• Title/Summary/Keyword: 치료 권고안

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Measurement of Radioactive Surface Contamination of the Restroom in the Hospital (병원 내 화장실의 방사성 표면오염도 측정)

  • Han, Sang-Hyun
    • Journal of the Korea Convergence Society
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    • v.11 no.8
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    • pp.71-76
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    • 2020
  • This study measured radioactive surface contamination in general public restrooms in hospitals and in dedicated toilets for nuclear medicine. The measurement method was measured using Berthold (LB 124, Germany) at the entrance to the restroom, inside the restroom, around the restroom, in the urinal, and around the urinal. As a result of the use of the restroom, there was no dedicated place waiting for patients who received radioisotopes in one of the three hospitals. As a result of measuring the restroom for exclusive use of radioisotopes, all measurement sites in the radioiodine therapy room were the highest, and the results of measuring the public restrooms showed background level contamination at all hospitals except hospital B. However, it was measured as 8.073 Bq/㎠ and 6.426 Bq/㎠ in the urinals in the public restroom on the first floor of the B hospital. Therefore, it is recommended to explain the dangers of radiation exposure to patients and provide a place for patients to wait. In addition, a plan should be sought to prevent patients from receiving radioisotopes from using unnecessary movements and general public restrooms.

Usefulness Evaluation on the Treatment Plan of Tomotherapy and VMAT in Radiotherapy for Prostate Cancer (전립선암의 방사선치료에서 토모테라피와 VMAT의 치료계획에 따른 유용성 평가)

  • Heo, Kwangmyoung;Han, Jaebok;Choi, Namgil
    • Journal of the Korean Society of Radiology
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    • v.9 no.7
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    • pp.449-457
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    • 2015
  • In this study, to evaluate the usefulness of the treatment plan of tomotherapy and volumetric modulated arc therapy (VMAT) in the radiotherapy for prostate cancer, the absorbed dose, dose volume histogram (DVH), treatment efficiency, and the results of dose verification accuracy using MapCHECK2 were compared and analyzed. Of the prostate cancer patients who underwent tomotherapy treatment in the Radiologic Oncology of H University Hospital between July 2014 and December 2014, 12 patients were randomly selected. As a result of analyzing the absorbed dose and DVH, both radiologic treatment plans showed slight differences in the treatment of the cancer tissues and the bladder, but the difference was in the error range of -5% to +3%, and did not exceed the side effect guideline or the tolerance dose limit. VMAT showed higher treatment efficiency than tomotherapy with a 2.5 times shorter treatment time and a 10.3 times less monitor unit (MU). Both showed 95% or higher dose accuracy satisfying the standard. VMAT showed 2.3% higher efficiency than tomotherapy. In both tomotherapy and VMAT, appropriate doses were absorbed for cancer tissues, and did not exceed the tolerance dose for normal tissues showing no significant difference in dose distribution. However, considering the shorter treatment time, lower total MU, and better treatment efficiency and dose verification accuracy, VMAT may be more useful than tomotherapy in cancer treatments.

Training of Radiofrequency Ablation for Thyroid Nodules in Korea: Current and Future Perspective (국내의 갑상선 고주파 절제술에 대한 교육: 현황 및 미래 전망)

  • Hye Shin Ahn;So Lyung Jung;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.1009-1016
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    • 2023
  • Radiofrequency ablation (RFA) is a minimally invasive treatment modality used as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. In Korea, RFA for thyroid nodules was first performed in 2002, and a large population study was published in 2008. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed its first recommendations for RFA in 2009, which were revised in 2012 and 2018. The KSThR guideline was the first guideline for RFA of thyroid nodules worldwide and has become a guideline for physicians to perform thyroid RFA in Korea and other countries around the world. These guidelines have contributed significantly to the establishment and widespread use of RFA worldwide. In addition, since 2015, the KSThR has conducted intensive hands-on courses depending on the level of the participants. In this article, the authors introduce the history of eduction for RFA conducted by the KSThR and describe the learning curve of RFA and current training programs in Korea, along with future directions for training programs.

Comparison of Urine Iodine/Creatinine ratio between Patients following Stringent and Less Stringent Low Iodine Diet for Radioiodine Remnant Ablation of Thyroid Cancer (갑상선암의 방사성요오드치료를 위한 저요오드식이 방법 차이에 따른 소변 중 요오드/크레아티닌 비의 비교)

  • Roh, Jee-Ho;Kim, Byung-Il;Ha, Ji-Su;Chang, Sei-Joong;Shin, Hye-Young;Choi, Joon-Hyuk;Kim, Do-Min;Kim, Chong-Soon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.322-326
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    • 2006
  • A low iodine diet (LID) for $1{\sim}2$ weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine ratio (urine I/Cr). Methods: From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Results: Total 27 patients were included in this investigation (M:F=1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID. Average of urine I/Cr ratio was $127.87{\pm}78.52{\mu}g/g$ in stringent LID for 1 week, and $289.75{\pm}188.24{\mu}g/g$ in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (p=0.008). The number of patients whose urine I/Cr ratios were below $100{\mu}g/g$ was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Conclusion: Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable.

A Study on Calibration Procedures for Ir-192 High Dose Rate Brachytherapy Sources (고선량률(HDR) 근접치료의 동위원소 Ir-192에 대한 측정방법에 관한 고찰)

  • Baek, Tae-Seong;Lee, Seung-Wook;Na, Soo-Kyong
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.1
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    • pp.19-26
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    • 2007
  • Purpose: To compare of the accuracy among various measurement procedures of HDR Brachytherapy, and to evaluate the clinical suitability and usefulness of alternative PMMA (polymethylmethacrylateplastics: $C_5H_8O_2$) plate phantom without any additional cost due to the purchase of measuring apparatus. Materials and Methods: We made a comparative study on three types of measuring systems: well type chamber, source calibration jig, and PMMA plate phantom. Farmer type chamber was used for source calibration jig method and PMMA plate phantom method. Measurement was done 5 times each in comparison with the measurement values from manufacturer. Measurement results from experiment were compared with that from the manufacturer which is offered with the source whenever a source is substituted by a new one and evaluate the accuracy of source activity. Results: As a consequence of Ir-192 source measurement using well type chamber, source calibration jig and PMMA plate phantom, RMS (Root Mean Square) values for the relative error are 0.6%, 1.57%, 2.1%, respectively, compared with the data from manufacturer. And the mean errors with standard deviation are given $-0.2{\pm}0.5%$, $0.97{\pm}1.23%$, $-0.89{\pm}1.87%$ respectively. Conclusion: From the results shown by the three types of measurement system (well type chamber, source calibration jig, and PMMA plate phantom), the measurement with well type chamber produced the best accuracy. It turns out that we can also use the alternative system of PMMA plate phantom clinically without purchasing any additional particular apparatus since the system does not exceed the recommendation of AAPM (American Association of Physicists in Medicine), which requires the error range of within ${\pm}5%$.

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The Korean Practice Parameter for the Treatment of Attention - Deficit Hyperactivity Disorder(II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안(II) - 진단 및 평가 -)

  • Cheon, Keun-Ah;Kim, Ji-Hoon;Kang, Hwa-Yeon;Kim, Bung-Nyun;Shin, Dong-Won;Ahn, Dong-Hyun;Yang, Su-Jin;Yoo, Han-Ik;Yoo, Hee-Jeong;Hong, Hyun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.18 no.1
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    • pp.10-15
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    • 2007
  • Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

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Treatment Guidelines for Community-acquired Pneumonia in Korea: An Evidence-based Approach to Appropriate Antimicrobial Therapy (지역사회획득 폐렴의 치료지침 권고안)

  • Song, Jae-Hoon;Jung, Ki-Suck;Kang, Moon Won;Kim, Do Jin;Pai, Hyunjoo;Suh, Gee Young;Shim, Tae Sun;Ahn, Joong Hyun;Ahn, Chul Min;Woo, Jun Hee;Lee, Nam Yong;Lee, Dong-Gun;Lee, Mi Suk;Lee, Sang Moo;Lee, Yeong Seon;Lee, Hyukmin;Chung, Doo Ryeon
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.281-302
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    • 2009
  • The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy. The etiology and antimicrobial susceptibility of major pneumonia pathogens can differ by country. Therefore, the ideal treatment guidelines for community-acquired pneumonia should be based on the studies performed in each country. We developed a treatment guideline for community-acquired pneumonia for immunocompetent adults in Korea. This guideline was developed by the joint committee of the Korean Society for Chemotherapy, the Korean Society of Infectious Diseases, and the Korean Academy of Tuberculosis and Respiratory diseases.

A Study on Mechanical Errors in Cone Beam Computed Tomography(CBCT) System (콘빔 전산화단층촬영(CBCT) 시스템에서 기계적 오류에 관한 연구)

  • Lee, Yi-Seong;Yoo, Eun-Jeong;Kim, Seung-Keun;Choi, Kyoung-Sik;Lee, Jeong-Woo;Suh, Tae-Suk;Kim, Joeng-Koo
    • Journal of radiological science and technology
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    • v.36 no.2
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    • pp.123-129
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    • 2013
  • This study investigated the rate of setup variance by the rotating unbalance of gantry in image-guided radiation therapy. The equipments used linear accelerator(Elekta Synergy TM, UK) and a three-dimensional volume imaging mode(3D Volume View) in cone beam computed tomography(CBCT) system. 2D images obtained by rotating $360^{\circ}$and $180^{\circ}$ were reconstructed to 3D image. Catpan503 phantom and homogeneous phantom were used to measure the setup errors. Ball-bearing phantom was used to check the rotation axis of the CBCT. The volume image from CBCT using Catphan503 phantom and homogeneous phantom were analyzed and compared to images from conventional CT in the six dimensional view(X, Y, Z, Roll, Pitch, and Yaw). The variance ratio of setup error were difference in X 0.6 mm, Y 0.5 mm Z 0.5 mm when the gantry rotated $360^{\circ}$ in orthogonal coordinate. whereas rotated $180^{\circ}$, the error measured 0.9 mm, 0.2 mm, 0.3 mm in X, Y, Z respectively. In the rotating coordinates, the more increased the rotating unbalance, the more raised average ratio of setup errors. The resolution of CBCT images showed 2 level of difference in the table recommended. CBCT had a good agreement compared to each recommended values which is the mechanical safety, geometry accuracy and image quality. The rotating unbalance of gentry vary hardly in orthogonal coordinate. However, in rotating coordinate of gantry exceeded the ${\pm}1^{\circ}$ of recommended value. Therefore, when we do sophisticated radiation therapy six dimensional correction is needed.

Quality Assurance of Leaf Speed for Dynamic Multileaf Collimator (MLC) Using Dynalog Files (Dynalog file을 이용한 동적다엽조준기의 Leaf 속도 정도관리 평가)

  • Kim, Joo Seob;Ahn, Woo Sang;Lee, Woo Suk;Park, Sung Ho;Choi, Wonsik;Shin, Seong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.305-312
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    • 2014
  • Purpose : The purpose of this study is to analyze the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC) and determine the appropriate period of quality assurance (QA). Materials and Methods : The quality assurance of the DMLC equipped with Millennium 120 leaves has been performed total 92 times from January 2012 to June 2014. The the accuracy of leaf position and isocenter coincidence for MLC were checked using the graph paper and Gafchromic EBT film, respectively. The stability of leaf speed was verified using a test file requiring the leaves to reach maximum leaf speed during the gantry rotation. At the end of every leaf speed QA, dynamic dynalog files created by MLC controller were analyzed using dynalog file viewer software. This file concludes the information about the planned versus actual position for all leaves and provides error RMS (root-mean square) for individual leaf deviations and error histogram for all leaf deviations. In this study, the data obtained from the leaf speed QA were used to screen the performance degradation of leaf speed and determine the need for motor replacement. Results : The leaf position accuracy and isocenteric coincidence of MLC was observed within a tolerance range recommanded from TG-142 reports. Total number of motor replacement were 56 motors over whole QA period. For all motors replaced from QA, gradually increased patterns of error RMS values were much more than suddenly increased patterns of error RMS values. Average error RMS values of gradually and suddenly increased patterns were 0.298 cm and 0.273 cm, respectively. However, The average error RMS values were within 0.35 cm recommended by the vendor, motors were replaced according to the criteria of no counts with misplacement > 1 cm. On average, motor replacement for gradually increased patterns of error RMS values 22 days. 28 motors were replaced regardless of the leaf speed QA. Conclusion : This study performed the periodic MLC QA for analyzing the mechanical and leaf speed accuracy of the dynamic multileaf collimator (DMLC). The leaf position accuracy and isocenteric coincidence showed whthin of MLC evaluation is observed within the tolerance value recommanded by TG-142 report. Based on the result obtained from leaf speed QA, we have concluded that QA protocol of leaf speed for DMLC was performed at least bimonthly in order to screen the performance of leaf speed. The periodic QA protocol can help to ensure for delivering accurate IMRT treatment to patients maintaining the performance of leaf speed.

Comparison of Treatment Planning on Dosimetric Differences Between 192Ir Sources for High-Dose Rate Brachytherapy (고선량률 근접치료에서 이리듐-192 선원의 선량특성 차이에 관한 치료계획 비교)

  • Yang, Oh-Nam;Shin, Seong Soo;Ahn, Woo Sang;Kim, Dae-Yong;Kwon, Kyung-Tae;Lim, Cheong-Hwan;Lee, Sang Ho;Choi, Wonsik
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.163-170
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    • 2016
  • To evaluate whether the difference in geometrical characteristics between high-dose-rate (HDR) $^{192}Ir$ sources would influence the dose distributions of intracavitary brachytherapy. Two types of microSelectron HDR $^{192}Ir$ sources (classic and new models) were selected in this study. Two-dimensional (2D) treatment plans for classic and new sources were generated by using PLATO treatment planning system. We compared the point A, point B, and bladder and rectum reference points based on ICRU 38 recommendation. The radial dose function of the new source agrees with that of the classic source except difference of up to 2.6% at the nearest radial distance. The differences of anisotropy functions agree within 2% for r=1, 3, and 5 cm and $20^{\circ}$ < ${\theta}$ < $165^{\circ}$. The largest discrepancies of anisotropy functions reached up to 27% for ${\theta}$ < $20^{\circ}$ at r=0.25 cm and were up to 13%, 10%, and 7% at r=1, 3, and 5 cm for ${\theta}$ > $170^{\circ}$, respectively. There were no significant differences in doses of point A, point B, and bladder point for the treatment plans between the new and classic sources. For the ICRU rectum point, the percent dose difference was on average 0.65% and up to 1.0%. The dose discrepancies between two treatment plans are mainly affected due to the geometrical difference of the source and the sealed capsule.