• Title/Summary/Keyword: 치료위치 확인

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Comparison of 2D and 3D Brachytherapy Planning for Cervical Cancer (자궁경부암 근접방사선치료 시 2차원, 3차원 치료계획 비교평가)

  • Kim, Jung Hoon
    • Journal of radiological science and technology
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    • v.40 no.2
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    • pp.303-309
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    • 2017
  • To evaluate the usefulness of 3-dimensional brachytherapy(BT) planning technique based on CT in cervical cancer. Patients with cervical cancer underwent 2-D BT treatment planning and then CT scan with HDR intracavitary applicators in place with same positions. Dose was prescribed to Point A with 5Gy per fraction on 2-D BT planning. For 3-D BT planning, and dose was prescribed to the High risk CTV for BT (HR CTV) with 5Gy. The 3-D BT planning goal was to cover at least 90% of the HR CTV with target 5Gy isodose surface while limiting the dose to $2cm^3$ of bladder to less than 7.5 Gy, and $2cm^3$ of rectum to less than 5Gy. In one patient of 10 patients, $D_{2cm3}$ of rectal dose was over 5Gy and 6patients at $D_{2cm3}$ of bladder dose on 2-D BT planning. There was a tendency to underestimate ICRU bladder dose than ICRU rectal dose. CT based 3-D BT planning for cervical cancer will enable evaluation of dose distributions for tumor and critical organs at risk. So, rectal and bladder morbidity as well as geographic miss will be reduced in case of the bulky disease or uterine malposition.

Stereotactic Radiosurgery for Recurrent Glioblastoma Multiforme using Yeungnam Localization Device - Technical note and Clinical trial - (뇌정위적 방사선 절제술에 필요한 위치선정용기구 제작과 치험 2예)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se;Kim, Oh-Lyong;Cho, Soo-Ho
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.101-105
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    • 1992
  • Authors performed a stereotactic radiosurgery with multiple noncoplanar convergent photon beams of linear accelerator (NELAC-1018 18 MeV, NEC) using a specially designed Yeungnam localization device for two patients with recurrent glioblastoma multiforme. One patient had 2 cm sized and the other 4 cm sized mass on the CT images. After single session of treatment with 15 and 20 Gy, headache was improved in a few days after radiosurgery with no remarkable untoward reactions. Our experience with these two patients were encouraging and we found that our localization device, which is easily adjustable and inexpensive, could be a valuable tool for stereotactic radiosurgery particularly in the treatment of recurrent brain tumor.

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Contralateral Breast Doses Depending on Treatment Set-up Positions for Left-sided Breast Tangential Irradiation (좌측 유방암 환자의 방사선 치료 시 환자자세에 따른 반대편 유방의 산란선량 측정)

  • Joo, Chan Seong;Park, Su Yeon;Kim, JongSik;Choi, Byeong Gi;Chung, Yoonsun;Park, Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.175-181
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    • 2015
  • Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.

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즉발감마선을 이용한 70MeV 양성자선량 급락지점 위치 측정에 관한 연구

  • Seo, Gyu-Seok;Kim, Jong-Won;Kim, Ju-Yeong;Min, Cheol-Hui;Jo, Seong-Gu;Kim, Chan-Hyeong
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2005.04a
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    • pp.100-102
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    • 2005
  • 양성자 빔을 이용한 치료는 종양부위에 높은 선량을 균일하게 전달하고 정상세포에는 적은 선량을 전달할 수 있어 암치료 효과가 높으나 정확한 치료와 환자의 안전을 위해서는 양성자선량의 급락지점을 정확히 아는 것이 중요하다. 본 연구에서는 양성자와 물질과의 핵반응으로 직각방향으로 방출되는 즉발감마선을 측정하여 양성자선량 급락지점을 측정할 수 있는 검출시스템을 몬테칼로 전산코드로 전산모사하였으며, 70MeV 단일에너지 빔과 최대에너지가 70MeV인 SOBP 빔을 모의피폭체인 물팬텀에 조사하고 검출시스템을 통해 직각방향으로 방출되는 즉발감마선의 분포를 계산하였다. 모의피폭체 안에서의 양성자선량의 분포와 측정된 즉발감마선의 분포를 서로 비교하여 두 분포 사이의 상관관계를 찾고 이 상관관계를 이용하여 양성자선량 급락지점을 결정할 수 있음을 확인할 수 있었다.

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Influence of Delayed Gastric Emptying in Radiotherapy after a Subtotal Gastrectomy (위부분절제술 후 방사선치료에서 음식물 배출지연에 따른 영향)

  • Kim, Dong-Hyun;Kim, Won-Taek;Lee, Mi-Ran;Ki, Yong-Gan;Nam, Ji-Ho;Park, Dal;Jeon, Ho-Sang;Jeon, Kye-Rok;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.194-200
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    • 2009
  • Purpose: This aim of this study was to evaluate changes in gastric volume and organ position as a result of delayed gastric emptying after a subtotal gastrectomy performed as part of the treatment of stomach cancer. Materials and Methods: The medical records of 32 patients who underwent concurrent chemoradiotherapy after a subtotal gastrectomy from March 2005 to December 2008 were reviewed. Of these, 5 patients that had more than 50 cc of residual gastric food detected at computed tomography (CT) simulation, were retrospectively enrolled in this study. Gastric volume and organ location was measured from CT images obtained before radiotherapy, twice weekly. In addition, authors evaluated the change of radiation dose distribution to planning the target volume and normal organ in a constant radiation therapy plan regardless of gastric volume variation. Results: A variation in the gastric volume was observed during the radiotherapy period (64.2~340.8 cc; mean, 188.2 cc). According to the change in gastric volume, the location of the left kidney was shifted up to 0.7 - 2.2 cm (mean, 1.2 cm) in the z-axis. Under-dose to planning target volume (V43, 79.5${\pm}$10.4%) and over-dose to left kidney (V20, 34.1${\pm}$12.1%; Mean dose, 23.5${\pm}$8.3 Gy) was expected, given that gastric volume change due to delayed gastric emptying wasn't taken into account. Conclusion: This study has shown that a great change in gastric volume and left kidney location may occur during the radiation therapy period following a subtotal gastrectomy, as a result of delayed gastric emptying. Detection of patients who experienced delayed gastric emptying and the application of gastric volume variation to radiation therapy planning will be very important.

A Study of the Registration of Simulator Images and Portal Images Using Landmarks in Radiation Treatment (랜드마크 (Landmark)를 이용한 방사선 치료 X선 시뮬레이터 영상과 포탈영상의 비교법 연구)

  • 이정애;서태석;최보영;이형구
    • Progress in Medical Physics
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    • v.12 no.2
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    • pp.177-184
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    • 2001
  • The goal of radiation treatment is to deliver a prescribed radiation dose to the target volume accurately while minimizing dose to normal tissues. Due to inaccurate placement of field and shielding block and patient's movement, there could be displacement errors between the planed and treatment regions. In order to verify the location of radiation treatment, we in this study developed the registration algorithm of the x-ray simulator images and portal images and quantified the inaccuracy in terms of shift, scale and rotation. The algorithm for registration of pairs of radiation fields consists of the alignment of pairs of radiation images by points matching and field displacement analysis by field boundary matching. In the first step, paired surface landmarks are matched to calculate the transformation parameters (scale, rotation and shift) using the corresponding line pairs which are created by connecting two landmarks of each image. In the next step, portal field boundary is extracted and then the two field boundaries are matched by the $\rho$-$\theta$ technique. Applying the phantom portal images, detection errors were calculated to be less than 2mm in translation, 1$^{\circ}$ in rotation and 1% in scale. In conclusion, we quantitatively analyzed the displacement error of x-ray simulator images and portal images. The present results could contribute to the study of the radiation treatment verification.

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Two Cases of Spasmodic Torticollis Managed by Yinyang balance appliance of FCST for the Meridian and Neurologic Balance (FCST의 음양균형장치를 활용한 경련성 사경증 증례보고)

  • Shon In-Cheol;Ahn Kyu-Suk;Sohn Kyung-Seok;Koh Gi-Wan;Yin Chang-Shik;Ha Sung-Joon;Lee Young-Jun
    • Korean Journal of Acupuncture
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    • v.23 no.4
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    • pp.111-122
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    • 2006
  • Objectives : Therapeutic effect of Balance Appliance of functional crebrospinal technique (FCST for meridian and neurologic yinyang balance was observed in two refractory torticollis cases. Methods : A unidentified severe torticollis two cases with several months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after $3{\sim}5$ months of therapy, which effect was reported to maintain for 6 months. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.

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A Study on QA for Radiation Therapy Machine by Using Implemented Electronic Portal Imaging Device (전자포탈영상장치의 제작과 방사선치료장치의 QA 적용에 관한 연구)

  • Lee, Dong-Hoon
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.43 no.6 s.312
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    • pp.68-75
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    • 2006
  • During cancer therapy by using high energy radiation, it is possible to improve the radiation therapy efficiency by performing a precise radiation therapy after verification of generated setup errors. In this paper, the video based electronic portal imaging device (EPID) which could display the portal image with near real time was developed to verify treatment position errors in radiation therapy instead of an analog typed portal film. This EPID system for applying QA tool of radiation therapy machine was consisted of a metal/fluorescent screen, $45^{\circ}$mirror, camera and image grabber. Radiation field verification has been performed to check quality assurance of the treatment machine itself by using this EPID system. The radiation field error was easily observed by edge detection of irradiated field size on EPID image when $0.6^{\circ}$ shift of collimator angle was generated. So, this implemented EPID system could be used as a radiation QA tool.

Rectal Balloon for the Immobilization of the Prostate Internal Motion (전립선암의 방사선치료 시 직장풍선의 유용성 평가)

  • Lee Sang-Kyu;Beak Jong-Geal;Kim Joo-Ho;Jeon Byong-Chul;Cho Jeong-Hee;Kim Dong-Wook;Na Soo-Kyong;Song Tae-Soo;Cho Jae-Ho
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.2
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    • pp.113-124
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    • 2005
  • Purpose : The using of endo-rectal balloon has proposed as optimal method that minimized the motion of prostate and the dose of rectum wall volume for treated prostate cancer patients, so we make the customized rectal balloon device. In this study, we analyzed the efficiency of the Self-customized rectal balloon in the aspects of its reproducibility. Materials and Methods : In 5 patients, for treatment planning, each patient was acquired CT slice images in state of with and without rectal balloon. Also they had CT scanning samely repeated third times in during radiation treatment (IMRT). In each case, we analyzed the deviation of rectal ballon position and verified the isodose distribution of rectum wall at closed prostate. Results : Using the rectal balloon, we minimized the planning target volume (PTV) by decreased the internal motion of prostate and overcome the dose limit of radiation therapy in prostate cancer by increased the gap between the rectum wall and high dose region. Conclusion : The using of rectal balloon, although, was reluctant to treat by patients. View a point of immobilization of prostate internal motion and dose escalation of GTV (gross tumor volume), its using consider large efficients for treated prostate cancer patients.

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The Change of Tumor Interstitial Fluid Pressure by Radiation Therapy in Patients with Metastatic Lymph Node in Head and Neck Area (방사선치료시 두경부 림파절 종양내 간질액 압력의 변화 양상)

  • Cho Moon-June;Kim Jae-Sung;Lee Intae;Kim Jun-Sang;Kim Ki-Hwan;Jang Ji-Young
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.127-132
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    • 2000
  • Purpose : To determine if the tumor intersitial fluid pressure (TIFP) and/or its change in patients with metastatic Iymph node in head and neck area can predict radiotherapy outcome. Materials and Methods : In 26 biopsy Proven metastatic Iymph node Patients in head and neck area with accessible by direct inspection and palpation, and of sufficient thickness (>1 cm) to permit accurate needle placement, we measured TIFP at cervical Iymph node before and during radiotherapy. Tumor size was measured clinically and radiologically. Results : The mean preradiotherapy TIFP was 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). Preradiotherapy TIFP significantly decreased when tumor size decreased (p=0.009). Preradiotherapy TIFP was not different between complete response group and group with partial or less response (p=0.75). Radiotherapy outcome was not different between group with above and group with below than average TIFP (p=0.229). TIFP decreased 36mmHg in complete response group and 29.7 mmHg in group with partial or less response. Conclusion :The mean TIFP was elevated with 24.7 mmHg. Preradiotherapy TIFP had marginally significant relationship with tumor size (p=0.06). TIFP decreased 36 mmHg in complete response group and 29.7 mmHg in group with partial or less respone but there was no statistically significant relationship in two groups.

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