• Radiation Oncology Journal
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• v.20 no.1
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• pp.41-52
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• 2002

Purpose : 3D conformal radiotherapy, the optimum dose delivered to the tumor and provided the risk of normal tissue unless marginal miss, was restricted by organ motion. For tumors in the thorax and abdomen, the planning target volume (PTV) is decided including the margin for movement of tumor volumes during treatment due to patients breathing. We designed the respiratory gating radiotherapy device (RGRD) for using during CT simulation, dose planning and beam delivery at identical breathing period conditions. Using RGRD, reducing the treatment margin for organ (thorax or abdomen) motion due to breathing and improve dose distribution for 3D conformal radiotherapy. Materials and Methods : The internal organ motion data for lung cancer patients were obtained by examining the diaphragm in the supine position to find the position dependency. We made a respiratory gating radiotherapy device (RGRD) that is composed of a strip band, drug sensor, micro switch, and a connected on-off switch in a LINAC control box. During same breathing period by RGRD, spiral CT scan, virtual simulation, and 3D dose planing for lung cancer patients were peformed, without an extended PTV margin for free breathing, and then the dose was delivered at the same positions. We calculated effective volumes and normal tissue complication probabilities (NTCP) using dose volume histograms for normal lung, and analyzed changes in doses associated with selected NTCP levels and tumor control probabilities (TCP) at these new dose levels. The effects of 3D conformal radiotherapy by RGRD were evaluated with DVH (Dose Volume Histogram), TCP, NTCP and dose statistics. Results : The average movement of a diaphragm was 1.5 cm in the supine position when patients breathed freely. Depending on the location of the tumor, the magnitude of the PTV margin needs to be extended from 1 cm to 3 cm, which can greatly increase normal tissue irradiation, and hence, results in increase of the normal tissue complications probabiliy. Simple and precise RGRD is very easy to setup on patients and is sensitive to length variation (+2 mm), it also delivers on-off information to patients and the LINAC machine. We evaluated the treatment plans of patients who had received conformal partial organ lung irradiation for the treatment of thorax malignancies. Using RGRD, the PTV margin by free breathing can be reduced about 2 cm for moving organs by breathing. TCP values are almost the same values $(4\~5\%\;increased)$ for lung cancer regardless of increasing the PTV margin to 2.0 cm but NTCP values are rapidly increased $(50\~70\%\;increased)$ for upon extending PTV margins by 2.0 cm. Conclusion : Internal organ motion due to breathing can be reduced effectively using our simple RGRD. This method can be used in clinical treatments to reduce organ motion induced margin, thereby reducing normal tissue irradiation. Using treatment planning software, the dose to normal tissues was analyzed by comparing dose statistics with and without RGRD. Potential benefits of radiotherapy derived from reduction or elimination of planning target volume (PTV) margins associated with patient breathing through the evaluation of the lung cancer patients treated with 3D conformal radiotherapy.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.327-329
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• 2007

A 44-year-old woman presented with recurrent, transient episodes of left-side hemiparesis. She had received a radiation dose of 6120 cGy to her cervical region for parotid gland carcinoma 13 years previously. Cerebral angiography revealed a long, irregular tight stenosis involving the right extracranial internal carotid artery [ICA] and common carotid artery [CCA], measuring approximately 90% at the most severe narrowing according to North American Symptomatic Carotid Endarterectomy Trial criteria. Endovascular stent placement resulted in restoration of the carotid lumen to about 80% of its original diameter. She showed no further ischemic events during the follow-up period of 48 months. Our clinical and angiographic findings suggest that carotid stenting is considered a safe and effective treatment option in patients with radiation-induced carotid stenosis.

• Journal of radiological science and technology
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• v.28 no.2
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• pp.117-122
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• 2005

According to the Para. 5 of Art 2 of the Korean Nuclear Safety Regulations, which was revised in 1999, internal dose assessment as well as external one should be performed by law for employees at a nuclear power plant from 2003, and their estimate errors should also be within 50%. Thus, more accurate internal dosimetry becomes important. Corresponding to such regulation revision, we are developing a more accurate thyroid-uptake internal dosimetric system and have developed a Monte Carlo simulation code, the so-called CALEFF, to calculate the detection efficiency of the dosimetric system. In this paper, we calculated detection efficiencies with various test conditions by using the CALEFF code and discussed their characteristics. We may use the detection efficiency calculated by the code in calibrating the thyroid internal dose from measured data.

• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.295-303
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• 2023

Whole-body counters are widely used to assess internal contamination after a nuclear accident. However, it is difficult to determine radioiodine activity due to limitations in conventional calibration phantoms. Inhaled or ingested radioiodine is heterogeneously distributed in the human body, necessitating time-dependent biodistribution for the assessment of the internal contamination caused by the radioiodine intake. This study aims at calculating counting efficiencies considering the biodistribution of ¹³¹I in whole-body counting measurement. Monte Carlo simulations with computational human phantoms were performed to calculate the whole-body counting efficiency for a realistic radioiodine distribution after its intake. The biodistributions of ¹³¹I for different age groups were computed based on biokinetic models and applied to age- and gender-specific computational phantoms to estimate counting efficiency. After calculating the whole-body counting efficiencies, the efficiency correction factors were derived as the ratio of the counting efficiencies obtained by considering a heterogeneous biodistribution of ¹³¹I over time to those obtained using the BOMAB phantom assuming a homogeneous distribution. Based on the correction factors, the internal contamination caused by ¹³¹I can be assessed using whole-body counters. These correction factors can minimize the influence of the biodistribution of ¹³¹I in whole-body counting measurement and improve the accuracy of internal dose assessment.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.25-31
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• 2019

Purpose: Metals induce metal artifact during CT-image for therapy planning, and it occurs images distortion, which affects the volumetric measurement and radiation calculation. In the case of using megavoltage computed tomography(MVCT), the volume of metals can be measured as similar to true volume due to minimal metal artifact outcome. In this study, radiation assessment was conducted by comparing teeth volume from images of kVCT and MVCT of head and neck cancer patients, then assigning to kVCT image to calculate radiation after obtaining the similar volume of true teeth volume from MVCT. Also, formal IR image was able to verify the accuracy of radiation calculation. Material and method: 5 head and neck cancer patients who had intensity-modulated radiation therapy from Radixact^® Series were of the subject in this study. Calculations of radiation when constraining true teeth volume out of kVCT image(A-CT) and when designated specific HU after teeth assigned using MVCT image were compared with formal IR image. Treatment planning was devised at the same constraints and mean dose was measured at the radiation assess points. The points were anterior of the teeth, between PTV and the teeth, the interior of PTV near the teeth, and the teeth where 5cm distance from PTV. Result: A difference of metals volume from kVCT and MVCT image was mean 3.49±2.61cc, maximum 7.43cc. PTV was limited to where the internal teeth were fully contained. The results of PTV dose evaluation showed that the average CI value of the kVCT treatment planning without the artifact correction was 0.86, and the average CI value of the kVCT with the artifact correction using MVCT image was 0.9. Conclusion: When the Treatment Planning was made without correction of metal artifacts, the dose of PTV was underestimated, indicating that dose uncertainty occurred. When the computerized treatment plan was made without correction of metal artifacts, the dose of PTV was underestimated, indicating that dose uncertainty occurred.

• Journal of Radiation Protection and Research
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• v.38 no.2
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• pp.52-59
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• 2013

The internal contamination screening method using gross beta measurement was performed for radioisotope workers. 24 h and spot urine samples from workers of medical isotope production facilities were collected and measured. Most of the results were similar with the background level of gross beta activity except for a specific worker. Gross beta activity was slightly increased in several hours after finishing work. And the environmental factor of production facilities causing internal contamination were estimated based on screening results. The additional detailed internal dose assessment must be followed after the screening for protection of workers. Moreover, a procedure was established to apply a simple internal contamination assessment for radiation workers.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.132-135
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• 2004

In this study, we investigated the effect of threshold on a delivered dose in organ with internal motion by respiration. With mathematic model for 3D dose calculation reported by Lujan et al., we had calculated the position of organ as a function of time in previous study. This result presented that the variation of organ is within 2 mm from initial exhale position to the organ position during operating 1 s. Gating threshold, in this study, is determined to the moving region of target during 1s at a primary position of exhale. This period of gating threshold is 50% of the duty cycle in a half breathing cycle which is period from the top position of exhalation to the bottom position of inhalation. Radiation fields were then delivered under three conditions; 1) existent of moving target in the region of threshold(1sec, 1.5sec), 2) existent of moving target out of the region of threshold, 3) non-moving target. The non-moving target delivery represents a dose different induced due to internal organ motion.

• Radiation Oncology Journal
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• v.32 no.3
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• pp.170-178
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• 2014

Purpose: We sought to evaluate the clinical outcomes of 3-dimensional conformal radiation therapy (3D-CRT) for portal vein tumor thrombosis (PVTT) alone in patients with advanced hepatocellular carcinoma. Materials and Methods: We retrospectively analyzed data on 46 patients who received 3D-CRT for PVTT alone between June 2002 and December 2011. Response was evaluated following the Response Evaluation Criteria in Solid Tumors. Prognostic factors and 1-year survival rates were compared between responders and non-responders. Results: Thirty-seven patients (80.4%) had category B Child-Pugh scores. The Eastern Cooperative Oncology Group performance status score was 2 in 20 patients. Thirty patients (65.2%) had main or bilateral PVTT. The median irradiation dose was 50 Gy (range, 35 to 60 Gy) and the daily median dose was 2 Gy (range, 2.0 to 2.5 Gy). PVTT response was classified as complete response in 3 patients (6.5%), partial response in 12 (26.1%), stable disease in 19 (41.3%), and progressive disease in 12 (26.1%). There were 2 cases of grade 3 toxicities during or 3 months after radiotherapy. Twelve patients in the responder group (15 patients) received at least 50 Gy irradiation, but about 84% of patients in the non-responder group received less than 50 Gy. The 1-year survival rate was 66.8% in responders and 27.4% in non-responders constituting a statistically significant difference (p = 0.008). Conclusion: Conformal radiotherapy for PVTT alone could be chosen as a palliative treatment modality in patients with unfavorable conditions (liver, patient, or tumor factors). However, more than 50 Gy of radiation may be required.

• Journal of Radiation Protection and Research
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• v.40 no.2
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• pp.92-100
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• 2015

For the purpose of improving the efficiency of the radiation impact assessment of dry interim storage facilities for the spent nuclear fuel of pressurized water reactors (PWRs), radiation impact assessment was performed after the application of sensitivity assessment according to the radiation source term designation method, development of a 2-step calculation technique, and cooling time credit. The present study successively designated radiation source terms in accordance with the cask arrangement order in the shielding building, assessed sensitivity, which affects direct dose, and confirmed that the radiation dosage of the external walls of the shielding building was dominantly affected by the two columns closest to the internal walls. In addition, in the case in which shielding buildings were introduced into storage facilities, the present study established and assessed the 2-step calculation technique, which can reduce the immense computational analysis time. Consequently, results similar to those from existing calculations were derived in approximately half the analysis time. Finally, when radiation source terms were established by adding the storage period of the storage casks successively stored in the storage facilities and the cooling period of the spent nuclear fuel, the radiation dose of the external walls of the buildings was confirmed to be approximately 40% lower than the calculated values; the cooling period was established as being identical. The present study was conducted to improve the efficiency of the Monte Carlo shielding analysis method for radiation impact assessment of interim storage facilities. If reliability is improved through the assessment of more diverse cases, the results of the present study can be used for the design of storage facilities and the establishment of site boundary standards.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.133-140
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• 1994

Recently, there are many considerations and studies on biological effects of radiations in radiation workers, as well as in accidentally or therapeutically irradiated persons. The most practical and reliable method of dosimetry for radiation accidents is the scoring of gross chromosomal aberrations in human lymphocytes (Ydr) as a biological dosimetry. By the way, although usual doses of $^{131}I$ administered therapeutically for thyroid cancer are ranging from 100 mCi to 200 mCi, there are differences of absorbed doses and Ydr, ranging from 0.004 to 0.04, on equally administered $^{131}I$ due to variations in metabolic characteristics, stage of tumors and physical status of subjects. In this study, We exert to obtain the dose-response relationships of $^{131}I$, as a good guide to evaluating acute effects of accidental irradiations and radiation induced leukemia or solid tumor, by in vitro induction of chromosomal aberrations. we studied the relationship between radiation dose (D) and the frequency of chromosomal aberrations (Ydr) obserbed in peripheral lymphocytes that were irradiated in vitro with $^{131}I$ at doses ranging from 0.05 to 6.00 Gy. By scoring cells with unstable chromosomal aberrations (dicentric chromosomes and ring chromosomes) we obtained this linear-quadratic dose response equation Ydr=0.064351 $D^2$-0.13143 D+0.045684 This dose-response relationship may be useful for evaluating acute and chronic $^{131}I$ induced biological effects.