• Title/Summary/Keyword: Image Study

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Assessment of Bone Metastasis using Nuclear Medicine Imaging in Breast Cancer : Comparison between PET/CT and Bone Scan (유방암 환자에서 골전이에 대한 핵의학적 평가)

  • Cho, Dae-Hyoun;Ahn, Byeong-Cheol;Kang, Sung-Min;Seo, Ji-Hyoung;Bae, Jin-Ho;Lee, Sang-Woo;Jeong, Jin-Hyang;Yoo, Jeong-Soo;Park, Ho-Young;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.1
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    • pp.30-41
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    • 2007
  • Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.

Research Framework for International Franchising (국제프랜차이징 연구요소 및 연구방향)

  • Kim, Ju-Young;Lim, Young-Kyun;Shim, Jae-Duck
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.61-118
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    • 2008
  • The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.

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Application of the Orally Inserted Guiding Device for the Improved Motion Artifacts of the Cervical Spine MRI (경추부 자기공명영상의 움직임 인공물 개선을 위한 구강내 삽입 유도 기구의 적용)

  • Lee, Jaeheun;Yu, Yunsik;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.6
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    • pp.317-323
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    • 2014
  • This study aims to suggest and test methods using an orally inserted guiding device in order to improve a motion artifact by involuntary oral motor such as removing one's dentures and swallowing saliva clinically structured cervical spine scan and to make the optimal image by minimizing motion artifact. A cervical spine test was conducted with 30 patients who wore dentures among those who had a cervical spinal disease from January 1, 2014 through June 30, 2014. As for testing methods, after removing denture, T1-TSE-Sagittal, T2-TSE-Sagittal, T1-TSE-Axial and T2-TSE-Axial were obtained in a normal position and a supine position; the orally inserted guiding device was inserted in patients' mouth; and then T1-TSE-Axial and T2-TSE-Axial were retested. As a result, in SNR, T1-TSE-Axial before inserting an orally inserted guiding device was $22.33{\pm}8.59$; T1-TSE-Axial after inserting the orally inserted guiding device was $25.21{\pm}7.93$; T2-TSE-Axial before inserting the orally inserted guiding device was $14.49{\pm}5.74$; and T2-TSE-Axial after inserting the orally inserted guiding device was $16.61{\pm}6.72$. In CNR, T1-TSE-Axial was measured at $0.23{\pm}0.01$ while T2-TSE-Axial at $0.21{\pm}0.01$. As a result of the qualitative analysis, T1-TSE-Axial before inserting the orally inserted guiding device was $3.49{\pm}0.11$; T1-TSE-Axial after inserting the orally inserted guiding device was $3.95{\pm}0.14$; T2-TSE-Axial before inserting the orally inserted guiding device was $3.25{\pm}0.18$; and T2-TSE-Axial after inserting the orally inserted guiding device was $3.68{\pm}0.09$. As a result of using an orally inserted guiding device, the resolution and contrast of the images improved as the patients' involuntary artifact decreased because of removing dentures and swallowing saliva, and it was found that the interpretation of the images and identification of the diseases improved.

Study on the neurodevelopmental predictors for the results of the Bayley Scales of Infant Development II in high-risk neonates (고위험 신생아에서 Bayley 발달 검사 결과에 영향을 미치는 신경발달 예후인자에 대한 연구)

  • Woo, Mi Kyeong;Kim, Dong Wook;Huh, Kyoung;Shim, Gyu Hong;Chey, Myoung Jae
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1221-1227
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    • 2009
  • Purpose:To identify the risk factors for poor neurodevelopmental outcomes in high-risk neonates. Methods:We studied 94 infants admitted to the neonatal intensive care unit at the Sanggye Paik Hospital between January 2002 and November 2005 and evaluated the follow-up data. The following events were considered as risk factors: ${\leq}32$ weeks of gestation, very low birth weight, Apgar scores of less than 5, neonatal resuscitation, neonatal seizure, congenital infection, and abnormalities in cranial ultrasound or magnetic resonance imaging (MRI). The infants who had any one of these risk factors were included. They were evaluated at their mean corrected age of 13.84${\pm}$8.03 months. Mental and Psychomotor Developmental Indices (MDI, PDI) were determined by a clinical psychologist using the Bayley Scales of Infant Development II. Results:The mean MDI and PDI of all the patients were 96.28${\pm}$26.70 and 94.00${\pm}$22.80, respectively. Abnormalities on cranial ultrasound or MRI were significant predictors of both low MDI (P<0.05) and low PDI (P<0.001). These abnormalities showed a stronger association with low PDI than with low MDI. The infants with periventricular leukomalacia had the lowest MDI and PDI ($70.10{\pm}28.68$ and $69.70{\pm}24.91$, respectively). Apgar score at 1 minute and very low birth weight were also significant predictors for low PDI (P<0.05, P<0.05, respectively). Conclusion:Image findings with cranial ultrasound or MRI were the strongest predictors of neurodevelopmental outcome. Periventricular leukomalacia was the best predictive factor for mental and psychomotor development.

The Effect of Hydroxyproline and Pro-Hyp Dipeptide on UV-damaged Skin of Hairless Mice (자외선에 의해 피부가 손상된 hairless mouse에서의 hydroxyproline, Pro-Hyp 경구반복투여시 피부 상태 개선 효과)

  • Lee, Ji-Hae;Seo, Jeong-Hye;Park, Young-Ho;Kim, Wan-Gi;Lim, Kyung-Min;Lee, Sang-Jun
    • Korean Journal of Food Science and Technology
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    • v.40 no.4
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    • pp.436-442
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    • 2008
  • Hydroxyproline and Pro-Hyp dipeptide are the digestive products of collagen hydrolysate called collagen peptide. Some suggested that collagen peptides could improve aged or damaged skins, however, the effects of collagen peptides on the skin have not been known. In this study, we investigated the effects of digestive products of collagen peptides, hydroxyproline and Pro-Hyp dipeptide on skin quality using the UV-damaged dorsal skin of hairless mouse as a model system. Female SKH hairless mice were pre-irradiated with UV for 7 weeks, and then hydroxyproline, Pro-Hyp dipeptide were orally administered for 7 weeks with UV irradiation. Wrinkle formation (by replica image), skin elasticity, barrier status (by TEWL, transepidermal water loss), epidermis thickness, and biophysical changes in the stratum comeum (by hematoxylin & eosin staining) were examined. With the oral peptide treatment, effects such as skin barrier maintenance, anti-skin thickening, and recovery of the stratum corneum were observed. These results indicate that oral intake of collagen peptides may have beneficial effects on damaged skin cells.

Stage Costume Design for Performance Hamlet (II) - The Study on Pattern and Manufactured Product - (햄릿 공연을 위한 무대의상 디자인 (II) - 패턴 및 실물제작 -)

  • Kim, Soon-Ku;Hwang, Seong-Won
    • Fashion & Textile Research Journal
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    • v.6 no.1
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    • pp.41-50
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    • 2004
  • This research proposes the on-stage costumes for the play Hamlet of Shakespeare performed by Yunheedan Guhri Pae - the Street Theater Troupe. Stage costumes have an important role in displaying the characteristics of each characters to the audience and has big visual effects. However, in order to design the costumes in the object viewpoints of the audience, the survey on the images of the characters who had actually watched the performance was taken place and proposed the costume design according to the results of the survey. Hamlet a: This result was applied to propose a sweater in black color, black leather pants and vest. Hamlet b: This result was applied to propose hooded coat in purple in middle level of brightness and color spectrum and yellow coat. For free image, loose pants in blue and vest in the same color tone were proposed. Gertrude a: This result was applied to use purple (violet) with reddish tone to propose the formation of a dress applying tailored suit. Gertrude b: This result was applied to propose purple gown and the one-piece dress with black laces. Ophelia a: This result was applied to propose feminine white dress and cape in purple color tone. Ophelia b: This result was applied to propose dyed and weaved clothes. Through the surveys as above, the images of each character was driven in adjectives, and using the results driven from the brightness, coloration, and color, color images were proposed. Only one costume cannot make up for the stage costumes and because it exists as an element of stage production, it is true that costumes are limited in some areas. However, that limit can become the motive of the costume. There is a limit, which the designer cannot produce the costumes as he or she had designed but I believe it is the center of the on-stage customers to display the characteristics of the characters according to the given concept. The limit of this research is the fact that because the costumes were designed so they fit the conditions already given, thus it was difficult to regard the process of designing and producing the costume as a project done according to the interaction. And in the future, if it is possible, I wish for the joint research with the people responsible for stage art to take place as a practical stage art. It was possible to produce practical costume since they were produced for actual performance and the production of costumes considering the dance steps, line of flow, and acting, was able to reduce the trial and error on stage. Through this research, I felt that the understanding and smooth interaction on diverse other areas not limited to the costume design should be taken place and believe that this was a research that proposes new research method since there had been only a few previous research regarding the on-stage costumes for actual performances. Therefore, this research had depended on the surveys given to the audiences to endow objectivity, however, I wish this research can contribute to defining effective process and methods for the on-stage costumes with more active researches with diverse methods and in diverse areas. I am sorry that the costume production for all the characters and all the scenes in Hamlet couldn't be done due to many limitations. As the following research assignment, I am planning on designing the costumes for all the scenes.

The Evaluation of Clinical Usefulness on Application of Myocardial Extract in Quantitative Perfusion SPECT (QPS 프로그램에서 Myocardial extract 적용에 따른 임상적 유용성 평가)

  • Yun, Jong-Jun;Lim, Yeong-Hyeon;Lee, Mu-Seok;Song, Hyeon-Seok;Jeong, Ji-Uk;Park, Se-Yun;Kim, Jae-Hwan;Kim, Jeong-Uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.88-93
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    • 2011
  • Purpose: As to analytical method of data, the AutoQUANT software in which it is used quantitative rating of the myocardial perfusion SPECT are reported that there is a difference. Therefore the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made data of the same patient. The purpose of this study is to offer the comparative analysis of myocardial extract method in Quantitative Perfusion SPECT. Materials and methods: We analyzed the 51 patients who were examined by Tc-99m MIBI gated myocardial SPECT in nuclear medicine department of Pusan National University Hospital from June to December 2010(34 men, 17 women, mean age $66.5{\pm}9.9$). We acquired the extracted image in myocardial extract protocol. QPS program that uses the AutoQUANT software measured TID(Transient Ischemic Dilation), ESD(Extent of Stress Defect), SSS(Summed Stress Score). Then analyzed the results. Results: The correlation of appyling myocardial extract is TID(r=0.98), ESD(r=0.99), SSS(r=0.99). In the 95% confidence limit, there was no satistically significant difference(TID p=0.78, ESD p=0.31, SSS p=0.19). After blinding test with a physician for making a qualitative analysis, there was no difference. Conclusion: Quantitative indices in QPS program showed good correlation and the results showed no statistically signigicant difference. The variance between method was small. therefore, the functional parameters by each method can be used interchangeably. Also, we expect patient's satisfaction.

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Investigating Dynamic Mutation Process of Issues Using Unstructured Text Analysis (비정형 텍스트 분석을 활용한 이슈의 동적 변이과정 고찰)

  • Lim, Myungsu;Kim, Namgyu
    • Journal of Intelligence and Information Systems
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    • v.22 no.1
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    • pp.1-18
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    • 2016
  • Owing to the extensive use of Web media and the development of the IT industry, a large amount of data has been generated, shared, and stored. Nowadays, various types of unstructured data such as image, sound, video, and text are distributed through Web media. Therefore, many attempts have been made in recent years to discover new value through an analysis of these unstructured data. Among these types of unstructured data, text is recognized as the most representative method for users to express and share their opinions on the Web. In this sense, demand for obtaining new insights through text analysis is steadily increasing. Accordingly, text mining is increasingly being used for different purposes in various fields. In particular, issue tracking is being widely studied not only in the academic world but also in industries because it can be used to extract various issues from text such as news, (SocialNetworkServices) to analyze the trends of these issues. Conventionally, issue tracking is used to identify major issues sustained over a long period of time through topic modeling and to analyze the detailed distribution of documents involved in each issue. However, because conventional issue tracking assumes that the content composing each issue does not change throughout the entire tracking period, it cannot represent the dynamic mutation process of detailed issues that can be created, merged, divided, and deleted between these periods. Moreover, because only keywords that appear consistently throughout the entire period can be derived as issue keywords, concrete issue keywords such as "nuclear test" and "separated families" may be concealed by more general issue keywords such as "North Korea" in an analysis over a long period of time. This implies that many meaningful but short-lived issues cannot be discovered by conventional issue tracking. Note that detailed keywords are preferable to general keywords because the former can be clues for providing actionable strategies. To overcome these limitations, we performed an independent analysis on the documents of each detailed period. We generated an issue flow diagram based on the similarity of each issue between two consecutive periods. The issue transition pattern among categories was analyzed by using the category information of each document. In this study, we then applied the proposed methodology to a real case of 53,739 news articles. We derived an issue flow diagram from the articles. We then proposed the following useful application scenarios for the issue flow diagram presented in the experiment section. First, we can identify an issue that actively appears during a certain period and promptly disappears in the next period. Second, the preceding and following issues of a particular issue can be easily discovered from the issue flow diagram. This implies that our methodology can be used to discover the association between inter-period issues. Finally, an interesting pattern of one-way and two-way transitions was discovered by analyzing the transition patterns of issues through category analysis. Thus, we discovered that a pair of mutually similar categories induces two-way transitions. In contrast, one-way transitions can be recognized as an indicator that issues in a certain category tend to be influenced by other issues in another category. For practical application of the proposed methodology, high-quality word and stop word dictionaries need to be constructed. In addition, not only the number of documents but also additional meta-information such as the read counts, written time, and comments of documents should be analyzed. A rigorous performance evaluation or validation of the proposed methodology should be performed in future works.

Evaluation of Ovary Dose for woman of Childbearing age Woman with Breast cancer in tomotherapy (가임기 여성의 유방암 토모치료 시 난소선량 평가비교)

  • Lee, Soo Hyeung;Park, Soo Yeun;Choi, Ji Min;Park, Ju Young;Kim, Jong Suk
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.337-343
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    • 2014
  • Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.

Reproducibility Evaluation of Deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis during radiation therapy for Left Breast cancer patients (좌측 유방암 환자의 방사선치료 중 환자의 호흡과 심장 위치 분석을 통한 Deep inspiration breath-hold(DIBH) 기법의 재현성 평가)

  • Jo, Jae Young;Bae, Sun Myung;Yoon, In Ha;Lee, Ho Yeon;Kang, Tae Young;Baek, Geum Mun;Bae, Jae Beom
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.297-303
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    • 2014
  • Purpose : The purpose of this study is reproducibility evaluation of deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis in radiation therapy for Left Breast cancer patients. Materials and Methods : Free breathing(FB) Computed Tomography(CT) images and DIBH CT images of three left breast cancer patients were used to evaluate the heart volume and dose during treatment planing system( Eclipse version 10.0, Varian, USA ). The signal of RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, Varian, USA) was used to evaluate respiration stability of DIBH during breast radiation therapy. The images for measurement of heart position were acquired by the Electronic portal imaging device(EPID) cine acquisition mode. The distance of heart at the three measuring points(A, B, C) on each image was measured by Offline Review (ARIA 10, Varian, USA). Results : Significant differences were found between the FB and DIBH plans for mean heart dose (6.82 vs. 1.91 Gy), heart $V_{30}$ (68.57 vs. $8.26cm^3$), $V_{20}$ (76.43 vs. $11.34cm^3$). The standard deviation of DIBH signal of each patient was ${\pm}0.07cm$, ${\pm}0.04cm$, ${\pm}0.13cm$, respectively. The Maximum and Minimum heart distance on EPID images were measured as 0.32 cm and 0.00 cm. Conclusion : Consequently, using the DIBH technique with radiation therapy for left breast cancer patients is very useful to establish the treatment plan and to reduce the heart dose. In addition, it is beneficial to using the Cine acquisition mode of EPID for the reproducibility evaluation of DIBH.