• Title/Summary/Keyword: 호흡 구간

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Dosimetric Analysis of Respiratory-Gated RapidArc with Varying Gating Window Times (호흡연동 래피드아크 치료 시 빔 조사 구간 설정에 따른 선량 변화 분석)

  • Yoon, Mee Sun;Kim, Yong-Hyeob;Jeong, Jae-Uk;Nam, Taek-Keun;Ahn, Sung-Ja;Chung, Woong-Ki;Song, Ju-Young
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.87-92
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    • 2015
  • The gated RapidArc may produce a dosimetric error due to the stop-and-go motion of heavy gantry which can misalign the gantry restart position and reduce the accuracy of important factors in RapidArc delivery such as MLC movement and gantry speed. In this study, the effect of stop-and-go motion in gated RapidArc was analyzed with varying gating window time, which determines the total number of stop-and-go motions. Total 10 RapidArc plans for treatment of liver cancer were prepared. The RPM gating system and the moving phantom were used to set up the accurate gating window time. Two different delivery quality assurance (DQA) plans were created for each RapidArc plan. One is the portal dosimetry plan and the other is MapCHECK2 plan. The respiratory cycle was set to 4 sec and DQA plans were delivered with three different gating conditions: no gating, 1-sec gating window, and 2-sec gating window. The error between calculated dose and measured dose was evaluated based on the pass rate calculated using the gamma evaluation method with 3%/3 mm criteria. The average pass rates in the portal dosimetry plans were $98.72{\pm}0.82%$, $94.91{\pm}1.64%$, and $98.23{\pm}0.97%$ for no gating, 1-sec gating, and 2-sec gating, respectively. The average pass rates in MapCHECK2 plans were $97.80{\pm}0.91%$, $95.38{\pm}1.31%$, and $97.50{\pm}0.96%$ for no gating, 1-sec gating, and 2-sec gating, respectively. We verified that the dosimetric accuracy of gated RapidArc increases as gating window time increases and efforts should be made to increase gating window time during the RapidArc treatment process.

Dosimetric Evaluation of Amplitude-based Respiratory Gating for Delivery of Volumetric Modulated Arc Therapy (진폭 기반 호흡연동 체적변조회전방사선치료의 선량학적 평가)

  • Lee, Chang Yeol;Kim, Woo Chul;Kim, Hun Jeong;Park, Jeong Hoon;Min, Chul Kee;Shin, Dong Oh;Choi, Sang Hyoun;Park, Seungwoo;Huh, Hyun Do
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.127-136
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    • 2015
  • The purpose of this study is to perform a dosimetric evaluation of amplitude-based respiratory gating for the delivery of volumetric modulated arc therapy (VMAT). We selected two types of breathing patterns, subjectively among patients with respiratory-gated treatment log files. For patients that showed consistent breathing patterns (CBP) relative to the 4D CT respiration patterns, the variability of the breath-holding position during treatment was observed within the thresholds. However, patients with inconsistent breathing patterns (IBP) show differences relative to those with CBP. The relative isodose distribution was evaluated using an EBT3 film by comparing gated delivery to static delivery, and an absolute dose measurement was performed with a $0.6cm^3$ Farmer-type ion chamber. The passing rate percentages under the 3%/3 mm gamma analysis for Patients 1, 2 and 3 were respectively 93.18%, 91.16%, and 95.46% for CBP, and 66.77%, 48.79%, and 40.36% for IBP. Under the more stringent criteria of 2%/2 mm, passing rates for Patients 1, 2 and 3 were respectively 73.05%, 67.14%, and 86.85% for CBP, and 46.53%, 32.73%, and 36.51% for IBP. The ion chamber measurements were within 3.5%, on average, of those calculated by the TPS and within 2.0%, on average, when compared to the static-point dose measurements for all cases of CBP. Inconsistent breathing patterns between 4D CT simulation and treatment may cause considerable dosimetric differences. Therefore, patient training is important to maintain consistent breathing amplitude during CT scan acquisition and treatment delivery.

Development of Error Analysis Program for Phase-based Respiratory Gating Radiation Therapy (위상기반 호흡연동 방사선치료 시 오차 분석 프로그램 개발)

  • Song, Ju-Young;Nah, Byung-Sik;Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Yoon, Mi-Sun
    • Progress in Medical Physics
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    • v.17 no.3
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    • pp.136-143
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    • 2006
  • The respiratory gating radiation therapy which Irradiates only in the stable respiratory period with analyzing the periodic motion of a reflective marker on the patient's abdomen has been applied to the precise radiation treatment in order to minimize the effect of organ motion induced by the respiration. This respiratory gating system establishes irradiation region using the amplitude-based or phase-based method. Although phase-based method Is preferred because of the stability in the real treatment conditions, it has some limits to explain the exact correlation between the marker motion and organ motion. Even when the variation of amplitude which can introduce target motion considered as an error is produced, the phase-based method has the possibility to irradiate including the error positions. In this study, the error analysis program was developed for the verification of the tumor position's variation correlated with the variation of marker's amplitude which can be occurred during a phase-based respiratory sating treatment. The analysis program was tested with a virtual treatment record file and with a record file using moving phantom which were modified considering the irregular amplitude's variation simulating the real clinical situations. In both cases, accurate discrimination of error points and error calculation were produced. When the treatment record files of a real patient were analyzed with the program, the accurate recognition and calculation of the error points were also verified. The analysis program developed in this study will be applied as a useful tool for the analysis of errors due to the irregular variation of patients' respiration during the phase-base respiratory gating radiation treatment.

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Radiation Treatment Planning Evaluation by Internal Target Volume Settings (내부표적체적 설정을 통한 방사선치료계획 평가)

  • Park, Ho-Chun;Han, Jae-Bok;Choi, Nam-Gil
    • The Journal of the Korea Contents Association
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    • v.15 no.8
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    • pp.416-423
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    • 2015
  • The study was conducted targeting 25 patients who underwent the respiratory gated radiation therapy in the abdominal region at Radiation Oncology of a University Hospital from December 2013 to June 2014 and types of cancer included liver(64%), CBD(8%), gastric(8%), GB(8%), pancreas(8%), SMA(4%). The means of ITV and PTV volume are 471.44 cm3 and 425.48 cm3, showing an increase in volume. Normal tissue volume was also found to have increased due to the increase of the section selected from PTV section to ITV section. Right kidney showed a significant increase in differences between increase in normal tissue volume, increase in target volume and increase in therapy irradiation area and difference between the means of dose applied to normal tissue. There was no significant difference in the mean dose applied to normal tissue according to the respiratory average. Both kidneys showed a significant difference in the difference between mean doses of target moving and normal tissue. In this study, both therapy methods through PTV section and ITV section volume setting were appropriate for protection doses of normal tissue and distributed over 95% of the prescribed dose and therefore, it is considered to be okay to be optionally used depending on the patient's therapeutic purpose. But in order to minimize the unexpected side effect, the plan of PTV section and ITV section should be established and used by evaluating normal tissue protection dose.

The Effects of Breathing Control on Kinetic Parameters of Lower Limbs during Walking Motion in Korean Dance (한국무용 걸음체 동작 시 호흡의 사용유무가 하지의 운동역학적 변인에 미치는 영향)

  • Park, Yang-Sun;Jang, Ji-Young
    • Korean Journal of Applied Biomechanics
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    • v.19 no.4
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    • pp.627-636
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    • 2009
  • This study aims to provide a scientific basis for the abstract beauty of dance by analyzing the effects of controlling the breath during the walking motion of Korean dance. The objective of the study is to determine the significance of breathing during Korean dance, as it is externally expressed and technologically segmented, let alone the internal beauty of Korean dance. The results of this study show that the position of the body center and ASIS during the walking motion that uses breath was lower than that of the walking motion that does not use the breath. In addition, in each replacement of the knee joint and ankle joint, a narrow angle, in which bending is used a lot, appeared during the walking motion that uses the breath, but not during the walking gesture that does not use the breath. This occurred during the bending motion. In the first peak point, the vertical ground reaction force during the walking motion that uses the breath was higher than that during the walking motion that does not use the breath.

Functional disposable use flow tube converting the respiratory air flow rate into averaged dynamic pressure (호흡기류를 동압력으로 변환하는 기능성 일회용 호흡관)

  • Kim, Kyung-Ah;Kim, Hyun-Shik;Lee, Tae-Soo;Cha, Eun-Jong
    • Journal of Sensor Science and Technology
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    • v.11 no.3
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    • pp.125-131
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    • 2002
  • Respiratory air flow rate is necessarily measured for the pulmonary function evaluation. The currently used devices are exposed to the problems of measurement reliability and cross-patient infection. The present study introduced a new technique which converted the bidirectional air flow rate into averaged dynamic pressure based on the famous Bernoulli's energy conservation principle. Single use plastic sensing element was assembled within the flow tube(mouth piece) made of paper, which was named "functional single use flow tube". Experiment demonstrated only ${\pm}1.5%$ relative error in the standard 3L volume measurement procedure well within the error limit suggested by the American Thoracic Society(ATS). Disposable use design completely eliminated cross-patient infection. The present device is best useful and safe for clinical respiratory air flow measurement such as spirometry.

The variability of tumor motion and respiration pattern in Stereotactic Body RadioTherapy(SBRT) for Lung cancer patients (RPM SystemTM을 이용한 호흡 관찰의 유용성 평가)

  • Park, hyun jun;Bae, sun myeong;Baek, Geum Mun;Kang, tae young;Seo, Dong Rin
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.17-25
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    • 2016
  • Purpose : The purpose of this study is to evaluate the variability of tumor motion and respiration pattern in lung cancer patients undergoing Stereotactic Body RadioTherapy(SBRT) by using On-Board imager (OBI) system and Real-time Position Management (RPM) System. Materials and Methods : This study population consisted of 60 lung cancer patient treated with stereotactic body radiotherapy (48 Gy / 4 fractions). Of these, 30 were treated with gating (group 1) and 30 without gating(group2): typically the patients whose tumors showed three-dimensional respiratory motion > 10 mm were selected for gating. 4-dimensional Computed Tomography (4DCT). Cone Beam CT (CBCT) and Fluoroscopy images were used to measure the tumor motion. RPM system was used to evaluate the variability of respiration pattern on SBRT for group1. Results : The mean difference of tumor motion among 4DCT, CBCT and Fluoroscopy images in the cranio-caudal direction was 2.3 mm in group 1, 2. The maximum difference was 12.5 mm in the group 1 and 8.5 mm in group 2. The number of treatment fractions that patient's respiration pattern was within Upper-Lower threshold on SBRT in group 2 was 31 fractions. A patient who exhibited the most unstable pattern exceeded 108 times in a fraction Conclusion : Although many patients in group 1 and 2 kept the reproducibility of tumor motion within 5 mm during their treatment, some patients exhibited variability of tumor motion in the CBCT and Fluoroscopy images. It was possible to improve the accuracy of dose delivery in SBRT without gating for lung cancer patient by using RPM system.

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A simple statistical model for determining the admission or discharge of dyspnea patients (호흡곤란 환자의 입퇴원 결정을 위한 간편 통계모형)

  • Park, Cheol-Yong;Kim, Tae-Yoon;Kwon, O-Jin;Park, Hyoung-Seob
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.2
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    • pp.279-289
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    • 2010
  • In this study, we propose a simple statistical model for determining the admission or discharge of 668 patients with a chief complaint of dyspnea. For this, we use 11 explanatory variables which are chosen to be important by clinical experts among 55 variables. As a modification process, we determine the discharge interval of each variable by the kernel density functions of the admitted and discharged patients. We then choose the optimal model for determining the discharge of patients based on the number of explanatory variables belonging to the corresponding discharge intervals. Since the numbers of the admitted and discharged patients are not balanced, we use, as the criteria for selecting the optimal model, the arithmetic mean of sensitivity and specificity and the harmonic mean of sensitivity and precision. The selected optimal model predicts the discharge if 7 or more explanatory variables belong to the corresponding discharge intervals.

Contribution of Root Respiration to Soil Respiration for Quercus acutissima Forest (상수리나무림의 토양호흡에 대한 뿌리호흡의 기여)

  • Lee, Kyu-Jin;Won, Ho-Yeon;Mun, Hyeong-Tae
    • Korean Journal of Environment and Ecology
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    • v.26 no.5
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    • pp.780-786
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    • 2012
  • A trenching method was used to determine the contribution of root respiration to soil respiration in Quercus acutissima forest in the vicinity of Gongju, Chungnam Province, Korea. $CO_2$ efflux in soil respiration plot($R_{control}$, $R_c$) and microblal respiration plot($R_{trenched}$, $R_t$) in Q. acutissima forest were measured from June 2011 to May 2012 by using IRGA soil respiration analyzer. Seasonal $CO_2$ efflux in $R_c$ and $R_t$ were higher in summer season than in winter season. In August, maximun $CO_2$ efflux in $R_c$ and $R_t$ was 1.345 and 0.897 g $CO_2\;m^{-2}\;hr^{-1}$, respectively. $CO_2$ efflux in $R_t$ was lower by 33.31% than that in $R_c$(P<0.05). In January, $CO_2$ efflux in $R_c$ and $R_t$ was 0.097 and 0.032g $CO_2\;m^{-2}\;hr^{-1}$, respectively. $CO_2$ efflux in $R_t$ was lower by 67.01% than that in $R_c$(P<0.01). The amount of annual $CO_2$ efflux from $R_c$ and $R_t$ was 4.320, 2.834kg $CO_2\;m^{-2}\;yr^{-1}$, respectively. There was a significant correlations between soil temperatures and soil respiration. Contribution of root respiration to total soil respiration in this Q. acutissima forest was 34.40%.

Evaluation of the usefulness of the method according to changes in patient breathing during chest 4D CT imaging (흉부 4D CT에서 호흡 변화에 대한 일시 중지 및 재개 방법의 유용성 평가)

  • Heo, Sol;Shin, Chung Hun;Jeong, Hyun Sook;Yoo, Soon Mi;Kim, Jeong Mi;Yun, In Ha;Hong, Seung Mo;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.47-54
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    • 2021
  • Purpose : In order to evaluate the usefulness of clinical application of the Pause & Resume methods by comparing and analyzing the data stability and dose reduction effect when repeat scan assuming irregular breathing and using the Pause & Resume method during chest 4D CT using QuasarTM Phantom. Materials and Methods : Using the QuasarTM Phantom, set the breathing rate per minute to 15 BPM and 7.5 BPM, and set the S15 point as an irregular breathing section, and then placed OSLD to this point and use the Pause & Resume method to measure the dose of S15. CTDIvol, DLP, and ALARA-CT were used for comparative analysis of radiation dose between Pause & Resume method and Repeat-scan. In order to evaluate the stability and usability of the data applying the Pause & Resume method, the captured images were sorted by Advanced Workstation Volume Share7 and then sent to EclipseTM, the diameter and volume were analyzed by forming a contour on the iron ball in the QuasarTM Phantom Results : When using Pause & Resume, the dose of OSLD measurement increased by 1.97 times in the section of S15. As a result of image evaluation, the average value of all volumes measured with and without the Pause & Resume method at 15 BPM and 7.5 BPM was 15.2 cm3±0.5%.Allthemeasuredvaluesfor the radius of iron ball were 3.1 cm regardless of whether Pause & Resume method was used or not. In the case of using Pause & Resume, 33% decreased from the lowest DLP value and 38% decreased from the highest DLP value of repeat scan, and the effective dose also decreased 32.1% from the minimum value and 37.6% from the maximum value. Conclusion: Irradiation dose was increased by Pause & Resume method because of the repeat scan on the S15 site where assuming irregular breathing occurred, However Pause & Resume method led to a significant reduction in dose on overall scan range. It also proved the usefulness of clinical application of the Pause & Resume method as a result of similar diameters and volumes of iron ball measurement.