Baek, Min Gyu;Kim, Min Woo;Ha, Se Min;Chae, Jong Pyo;Jo, Guang Sub;Lee, Sang Bong
The Journal of Korean Society for Radiation Therapy
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v.32
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pp.7-15
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2020
Purpose: In modern radiotherapy technology, several methods of image guided radiation therapy (IGRT) are used to deliver accurate doses to tumor target locations and normal organs, including CBCT (Cone Beam Computed Tomography) and other devices, ExacTrac System, other than CBCT equipped with linear accelerators. In previous studies comparing the two systems, positional errors were analysed rearwards using Offline-view or evaluated only with a Yaw rotation with the X, Y, and Z axes. In this study, when using CBCT and ExacTrac to perform 6 Degree of the Freedom(DoF) Online IGRT in a treatment center with two equipment, the difference between the set-up calibration values seen in each system, the time taken for patient set-up, and the radiation usefulness of the imaging device is evaluated. Materials and Methods: In order to evaluate the difference between mobile calibrations and exposure radiation dose, the glass dosimetry and Rando Phantom were used for 11 cancer patients with head circumference from March to October 2017 in order to assess the difference between mobile calibrations and the time taken from Set-up to shortly before IGRT. CBCT and ExacTrac System were used for IGRT of all patients. An average of 10 CBCT and ExacTrac images were obtained per patient during the total treatment period, and the difference in 6D Online Automation values between the two systems was calculated within the ROI setting. In this case, the area of interest designation in the image obtained from CBCT was fixed to the same anatomical structure as the image obtained through ExacTrac. The difference in positional values for the six axes (SI, AP, LR; Rotation group: Pitch, Roll, Rtn) between the two systems, the total time taken from patient set-up to just before IGRT, and exposure dose were measured and compared respectively with the RandoPhantom. Results: the set-up error in the phantom and patient was less than 1mm in the translation group and less than 1.5° in the rotation group, and the RMS values of all axes except the Rtn value were less than 1mm and 1°. The time taken to correct the set-up error in each system was an average of 256±47.6sec for IGRT using CBCT and 84±3.5sec for ExacTrac, respectively. Radiation exposure dose by IGRT per treatment was measured at 37 times higher than ExacTrac in CBCT and ExacTrac at 2.468mGy and 0.066mGy at Oral Mucosa among the 7 measurement locations in the head and neck area. Conclusion: Through 6D online automatic positioning between the CBCT and ExacTrac systems, the set-up error was found to be less than 1mm, 1.02°, including the patient's movement (random error), as well as the systematic error of the two systems. This error range is considered to be reasonable when considering that the PTV Margin is 3mm during the head and neck IMRT treatment in the present study. However, considering the changes in target and risk organs due to changes in patient weight during the treatment period, it is considered to be appropriately used in combination with CBCT.
Filter absorbs low-energy X-ray to increase the average energy and reduces patient exposure dose. This study investigates if the materials of Mo and W could be used for the digital imaging device CR by conducting image assessment and dose measurement of SNR, FOM and histogram. In addition, measurement of beam quality was conducted depending on the material of the filter, and at the same time, a proper combination of filters was examined depending on the change in tube voltage (kVp). In regard to entrance skin dose, Mo filter showed the dose reduction by 42~56%, compared to Cu filter. Moreover, Mo filter showed higher transmission dose by around 1.5 times than that of Cu filter. In image assessment, it was found that W was unsuitable to be used as a filter, whereas Mo could be used as a filter to reduce dose without decline in image quality at the tube voltage of 80 kVp or higher. As tube voltage increased, 2.0 mm Al+0.1 mm Mo almost had a similar histogram width to that of 2.0 mm Al+0.2 mm Cu. Therefore, Mo filter can be used at relatively high tube voltage of 80 kVp, 100 kVp and 120 kVp. The SNR of 2.0 mm Al+0.1 mm Mo did not show any significant difference from those of 2.0 mm Al+0.2 mm Cu and 2.0 mm Al+0.1 mm Cu. As a result, if Mo filter is used to replace Cu filter in general radiography, where 80 kVp or higher is used for digital radiation image, patient exposure dose can be reduced significantly without decline in image quality, compared to Cu filter. Therefore, it is believed that Mo filter can be applied to chest X-ray and high tube voltage X-ray in actual clinical practice.
According to the capacity design concept which forms the basis of the current steel seismic codes, the braces in concentrically braced frames (CBFs) should dissipate seismic energy through cyclic tension yielding and cyclic compression buckling while the beams and the columns should remain elastic. Brace buckling in inverted V-braced frames induces unbalanced vertical forces which, in turn, impose the additional beam moments and column axial forces. However, due to difficulty in predicting the location of buckling stories, the most conservative approach implied in the design code is to estimate the column axial forces by adding all the unbalanced vertical forces in the upper stories. One alternative approach, less conservative and recommended by the current code, is to estimate the column axial forces based on the amplified seismic load expected at the mechanism-level response. Both are either too conservative or lacking technical foundation. In this paper, three combination rules for a rational estimation of the column axial forces were proposed. The idea central to the three methods is to detect the stories of high buckling potential based on pushover analysis and dynamic behavior. The unbalanced vertical forces in the stories detected as high buckling potential are summed in a linear manner while those in other stories are combined by following the SRSS(square root of sum of squares) rule. The accuracy and design advantage of the three methods were validated by comparing extensive inelastic dynamic analysis results. The mode-shape based method(MSBM), which is both simple and accurate, is recommended as the method of choice for practicing engineers among the three.
Background: High-dose chemotherapy is increasingly employed in many refractory malignant diseases. This therapy has been reported to increase response rate and survival benefits but it is also associated with higher treatment-related morbidity and mortality. We evaluated clinical characteristics and course of the pulmonary toxicity following high-dose chemotherapy with peripheral blood stem cell transplantation. Methods: Ninety-seven patients who had received high-dose chemotherapy with peripheral blood stem cell transplantation were evaluated. Five patients who developed lung lesions which were not related to infection nor primary malignant disease underwent transbronchial lung biopsy. The patients' clinical characteristics, treatments, and prognosis were reviewed retrospectively. Results: Five patients(5.1%) developed idiopathic pneumonia syndrome. The high dose chemotherapy regimens employed were cyclophosphamide, BCNU, and cisplatin in 3 cases, one case of BCNU, etoposide, Ara-C, and cyclophosphamide combination, and a regimen consisting of BCNU, etoposide, Ara-C, and melphalan. The total dose of BCNU used was 300-400 mg/$m^2$ and that of cyclophosphsmide was 6,000 mg/$m^2$. All of 5 patients received radiation therapy before this treatment. After an average duration of 14 weeks (4-26 weeks) of high-dose chemotherapy, patients developed cough, dyspnea and fever. The chest X-rays showed bilateral diffuse infiltration in 3 cases and the focal infiltration in the other 2 cases. All the patients received corticosteroid therapy as a treatment for the lung lesions. Two of them progressed to acute respiratory distress syndrome and died. Three patients recovered without residual lung lesion but one of them died of dilated cardiomyopathy. Conclusion: High-dose chemotherapy with peripheral blood stem cell transplantation especially which containing BCNU regimen may develop idiopathic pneumonia syndrome related to pulmonary toxicity and corticosteroid therapy may be bel1eficial in some cases.
The position of the internal organs can change continually and periodically inside the body due to the respiration. To reduce the respiration induced uncertainty of dose localization, one can use a respiratory gated radiotherapy where a radiation beam is exposed during the specific time of period. The main disadvantage of this method is that it usually requests a long treatment time, the massive effort during the treatment and the limitation of the patient selection. In this sense, the combination of the real-time position management (RPM) system and the volumetric intensity modulated radiotherapy (RapidArc) is promising since it provides a short treatment time compared with the conventional respiratory gated treatments. In this study, we evaluated the accuracy of the respiratory gated RapidArc treatment. Total sic patient cases were used for this study and each case was planned by RapidArc technique using varian ECLIPSE v8.6 planning machine. For the Quality Assurance (QA), a MatriXX detector and I'mRT software were used. The results show that more than 97% of area gives the gamma value less than one with 3% dose and 3 mm distance to agreement condition, which indicates the measured dose is well matched with the treatment plan's dose distribution for the gated RapidArc treatment cases.
Yi Byong Yong;Nha Sang Kyun;Choi Eun Kyung;Kim Jong Hoon;Chang Hyesook;Kim Mi Hwa
Radiation Oncology Journal
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v.15
no.1
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pp.71-78
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1997
Purpose : To collect beam data for dynamic wedge fields using conventional measurement tools without the multi-detector system, such as the linear diode detectors or ionization chambers. Materials and Methods : The accelerator CL 2100 C/D has two photon energies of 6MV and 15MV with dynamic wedge an91es of 15o, 30o, 45o and 60o. Wedge transmission factors, percentage depth doses(PDD's) and dose Profiles were measured. The measurements for wedge transmission factors are performed for field sizes ranging from $4\times4cm^2\;to\;20\times20cm^2$ in 1-2cm steps. Various rectangular field sizes are also measured for each photon energy of 6MV and 15MV, with the combination of each dynamic wedge angle of 15o 30o. 45o and 60o. These factors are compared to the calculated wedge factors using STT(Segmented Treatment Table) value. PDD's are measured with the film and the chamber in water Phantom for fixed square field. Converting parameters for film data to chamber data could be obtained from this procedure. The PDD's for dynamic wedged fields could be obtained from film dosimetry by using the converting parameters without using ionization chamber. Dose profiles are obtained from interpolation and STT weighted superposition of data through selected asymmetric static field measurement using ionization chamber. Results : The measured values of wedge transmission factors show good agreement to the calculated values The wedge factors of rectangular fields for constant V-field were equal to those of square fields The differences between open fields' PDDs and those from dynamic fields are insignificant. Dose profiles from superposition method showed acceptable range of accuracy(maximum 2% error) when we compare to those from film dosimetry. Conclusion : The results from this superposition method showed that commissionning of dynamic wedge could be done with conventional dosimetric tools such as Point detector system and film dosimetry winthin maximum 2% error range of accuracy.
For intraoperative radiation therapy using electron beams, a cone system to deliver a large dose to the tumor during surgical operation and to save the surrounding normal tissue should be developed and dosimetry for the cone system is necessary to find proper X-ray collimator setting as well as to get useful data for clinical use. We developed a docking type of a cone system consisting of two parts made of aluminum: holder and cone. The cones which range from 4cm to 9cm with 1cm step at 100cm SSD of photon beam are 28cm long circular tubular cylinders. The system has two 26cm long holders: one for the cones larger than or equal to 7cm diamter and another for the smaller ones than 7cm. On the side of the holder is an aperture for insertion of a lamp and mirror to observe treatment field. Depth dose curve. dose profile and output factor at dept of dose maximum. and dose distribution in water for each cone size were measured with a p-type silicone detector controlled by a linear scanner for several extra opening of X-ray collimators. For a combination of electron energy and cone size, the opening of the X-ray collimator was caused to the surface dose, depths of dose maximum and 80%, dose profile and output factor. The variation of the output factor was the most remarkable. The output factors of 9MeV electron, as an example, range from 0.637 to 1.549. The opening of X-ray collimators would cause the quantity of scattered electrons coming to the IORT cone system. which in turn would change the dose distribution as well as the output factor. Dosimetry for an IORT cone system is inevitable to minimize uncertainty in the clinical use.
Wedge shaped isodoses are desired in a number of clinical situations. Hard wedge filters have provided nominal angled isodoses with dosimetric consequences of beam hardening, increased peripheral dosing, nonidealized gradients at deep depths along with the practical consequendes of filter handling and placement problems. Dynamic wedging uses a combination of a moving collimator and changing monitor dose to achieve angled isodoses. The segmented treatment tables(STT) that monitor unit setting by every distance of moving collimator, was induced by numerical formular. The characteristics of dynamic wedge by STT compared with real dosimetry. Methods and Materials : The accelerator CLINAC 2100C/D at Yonsei Cancer Center has two photon energies (6MV and 10MV), currently with dynamic wedge angles of 15$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$. The segmented treatment tables(STT) that drive the collimator in concert with a changing monitor unit are unique for field sizes ranging from 4.0cm to 20.0cm in 0.5cm steps. Transmission wedge factors were measured for each STT with an standard ion chamber. Isodose profiles, isodose curves, percentage depth dose for dynamic wedge filters were measured with film dosimetry. Dynamic wedge angle by STT was well coincident with film dosimetry. Percent depth doses were found to be closer to open field but more shallow than hard wedge filter. The wedge transmission factor were decreased by increased the wedge angle and more higher than hard wedge filters. Dynamic wedging probided more consistent gradients across the field compared with hard wedge filters. Dynamic wedging has practical and dosimetric advantages over hard filters for rapid setup and keeping from table collisions. Dynamic wedge filters are positive replacement for hard filters and introduction of dynamic conformal radiotherapy and intensity modulation radiotherapy in a future.
The objectives of this study was to investigate the amount of tooth ablation and the change of intrapulpal temperature by Er:YAG laser as it relates to pulse energy and pulse repetition rate at the identical power and, thereby, to reveal which of the two parameters strongly relates with ablation efficiency and intrapulpal temperature. Extracted healthy human molar teeth were sectioned into two pieces and each specimen was irradiated within the combination of pulse energy and pulse repetition time at the same power of 3W; $300mJy{\times}10Hz$ group, $200mJy{\times}15Hz$ group, and $150mJy{\times}20Hz$ group. Each specimen comprised ten tooth specimens. A laser beam with conjunction of a water flow rate of 1.6 ml/min was applied over enamel surfaces of the specimens during 3 seconds and the ablation amount was determined by difference in weight before and after irradiation. To investigate the temperature change in the pulp according to the above groups, another five extracted healthy human molar teeth were prepared. Each tooth was embedded into resin block and the temperature-measuring probes were kept on the irradiated and the opposite walls in the dental pulp during lasing. When the power was kept constant at 3W, ablation amount increased with pulse energy rather than pulse repetition rate (p=0.000). Although intrapulpal temperature increased with pulse repetition rate, there were no significant differences among the groups and between the irradiated and the opposite pulpal walls, except at a condition of $150y{\times}20Hz$ (p=0.033). Conclusively, it is suggested that ablation efficacy is influenced by pulse energy rather than pulse repetition rate.
Quality control methods for the first G-band vapor radiometer (GVR) mounted on a weather aircraft in Korea were developed using the GVR Precipitable Water Vapor (PWV). The aircraft attitude information (degree of pitch and roll) was applied to quality control to select the shortest vertical path of the GVR beam. In addition, quality control was applied to remove a GVR PWV ≥20 mm. It was found that the difference between the warm load average power and sky load average power converged to near 0 when the GVR PWV increased to 20 mm or higher. This could be due to the high brightness temperature of the substratus and mesoclouds, which was confirmed by the Communication, Ocean and Meteorological Satellite (COMS) data (cloud type, cloud top height, and cloud amount), cloud combination probe (CCP), and precipitation imaging probe (PIP). The GVR PWV before and after the application of quality control on a cloudy day was quantitatively compared with that of a local data assimilation and prediction system (LDAPS). The Root Mean Square Difference (RMSD) decreased from 2.9 to 1.8 mm and the RMSD with Korea Local Analysis and Precipitation System (KLAPS) decreased from 5.4 to 4.3 mm, showing improved accuracy. In addition, the quality control effectiveness of GVR PWV suggested in this study was verified through comparison with the COMS PWV by using the GVR PWV applied with quality control and the dropsonde PWV.
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