.W.Q}$) was 5.28 cGy/nC. The calculated factor was then used to determine the absorbed dose to water from which the air kerma strength for an Ir-192 source can be easily derived at the reference point (5 cm). The calculated air kerma strength showed discrepancies of -0.6% to +1.8% relative to the air kerma strength provided by the vendor, In this work we demonstrated that the air kerma strength ($S_k$) could be determined from the absorbed dose to water calibration factor for Ir-192 source. In audition, this source calibration method could be applied directly to the dose Calculation formalism of AAPM report TG-43.

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Analysis of micro inorganic materials in linerboard mill (골판지 원지 제조 공정 내 미세 무기물질의 분석)

  • 윤혜정;류정용;김용환;신종호;송봉근
    • Proceedings of the Korea Technical Association of the Pulp and Paper Industry Conference
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    • 2000.11a
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    • pp.132-132
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    • 2000
  • 환경오염과 이상기후의 영향으로 인한 수자원의 고갈과 함께 국내의 경우 수자원 개발 계획 및 수요량을 감안할 때 향후 7 년 내에 물부족 현상을 겪을 것이라는 보고가 있 었으며, 환경부담을 줄이기 위해 폐수의 배출기준은 강화되고 있다. 이러한 상황에서 제조 특성상 타 업종에 비해 폐수 발생량이 높은 편인 국내의 제지산업은 여러 해전부터 이에 대 한 방안을 모색하여 왔다. 일반적으로 폐수 수질 관리와 청수 사용량의 절감을 위해 고가의 폐수 처리 장치를 설치하거나 폐수 재활용을 통해 공정을 극도로 폐쇄화하는 방안으로 연구 가 진행되어 왔다. 이 중 용수의 재활용이 가장 경제적인 방법이지만, 재활용이 지속될수록 각종 무기염과 콜로이드성 유기물질이 축적되어 각종 약품의 효능 저하, 탈수속도의 저하 및 생산 제품의 품질 악화 등의 문제를 유발한다고 알려져 있다. 이를 해결하고자 하는 노 력으로 펄프 원료에 따른 공정수 내 용해성 물질의 분석과 재활용 횟수에 따른 각종 SS와 D DS의 축적 정도에 대한 기초 연구가 수행되었으며, 고폐쇄화된 공정에서 성능을 발휘할 수 있는 첨가제의 개발과 적용 방법에 대한 연구도 수행된 바 있다.여러 지종 가운데 골판지 원지는 용수의 재활용률이 상당히 높은 지종이기 때문에 공정수의 재활용이 진행될수록 열악한 저급 원료로부터 각종의 다양한 물질이 용출 혹은 배 출되며, 이러한‘물질은 골판지 원지의 강도 발현에 더욱 악영향을 미칠 것으로 판단되었다. 미세분으로 구성된 SS의 경우 이미 많은 연구를 통해 특성이 파악되었기 때문에 본 연구에 서는 ss를 제외한 공정수를 두 가지로 크게 나누어 고려하였다. 즉, ss로 측정되지 않지만 닥도를 유발할 수 있는 미세 무기물질과, 용해성의 무기염, 첨가제 및 추출물 둥으로 이루어 진 용해성 성분으로 나누어 분석하였으며, 또한 각각이 초지 특성에 미치는 영향을 살펴보 고자 하였다.을 해석코자 하였으며, 그 방법으 로 수치해석기법을 도입하였다. 또 실제 캘린더링 전후의 두께 변화를 측정하여 유리전이온도 의 도달 깊이와 비교하였다. 지필의 압축 정도는 롤의 직경과 닙 폭을 이용하여 MD 방향으 로 함수화하였으며, 열전달 계수로는 겉보기 값을 사용하였다. 이때 지펼은 균질한 것으로 가 정하였다. 함수율은 유리전이온도를 좌우하는 가장 큰 인자이나 본 연구에서는 항온항습처리 를 통해 유입지의 함수율을 고정시켰으며 캘린더링 시 함수율의 변이는 없다고 가정하였다. 그 결과 열침투깊이가 증가할수록 지필은 보다 변형되기 쉬운 상태가 되어 주어진 압력 조건에 대해 소성변형 정도가 증가하는 것으로 나타났다. 이는 캘린더링 전후에 두께 변화를 측정하여 정량적으로 평가할 수 있었다. 수치해석기법을 통해 같은 압력 조건에서 온도가 증 가함에 따라 혹은 같은 온도 조건에서 압력이 증가함에 따라 지필 내의 유리전이온도의 침투 깊이가 증가함을 알 수 있었으며 이는 캘린더링 전후의 두께 변화의 측정 결과와 일치하였 다. 또 NRT가 증가함에 따라서도 유리전이온도 침투 깊이가 증가하였다.합편에 비해 일부 우수한 양상을 보였지만 본 실험의 범위내에서는 통계적 정량적 차이를 제시할 수는 없었다. 향후 보다 광범위한 동물 실험이 필요할 것으로 사료된다.된다.하고도 완전교정술 도달 확률이 높은 치료전략이라는 사실을 입증하였으며 주대동맥폐동맥혈관부행지의 크기나 숫자가 단일화하기 쉬운 형태학적 특징을 지닌 경우에는 조기에 일단계완전교정술을 시행하여 양호한 결과를 얻을 수 있다는 사실을 발견하였다. 반면 본 환아군 중 단일화술을 먼저 시도한 군에서는 비록 단계적인 단일화를 시도한 군에서 단일화술과 관계된 수술사망율이 약간 낮기는 하였으나 완전교정술까지 완료될 가능성에는 차이가 없었다. 그러나 이 경우 보다 정련된 적응 환자의 선택을 통한 단일화 우선전략의 시도와 장기 추

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Implant supported removable dental prosthesis with magnetic attachment in crossed occlusion: A case report (엇갈린 교합에서 implant와 magnetic attachment를 이용한 국소의치 증례)

  • Lee, Yu Jin;Lee, Richard sungbok;Lee, Suk Won;Park, Su Jung;Ahn, Su Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.1
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    • pp.53-60
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    • 2017
  • When attempting to restore the oral function of a partially edentulous patient, there are a number of prosthetic treatment options available, depending on the structure of remaining teeth. For example, when only one set of maxillary and mandibular teeth are diagonally in place across from each other, it is difficult to gain stable occlusion. In this case, implants can be put in place at the corresponding edentulous area to achieve balance. By doing so, a stable occlusion can be achieved. For this case report, a patient with crossed occlusion after extraction was treated with maxillary RDP (removable dental prosthesis) and mandibular implant-supported RDP (removable dental prosthesis). Moreover, an implant fixture was placed under the posterior molar of the distal extension base diagonally across from the remaining maxillary teeth. Then, magnetic attachment was implemented. According to the patient who received the treatment, the result was functionally and aesthetically satisfactory.

An Experimental Study on the Effect of Combined X-ray and Microwave Hyperthermia on the Rectum and Urinary Bladder of Rats (흰쥐의 직장과 방광에 X-선 조사와 마이크로파 온열요법의 효과에 관한 실험적 연구)

  • Lee, Kyung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.4 no.2
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    • pp.115-128
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    • 1986
  • Hyperthermia can enhance the radiation effect as a synergistic reaction in combined X-ray irradiation and hyperthermia; hyperthermia sensitize radioresistant S-phase cells and inhibit cellular recovery from sublethal damage. We fabricated 100 watts, 2450 MHz microwave applicator for hyperthermia and planned the method and condition of heating and measured the temperature by using Agar phantom as a preliminary test. For biological examination, 102 rats were divided into 4 groups as hyperthermia, X-ray irradiation (6Gy-15Gy), combined X-ray and hyperthermia, and normal control groups. Microscopic examination of the rectum and bladder was done and the results were as followings: 1. The microwave generator with 100 watts, 2450MHz magnetron could be heating up to $40^{\circ}{\sim}50^{\circ}C$ for one hour in living tissue. 2. The thermal distribution in tissue equivalent phantom with microwave can be maintained at $40^{\circ}{\sim}44^{\circ}C$ in area of 3cm in depth and 2-10cm in diameter. 3. In Hyperthermia alone group, there was submucosal edema of the rectum but no histologic change in the urinary bladder was seen. 4. The minimal necrosis of the mucosa was appeared in the rectum and bladder after 15 days of 6 Gy and 8 Gy irradiation respectively. The minimal necrosis of the muscle layer of rectum and bladder was appeared after 15 days of 8Gy and 60days of 10Gy irradiation respectively. 5. In combined group of radiation and hyperthermia, thermal enhancement ratio (calculated at necrosis of mucosa and muscle layer) of rectum and bladder was 1.0, and it suggest that there is no change of tolerance dose of normal rectum and bladder.

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A Study on Dose Distribution around Fletcher-Suit Colpostat Containing Cs-137 Source by a Computer (컴퓨터 의한 Fletcher-Suit Colpostat 주변의 Cs-137의 선량분포에 관한 연구)

  • Kang Wee-Saing
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.305-311
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    • 1989
  • Fletcher-Suit colpostat has an internal structure to reduce dose to bladder and rectum. Some programs were developed to calculate dose at any point in water in three dimension around the colpostat containing Cs-137 tube, to find the shielding effect to dose by the internal structure, and to draw isodose curves and iso-shielding effect curves. Computer was an IBM compatible AT with EGA card and language was MS-Basic V6.0, Material, shape and geometry of the strucure, tube and colpostat were considered in algorithm for calculation of dose. Dose rates per unit mg. Ra. eq. in water calculated by a program were stored in auxiliary memory devices and retrieved in another programs. Isodose curves on medial side shrinked. Dose distribution was not symmetric about a transverse axis bisecting the colpostat. Reduction of dose was more excessive on top side than on bottom. Iso-shielding effect curve showed that the shielding effect was higher on top side than on bottom, and that there was shielding effect over almost all area of medial side. Such results were related to both shifted position of tube in the colpostat and asymmetric distribution of active source in the tube. Maximum of shielding effect was $49\%$ on top side and $44\%$ on bottom side. The direction of iso-shielding effect curve was generally radial from the center of active source. In treatment planning using Fletcher-Suit colpostat, the internal structure should be considered to find precise doses to bladder and rectum, etc.

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Full-mouth rehabilitation with increasing vertical dimension on the patient with severely worn-out dentition and orthognathic surgery history: A case report (악교정수술 병력을 가진 과도한 치아 마모를 보이는 환자의 수직고경 증가를 동반한 전악 수복 증례)

  • Sang-Myeong Tak;Chang-Mo Jeong;Jung-Bo Huh;So-Hyoun Lee;Mi-Jung Yun
    • The Journal of Korean Academy of Prosthodontics
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    • v.61 no.1
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    • pp.33-43
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    • 2023
  • Pathological wear across the entire dentition causes problems such as collapsed occlusal plane, reduced vertical dimension, anterior premature contact, inadequate anterior guidance, and tooth migration, thereby induce symptoms such as temporomandibular joint disorder, reduced masticatory efficiency, and tooth hypersensitivity. For the treatment of patients with excessive wear, evaluation of vertical dimension should be preceded along with analysis of the cause. The patient in this case was a 45-year-old female with a history of orthognathic surgery. Through clinical examination, radiographic examination, and model analysis, overall tooth wear, interdental spacing in the anterior maxillary region, retruded condylar position, and insufficient interocclusal space for prosthetic restoration were confirmed. Full mouth rehabilitation with increased vertical dimension was planned, the patient's adaptation to the new vertical dimension was evaluated with a removable occlusal splint and temporary prosthesis, and cross-mounting was performed based on the temporary restoration to fabricate the definitive zirconia prosthesis, maintaining the adjusted vertical dimension. It showed satisfactory functional and esthetic results through stable restoration of the occlusal relationship.

A Study on Property Change of Auto Body Color Design (자동차 바디컬러 디자인의 속성 변화에 관한 연구)

  • Cho, Kyung-Sil;Lee, Myung-Ki
    • Archives of design research
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    • v.19 no.1 s.63
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    • pp.253-262
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    • 2006
  • Research of color has been developed and also has raised consumer desire through changing from a tool to pursue curiosity or beauty to a tool creating effects in the 20th century. People have been interested in colors as a dynamic expression of results since the color TV appeared. The meaning of colors has been recently diversified as the roles of colors became important to the emotional aspects of design. While auto colors have developed along with such changes of the times, black led the color trend during the first half of the 20th century from 1900 to 1950, a transitional period of economic growth and world war. Since then, automobile production has increased apace with the rapid economic growth throughout the world and automobiles became the most expensive item out of the goods that people use. Accordingly, increasing production induced facility investment in mass production and a technology leveling was achieved. Auto manufacturing processes are very complicated, auto makers gradually recognized that software changes such as to colors or materials was an easier way for the improvement of brand identity as opposed to hardware changes such as the mechanical or design components of the body. Color planning and development systems were segmented in various aspects. In the segmentation issue, pigment technology and painting methods are important elements that have an influence on body colors and have a higher technical correlation with colors than in other industries. In other words, the advanced mixture of pigments is creating new body colors that have not existed previously. This diversifies the painting structure and methods and so maximizes the transparency and depth of body colors. Thus, body colors that are closely related to technical factors will increase in the future and research on color preferences by region have been systemized to cope with global competition due to the expansion and change of auto export regions.

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A Comparison of Peripheral Doses Scattered from a Physical Wedge and an Enhanced Dynamic Wedge (금속쐐기와 기능강화동적쐐기의 조사야 주변부 선량 비교)

  • Park, Jong-Min;Kim, Hee-Jung;Min, Je-Soon;Lee, Je-Hee;Park, Charn-Il;Ye, Sung-Joon
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.107-117
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    • 2007
  • In order to evaluate the radio-protective advantage of an enhanced dynamic wedge (EDW) over a physical wedge (PW), we measured peripheral doses scattered from both types of wedges using a 2D array of ion-chambers. A 2D array of ion-chambers was used for this purpose. In order to confirm the accuracy of the device we first compared measured profiles of open fields with the profiles calculated by our commissioned treatment planning system. Then, we measured peripheral doses for the wedge angles of $15^{\circ},\;30^{\circ},\;45^{\circ},\;and\;60^{\circ}$ at source to surface distances (SSD) of 80 cm and 90 cm. The measured points were located at 0.5 cm depth from 1 cm to 5 cm outside of the field edge. In addition, the measurements were repeated by using thermoluminescence dosimeters (TLD). The peripheral doses of EDW were (1.4% to 11.9%) lower than those of PW (2.5% to 12.4%). At 15 MV energy, the average peripheral doses of both wedges were 2.9% higher than those at 6MV energy. At a small SSD (80 cm vs. 90 cm), peripheral dose differences were more recognizable. The average peripheral doses to the heel direction were 0.9% lower than those to the toe direction. The results from the TLD measurements confirmed these findings with similar tendency. Dynamic wedges can reduce unnecessary scattered doses to normal tissues outside of the field edge in many clinical situations. Such an advantage is more profound in the treatment of steeper wedge angles, and shorter SSD.

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Efficiency Study of 2D Diode Array Detector for IMRT Quality Assurance (2D 어레이 다이오드 검출기를 통한 IMRT 계산선량의 정확성 평가 및 효용성 연구)

  • Kim, Tae-Ho;Oh, Seung-Jong;Kim, Min-Joo;Jung, Won-Gyun;Chung, Jin-Beom;Kim, Jae-Sung;Kim, Si-Yong;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.61-66
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    • 2011
  • In this study, we evaluated the effect of grid size on dose calculation accuracy using 2 head & neck and 2 prostate IMRT cases and based on this study's findings, we also evaluated the efficiency of a 2D diode array detector for IMRT quality assurance. Dose distributions of four IMRT plan data were calculated at four calculation grid sizes (1.25, 2.5, 5, and 10 mm) and the calculated dose distributions were compared with measured dose distributions using 2D diode array detector. Although there was no obvious difference in pass rate of gamma analysis with 3 mm/3% acceptance criteria for the others except 10 mm grid size, we found that the pass rates of 2.5, 5 and 10 mm grid size were decreased 5%, 20% and 31.53% respectively according to the application of the fine acceptance criteria, 3 mm/3%, 2 mm/2% and 1 mm/1%. The calculation time were about 11.5 min, 4.77 min, 2.95 min, and 11.5 min at 1.25, 2.5, 5, and 10 mm, respectively and as the grid size increased to double, the calculation time decreased about one-half. The grid size effect was observed more clearly in the high gradient area than the low gradient area. In conclusion, 2.5 mm grid size is considered acceptable for most IMRT plans but at least in the high gradient area, 1.25 mm grid size is required to accurately predict the dose distribution. These results are exactly same as the precious studies' results and theory. So we confirmed that 2D array diode detector was suitable for the IMRT QA.