• Title/Summary/Keyword: Low-Dose Radiation

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Survival outcomes after adjuvant radiotherapy for aggressive fibromatosis depend on time frame and nuclear β-catenin

  • Kim, Jae Sik;Kim, Hak Jae;Lee, Me-Yeon;Moon, Kyung Chul;Song, Seung Geun;Kim, Han-Soo;Han, Ilkyu;Kim, Il Han
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.37-42
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    • 2019
  • Purpose: To identify prognostic factors influencing progression-free survival (PFS) of aggressive fibromatosis (AF) after postoperative radiotherapy (PORT) and assess correlations between immunohistochemistry (IHC) features of β-catenin/smooth muscle actin (SMA) and PFS. Materials and Methods: Records of 37 patients with AF treated by PORT from 1984 to 2015 were retrospectively reviewed. Fifteen patients underwent wide excision for AF and 22 patients received debulking operation. The median total dose of PORT was 59.4 Gy. IHC staining results of β-catenin and SMA were available for 11 and 12 patients, respectively. Results: The median follow-up duration was 105.9 months. Five-year PFS rate was 70.9%. Tumor size or margin status was not related to PFS in univariate analysis (p = 0.197 and p = 0.716, respectively). Multivariate analysis showed that increased interval from surgery to PORT (>5.7 weeks) was a marginal risk factor for PFS (p = 0.054). Administration of PORT at the initial diagnosis resulted in significantly improved PFS compared to deferring PORT after recurrence (p = 0.045). Patient with both risk factors of deferring PORT after recurrence and interval from surgery to PORT >5.7 weeks had significantly lower 5-year PFS than patients without risk factor (34.1% vs. 100.0%; p = 0.012). Nuclear β-catenin intensity tended to inversely correlate with 5-year PFS, although it did not reach statistical significance (62.5% at low vs. 100.0% at high; p = 0.260). SMA intensity was not related to PFS (p = 0.700). Conclusion: PORT should be performed immediately after surgery irrespective of margin status or tumor size especially in recurrent case. Nuclear β-catenin staining intensity of IHC might correlate with local recurrence.

Effect of Irradiation Temperature on Physicochemical and Sensory Properties of Tarakjuk (Milk Porridge) (방사선 조사 온도가 타락죽의 이화학적 및 관능적 품질 특성에 미치는 영향)

  • Han, In-Jun;Song, Beom-Seok;Lee, Ju-Woon;Kim, Jae-Hun;Choi, Kap-Sung;Park, Jeong-Ro;Chun, Soon-Sil
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.9
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    • pp.1307-1313
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    • 2011
  • This study was conducted to evaluate the effects of irradiation temperature on the physicochemical and sensory properties of Tarakjuk, milk porridge. Tarakjuk was gamma-irradiated at different temperatures of $25^{\circ}C$ (in room), $4^{\circ}C$ (in ice), and $-20^{\circ}C$ (in dry ice) at a dose of 10 kGy, and then autoclaved at $120^{\circ}C$ for 15 min for comparison. pH and Hunter's color value of Tarakjuk were not changed by irradiation regardless of the temperature. However, the TBA (2-thiobarbituric acid) value decreased as irradiation temperature was decreased. The viscosity of Tarakjuk irradiated in dry ice was significantly higher than that irradiated at room temperature and in ice (p<0.05). For the sensory evaluation, there were no significant differences in overall acceptability between non-treated Tarakjuk and that irradiated in dry ice. Flavor pattern analysis using an electronic nose with a SAW (surface acoustic wave) sensor determined that the main peaks at retention times 3.88 and 7.34 sec were related with off-flavor induced by irradiation and unique flavor of Tarakjuk, respectively. These results indicated that irradiation at freezing temperature improved quality deterioration of Tarakjuk by gamma irradiation. However, sensory quality of Tarakjuk irradiated at freezing temperature was still lower than that of non-irradiated Tarakjuk. Therefore, further research is needed to improve the quality of Tarakjuk using combined treatment such as addition of antioxidants and vacuum packaging method.

Study to Protocol of PET Acquisition Time for Patient Body Type in PET/CT (PET/CT 검사에서 환자체형에 따른 적정검사 프로토콜에 관한 고찰)

  • Cho, Seok Won;Ham, Joon-Chul;Kang, Chun Goo;Bahn, Young Kag;Lee, Seung Jae;Lim, Han Sang;Lee, Chang-Ho;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.72-77
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    • 2013
  • Purpose: Whole-body PET using radiopharmaceutical is one of the imaging study methods for physiological changes of body. High specificity of the PET-CT examination is used to detect an early stages of cancer and metastatic cancer by imaging a physiological changes. During the imaging process, PET image has been characterized by a relatively low image quality due to its low sensitivity and the acquisition of random and scatter coincidences as well as patients figure. Therefore, the image quality as the changes of the acquisition times of patient weight was evaluated in this study. Materials and Methods: Thirty patients who presented to our hospital were enrolled. They were divided to normal, overweight, and obese group using BMI index, respectively. The patients with a liver disease and diabetes were excluded. $^{18}F-FDG$ was administered to the patients as 5.2 MBq per kg. After an hour from an injection, image acquisition was obtained as List mode in a part of liver in 1 bed. SNR (signal-to-noise ratio) of each groups acquisition times were confirmed from the calculated radiation counts and random fractions. The statistical significance of three groups was confirmed through one-way ANOVA test. On the basis of the counts of 2 minutes on normal group, the SNR of overweight group and obese group were compared. Results: The SNR were increased with loger aquisition time in 3 groups. In the condition of same acquisition time, the SNR had a statistical significance (P<0.05). The SNR were decreased to the normal, overweight, and obese, respectively. Liver activity had no significance difference on each group and RF had the significance differences (P<0.05). On the basis of the counts of 2 minutes on normal group, there were no statistical significance in a three minute acquisitions of overweight group and two minute acquisitions of obese group (P=0.150). Conclusion: In this study, the administrated amount of radiation dose did not adjust as the change of the patients weight. Increasing the acquisition time when the administration of the same amount of dose was able to get a good result of SNR. When the Based 2 minute on normal group, if overweight and obese case the increased acquisition time of 3 minute was able to obtain a similar SNR. On the basis of the normal group, the acquisition times of overweight and obese group were increased to 3 minutes per bed and the SNR were similar to the normal group.

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Selective Beam Shielding Method of Gamma-Knife Unit Using Various Plugging Patterns (다양한 Plugging 형태를 이용한 감마나이프의 선택적 빔 차폐 방법)

  • Jang Geon Ho;Lim Young Jin;Shin Dong Oh;Choi Doo Ho;Hong Seong Eon;Leem Won
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.439-448
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    • 1993
  • The B-type gamma knife unit was installed at Kyung-Hee University Hospital in March 1992. The selective beam plugging method can be used to reduce the low percentage isodose profiles of normal sensitive organ and to modify the isodose curves of treatment volume for better shaping of the target volume. For representing the changes of the low percentage isodose profiles, the variations of dose distribution for several cases were discussed in this paper. The film dosimetry was peformed for the evaluation of calculated isodose profiles predicted by KULA dose planning system. The results were verified by RFA-3 automatic densitometry. The clinical application of selective beam shielding method was peformed in 17 patients in 100 patients who have undergone gamma knife radiosurgery for a year. The calculated and the measured isodose profiles for the high percentage regions were well consistent with each other. When the target of pituitary tumor is macro-size, the selective beam shielding method is the most applicable method. When the target size, however, is small, the correct selection of the proper helmet size is very important. All patients were exposed almost about 3~12 Gy for brain stem, and 3~11.2 Gy for optic apparatus. It is recommended that the same or other plugging patterns with multiple isocenters should be used for protection of the radiosensitive normal structures with precise treatment of CNS lesions.

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Effect of Electron-Beam Irradiation on Flavor Components in Pear (Pyrus pyrifolia cv. Niitaka) (전자선 조사가 신고배의 향기성분에 미치는 영향)

  • Kim, Won;Shim, Sung-Lye;Ryu, Keun-Young;Jun, Sam-Nyeo;Jung, Chan-Hee;Seo, Hye-Young;Song, Hyun-Pa;Kim, Kyong-Su
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.2
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    • pp.195-202
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    • 2008
  • This study was performed to examine the effects of electron beam irradiation on volatile flavor components of Shingo pear (Pyrus pyrifolia cv. Niitaka) and on their changes according to storing period following irradiation. Volatile flavor components in pear were extracted using simultaneous steam distillation and extraction (SDE) apparatus and analyzed by GC/MS. 46 components were identified in control whereas 45, 44, 48 and 51 components were identified in irradiated samples by electron beam at 0.25, 0.5, 1, and 3 kGy, respectively. Hexanal, n-hexanol, and (E)-2-hexenal were identified as the major volatile flavor components of all samples. The characteristic volatile flavor components of irradiated pear by electron beam were similar to those of control, and their effects depending on irradiation source were not different. In addition, there was no noticeable change in volatile flavor components of pear with storage at $4^{\circ}C$ for 30 days or with irradiation. Sensory evaluation indicated that the consumer receptiveness tended to be higher at a low level of radiation dose under 1 kGy than control, albeit not significant. Therefore, electron beam irradiation at low level of radiation dose under 1 kGy could be considered as an effective method to exterminate vermin and thus to improve the shelf-stability of pear without deterioration.

Improvement of a Planning Technique Based on Heuristic Target Shaping for Stereotactic Radiosurgery (방사선 수술시 경험적 표적 근사화에 근거한 최적화 방법 개선)

  • Oh Seungjong;Choi Kyoung-Sik;Song Ju-Young;Suh Tae-Suk
    • Progress in Medical Physics
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    • v.16 no.4
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    • pp.176-182
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    • 2005
  • Stereotactic radiosurgery (SRS) is a technique to deliver a high dose to a target region and a low dose to a critical organ through only one or a few irradiation. The SRS must be planned exactly. Currently the surgery plan is peformed by trial and error method. There are many questions about the reliability and reproducibility of the plan result. This study Improve each step of the Oh's method based on heuristic target shaping to obtain the better result. The target was reconstructed using cylinders with same height and the neighbored cylinders were combined according to the difference of each center and diameter. Then, spheres were packed within each cylinders by the packing rules. Two virtual targets were used to compare this method with Oh's method. As a result, the numbers of isocenter were successfully reduced - more than $35\%$ and $26\%$ - without serious differences of proscription isodose to tumour volume ratio (PITV) and maximum dose to proscription dose ratio (MDPD). This technique using cylinder piling and sphere packing will be a helpful tool to planner in stereotactic radiosurgery.

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Comparison of Beam Delivery Modes in Prostate Cancer Proton Therapy: A Treatment Planning Comparison Study (전립선암 환자 양성자치료 시 빔 전달방식에 따른 치료계획 비교)

  • Kim, Youn Young;Youm, Doo Seok;Jang, Yo Jong;Kang, Dong Yun;Park, Jeong Hoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.153-158
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    • 2013
  • Purpose: After making two plans, the Double Scattering (DS) Mode and The Pencil Beam Scanning (PBS) Mode, of patients on early prostate cancer, we not only compare the dose conformity and the dose homogeneity by analyzing each DVH, CN and HI, but also evaluate normal structures's sparing effect on each mode. Materials and Methods: Planes about nine patients, who did proton therapy, on prostate cancer was setted using the Eclipse proton external beam planning system. The prescription dose, every $2.5 Gy{\times}28$ fractions=70 Gy, was delivered to the PTV. The CN and the HI were getted by anlazing each DVHs for the DS Plan and the PBS Plan. Also, normal structures' %volumes according to dose of the PBS are campared with those of the DS. Results: The average CN of the PTV is increase 16.63% from DS $0.68{\pm}0.07$ to PBS $0.79{\pm}0.01$, and the average IN of the PTV is decrease -22.66 % from DS $0.12{\pm}0.03$ to PBS $0.09{\pm}0.01$. The PBS has litter %Volumes of normal structures than the DS about every patient except Rectum. The average %Volume of Left Femoral Head receiving ${\geq}30$ Gy shows most high decreasing rate, -79.93%, from DS to PBS and the average %Volume of Rectum receiving ${\geq}70$ Gy shows most low decreasing rate, -3.03%, from DS to PBS. Conclusion: Therefore, the PBS is more effective achieving the dose conformity and the dose Homogeneity than DS, and better to reduce unnecessary dose arriving normal structures, especially the femoral heads.

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Dose Verification Using Pelvic Phantom in High Dose Rate (HDR) Brachytherapy (자궁경부암용 팬톰을 이용한 HDR (High dose rate) 근접치료의 선량 평가)

  • 장지나;허순녕;김회남;윤세철;최보영;이형구;서태석
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.15-19
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    • 2003
  • High dose rate (HDR) brachytherapy for treating a cervix carcinoma has become popular, because it eliminates many of the problems associated with conventional brachytherapy. In order to improve the clinical effectiveness with HDR brachytherapy, a dose calculation algorithm, optimization procedures, and image registrations need to be verified by comparing the dose distributions from a planning computer and those from a phantom. In this study, the phantom was fabricated in order to verify the absolute doses and the relative dose distributions. The measured doses from the phantom were then compared with the treatment planning system for the dose verification. The phantom needs to be designed such that the dose distributions can be quantitatively evaluated by utilizing the dosimeters with a high spatial resolution. Therefore, the small size of the thermoluminescent dosimeter (TLD) chips with a dimension of <1/8"and film dosimetry with a spatial resolution of <1mm used to measure the radiation dosages in the phantom. The phantom called a pelvic phantom was made from water and the tissue-equivalent acrylic plates. In order to firmly hold the HDR applicators in the water phantom, the applicators were inserted into the grooves of the applicator holder. The dose distributions around the applicators, such as Point A and B, were measured by placing a series of TLD chips (TLD-to-TLD distance: 5mm) in the three TLD holders, and placing three verification films in the orthogonal planes. This study used a Nucletron Plato treatment planning system and a Microselectron Ir-192 source unit. The results showed good agreement between the treatment plan and measurement. The comparisons of the absolute dose showed agreement within $\pm$4.0 % of the dose at point A and B, and the bladder and rectum point. In addition, the relative dose distributions by film dosimetry and those calculated by the planning computer show good agreement. This pelvic phantom could be a useful to verify the dose calculation algorithm and the accuracy of the image localization algorithm in the high dose rate (HDR) planning computer. The dose verification with film dosimetry and TLD as quality assurance (QA) tools are currently being undertaken in the Catholic University, Seoul, Korea.

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Nationwise Survey of the X-ray Beam Collimator Utilization in General Diagnostic Radiograph (진단방사선 일반촬영에서의 X-ray Beam Collimator 사용 전국 실태조사)

  • Kim, Jee Hye;Sung, Dong-Wook;Kim, Jeong Wook;Shin, Jin Ho;Lee, Soon Keun;Jung, Kyung Il;Uhm, Jong Kwan;Lee, Ki Nam;Seong, Ho Jin;Kim, Youn Hyun;Kim, Hyeog Ju
    • Progress in Medical Physics
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    • v.24 no.2
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    • pp.119-126
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    • 2013
  • Due to the introduction of CR and DR, it has been neglected the use of the X-ray beam collimator and field size. This study examines nationwide survey of the proper use of collimator and field size by area in a specific field of plain radiography and the current status. Authors emphasized the need for the field size criteria, and propose a standard reference field size in each specific radiologic examination. Total 333 medical institutions (included in Seoul, Gyeonggi-do, Jeolla, Chungcheong, Gangwon-do, Busan area), were investigated in relation to the status of the X-ray beam collimation field size, type specific inspection areas, medical facilities, and image analyses by type to figure out whether they use the adjustment of image field to the specific examination. To assess the awareness and the impact of radiation exposure to the collimation adjustable, 168 radiographers who was working in 10 general hospitals, 10 hospitals, and 10 clinics, were surveyed how they haver adjusted the actual field size. We examine that 61.3% of medical institutions used the "Proper collimation" and only 49.9% of them employed proper one in lumbar spine densely crowded by major organs. 69% among general hospitals, and 65% among hospitals using DR system were using proper collimation. Radiographers recognized that proper adjustment of collimation could reduce the harmful radiation dose on patients. In the survey, 97.6% of respondents were aware of this fact, but only 83.3% of respondents did the adjustment of the size of the collimation field. The using of proper collimation field was low in the nationwide survey, so the effort to reduce the radiation dose on the patients is urgently needed. A unified standard for the field accompanied by thorough education should be needed.

Dosimetric and clinical review on the application of TOMO_edge mode (토모테라피 Edge 모드를 이용한 임상적 유용성 고찰)

  • Kim, Lizzy
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.177-182
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    • 2014
  • Purpose : The goal of this study was to compare and analysis the dose distribution and treatment time between Tomotherapy planning with fixed jaw(FJ) and dynamic jaw(DJ). Materials and Methods : Seven patients were selected in the study including five common clinical cases(brain, head and neck(HN), lung, prostate, spine). 1) Helical Tomotherapy plans with FJ and DJ were generated with the same planning parameters such as Modulation factor, Pitch and Field width. 2) Tomo_edge plans with a larger field width were generated to compare to conventional HT delivery with fixed jaw. Dosimetric evaluation indices for target coverage are Dmin, Conformity index(CI) and for whole body including target are $V_{10%}$, $V_{25%}$, $V_{50%}$, $V_{75%}$ using Dose-volume histogram(DVH). Also, Treatment time and Cumulative MU were used for clinical review on Tomo_edge. Results : In case of using the same field width of Tomotherapy planning with FJ and DJ, the averaged variations were $V_{10%}$: -11.91%, $V_{25%}$: -7.6%, $V_{50%}$ :-4.75%, $V_{75%}$: -1.04%. Tomo_edge with a larger field width provides the averaged variations for target coverage: Dmin: -0.72%, CI: -1.25% and also shows the tendency of a sharp $V_{x%}$ decline in low dose area. The clinical improvements in the larger field width with DJ were observed in the treatment time, ranging from -51.21% to -15.11, and the Cumulative MU decrease, ranging from -57.74% to -15.31%. Conclusion : Target coverage achieved by FJ and DJ with the same field width has little differences. But integral doses on whole body efficiently decreased. Compared to the conventional HT delivery, Tomo_edge with a larger field width presents a little worse target coverage. However, it provides faster treatment delivery and improved cranial-caudal target dose conformity. Therefore, Tomo_edge mode is efficient in improving the treatment time and integral dose while maintaining comparable plan quality in clinic.