• Title/Summary/Keyword: 3D dose evaluation

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Feasibility and Efficacy of Adaptive Intensity Modulated Radiotherapy Planning according to Tumor Volume Change in Early Stage Non-small Cell Lung Cancer with Stereotactic Body Radiotherapy (폐암의 정위적체부방사선치료에서 육안적종양체적 변화에 따른 적응방사선치료의 효용성 및 가능성 연구)

  • Park, Jae Won;Kang, Min Kyu;Yea, Ji Woon
    • Progress in Medical Physics
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    • v.26 no.2
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    • pp.79-86
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    • 2015
  • The purpose of this study is to evaluate efficacy and feasibility of adaptive radiotherapy according to tumor volume change (TVC) in early stage non-small cell lung cancer (NSCLC) using stereotactic body radiotherapy (SBRT). Twenty-two lesions previously treated with SBRT were selected. SBRT was usually performed with a total dose of 48 Gy or 60 Gy in four fractions with an interval of three to four days between treatments. For evaluation of TVC, gross tumor volume (GTV) was contoured on each cone-beam computed tomography (CBCT) image used for image guidance. Intensity modulated radiotherapy (IMRT) planning was performed in the first CBCT (CBCT1) using a baseline plan. For ART planning (ART), re-optimization was performed at $2^{nd}$, $3^{rd}$, and $4^{th}$ CBCTs (CBCT2, CBCT3, and CBCT4) using the same angle and constraint used for the baseline plan. The ART plan was compared with the non-ART plan, which generated copying of the baseline plan to other CBCTs. Average GTV volume was 10.7 cc. Average TVC was -1.5%, 7.3%, and -25.1% in CBCT2, CBCT3, and CBCT4 and the TVC after CBCT3 was significant (p<0.05). However, the nine lesions were increased GTV in CBCT2. In the ART plan, $V_{20\;Gy}$, $D_{1500\;cc}$, and $D_{1000\;cc}$ of lung were significantly decreased (p<0.05), and $V_{30\;Gy}$ and $V_{32\;Gy}$ of the chest wall were also decreased (p<0.05). While D min of planning target volume (PTV) decreased by 8.3% in the non-ART plan of CBCT2 compared with the baseline plan in lesions with increased tumor size (p=0.021), PTV coverage was not compromised in the ART plan. Based on this result, use of the ART plan may improve target coverage and OAR saving. Thus ART using CBCT should be considered in early stage NSCLC with SBRT.

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity.modulated Radiation Therapy (세기조절방사선치료 시 콘빔CT (CBCT)를 이용한 환자자세 검증 및 보정평가)

  • Do, Gyeong-Min;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.83-88
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    • 2009
  • Purpose: Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. Materials and Methods: The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. Results: When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07o in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. Conclusion: By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and correct the change of position and target volume and treat more accurately, and could calculate and compare the errors. The results of this study show that CBCT was useful to deliver accurate treatment according to the treatment plan and to increase the reproducibility of repeated treatment, and satisfactory results were obtained. Accuracy enhanced through CBCT is highly required in IMRT, in which the shape of the target volume is complex and the change of dose distribution is radical. In addition, further research is required on the criteria for match focus by treatment site and treatment purpose.

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Effect of UV-C Irradiation on the Inactivation of Listeria monocytogenes and Lipid Oxidation in Hamburger Patties during Storage (UV-C 조사가 햄버거 패티 저장 중 Listeria monocytogenes의 생육저해 및 지질산화에 미치는 영향)

  • Kim, Hyun-Jin;Kim, Seul-Ki;Chun, Ho-Hyun;Song, Kyung-Bin
    • Food Science and Preservation
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    • v.17 no.3
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    • pp.425-429
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    • 2010
  • Inactivation by UV-C irradiation of Listeria monocytogenes cocktail inoculated on hamburger patties was examined. Hamburger patty samples were inoculated with 6-7 log CFU/mL of L. monocytogenes cocktail, and then exposed to doses of 0, 1, 5, or $10kJ/m^2$ of UV-C light, followed by storage at $4{\pm}1^{\circ}C$ for 7 d. Microbiological evaluation indicated that the populations of L. monocytogenes decreased significantly (p<0.05) as irradiation dose increased. In particular, L. monocytogenes populations decreased by 2.03 log CFU/g after exposure to 10 $kJ/m^2$, compared with control samples. The thiobarbituric acid-reactive substance levels of hamburger patty samples increased during storage, regardless of UV-C irradiation status. These results indicate that UV-C irradiation may be useful in improving the microbial safety of hamburger patties during storage.

Performance evaluation study of a commercially available smart patient-controlled analgesia pump with the microbalance method and an infusion analyzer

  • Park, Jinsoo;Jung, Bongsu
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.2
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    • pp.129-143
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    • 2022
  • Background: Patient-controlled analgesia (PCA) has been widely used as an effective medical treatment for pain and for postoperative analgesia. However, improper dose errors in intravenous (IV) administration of narcotic analgesics from a PCA infusion pump can cause patient harm. Furthermore, opioid overdose is considered one of the highest risk factors for patients receiving pain medications. Therefore, accurate delivery of opioid analgesics is a critical function of PCA infusion pumps. Methods: We designed a microbalance method that consisted of a closed acrylic chamber containing a layer and an oil layer with an electronic balance. A commercially available infusion analyzer (IDA-5, Fluke Co., Everett, WA, USA) was used to measure the accuracy of the infusion flow rate from a commercially available smart PCA infusion pump (PS-1000, UNIMEDICS, Co., Ltd., Seoul, Korea) and compared with the results of the microbalance method. We evaluated the uncertainty of the flow rate measurement using the ISO guide (GUM:1995 part3). The battery life, delay time of the occlusion alarm, and bolus function of the PCA pump were also tested. Results: The microbalance method was good in the short-term 2 h measurement, and IDA-5 was good in the long-term 24 h measurement. The two measurement systems can complement each other in the case of the measurement time. Regarding battery performance, PS-1000 lasted approximately 5 days in a 1 ml/hr flow rate condition without recharging the battery. The occlusion pressure alarm delays of PS-1000 satisfied the conventional alarm threshold of occlusion pressure (300-800 mmHg). Average accuracy bolus volume was measured as 63%, 95%, and 98.5% with 0.1 ml, 1 ml, and 2 ml bolus volume presets, respectively. A 1 ml/hr flow rate measurement was evaluated as 2.08% of expanded uncertainty, with a 95% confidence level. Conclusion: PS-1000 showed a flow accuracy to be within the infusion pump standard, which is ± 5% of flow accuracy. Occlusion alarm of PS-1000 was quickly transmitted, resulting in better safety for patients receiving IV infusion of opioids. PS-1000 is sufficient for a portable smart PCA infusion pump.

Accuracy Evaluation of Tumor Therapy during Respiratory Gated Radiation Therapy (호흡동조방사선 치료 시 종양 치료의 정확도 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chol-Soo;Kang, Se-Sik
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.113-122
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    • 2010
  • Purpose: To evaluate the accuracy of a target position at static and dynamic state by using Dynamic phantom for the difference between tumor's actual movement during respiratory gated radiation therapy and skin movement measured by RPM (Real-time Position Management). Materials and Methods: It self-produced Dynamic phantom that moves two-dimensionally to measure a tumor moved by breath. After putting marker block on dynamic phantom, it analyzed the amplitude and status change depending on respiratory time setup in advance by using RPM. It places marker block on dynamic phantom based on this result, inserts Gafchromic EBT film into the target, and investigates 5 Gy respectively at static and dynamic state. And it scanned investigated Gafchromic EBT film and analyzed dose distribution by using automatic calculation. Results: As a result of an analysis of Gafchromic EBT film's radiation amount at static and dynamic state, it could be known that dose distribution involving 90% is distributed within margin of error of 3 mm. Conclusion: As a result of an analysis of dose distribution's change depending on patient's respiratory cycle during respiratory gated radiation therapy, it is expected that the treatment would be possible within recommended margin of error at ICRP 60.

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Evaluation of Metal Volume and Proton Dose Distribution Using MVCT for Head and Neck Proton Treatment Plan (두경부 양성자 치료계획 시 MVCT를 이용한 Metal Volume 평가 및 양성자 선량분포 평가)

  • Seo, Sung Gook;Kwon, Dong Yeol;Park, Se Joon;Park, Yong Chul;Choi, Byung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.25-32
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    • 2019
  • Purpose: The size, shape, and volume of prosthetic appliance depend on the metal artifacts resulting from dental implant during head and neck treatment with radiation. This reduced the accuracy of contouring targets and surrounding normal tissues in radiation treatment plan. Therefore, the purpose of this study is to obtain the images of metal representing the size of tooth through MVCT, SMART-MAR CT and KVCT, evaluate the volumes, apply them into the proton therapy plan, and analyze the difference of dose distribution. Materials and Methods : Metal A ($0.5{\times}0.5{\times}0.5cm$), Metal B ($1{\times}1{\times}1cm$), and Metal C ($1{\times}2{\times}1cm$) similar in size to inlay, crown, and bridge taking the treatments used at the dentist's into account were made with Cerrobend ($9.64g/cm^3$). Metal was placed into the In House Head & Neck Phantom and by using CT Simulator (Discovery CT 590RT, GE, USA) the images of KVCT and SMART-MAR were obtained with slice thickness 1.25 mm. The images of MVCT were obtained in the same way with $RADIXACT^{(R)}$ Series (Accuracy $Precision^{(R)}$, USA). The images of metal obtained through MVCT, SMART-MAR CT, and KVCT were compared in both size of axis X, Y, and Z and volume based on the Autocontour Thresholds Raw Values from the computerized treatment planning equipment Pinnacle (Ver 9.10, Philips, Palo Alto, USA). The proton treatment plan (Ray station 5.1, RaySearch, USA) was set by fusing the contour of metal B ($1{\times}1{\times}1cm$) obtained from the above experiment by each CT into KVCT in order to compare the difference of dose distribution. Result: Referencing the actual sizes, it was appeared: Metal A (MVCT: 1.0 times, SMART-MAR CT: 1.84 times, and KVCT: 1.92 times), Metal B (MVCT: 1.02 times, SMART-MAR CT: 1.47 times, and KVCT: 1.82 times), and Metal C (MVCT: 1.0 times, SMART-MAR CT: 1.46 times, and KVCT: 1.66 times). MVCT was measured most similarly to the actual metal volume. As a result of measurement by applying the volume of metal B into proton treatment plan, the dose of $D_{99%}$ volume was measured as: MVCT: 3094 CcGE, SMART-MAR CT: 2902 CcGE, and KVCT: 2880 CcGE, against the reference 3082 CcGE Conclusion: Overall volume and axes X and Z were most identical to the actual sizes in MVCT and axis Y, which is in the superior-Inferior direction, was regular in length without differences in CT. The best dose distribution was shown in MVCT having similar size, shape, and volume of metal when treating head and neck protons. Thus it is thought that it would be very useful if the contour of prosthetic appliance using MVCT is applied into KVCT for proton treatment plan.

Teratological Evaluation of Azinphos-Methyl in Rat Fetuses (Azinphos-methyl이 랫트 태아에 미치는 기형학적 연구)

  • Cho, Myung-Haing;Lee, Chang-Eop;Lee, Yong-Soon
    • Toxicological Research
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    • v.4 no.1
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    • pp.55-84
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    • 1988
  • This study was carried out to investigate the teratological potential of azinphos-methyl in the rat fetuses and to establish the nature of the effects on organogenesis and intrauterine development. The Sprague-Dawley female rats (180-210g) without previous litter were used in this study. Azinphos-methyl dosages of 0.094mg/kg, 0.4mg/kg, 1.5mg/kg were selected based on the acute intragastric $LD_{50}$ of 15mg/kg in the rat. Azinphos-methyl in water (Treatment Group), non-treatment control (Negative Control), water control (Sham Control), were administered by oral route and aqueous solution of acetyl salicylic acid (Positive Control) was administered by gavage at rate of 10 ml/kg of body weight from day 6 through 15. The results obtained were summarized as follows. 1. Decreased body weight of dams was observed in animals treated with aspirin and azinphos-methyl 1.5 mg/kg from day 7 through 14. (P<0.01) 2. There was an apparent decrement in the absolute liver weight in the azinphos-methyl 1.5 mg/kg treated group (P<0.05). However, the absolute and relative kidney weight in aspirin group (P<0.05, P<0.01) and the absolute and relative ovary weight in aspirin, azinphos-methyl treatment groups (P<0.01, P<0.05) were increased. 3. Decreased protein contents of dam's liver was observed in the aspirin and high dose azinphos-methyl treated group of animals (P<0.01). 4. The number of male-female ratio per dam increased in azinphos-methyl 1.5 mg/kg group but there was an apparent decrement in the body weight of fetuses in aspirin and high dose azinphos-methyl group (P<0.01, P<0.05). Total immature and resorbed fetuses were increased in aspirin group and the number of dead fetuses were also increased in azinphos-methyl 1.5mg/kg treated group of animals. (P<0.01, P<0.05). 5. In soft tissue defects, diaphragmatic hernia in diaphragm, anophthalmia, enlarged olfactory bulb, hydrocephalus, absence of third and lateral ventricle in skull, hydronephrosis in kidney, atrophy of left ventricle wall, enlarged apex in heart were observed. Especially, defects of diaphragm, heart and eye ball showed peak incidences in the high dose azinphosmethyl and aspirin group. (P<0.01). 6. Variations in the ossification patterns of skull, sternebrae, tail, forelimbs and hindlimbs showed peak incidences in the aspirin and high dose azinphos-methyl group. (P<0.01). 7. In the developmental indices of offspring, the mortality of aspirin and azinphos-methyl 1.5mg/kg treated group was higher than that of negative control. And, there was an apparent decrement in the body weight of fetuses (P<0.01) and considerable differences were obtained in pivoting, development of fur, auditory function, vision, quadrupled muscle development and testes descent in aspirin and azinphos-methyl 1.5mg/kg group. (P<0.01).

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Acute toxicity evaluation of maitake mushroom extract and the mixture of maitake and white jelly mushroom extract (잎새버섯(Grifola frondosa) 추출물 및 잎새버섯과 흰목이 (Tremella fuciformis) 혼합추출물의 급성독성시험)

  • Oh, Young-Joo;Park, Kum-Ju;Ha, Hyo-Cheol;Kim, Hyun-Su
    • Journal of Mushroom
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    • v.8 no.3
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    • pp.91-95
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    • 2010
  • The acute toxicity of a crude extract of maitake mushroom(Grifola frondosa practical compound: GFPC) and the mixture of maitake mushroom extract and white jelly mushroom extract(Tremella fuciformis practical compound: TFPC). For acute oral toxicity test, male and female ICR mice were randomly assigned to five groups, consisting of 12 animals each, six males and six females, received either GFPC or the mixture of GFPC and TFPC, at dose of 0, 2,000 and 5,000mg/kg b.w. by orally(10ml/kg b.w.). For the period of 48hr, clinical signs, body weight and food intake were measured. All animals survived during the study and did not show any clinical signs. Food intake was mildly decreased in both GFPC and the mixture of GFPC and TFPC treated groups, however, body weight gain showed no significant difference among the groups. It is suggested that LD50 of GFPC and the mixture of GFPC and TFPC by oral administration was estimated to be over 5,000mg/kg in both sexes of mice. These results conform that GFPC and the mixture of GFPC and TFPC are safe and no toxic at average dietary level.

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Comparative Evaluation of Probiotic Activities of Bifidobacterium longum MK-G7 with Commercial Bifidobacteria Strains

  • Jung, Hoo-Kil;Kim, Eung-Ryool;Ji, Geun-Eog;Park, Jong-Hyun;Cha, Seong-Kwan;Juhn, Suk-Lak
    • Journal of Microbiology and Biotechnology
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    • v.10 no.2
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    • pp.147-153
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    • 2000
  • This study was conducted to compare probiotic activities and physiological functions of Bifidobacterium longum Mk-G7 with weveral commercial and type strains of bifidobacteria. bif. longum MK-G7 showed the highest acid tolerance against HCl and acetic acid, whereas bif. infantis Y-1 showed the lowest acid tolerance and more than 4 log cycles of viable cell count decreased due to acid injuty. Viable cell counts of bifidobacteria strains decreased more than 1.5 log cycles owing to oxygen toxicity, with the exception of Bif. longum MK-G7, Bif. infantis Y-2, Bif. longum Y-3, Bif. longum Y-6, and Bif. longum RD-13 showed the highest bile tolerance, whereas Bif. longum MK-G7 showed a medium level of bile tolerance. Only Bif. longum MK-G7 howed much higher antibiotic resistance against both tetracycline and penicillin-G in the MIC(minimum inhibitory concentration) level of 24.8 mg/I and 0.52mg/I, respectively. Bif longum Y-6, and Bif. bifidum ATCC 29539 showed more than 80% of anti-mutagenicity against NQO(4-nitroquinolinel-oxide). Since the production of cytokines such as $TNF(tumor necrosis factor)-{\alpha}$ and IL (interleukin)-6, and NO(nitric oxide) in the macrophage cell line Raw 264.7 cells increased as Bif. longum MK-G7 cell concentration increased, ti was suggested that Bif. longum MK-G7 is able to enhance immunopotentiating activity in vitro. When freeze-dred Bif. longum MK-G7 was administered to mice at the dose of 1,2,4, and 6 g/kg of body weight, all of the mice survived in all feeding groups, proving the GRAS(generally recognized as safe) status of Bif. longum MK-G7. When fermented milk containing Bif. longum MK-G7 was administered to human volunteers, viable cell count of total bifidobacteria and anaerobes in the feces increased up to 0.5 log cycles more than before the administration. In particular, Bif. logum MK-G7 ingibited the growth of Bacteroides at the level of 1.0-1.5 log cycles.

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Optimization of Tube Voltage according to Patient's Body Type during Limb examination in Digital X-ray Equipment (디지털 엑스선 장비의 사지 검사 시 환자 체형에 따른 관전압 최적화)

  • Kim, Sang-Hyun
    • Journal of the Korean Society of Radiology
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    • v.11 no.5
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    • pp.379-385
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    • 2017
  • This study identifies the optimal tube voltages depending on the changes in the patient's body type for limb tests using a digital radiography (DR) system. For the upper-limp test, the dose area product (DAP) was fixed at $5.06dGy{\ast} cm^2$, and for the lower-limb test, the DAP was fixed at $5.04dGy{\ast} cm^2$. Afterwards, the tube voltage was changed to four different stages and the images were taken three times at each stage. The thickness of the limbs was increased by 10 mm to 30 mm to change in the patient's body type. For a quantitative evaluation, Image J was used to calculate the contrast to noise ratio (CNR) and signal to noise ratio (SNR) among the four groups, according to the tube voltage. For statistical testing, the statistically significant differences were analyzed through the Kruskal-Wallis test at a 95% confidence level. For the qualitative analysis of the images, the pre-determined items were evaluated based on a 5-point Likert scale. In both upper-limb and lower-limb tests, the more the tube voltage increased, the more the CNR and SNR of the images decreased. The test on the changes depending on the patient's body shape showed that the more the thickness increased, the more the CNR and SNR decreased. In the qualitative evaluation on the upper limbs, the more the tube voltage increased, the more score increased to 4.6 at the maximum of 55kV and 3.6 at 40kV, respectively. The mean score for the lower limbs was 4.4, regardless of the tube voltage. The more either the upper or lower limbs got thicker, the more the score generally decreased. The score of the upper limps sharply dropped at 40kV, whereas that of the lower limps sharply dropped at 50kV. For patients with a standard thickness, the optimized images can be obtained when taken at 45kV for the upper limbs, and at 50kV for the lower limbs. However, when the thickness of the patient's limbs increases, it is best to set the tube voltage at 50 kV for the upper limbs and at 55 kV for the lower limbs.