• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.7-15
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• 2019

Purpose: The purpose of this study is to evaluate beam delivery accuracy for small sized lung SBRT through experiment. In order to assess the accuracy, Eclipse TPS(Treatment planning system) equipped Acuros XB and radiochromic film were used for the dose distribution. Comparing calculated and measured dose distribution, evaluated the margin for PTV(Planning target volume) in lung tissue. Materials and Methods : Acquiring CT images for Rando phantom, planned virtual target volume by size(diameter 2, 3, 4, 5 cm) in right lung. All plans were normalized to the target Volume=prescribed 95 % with 6MV FFF VMAT 2 Arc. To compare with calculated and measured dose distribution, film was inserted in rando phantom and irradiated in axial direction. The indexes of evaluation are percentage difference(%Diff) for absolute dose, RMSE(Root-mean-square-error) value for relative dose, coverage ratio and average dose in PTV. Results: The maximum difference at center point was -4.65 % in diameter 2 cm size. And the RMSE value between the calculated and measured off-axis dose distribution indicated that the measured dose distribution in diameter 2 cm was different from calculated and inaccurate compare to diameter 5 cm. In addition, Distance prescribed 95 % dose($D_{95}$) in diameter 2 cm was not covered in PTV and average dose value was lowest in all sizes. Conclusion: This study demonstrated that small sized PTV was not enough covered with prescribed dose in low density lung tissue. All indexes of experimental results in diameter 2 cm were much different from other sizes. It is showed that minimized PTV is not accurate and affects the results of radiation therapy. It is considered that extended margin at small PTV in low density lung tissue for enhancing target center dose is necessary and don't need to constraint Maximum dose in optimization.

• Progress in Medical Physics
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• v.10 no.2
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• pp.63-71
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• 1999

For the purpose of utilization in 3-D conformal radiotherapy and whole body radiosurgery, the Whole Body 3-Dimensional Topographic Radiation Therapy System has been developed. Whole body frame was constructed in order to be installed on the couch. Radiopaque catheters were engraved on it for the dedicated coordinate system and a MeV-Green immobilizer was used for the patient setup by the help of side panels and plastic rods. By designing and constructing the whole body frame in this way, geometrical limitation to the gantry rotation in 3-D conformal radiotherapy could be minimized and problem which radiation transmission may be altered in particular incident angles was solved. By analyzing CT images containing information of patient setup with respect to the whole body frame, localization and coordination of the target is performed so that patient setup error may be eliminated between simulation and treatment. For the verification of setup, the change of patient positioning is detected and adjusted in order to minimize the setup error by means of comparison of the body outlines using 3 CCTV cameras. To enhance efficiency of treatment procedure, this work can be done in real time by watching the change of patient setup through the monitor. The method of image subtraction in IDL (Interactive Data Language) was used to visualize the change of patient setup. Rotating X-ray system was constructed for detecting target movement due to internal organ motion. Landmark screws were implanted either on the bones around target or inside target, and variation of target location with respect to markers may be visualized in order to minimize internal setup error through the anterior and the lateral image information taken from rotating X-ray system. For CT simulation, simulation software was developed using IDL on GUI(Graphic User Interface) basis for PC and includes functions of graphic handling, editing and data acquisition of images of internal organs as well as target for the preparation of treatment planning.

• Progress in Medical Physics
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• v.17 no.4
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• pp.192-200
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• 2006

We evaluated the positional accuracy of the delivered beams to the target in a phantom by simulating the whole process of the radiation treatments Including CT scanning, planning and beam exposures with MLCs. For this purpose, a phantom was made to calibrate the alignment between the CT and the attached laser system. A new, convenient method was also devised to align the setup lasers in the treatment room. Film was used for the Identification of the delivered beam and analyzed with a homemade computer program. The positional differences between the target and the beam centers varied with the couch rotations. The accelerator we used showed a maximum discrepancy of 2.0 mm at the table angle of $295^{\circ}$. The same measurements based on the new isocenter from the Winston-Lutz test resulted in the maximum of 1.35 mm for all rotation angles. The evaluation of the differences between the target and the beam centers is useful for the treatment planning.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.239-246
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• 2018

목 적 : 본 연구의 목적은 치료저항성 뚜렛장애를 가진 소아 청소년들에 대해서 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술의 효과를 평가하는 것이다. 방 법 : 이 연구는 미국정신의학회 진단기준 및 통계편람, 제 4판을 기준으로 뚜렛장애로 진단받은 10명의 소아 청소년(평균연령 $12.56{\pm}1.04$세)을 대상으로 하였다. 모든 참가자들은 1년 이상 지속적으로 충분한 용량의 약물치료를 받았음에도 불구하고 한국판 예일 틱 증상 평가척도(YGTSS) 20점 이상, 임상인상척도(CGI-TS) 4점 이상을 받았다. 참가자들은 보조운동영역을 표적으로 1 Hz 반복적 경두개자기자극 치료를 매일 20분간 받았으며, 총 20회 치료를 받았다. YGTSS, CGI-TS 및 이상반응 체크리스트는 연구 시작 전과 연구 시작 후 4, 8, 12주에 시행되었다. 결 과 : 틱 증상은 연구 12주차까지 호전된 상태로 지속되었으며, YGTSS와 CGI-TS가 통계적으로 유의하게 감소하였다. 특히 음성 틱 점수의 감소가 운동 틱 점수의 변화보다 전체 YGTSS 점수의 감소에 큰 역할을 한 것으로 나타났다. 그리고 전체 10명의 참가자 중 9명이 심각한 부작용 없이 연구를 끝까지 완료하였다. 결 론 : 본 연구는 보조운동영역을 표적으로 한 저빈도 반복적 경두개자기자극술이 치료 저항성 뚜렛장애를 가진 소아 청소년들에게 효과적이고 안전한 치료도구가 될 수 있음을 시사한다. 이러한 반복적 경두개자기자극술의 치료효과를 확정하기 위해서는 보다 많은 환자를 대상으로 한 잘 통제된 연구가 필요할 것이다.

• Proceedings of the Korea Contents Association Conference
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• 2014.11a
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• pp.227-228
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• 2014

방사선치료의 발전으로 3차원치료보다 진보된 호흡연동방사선치료가 시행되어지고 있다. 호흡의 규칙성과 환자의 위치 재현성이 중요한 치료적응 인자이며, 호흡연동 방사선치료의 효율을 높일 수 있는 지표이다. 국가암통계상 고령의 암환자가 증가하며, 수술, 화학요법을 병행하는 암 치료법이 널리 이용이 되고 있다. 고식적인 치료를 요하는 고령의 복부 암 환자분들에 호흡연동 방사선치료법을 사용하는데 에는 호흡의 불규칙성과 체위의 재현성의 문제점으로 인한 치료 효율의 저하를 가져온다. 본 연구에서는 호흡에 의한 종양 움직임이 있는 방사선 치료에서 내부표적체적 기반의 치료계획과 호흡연동 기법을 적용한 치료계획과의 선량비교 분석하였다. 2가지 치료법 모두 정상조직 보호선량에 부합한 것으로 나타났으며 치료체적은 처방선량의 95%이상 포함된 선량분포로 적합하였다. ITV 설정을 통한 3D Plan은 고식적 치료을 목적으로 하는 고령의 환자, 체위 및 호흡의 불안정성 환자에게 처방선량의 95% 이상의 4D Plan의 치료법 보다 짧은 시간에 치료함으로써 치료효율을 높일 수 있을 거라 사료된다. 다만 정상조직보호선량(NTCP)에 부합하는지에 대한 평가가 전제되어야 한다.

• Progress in Medical Physics
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• v.27 no.2
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• pp.93-97
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• 2016

In this study, we evaluate the effect of respiration on the dose distribution in patient target volume (PTV) during intensity-modulated radiation therapy (IMRT) and research methods to reduce this impact. The dose distributions, homogeneity index (HI), coverage index (CVI), and conformity index of the PTV, which is calculated from the dose-volume histogram (DVH), are compared between the maximum intensity projection (MIP) image-based plan and other images at respiration phases of 30%, 60% and 90%. In addition, the reducing effect of complication caused by patient respiration is estimated in the case of a bolus and the expended PTV on the skin. The HI is increased by approximately twice, and the CVI is relatively decreased without the bolus at other respiration phases. With the bolus and expended PTV, the change in the dose distribution of the PTV is relatively small with patient respiration. Therefore, the usage of the bolus and expended PTV can be considered as one of the methods to improve the accuracy of IMRT in the treatment of breast cancer patients with respiratory motion.

• The Journal of Korean Society for Radiation Therapy
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• v.7 no.1
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• pp.45-53
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• 1995

목적 : 뇌정위 방사선수술은 AVM(ateriovenous malformation)이나 작은 크기의 종양에 1회에 고선량의 방사선을 조사하는 기술이다. 선형가속기를 이용한 방사선 수술을 하기 위하여 최근 본원에 설치한 Philips SL 75-5 선형가속기와 isocentric sub system(ISS)에 의한 뇌정위 방사선 수술에 있어서 표적의 위치선정과, gantry와 couch의 회전시 기하학적 오차가 중요시 되는데 isocentric sub system의 오차를 분석 하였다. 대상 및 방법 : 방사선원으로는 Philips SL 75-5 선형가속기의 5MV 광자선을 사용하였고, 원형의 작은 광자선속을 위하여 isocenter에서의 직경이 26mm인 secondary cone을 gimbal baaring에 삽입하여 사용하였다. 표적의 크기와 좌표를 정하기 위하여 CT나 angio localizer를 이용하고, 표적좌표 선정을 위하여 BRW phantom base와 target pointer를 이용하여 임의의 BRW-coordinator를 바꾸어 가면서 gantry angle와 ISS head 각도를 임의로 바꾸어 가면서 film에 방사선을 조사하였다. 흑화된 film을 view box 위에 놓고 광학판독기구로 film 가장자리의 오차를 scale 확대경으로 측정하여 오차를 분석하였다. 결과 : 표적좌표 선정의 정확도를 확인하기 위하여 임의의 표적좌표에 gantry의 10개각도 ISShead의 10개각도에서 각각 광자선을 조사시켜 film을 이용하여 오차를 측정한 결과 collimator cone의 직경이 26mm일때 전체 평균오차가 0.219+-0.03mm이었다. 결론 : Isocentric sub system은 gantry head와 ISS arm 사이에 gimbal bearing이 있어서 이 부위를 flexible하게 연결함으로 gantry의 회전에 무관하게 정확한 isocenter를 유지시켜 주고 ISS head는 couch와 독립되어 움직이므로 isocentric sub system isocenter의 오차를 최대한 줄일수 있음을 알았다.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2015.10a
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• pp.958-960
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• 2015

Sickle cells possess a unique combination of traits that may enable their use as models for novel synthetic tumor targeting controlled release drug carriers with the ability to treat disseminated tumors in advanced metastatic disease. In this study, we assess the ability of light-activated release sickle cells to enhance tumor delivery of the fluorescent dye calcein by delayed photolysis controlled release compared to free systemic administration of calcein. Sickle cells from mouse models of the disease were shown to preferentially accumulate in tumors compared to adjacent tissue, in 4T1 tumors in mice on a time scale about 12 hours. Sickle cells photosensitized with protoporphyrin IX achieved delayed release of 50% of contents 8-16 hours after photoactivation, which was deemed useful for in vivo delivery of cargo to tumors given the tumor accumulation time of the sickle cells. Sickle cells may be useful as a model for new synthetic drug carrier particles with delayed photolysis controlled release properties.

• Progress in Medical Physics
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• v.23 no.2
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• pp.99-105
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• 2012

We investigated the influence of photon energy, couch and collimator angle differences between arcs on dose distribution of RapidArc treatment planning for prostate cancer. RapidArc plans were created for 6 MV and 10 MV photons using 2 arcs coplanar and noncoplanar fields. The collimator angle differences between two arcs were $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, $45^{\circ}$, $60^{\circ}$, $75^{\circ}$ and $90^{\circ}$. The plans were optimized using same dose constrains for target and OAR (organ at risk). To evaluate the dose distribution, plans were analyzed using CI (conformity index), HI (homogeneity index), QOC (quality of coverage), etc. Photon energy, couch and collimator angle differences between arcs had a little influence on the target and OAR. The difference of dosimetric indices was less than 3.6% in the target and OAR. However, there was significant increase in the region exposed to low dose. The increase of V15% in the femur was 6.4% (left) and 5.5% (right) for the 6 MV treatment plan and 23.4% (left), 24.1% (right) for the noncoplanar plan. The increase of V10% in the Far Region distant from target was 54.2 cc for the 6 MV photon energy, 343.4 cc for the noncoplanar and 457.8 cc for the no collimator rotation between arcs.

• The Journal of Korean Society for Radiation Therapy
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• v.35
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• pp.33-39
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• 2023

Purpose: The purpose of this study is to find out the dose variation according to thickness of the air gap between the patient's body surface and immobilization device in the treatment plan. Materials and Methods : Four conditions were created by adjusting the air gap thickness using 5 mm bolus, ranging from 0 mm to 3 mm bolus. Immobilization was placed on top in each case. And computed tomography was used to acquire images. The treatment plan that 430 cGy (Relative Biological Effectiveness,RBE) is irradiated 6 times and the dose of 2580 cGy (RBE) is delivered to 95% of Clinical Target Volume (CTV). The dose on CTV was evaluated by Full Width Half Maximum (FWHM) of the lateral dose profile and skin dose was evaluated by Dose Volume Histogram (DVH). Result: Results showed that the FWHM values of the lateral dose profile of CTV were 4.89, 4.86, 5.10, and 5.10 cm. The differences in average values at the on the four conditions were 3.25±1.7 cGy (RBE) among D_95% and 1193.5±10.2 cGy (RBE) among D_95% respectively. The average skin volume at 1% of the prescription dose was 83.22±4.8%, with no significant differences in both CTV and skin. Conclusion: When creating a solid-type immobilization device for carbon particle therapy, a slight air gap is recommended to ensure that it does not extend beyond the dose application range of the CTV.