Oh Yoon Kyeong;Ha Chul Soo;Park Hee Chul;Lee Seung Il;Ryu So Yeon;Kee Keun Hong;Jeon Ho Jong
Radiation Oncology Journal
/
v.20
no.1
/
pp.34-40
/
2002
Purpose : This study was undertaken to retrospectively evaluate white blood ceil kinetics, especially lymphocyte depression after different treatments, and to find the correlation between immunosuppression and large blood volume and dynamic blood flow within the mediastinal radiotherapy (RT) field in lung cancer. Materials and Methods : Thirty-four patients with lung cancer were retrospectively evaluated; 10 patients had only radiotherapy (RT group), 8 had chemotherapy (CT group) and 16 fad chemotherapy and radio-therapy (RT/CT group). The mean follow-up periods of the RT-including groups (RT group and RT/CT group) and the RT-excluding group (CT group) were 6 and 8 months, respectively. Complete blood cell counts including lymphocyte percentage $(\%)$ were checked weekly during RT but less frequently during CT and after RT and after RT. Results : Changes in total white blood cell counts were not significantly different among the three groups. The lymphocyte count and lymphocyte $\%$ were much lower in the RT-including groups than in the RT-excluding group. The difference between pre-treatment and final lymphocyte count and the difference between pre-treatment and final lymphocyte $\%$ were significant (p=0.044 and p=0.037) between the RT-including groups and the RT-excluding group. Conclusion : lymphopenia was more marked after treatment containing RT than CT only. Lymphopenia may be one cause of a compromised immune system after mediastinal irradiation in lung cancer. We suggest cautiously that previous studies showing evidence of lymphocyte apoptosis after low-dose irradiation and large blood volume and dynamic blood flow within the RT fields could be somewhat related to lymphopenia after mediastinal irradiation.
Kim, Myoungju;Im, Inchul;Lee, Jaeseung;Kang, Suman
Journal of the Korean Society of Radiology
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v.7
no.2
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pp.157-163
/
2013
This study was to analyze quantitatively movement of planning target volume (PTV) and change of PTV volume through movement of diaphragm according to breathing phase. The purpose of present study was to investigate optimized respiration phase for radiation therapy of lung cancer. Simulated breathing training was performed in order to minimize systematic errors which is caused non-specific or irregular breathing. We performed 4-dimensional computed tomography (4DCTi) in accordance with each respiratory phase in the normalized respiratory gated radiation therapy procedures, then not only defined PTVi in 0 ~ 90%, 30 ~ 70% and 40 ~ 60% in the reconstructed 4DCTi images but analyzed quantitatively movement and changes of volume in PTVi. As a results, average respiratory cycle was $3.4{\pm}0.5$ seconds by simulated breathing training. R2-value which is expressed as concordance between clinically induced expected value and actual measured value, was almost 1. There was a statistically significant. And also movement of PTVi according to each respiration phase 0 ~ 90%, 30 ~ 70% and 40 ~ 60% were $13.4{\pm}6.4mm$, $6.1{\pm}2.9mm$ and $4.0{\pm}2.1mm$ respectively. Change of volume in PTVi of respiration phase 30 ~ 70% was decreased by $32.6{\pm}8.7%$ and 40 ~ 60% was decreased by $41.6{\pm}6.2%$. In conclusion, PTVi movement and volume change was reduced, when we apply a short breathing phase (40 ~ 60%: 30% duty cycle) range. Furthermore, PTVi margin considered respiration was not only within 4mm but able to get uniformity of dose.
Purpose: 4DCT scans performed for radiotherapy were retrospectively analyzed to assess the possible benefits of respiratory gating in non-small cell lung cancer (NSCLC) and established the predictive factors for identifying patients who could benefit from this approach. Materials and Methods: Three treatment planning was performed for 15 patients with stage I~III NSCLC using different planning target volumes (PTVs) as follows: 1) PTVroutine, derived from the addition of conventional uniform margins to gross tumor volume (GTV) of a single bin, 2) PTVall phases (patient-specific PTV), derived from the composite GTV of all 6 bins of the 4DCT, and 3) PTVgating, derived from the composite GTV of 3 consecutive bins at end-exhalation. Results: The reductions in PTV were 43.2% and 9.5%, respectively, for the PTVall phases vs. PTVroutine and PTVgating vs. PTVall phases. Compared to PTVroutine, the use of PTVall phases and PTVgating reduced the mean lung dose (MLD) by 18.1% and 21.6%, and $V_{20}$ by 18.2% and 22.0%, respectively. Significant correlations were seen between certain predictive factors selected from the tumor mobility and volume analysis, such as the 3D mobility vector, the reduction in 3D mobility and PTV with gating, and the ratio of GTV overlap between 2 extreme bins and additional reductions in both MLD and $V_{20}$ with gating. Conclusion: The additional benefits with gating compared to the use of patient-specific PTV were modest; however, there were distinct correlations and differences according to the predictive factors. Therefore, these predictive factors might be useful for identifying patients who could benefit from respiratory-gated radiotherapy.
Kim, Tae-Man;Ku, Ji-Young;Dho, Ho-Seog;Cho, Chun-Hyung;Ko, Jae-Hun
Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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v.14
no.4
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pp.343-356
/
2016
The Korea Radioactive Waste Agency (KORAD) has developed a dual-purpose metal cask for the dry storage of spent nuclear fuel that has been generated by domestic light-water reactors. The metal cask was designed in compliance with international and domestic technology standards, and safety was the most important consideration in developing the design. It was designed to maintain its integrity for 50 years in terms of major safety factors. The metal cask ensures the minimization of waste generated by maintenance activities during the storage period as well as the safe management of the waste. An activation evaluation of the main body, which includes internal and external components of metal casks whose design lifetime has expired, provides quantitative data on their radioactive inventory. The radioactive inventory of the main body and the components of the metal cask were calculated by applying the MCNP5 ORIGEN-2 evaluation system and by considering each component's chemical composition, neutron flux distribution, and reaction rate, as well as the duration of neutron irradiation during the storage period. The evaluation results revealed that 10 years after the end of the cask's design life, $^{60}Co$ had greater radioactivity than other nuclides among the metal materials. In the case of the neutron shield, nuclides that emit high-energy gamma rays such as $^{28}Al$ and $^{24}Na$ had greater radioactivity immediately after the design lifetime. However, their radioactivity level became negligible after six months due to their short half-life. The surface exposure dose rates of the canister and the main body of the metal cask from which the spent nuclear fuel had been removed with expiration of the design lifetime were determined to be at very low levels, and the radiation exposure doses to which radiation workers were subjected during the decommissioning process appeared to be at insignificant levels. The evaluations of this study strongly suggest that the nuclide inventory of a spent nuclear fuel metal cask can be utilized as basic data when decommissioning of a metal cask is planned, for example, for the development of a decommissioning plan, the determination of a decommissioning method, the estimation of radiation exposure to workers engaged in decommissioning operations, the management/reuse of radioactive wastes, etc.
The purpose of this study was to confirm the feasibility of imaging of therapy region from the boron neutron capture therapy (BNCT) using the measurement of the prompt gamma ray depending on the neutron flux. Through the Monte Carlo simulation, we performed the verification of physical phenomena from the BNCT; (1) the effects of neutron according to the existence of boron uptake region (BUR), (2) the internal and external measurement of prompt gamma ray dose, (3) the energy spectrum by the prompt gamma ray. All simulation results were deducted using the Monte Carlo n-particle extended (MCNPX, Ver.2.6.0, Los Alamos National Laboratory, Los Alamos, NM, USA) simulation tool. The virtual water phantom, thermal neutron source, and BURs were simulated using the MCNPX. The energy of the thermal neutron source was defined as below 1 eV with 2,000,000 n/sec flux. The prompt gamma ray was measured with the direction of beam path in the water phantom. The detector material was defined as the lutetium-yttrium oxyorthosilicate (Lu0,6Y1,4Si0,5:Ce; LYSO) scintillator with lead shielding for the collimation. The BUR's height was 5 cm with the 28 frames (bin: 0.18 cm) for the dose calculation. The neutron flux was decreased dramatically at the shallow region of BUR. In addition, the dose of prompt gamma ray was confirmed at the 9 cm depth from water surface, which is the start point of the BUR. In the energy spectrum, the prompt gamma ray peak of the 478 keV was appeared clearly with full width at half maximum (FWHM) of the 41 keV (energy resolution: 8.5%). In conclusion, the therapy region can be monitored by the gamma camera and single photon emission computed tomography (SPECT) using the measurement of the prompt gamma ray during the BNCT.
Human skin is the first line of defense for the protection of the internal organs of the body from different stimuli. Ultraviolet B (UVB) irradiation induces skin damage and inflammation through the secretion of various cytokines, which are immune regulators produced by cells. To prevent the initiation of skin inflammation, keratinocytes that have been irreversibly damaged by radiation must be removed through the apoptotic mechanism. Ixeris dentata (family: Asteraceae) is a perennial medicinal herb indigenous to Korea. It has been used in Korea, China, and Japan to treat in digestion, pneumonia, diabetes, hepatitis, and tumors. To gain insight into the anti-inflammatory effects of I. dentata, we examined its influence on UVB-induced pro-inflammatory cytokine production in human keratinocytes (HaCaT cells), by observing cells that were stimulated with UVB in the presence or absence of I. dentata. In the present study, pro-inflammatory cytokine production was determined by performing enzyme-linked immunosorbent assay, reverse transcription polymerase chain reaction, and western blot analysis to measure the activation of mitogen-activated protein kinase (MAPKs). I. dentata inhibited UVBinduced production of the pro-inflammatory cytokine interleukin (IL)-6 in a dose-dependent manner. Further, I. dentata inhibited the UVB-induced expression of cyclooxygenase (COX)-2. Furthermore, I. dentata inhibited the phosphorylation of c-Jun NH2-terminal kinase and p38 MAPKs, suggesting that it inhibits the secretion of the pro-inflammatory cytokines IL-6 and IL-8, and COX-2 expression, by blocking MAPK phosphorylation. These results suggest that I. dentate can potentially protect against UVB-induced skin inflammation.
Inflammation scan using radiolabelled leukocytes has high sensitivity and specificity. Several methods for labelling leukocytes have been evaluated using P-32 diisopropyl fluorophosphate (DFP-32), H-3 thymidine, Cr-51 chromate, Ga-67 citrate and Tc-99m-sulfur colloid. In-111-oxine has proved so far to be the most reliable agent for labelling leukocytes. In-111-oxine is, however, expensive, not easily available when needed, and its radiation dose to leukocytes is relatively high. Moreover, resolution of the resultant image is relatively poor. Tc-99m is still the agent of choice because of, as compared with the indium, its favorable physical characteristics, lower cost and availability. Now the technique for labelling the leukocytes with technetium is successfully obtained using the lipophilic HAPAO with higher efficiency for granulocytes than for other cells. With this technique it is possible to label leukocytes in plasma to improve the viability of the leukocytes. Inflammation scan using Tc-99m-HMPAO has been evaluated in several laboratories, and difference in methods for separation and labelling accounts for difference in efficiency, viability and biodistribution of the labelled leukocytes. We performed inflammation scan using leukocytes labelled with Tc-99m-HMPAO in three dogs 24 hours after inoculation of live E. Coli and A. Aureus in their right abdominal wall. We separated mixed leukocytes by simple sedimentation using 6% hetastarch (HES) and labelled the leukocytes with Tc-99m-HMPAO in 20% cell free plama diluted with phosphate buffer solution(Fig. 1). Uptake was high in the liver and spleen but is was minimal in the lungs on whole body scan. Kidneys and intestine showed minimal activity although it was high in the urinary bladder(Fig. 2). Uptake of labelled leukocytes in the inflammation site was do(mite on 2 hour-postinjection scan and abscess was clearly delineated on 24 hour-delayed scan with high target-to-nontarget ratio(Fig. 3, 4). Inflammation scan using mixed leukocytes labelled with Tc-99m-HMPAO is very sensitive and specific in early detection of inflammation.
Sparse-view computed tomography (CT) imaging technique is able to reduce radiation dose, ensure the uniformity of image characteristics among projections and suppress noise. However, the reconstructed images obtained by the sparse-view CT imaging technique suffer from severe artifacts, resulting in the distortion of image quality and internal structures. In this study, we proposed a convolutional neural network (CNN) with wavelet transformation and residual learning for reducing artifacts in sparse-view CT image, and the performance of the trained model was quantitatively analyzed. The CNN consisted of wavelet transformation, convolutional and inverse wavelet transformation layers, and input and output images were configured as sparse-view CT images and residual images, respectively. For training the CNN, the loss function was calculated by using mean squared error (MSE), and the Adam function was used as an optimizer. Result images were obtained by subtracting the residual images, which were predicted by the trained model, from sparse-view CT images. The quantitative accuracy of the result images were measured in terms of peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). The results showed that the trained model is able to improve the spatial resolution of the result images as well as reduce artifacts in sparse-view CT images effectively. Also, the trained model increased the PSNR and SSIM by 8.18% and 19.71% in comparison to the imaging model trained without wavelet transformation and residual learning, respectively. Therefore, the imaging model proposed in this study can restore the image quality of sparse-view CT image by reducing artifacts, improving spatial resolution and quantitative accuracy.
Background : Arsenic trioxide ($As_2O_3$) has been used to treat acute promyelocytic leukemia, and it induces apoptosis in a variety of solid tumor cell lines including non-small cell lung cancer cells. However, nonsteroidal antiinflammatory drugs (NSAID) can enhance tumor response to chemotherapeutic drugs or radiation. It was previously demonstrated that a combination treatment with $As_2O_3$ and sulindac induces the apoptosis of NCI-H157 human lung carcinoma cells by activating the caspase cascade. This study aimed to determine if a combination treatment augmented its apoptotic potential through other pathways except for the activation of the caspase cascade. Material and Methods : The NCI-H157 cells were treated with $As_2O_3$, sulindac and antioxidants such as glutathione (GSH) and N-acetylcysteine (NAC). The cell viability was measured by a MTT assay, and the level of intracellular hydrogen peroxide ($H_2O_2$) generation was monitored fluorimetrically using a scopoletin-horse radish peroxidase (HRP) assay. Western blotting and mitochondrial membrane potential transition analysis were performed in order to define the mechanical basis of apoptosis. Results : The viability of the cells was decreased by a combination treatment of $As_2O_3$ and sulindac, and the cells were protected using antioxidants in a dose-dependent manner. The increased $H_2O_2$ generation by the combination treatment was inhibited by antioxidants. The combination treatment induced changes in the mitochondrial transmembrane potential as well as the expression of the Bcl-2 family proteins, and increased cytochrome c release into the cytosol. However, the antioxidants inhibited the effects of the combination treatment. Conclusion : Combination treatment with $As_2O_3$ and sulindac induces apoptosis in NCI-H157 human lung carcinoma cells via ROS generation with a mitochondrial dysfunction.
Jiyoung Song;Bo Da Nam;Soon Ho Yoon;Jin Young Yoo;Yeon Joo Jeong;Chang Dong Yeo;Seong Yong Lim;Sung Yong Lee;Hyun Koo Kim;Byoung Hyuck Kim;Kwang Nam Jin;Hwan Seok Yong
Journal of the Korean Society of Radiology
/
v.82
no.3
/
pp.562-574
/
2021
MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.
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