• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.8-13
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• 1992

Low doses of ionizing radiation from external or internal sources cause heterogeneous distribution of energy deposition events in the exposed biological system. With the cell being the individual element of the tissue system, the fraction of cells hit, the dose received by the hit, and the biological response of the cell to the dose received eventually determine the effect in tissue. The hit cell may experience detriment, such as change in its DNA leading to a malignant transformation, or it may derive benefit in terms of an adaptive response such as a temporary improvement of DNA repair or temporary prevention of effects from intracellular radicals through enhanced radical detoxification. These responses are protective also to toxic substances that are generated during normal metabolism. Within a multicellular system, the probability of detriment must be weighed against the probability of benefit through adaptive responses with protection against various toxic agents including those produced by normal metabolism. Because irradiation can principally induce both, detriment and adaptive responses, one type of affected cells may not be simply summed up at the expense of cells with other types of effects, in assessing risk to tissue. An inventory of various types of effects in the blood forming system of mammals, even with large ranges of uncertainty, uncovers the possibility of benefit to the system from exposure to low doses of low LET radiation. This experimental approach may complement epidemiological data on individuals exposed to low doses of ionizing radiation and may lead to a more rational appraisal of risk.

• Progress in Medical Physics
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• v.26 no.4
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• pp.208-214
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• 2015

The aim of this study is to investigate the effect of low magnetic field on dose distribution in the partial-breast irradiation (PBI). Eleven patients with an invasive early-stage breast carcinoma were treated prospectively with PBI using 38.5 Gy delivered in 10 fractions using the $ViewRay^{(R)}$ system. For each of the treatment plans, dose distribution was calculated with magnetic field and without magnetic field, and the difference between dose and volume for each organ were evaluated. For planning target volume (PTV), the analysis included the point minimum ($D_{min}$), maximum, mean dose ($D_{mean}$) and volume receiving at least 90% ($V_{90%}$), 95% ($V_{95%}$) and 107% ($V_{107%}$) of the prescribed dose, respectively. For organs at risk (OARs), the ipsilateral lung was analyzed with $D_{mean}$ and the volume receiving 20 Gy ($V_{20\;Gy}$), and the contralateral lung was analyzed with only $D_{mean}$. The heart was analyzed with $D_{mean}$, $D_{max}$, and $V_{20\;Gy}$, and both inner and outer shells were analyzed with the point $D_{min}$, $D_{max}$ and $D_{mean}$, respectively. For PTV, the effect of low magnetic field on dose distribution showed a difference of up to 2% for volume change and 4 Gy for dose. In OARs analysis, the significant effect of the magnetic field was not observed. Despite small deviation values, the average difference of mean dose values showed significant difference (p<0.001), but there was no difference of point minimum dose values in both sehll structures. The largest deviation for the average difference of $D_{max}$ in the outer shell structure was $5.0{\pm}10.5Gy$ (p=0.148). The effect of low magnetic field of 0.35 T on dose deposition by a Co-60 beam was not significantly observed within the body for PBI IMRT plans. The dose deposition was only appreciable outside the body, where a dose build-up due to contaminated electrons generated in the treatment head and scattered electrons formed near the body surface.

• Progress in Medical Physics
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• v.24 no.1
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• pp.1-24
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• 2013

As image-guided radiation therapy (IGRT) has been commonly used for more accurate patient setup and monitoring tumor movement during radiation therapy, the necessity for management of imaging dose is increased. However, it has not been an interest issue to radiation therapy communities because the imaging dose is much lower than the therapeutic dose. However, since the cumulative dose from 4DCT and repeated imaging for daily setup verificationin would not be ignorable, appropriate dose management based on ALARA (As Low As Reasonably Achievable) principle is required. In this study, we aimed that (1) survey on imaging equipments and modalities used for IGRT, (2) estimation of IGRT imaging dose depending on treatment types and equipments, (3) collecting data of effective dose on treatment sites from each equipment and imaging protocol, and thus finally provide guideline for imaging dose reduction and optimization.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.613-618
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• 2020

The average dose of Fast Low Dose C-arm CT used during hepatic arterial chemoembolization was compared with the average dose of DSA, and the exposure dose was analyzed by analyzing the average dose for each test technique in the total accumulated dose. 50 patients were randomly selected at our clinic and compared with Fast Low Dose C-arm CT, DAP and Air Kerma of DSA, and the accumulation of four test techniques (DSA, Fast Low Dose C-arm CT, Roadmap, Fluoroscopy) The proportion of dose (DAP, Air Kerma) was analyzed. For statistical comparative analysis, the corresponding sample T test and ANOVA test (post hoc test: Tukey) were performed using the statistical program SPSS 20.0. Fast Low Dose C-arm CT showed statistically significantly lower average dose (DAP, Air Kerma) than DSA. Reducing the number of tests for DSA can reduce the patient's exposure to medical radiation.

• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.3-9
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• 1991

Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. The main characteristics of brachytherapy are delivering of higher dose to target volume shortening of total treatment period and sparing of normal tissue. Recent development of iridium ribbons for low dose rate implant provides improvement of technology of brachytherapy in terms of safety and efficiency. High dose rate method. on the other hand, is effective to avoid unnecessary expoure of medical personnel.

• Radiation Oncology Journal
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• v.29 no.2
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• pp.63-70
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• 2011

Purpose: To evaluate the extent of pain response and objective response to palliative radiotherapy (RT) for bone metastases from hepatocellular carcinoma according to RT dose. Materials and Methods: From January 2007 to June 2010, palliative RT was conducted for 103 patients (223 sites) with bone metastases from hepatocellular carcinoma. Treatment sites were divided into the high RT dose and low RT dose groups by biologically effective dose (BED) of 39 $Gy_{10}$. Pain responses were evaluated using the numeric rating scale. Pain scores before and after RT were compared and categorized into 'Decreased', 'No change' and 'Increased'. Radiological objective responses were categorized into complete response, partial response, stable disease and progression using modified RECIST (Response Evaluation Criteria In Solid Tumors) criteria; the factors predicting patients' survival were analyzed. Results: The median follow-up period was 6 months (range, 0 to 46 months), and the radiologic responses existed in 67 RT sites (66.3%) and 44 sites (89.8%) in the high and low RT dose group, respectively. A dose-response relationship was found in relation to RT dose (p=0.02). Pain responses were 75% and 65% in the high and low RT dose groups, respectively. However, no statistical difference in pain response was found between the two groups (p=0.24). There were no differences in the toxicity profiles between the high and low RT dose groups. Median survival from the time of bone metastases diagnosis was 11 months (range, 0 to 46 months). The Child-Pugh classification at the time of palliative RT was the only significant predictive factor for patient survival after RT. Median survival time was 14 months under Child-Pugh A and 2 months under Child-Pugh B and C. Conclusion: The rate of radiologic objective response was higher in the high RT dose group. Palliative AT with a high dose would provide an improvement in patient quality of life through enhanced tumor response, especially in patients with proper liver function.

• Journal of Radiation Protection and Research
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• v.47 no.3
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• pp.158-166
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• 2022

Background: The effects of radiation on the health of radiation workers who are constantly susceptible to occupational exposure must be assessed based on an accurate and reliable reconstruction of organ-absorbed doses that can be calculated using personal dosimeter readings measured as H_p(10) and dose conversion coefficients. However, the data used in the dose reconstruction contain significant biases arising from the lack of reality and could result in an inaccurate measure of organ-absorbed doses. Therefore, this study quantified the biases involved in organ dose reconstruction and calculated the bias-corrected H_p(10)-to-organ-absorbed dose coefficients for the use in epidemiological studies of Korean radiation workers. Materials and Methods: Two major biases were considered: (a) the bias in H_p(10) arising from the difference between the dosimeter calibration geometry and the actual exposure geometry, and (b) the bias in air kerma-to-H_p(10) conversion coefficients resulting from geometric differences between the human body and slab phantom. The biases were quantified by implementing personal dosimeters on the slab and human phantoms coupled with a Monte Carlo method and considered to calculate the bias-corrected H_p(10)-to-organ-absorbed dose conversion coefficients. Results and Discussion: The bias in H_p(10) was significant for large incident angles and low energies (e.g., 0.32 for right lateral at 218 keV), whereas the bias in dose coefficients was significant for the posteroanterior (PA) geometry only (e.g., 0.79 at 218 keV). The bias-corrected H_p(10)-to-organ-absorbed dose conversion coefficients derived in this study were up to 3.09- fold greater than those from the International Commission on Radiological Protection publications without considering the biases. Conclusion: The obtained results will aid future studies in assessing the health effects of occupational exposure of Korean radiation workers. The bias-corrected dose coefficients of this study can be used to calculate organ doses for Korean radiation workers based on personal dose records.

• Journal of radiological science and technology
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• v.43 no.5
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• pp.375-382
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• 2020

PET/CT is a medical equipment that detects 0.511 MeV of gamma rays. The radiation workers are inevitably exposed to ionizing radiation in the process of handling the isotope. Accordingly, PET/CT workers use syringe shields made of lead and tungsten to protect their hands. However, lead and tungsten are known to generate very high scattering particles by interacting with gamma rays. Therefore, in this study, we tried to find out the effect on the scattering particles emitted from the syringe shield. In the experiment, first, the exposure dose to the hand (Rod phantom) was evaluated according to the metal material (lead, tungsten, iron, stainless steel) using Monte Carlo simulation. The exposure dose was compared according to whether or not plastic is attached. Second, the exposure dose of scattering particles was measured using a dosimeter and lead. As a result of the experiment, the shielding rate of plastics using the Monte Carlo simulation showed the largest difference in dose of about 40 % in lead, and the lowest in iron, about 15 %. As a result of the dosimeter test, when the plastic tape was wound on lead, it was found that the reduction rate was about 15 %, 28 %, and 39 % depending on the thickness. Based on the above results, it was found that 0.511 MeV of gamma ray interacts with the shielding tool to emit scattered rays and has a very large effect on radiation exposure. However, it was considered that the scattering particles could be sufficiently removed with plastics with a low atomic number. From now on, when using high-energy radiation, the shielding tool and the skin should not be in direct contact, and should be covered with a material with a low atomic number.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.33-41
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• 2019

Purpose : To evaluate the effectiveness of Jaw-tracking(JT) technique in Intensity-modulated radiation therapy(IMRT) and Volumetric-modulated arc therapy(VMAT) for radiation therapy of esophageal cancer by analyzing volume dose of perimetrical normal organs along with the low-dose volume regions. Materials and Method: A total of 27 patients were selected who received radiation therapy for esophageal cancer with using $VitalBeam^{TM}$(Varian Medical System, U.S.A) in our hospital. Using Eclipse system(Ver. 13.6 Varian, U.S.A), radiation treatment planning was set up with Jaw-tracking technique(JT) and Non-Jaw-tracking technique(NJT), and was conducted for the patients with T-shaped Planning target volume(PTV), including Supraclavicular lymph nodes(SCL). PTV was classified into whether celiac area was included or not to identify the influence on the radiation field. To compare the treatment plans, Organ at risk(OAR) was defined to bilateral lung, heart, and spinal cord and evaluated for Conformity index(CI) and Homogeneity index(HI). Portal dosimetry was performed to verify a clinical application using Electronic portal imaging device(EPID) and Gamma analysis was performed with establishing thresholds of radiation field as a parameter, with various range of 0 %, 5 %, and 10 %. Results: All treatment plans were established on gamma pass rates of 95 % with 3 mm/3 % criteria. For a threshold of 10 %, both JT and NJT passed with rate of more than 95 % and both gamma passing rate decreased more than 1 % in IMRT as the low dose threshold decreased to 5 % and 0 %. For the case of JT in IMRT on PTV without celiac area, $V_5$ and $V_{10}$ of both lung showed a decrease by respectively 8.5 % and 5.3 % in average and up to 14.7 %. A $D_{mean}$ decreased by $72.3{\pm}51cGy$, while there was an increase in radiation dose reduction in PTV including celiac area. A $D_{mean}$ of heart decreased by $68.9{\pm}38.5cGy$ and that of spinal cord decreased by $39.7{\pm}30cGy$. For the case of JT in VMAT, $V_5$ decreased by 2.5 % in average in lungs, and also a little amount in heart and spinal cord. Radiation dose reduction of JT showed an increase when PTV includes celiac area in VMAT. Conclusion: In the radiation treatment planning for esophageal cancer, IMRT showed a significant decrease in $V_5$, and $V_{10}$ of both lungs when applying JT, and dose reduction was greater when the irradiated area in low-dose field is larger. Therefore, IMRT is more advantageous in applying JT than VMAT for radiation therapy of esophageal cancer and can protect the normal organs from MLC leakage and transmitted doses in low-dose field.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3257-3265
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• 2015

Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.