• Title/Summary/Keyword: Linac based

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Fractionated Stereotactic Radiotherapy in Pediatric Diffuse Intrinsic Brain Stem Gliomas

  • Choi, Woo-Jin;Yee, Gi-Taek;Han, Seong-Rok;Yoon, Sang-Won;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.3
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    • pp.154-158
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    • 2006
  • Objective : We treated 10 pediatric diffuse intrinsic brain stem glioma[BSG] patients with Novalis system [linac based radiotherapy unit, Germany] and examined the efficacy of the Fractionated Stereotactic Radiotherapy[FSRT]. Methods : A retrospective review was conducted on 10 pediatric diffuse intrinsic BSG patients who were treated with FSRT between May, 2001 and August, 2004. The mean age of the patient group was 7.7 years old. Male to female ratio was 4 to 1. The mean dose of FSRT was 38.7Gy, mean fractionated dose was 2.6Gy, mean fractionation size was 16.6, and target volume was $42.78cm^3$. The mean follow up period was 14 months. Results : Four weeks after completion of FSRT, improvements on neurological status and Karnofsky performance scale[KPS] score were recorded in 9/10 (90%] patients and magnetic resonance imaging[MRI] showed decrease in target tumor volume in 8 pediatric patients. The median survival period was 13.5 months after FSRT and treatment toxicity was mild. Conclusion : It is difficult for surgeons to choose surgical treatment for diffuse intrinsic BSG due to its dangerous anatomical structures. FSRT made it possible to control the tumor volume to improve neurological symptoms with minimal complications. We expect that FSRT is a feasible treatment modality for pediatric diffuse intrinsic BSG with tolerable toxicities.

Optimized Design and Manufacture of Wideband Pulsed Gamma-ray Sensors (광대역 펄스감마선 탐지센서 최적화 설계 및 제작)

  • Jeong, Sang-hun;Lee, Nam-ho
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.1
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    • pp.223-228
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    • 2017
  • In this paper, we are proposing an optimal design of wideband pulsed type gamma-ray sensors. These sensors were manufactured based on the design results and after word electrical properties were analyzed. The sensor input parameters were derived on the basis of pulsed gamma-ray spectrum and time-dependent energy rate, and the output current which were derived on the basis of the sensor sensitivity control circuit. Pulsed gamma-ray sensors were designed using the TCAD simulators. The design results show that the optimal Epi layer thickness is 45um with the applied voltage 3.3V and the diameter is 2.0mm. The doping concentrations are as follows : N-type is an Arsenic as $1{\times}10^{19}/cm^3$, P-type is a Boron as $1{\times}10^{19}/cm^3$ and Epi layer is Phosphorus as $3.4{\times}10^{12}/cm^3$. The fabricated sensor was a leakage current, 12pA at voltage -3.3V and fully depleted mode at voltage -5V. A test result of pulsed radiation shows that the sensor gives out the optimal photocurrent.

Landmarks in The Skull for Stereotactic Radiotherapy

  • Hiroki, Ohtani;Toraji, Irifune;Etsuo, Kunieda;Hidetoshi, Saitoh;Masahiro, Fukushi;Tsuguhisa, Katoh
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.144-145
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    • 2002
  • Stereotactic radiotherapy is required to irradiate a small tumor accurately. The radiotherapy showing improves when making an accidental error little boundlessly. It is performed according to treatment planning that is established by the outside landmark of head. At present, when stereotactic radiotherapy for a head is done, the Leksell Flame is fixed on the head, and positioning based on the point and so on which it is in that fixed implement is performed. However, there are problems on the method done at present in the point such as reappearance when the fractionated irradiation method in which the Leksell Flame is removed and installed at every treatment is done because there are landmarks outside the head. Landmarks in the skull were decided, and that precision was examined for the purpose of the improvement of the radiation therapeutic gain. Linac-graphy with longitudinal and lateral view were taken with 6 MV photon beams. A distance to base point inside the skull, each film measured the angle from a center of the small irradiation field, and comparison was done. From the results, a large accidental error wasn't seen as a result of the measurement by every film. Stereotactic radiotherapy for a head treatment had an accidental error of about several millimeters when treatment positioning was done. Therefore, it was thought that there was no problem about an accidental error to arise by putting a landmark in the skull. And, because an accidental error was easy to discover, we thought that modification could be done easily. It was suggested that a landmark in the skull on thus study were useful for improvement of stereotactic radiotherapy.

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Evaluation of Electron Beam Dose Distribution by Age Diffusion Equation (연령 확산 이론에 의한 전자선의 조직내 선량분포 평가)

  • 추성실
    • Progress in Medical Physics
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    • v.4 no.1
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    • pp.29-39
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    • 1993
  • Electron beams have found unique and complementary used in the treatment of cancer, but it's very difficult to delineate dose distribution, because of multi-collisions. Numerical solution is more usefull to describe electron distributed in tissue. A semi-empirical eqution is given for the dose at any point at various depths in water. This equation is a modificated model which was based on solutions of a general age diffusion equation. Parameters have been calulated from electron beams data with energies 6~18MeV form a LINAC for use in computerised dosimetry calculations. The depth doses and isodose curves are predicted as a function of the practical range, source skin distance and field size. Depth dose accuracy have been achieved 2% above 50% depth dose and 5% at lower doses, relative to maximum dose. Also, the shape of the isodose curves with the constrictions at higher dose and bulging ot lower values are accurately predicted. Computer calculated beams have been used to generate ever isodose distribution for certain clinical situations.

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Clinical Outcomes of Intracranial Nonvestibular Schwannomas Treated with Linac-Based Stereotactic Radiosurgery and Radiotherapy

  • Puataweepong, Putipun;Dhanachai, Mantana;Hansasuta, Ake;Saetia, Kriangsak;Dangprasert, Somjai;Sitathanee, Chomporn;Yongvithisatid, Pornpan
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3271-3276
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    • 2016
  • Background: Intracranial nonvestibular schwannomas arising from various cranial nerves excluding CN VIII are uncommon. Recently, stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) have been widely reported as effective treatment modalities for nonvestibular schwannomas. The purpose of this study was to study the long term clinical outcome for nonvestibular schwannomas treated with both X-Knife and CyberKnife (CK) radiosurgery at one institution. Materials and Methods: From 2004 to 2013, fifty-two nonvestibular schwannoma patients were included in this study, 33 patients (63%) were treated with CK, and 19 (37%) were treated with X-Knife. The majority of the tumors were jugular foramen schwannomas (38%) and trigeminal schwannomas (27%). HSRT was given for 45 patients (86%), whereas CSRT was for 6 (12%) and SRS for 1 (2%). Results: The median pretreatment volume was $9.4cm^3$ (range, $0.57-52cm^3$). With the median follow up time of 36 months (range, 3-135), the 3 and 5 year progression free survival was 94 % and 88%, respectively. Tumor size was decreased in 13 (25%), stable in 29 (56%), and increased in 10 (19%). Among the latter, 3 (30%) required additional treatment because of neurologic deterioration. No patient was found to develop any new cranial nerve deficit after SRS/SRT. Conclusions: These data confirmed that SRS/SRT provide high tumor control rates with low complications. Large volume tumors and cystic expansion after radiation should be carefully followed up with neurological examination and MRI, because it may frequently cause neurological deterioration requiring further surgery.

Calculation of Dose Distribution for SBRT Patient Using Geant4 Simulation Code (Geant4 전산모사 코드를 이용한 SBRT 환자의 선량분포 계산)

  • Kang, Jeongku;Lee, Jeongok;Lee, Dong Joon
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.36-41
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    • 2015
  • The Monte Carlo based dose calculation program for stereotactic body radiotherapy was developed in this study. The Geant4 toolkit widely used in the radiotherapy was used for this study. The photon energy spectrum of the medical linac studied in the previous research was applied for the patient dose calculations. The geometry of the radiation fields defined by multi-leaf collimators were taken into account in the PrimaryGeneratorAction class of the Geant4 code. The total of 8 fields were demonstrated in the patient dose calculations, where rotation matrix as a function of gantry angle was used for the determination of the source positions. The DicomHandler class converted the binary file format of the DICOM data containing the matrix number, pixel size, endian type, HU number, bit size, padding value and high bits order to the ASCII file format. The patient phantom was constructed using the converted ASCII file. The EGSnrc code was used to compare the calculation efficiency of the material data.

Development of Monte Carlo Simulation Code for the Dose Calculation of the Stereotactic Radiosurgery (뇌 정위 방사선수술의 선량 계산을 위한 몬테카를로 시뮬레이션 코드 개발)

  • Kang, Jeongku;Lee, Dong Joon
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.303-308
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    • 2012
  • The Geant4 based Monte Carlo code for the application of stereotactic radiosurgery was developed. The probability density function and cumulative density function to determine the incident photon energy were calculated from pre-calculated energy spectrum for the linac by multiplying the weighting factors corresponding to the energy bins. The messenger class to transfer the various MLC fields generated by the planning system was used. The rotation matrix of rotateX and rotateY were used for simulating gantry and table rotation respectively. We construct accelerator world and phantom world in the main world coordinate to rotate accelerator and phantom world independently. We used dicomHandler class object to convert from the dicom binary file to the text file which contains the matrix number, pixel size, pixel's HU, bit size, padding value and high bits order. We reconstruct this class object to work fine. We also reconstruct the PrimaryGeneratorAction class to speed up the calculation time. because of the huge calculation time we discard search process of the ThitsMap and used direct access method from the first to the last element to produce the result files.

Dose Assessment According to Application of Carbon Fabric Blanket During Radiation Therapy of the Spine Metastasis Cancer (척추 전이암 환자의 방사선치료 시 Carbon Fabric Blanket 적용에 따른 선량평가)

  • Yang, Myung-Sic;Kim, Jung-Soo;Lee, Sun-Young;Kwon, Hyoung-Cheol
    • Journal of radiological science and technology
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    • v.42 no.1
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    • pp.61-66
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    • 2019
  • The purpose of this study was to improve the unstable treatment posture by placing the Carbon fabric blanket on the couch which was used for the patient fixation for the unstable posture from the severe pain caused by the neuromuscular pressure of the spinal metastatic cancer patient and to analyze the dose difference caused by the energy loss of high energy radiation. Using a linear accelerator, a FC-65G was installed at a depth of 5 cm at a solid phantom at 6 MV and 10 MV energies. The SAD was 100 cm, Gantry angle was $0^{\circ}$, a Cotton and Carbon blanket with a thickness of 1 cm on the couch, The blankets were placed on the couch and the dose was measured according to field size. For the dose measurement, and the dose was measured at 100 MU each time, and the mean value was calculated by repeating the measurement three times in order to reduce the error. The results showed that the difference rate in dose between Carbon blanket and Cotton blanket was respectively -0.54% and -0.75% based on the absence of the blanket(Non). Therefore, it is considered that the use of Carbon fabric blanket, which reduces the patient's pain and does not affect the depth dose, may be useful during radiation therapy of the spine metastasis cancer.

Trend Analysis on Korean and International Management for Activated Material Waste from Medical Linear Accelerator

  • Kwon, Na Hye;Jang, Young Jae;Kim, Dong Wook;Shin, Dong Oh;Kim, Kum Bae;Kim, Jin Sung;Choi, Sang Hyoun
    • Progress in Medical Physics
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    • v.31 no.4
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    • pp.194-204
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    • 2020
  • This study investigated and analyzed the Korean and international status of radioactive waste management for medical linear accelerators (linacs) and proceed prior research to suggest radiation safety regulations and guidelines for the safe use of radiation. We analyzed the number of linacs installed in the radiation oncology departments of 103 institutions. In addition, we analyzed the procedures and standards for disposal in Korea and foreign countries. For foreign countries, we analyzed the status based on reports from the United States, Japan, Europe, and Canada. A total of 182 linacs are installed in Korea and 95% of them use more than 10 MV of energy. In Korea, standards for managing radioactive waste from a linac, disposal procedures, and clearance criteria have yet to be established. Therefore, radioactive waste is disposed of in different ways depending on the hospitals where they originate. Japan, the US, and Canada have recommended clearance levels and procedures for linacs. Other countries have provided management guidelines for research or large-scale accelerators, but not for medical purposes. In this study, we investigated the management of radioactive waste from medical linacs in Korea and abroad. Several foreign countries have suggested a clearance level and criteria for disposing of waste storage drums. For the safe management of medical linacs, it is necessary to establish safety management regulations. In Korea, standards for disposal, such as radiation or dose limits, are required for medical linacs. A system for clearance when disposing at a medical institution should be created.

Development of Independent Target Approximation by Auto-computation of 3-D Distribution Units for Stereotactic Radiosurgery (정위적 방사선 수술시 3차원적 공간상 단위분포들의 자동계산법에 의한 간접적 병소 근사화 방법의 개발)

  • Choi Kyoung Sik;Oh Seung Jong;Lee Jeong Woo;Kim Jeung Kee;Suh Tae Suk;Choe Bo Young;Kim Moon Chan;Chung Hyun-Tai
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.24-31
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    • 2005
  • The stereotactic radiosurgery (SRS) describes a method of delivering a high dose of radiation to a small tar-get volume in the brain, generally in a single fraction, while the dose delivered to the surrounding normal tissue should be minimized. To perform automatic plan of the SRS, a new method of multi-isocenter/shot linear accelerator (linac) and gamma knife (GK) radiosurgery treatment plan was developed, based on a physical lattice structure in target. The optimal radiosurgical plan had been constructed by many beam parameters in a linear accelerator or gamma knife-based radiation therapy. In this work, an isocenter/shot was modeled as a sphere, which is equal to the circular collimator/helmet hole size because the dimension of the 50% isodose level in the dose profile is similar to its size. In a computer-aided system, it accomplished first an automatic arrangement of multi-isocenter/shot considering two parameters such as positions and collimator/helmet sizes for each isocenter/shot. Simultaneously, an irregularly shaped target was approximated by cubic structures through computation of voxel units. The treatment planning method by the technique was evaluated as a dose distribution by dose volume histograms, dose conformity, and dose homogeneity to targets. For irregularly shaped targets, the new method performed optimal multi-isocenter packing, and it only took a few seconds in a computer-aided system. The targets were included in a more than 50% isodose curve. The dose conformity was ordinarily acceptable levels and the dose homogeneity was always less than 2.0, satisfying for various targets referred to Radiation Therapy Oncology Group (RTOG) SRS criteria. In conclusion, this approach by physical lattice structure could be a useful radiosurgical plan without restrictions in the various tumor shapes and the different modality techniques such as linac and GK for SRS.

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