• Title/Summary/Keyword: Enhanced CT

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Intensity Modulated Whole Pelvic Radiotherapy in Patients with Cervix Cancer: Analysis of Acute Toxicity (자궁경부암 환자에서 전골반 강도변조방사선치료에 의한 급성부작용)

  • Choi, Young-Min;Lee, Hyung-Sik;Hur, Won-Joo;Cha, Moon-Seok;Kim, Hyun-Ho
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.248-254
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    • 2006
  • $\underline{Purpose}$: To evaluate acute toxicities in cervix cancer patients receiving intensity modulated whole pelvic radiation therapy (IM-WPRT). $\underline{Materials\;and\;Methods}$: Between August 2004 and April 2006, 17 patients who underwent IM-WPRT were analysed. An intravenous contrast agent was used for radiotherapy planning computed tomography (CT). The central clinical target volume (CTV) included the primary tumor, uterus, vagina, and parametrium. The nodal CTV was defined as the lymph nodes larger than 1 cm seen on CT and the contrased-enhanced pelvic vessels. The planning target volume (PTV) was the 1-cm expanded volume around the central CTV, except for a 5-mm expansion from the posterior vagina, and the nodal PTV was defined as the nodal CTV plus a 1.5 cm margin. IM-WPRT was prescribed to deliver a dose of 50 Gy to more than 95% of the PTV. Acute toxicity was assessed with common toxicity criteria up to 60 days after radiotherapy. $\underline{Results}$: Grade 1 nausea developed in 10 (58.9%) patients, and grade 1 and 2 diarrhea developed in 11 (64.7%) and 1 (5.9%) patients, respectively. No grade 3 or higher gastrointestinal toxicity was seen. Leukopenia, anemia, and thrombocytopenia occurred in 15 (88.2%). 7 (41.2%), and 2 (11.8%) patients, respectively, as hematologic toxicities. Grade 3 leukopenia developed in 2 patients who were treated with concurrent chemoradiotherapy. $\underline{Conclusion}$: IM-WPRT can be a useful treatment for cervix cancer patients with decreased severe acute toxicities and a resultant improved compliance to whole pelvic irradiation.

A Study of the Adjustment and Treatment Depending on the Change of Prostate Location Using DIPS in Proton Beam Therapy for Prostate Gland in which a Fiducial Gold Marker was Inserted (Fiducial Gold Marker가 삽입된 전립선암 양성자 치료 시 Digital Image Positioning System (DIPS)을 이용한 전립선의 위치변화에 따른 보정에 관한 연구)

  • Park, June-Ki;Kim, Sun-Young;Kim, Tae-Yoon;Choi, Kye-Sook;Yeom, Doo-Suk;Kang, Dong-Yoon;Choi, Seung-O;Park, Ji-Youn
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.25-29
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    • 2008
  • Purpose: To monitor the changes of location of prostate gland using DIPS and to examine the adjustment and proton beam therapy depending on the movement of prostate gland in proton beam therapy for prostate gland in which a fiducial gold marker was inserted. Materials and Methods: This study was conducted in ten patients with prostate cancer who received proton beam therapy since April of 2008. To monitor the change of prostate location, three fiducial gold markers were inserted prior to the treatment. To minimize the movement of prostate gland, patients were recommended to urinate prior to the treatment, to intake a certain amount of water and to concomitantly undergo rectal balloon. In these patients, the set-up position was identical to that for a CT-simulation. The PA (posterior-anterior) and lateral images were obtained using both DIPS (digital image positioning system) and a plain radiography, and they were compared between the two imaging modalities. Thus, the changes of the location of fiducial gold marker were assessed based on three coordinates (x, y, z) and then adjusted. This was followed by proton beam therapy. Results: Images which were taken using a plain radiography were compared with those which were taken using DIPS. In ten patients, according to a reference bony marker, the mean changes of the location of fiducial gold marker based on an iso-center were X-axis: $\pm$0.116 cm, Y-axis: $\pm$0.19 cm and Z-axis: $\pm$0.176 cm. These ten patients showed a difference in the changes of location of prostate gland and it ranged between RT: 0.04 cm and RT: 0.24 cm on the X-axis; between Inf: 0.03 cm and Sup: 0.42 cm on the Y-axis; and Post: 0.05 cm and Ant: 0.35 cm on the Z-axis. Conclusion: To minimize the movement of prostate gland, as the pre-treatment prior to the treatment. In all the patients, however, three fiducial gold markers showed a daily variation which were inserted in the prostate gland. Based on the above data, Thus, the requirement of gold marker matching system depending on the daily variation in the proton beam therapy for which more accurate establishment of target was confirmed. It is assumed that an accurate effect of proton beam therapy would be enhanced by adjusting the target-center depending on the location change of prostate gland using DIPS which was used in the current study.

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Improved Electrochemical Performance and Minimized Residual Li on LiNi0.6Co0.2Mn0.2O2 Active Material Using KCl (KCl을 사용한 LiNi0.6Co0.2Mn0.2O2계 양극활물질의 잔류리튬 저감 및 전기화학특성 개선)

  • Yoo, Gi-Won;Shin, Mi-Ra;Shin, Tae-Myung;Hong, Tae-Whan;Kim, Hong-kyeong
    • Journal of the Korean Electrochemical Society
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    • v.20 no.1
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    • pp.7-12
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    • 2017
  • Using a precursor of $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ as a starting material, a surface-modified cathode material was obtained by coating with KCl, where the added KCl reduces residual Li compounds such as $Li_2CO_3$ and LiOH, on the surface. The resulting electrochemical properties were investigated. The amounts of $Li_2CO_3$ and LiOH decreased from 8,464 ppm to 1,639 ppm and from 8,088 ppm to 6,287 ppm, respectively, with 1 wt% KCl added $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ that had been calcined at $800^{\circ}C$. X-ray diffraction results revealed that 1 wt% of KCl added $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ did not affect the parent structure but enhanced the development of hexagonal crystallites. Additionally, the charge transfer resistance ($R_{ct}$) decreased dramatically from $225{\Omega}$ to $99{\Omega}$, and the discharge capacity increased to 182.73mAh/g. Using atomic force microscopy, we observed that the surface area decreased by half because of the exothermic heat released by the Li residues. The reduced surface area protects the cathode material from reacting with the electrolyte and hinders the development of a solid electrolyte interphase (SEI) film on the surface of the oxide particles. Finally, we found that the introduction of KCl into $LiNi_{0.6}Co_{0.2}Mn_{0.2}O_2$ is a very effective method of enhancing the electrochemical properties of this active material by reducing the residual Li. To the best of our knowledge, this report is the first to demonstrate this phenomenon.

Effect of Fe and BO3 Substitution in Li1+xFexTi2-x(PO4)3-y(BO3)y Glass Electrolytes (Li1+xFexTi2-x(PO4)3-y(BO3)y 계 유리 전해질에서 Fe 및 BO3 치환 효과)

  • Choi, Byung-Hyun;Jun, Hyung Tak;Yi, Eun Jeong;Hwang, Haejin
    • Journal of the Korean Electrochemical Society
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    • v.24 no.3
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    • pp.52-64
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    • 2021
  • The effect of Fe and BO3 doping on structure, thermal, and electrical properties of Li1+xFexTi2-x(PO4)3-y(BO3)y (x = 0.2, 0.5)-based glass and glass ceramics was investigated. In addition, their crystallization behavior during sintering and ionic conductivity were also investigated in terms of sintering temperature. FT-IR and XPS results indicated that Fe2+ and Fe3+ ions in Li1+xFexTi2-x(PO4)3-y(BO3)y glass worked as a network modifier (FeO6 octahedra) and also as a network former (FeO4 tetrahedra). In the case of the glass with low substitution of BO3, boron formed (PB)O4 network structure, while boron preferred BO3 triangles or B3O3 boroxol rings with increasing the BO3 content owing to boic oxide anomaly, which can result in an increased non-bridging oxygen. The glass transition temperature (GTT) and crystallization temperature (CT) was lowered as the BO3 substitution was increased, while Fe2+ lowered the GTT and raised the CT. The ionic conductivity of Li1+xFexTi2-x(PO4)3-y(BO3)y glass ceramics were 8.85×10-4 and 1.38×10-4S/cm for x = 0.2 and 0.5, respectively. The oxidation state of doped Fe and boric oxide anomaly were due to the enhanced lithium ion conductivity of glass ceramics.

LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies (국소 치료 후 잔존 간세포암의 진단을 위한 LI-RADS 치료 반응 알고리즘과 Modified RECIST 기준 간 비교: 비교 연구를 대상으로 한 체계적 문헌고찰과 메타분석)

  • Dong Hwan Kim;Bohyun Kim;Joon-Il Choi;Soon Nam Oh;Sung Eun Rha
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.331-343
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    • 2022
  • Purpose To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT). Materials and Methods Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression. Results For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53). Conclusion The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

Nanopharmaceutical Approach for Enhanced Anti-cancer Activity of Betulinic Acid in Lung-cancer Treatment via Activation of PARP: Interaction with DNA as a Target -Anti-cancer Potential of Nano-betulinic Acid in Lung Cancer-

  • Das, Jayeeta;Samadder, Asmita;Das, Sreemanti;Paul, Avijit;Khuda-Bukhsh, Anisur Rahman
    • Journal of Pharmacopuncture
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    • v.19 no.1
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    • pp.37-44
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    • 2016
  • Objectives: This study examined the relative efficacies of a derivative of betulinic acid (dBA) and its poly (lactide-co-glycolide) (PLGA) nano-encapsulated form in A549 lung cancer cells in vivo and in co-mutagen [sodium arsenite (SA) + benzo[a]pyrene (BaP)]-induced lung cancer in mice in vivo. Methods: dBA was loaded with PLGA nanoparticles by using the standard solvent displacement method. The sizes and morphologies of nano-dBA (NdBA) were determined by using transmission electron microscopy (TEM), and their intracellular localization was verified by using confocal microscopy. The binding and interaction of NdBA with calf thymus deoxyribonucleic acid (CT-DNA) as a target were analyzed by using conventional circular dichroism (CD) and melting temperature (Tm) profile data. Apoptotic signalling cascades in vitro and in vivo were studied by using an enzyme-linked immunosorbent assay (ELISA); the ability of NdBA to cross the blood-brain barrier (BBB) was also examined. The stage of cell cycle arrest was confirmed by using a fluorescence-activated cell-sorting (FACS) data analysis. Results: The average size of the nanoparticles was ~ 110 nm. Confocal microscopy images confirmed the presence of NdBA in the cellular cytoplasm. The bio-physical properties of dBA and NdBA ascertained from the CD and the Tm profiles revealed that NdBA had greater interaction with the target DNA than dBA did. Both dBA and NdBA arrested cell proliferation at G0/G1, NdBA showing the greater effect. NdBA also induced a greater degree of cytotoxicity in A549 cells, but it had an insignificant cytotoxic effect in normal L6 cells. The results of flow cytometric, cytogenetial and histopathological studies in mice revealed that NdBA caused less nuclear condensation and DNA damage than dBA did. TEM images showed the presence of NdBA in brain samples of NdBA fed mice, indicating its ability to cross the BBB. Conclusion: Thus, compared to dBA, NdBA appears to have greater chemoprotective potential against lung cancer.

A Case of Ectopic Cystic Thymoma (이소성 낭성 흉선종 1예)

  • Lee, Jae Hyung;Kim, Il Ok;Lee, Hee Kyung;Min, Kyueng Whan;Kim, Sang Heon;Kim, Tae Hyung;Sohn, Jang Won;Yoon, Ho Joo;Shin, Dong Ho;Park, Chan Kum;Kang, Jung Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.331-335
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    • 2007
  • A thymoma commonly occurs in the superior mediastinum or the upper part of the anterior mediastinum but can be located in other places in rare cases. Cystic degeneration in a thymoma is a relatively common but focal event. In rare cases, the process proceeds to the extent that most if not all of the lesion becomes cystic. We report a case of a patient with a paracardial cystic thymoma in the lower aspect of the anterior mediastinum. A 49-year-old woman was referred to our hospital because of a mass discovered incidentally on a chest X-ray. She showed no symptoms or signs. Contrast-enhanced chest CT scan revealed a $5{\times}5cm$ sized, well-marginated, right paracardial cystic mass with a curvilinear and oval enhancing solid portion. A Surgical resection was performed. The mass was discontinuous with normal thymic tissue. Microscopy revealed a type B1 thymoma with prominent foci of medullary differentiation according to the WHO classification. There was no capsular or local invasion. The postoperative course was uneventful and the patient was discharged in good health.

A Study about Amendment of Safety Control of Computed Tomography (전산화단층촬영용장치의 안전관리 개정에 관한 연구)

  • Kim, Kyotae;Heo, Yeji;Oh, Kyungmin;Noh, Sicheul;Kang, Sangsik;Nam, Sanghee;Park, Jikoon
    • Journal of the Korean Society of Radiology
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    • v.7 no.6
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    • pp.383-387
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    • 2013
  • Diagnostic imaging systems play a critical role in obtaining anatomical images, which increases the frequency of inspection all over the world. However the likelihood that patients are exposed to relatively high radiation dose increases, which may lead to an increase of patient dose due to unnecessary radiation exposure unless appropriate management is accompanied. Thus the revised edition of IEC 60601-2-44 which is constancy tests for CT equipment which is designated as special medical equipment and is subject to safety management was studied. The results suggested the 3rd has been revised rationally in order to overcome the limitations in the 2nd by adopting clear and enhanced references, which implies the replacement of IEC 60601-2-44 2nd edition with IEC 60601-2-44 3rd will prevent the patients from the harm from improper medical equipment.

MR Imaging of Intracranial Pediatric Meningiomas: Manifestations in 16 Patients (두개강내 소아 수막종 16예의 자기공명영상 소견)

  • Eo, Hong;Kim, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.188-196
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    • 2008
  • Purpose : To describe the clinical, MR imaging, and pathologic findings of pediatric meningiomas. Materials and Methods : The authors retrospectively reviewed the medical records and MR images of 16 pediatric patients with pathologically proven meningioma. Mean patient age at diagnosis was 14 years (range, 3-18). MR images were reviewed for details of lesion sizes, locations, signal intensity (SI), marginal characteristics, internal architectures, enhancements, and dural and parenchymal changes. The findings of other imaging modalities and of pathological examinations were also analyzed. Results : Mean tumor size was 5.24 cm (range, 1.3-18.1 cm) and locations were supratentorial in 12 and infratentorial in 4. SI of masses were variable, that is, high in 9, iso in 4, and low in 3 on T2 weighted images (T2WI), and low (n=11), iso (n=4), or high (n=1) on T1WI images. All lesions were visualized as well-demarcated enhancing masses. Five of the tumors were heterogeneous with cystic or necrotic components. Dural attachment was observed in 11 patients and adjacent brain edema in 10. Tumors exhibited hyperdense (n=6) or isodense (n=4) on non-enhanced CT scans, and 3 of the 7 angiograms demonstrated blood supply from the internal carotid artery. Pathologic examinations revealed the following subtypes; transitional cell (n=4), meningotheliomatous (n=4), chordoid (n=2), fibrous (n=2), clear cell (n=1), hyalinized (n=1), rhabdoid papillary (n=1), and atypical (n=1). Conclusion : Pediatric meningiomas occur usually in teenagers, have diverse pathological types, and may produce atypical imaging findings, such as, a heterogeneous internal content or findings suggestive of intraaxial tumors.

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Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.