Kim, Jong-Won;Kim, Dae-Hyun;Choi, Joon-Yong;Won, Yeong-Jin
Journal of radiological science and technology
/
v.35
no.4
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pp.327-333
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2012
Purpose: To analyze the correlation between dose volume histograms(DVH) based on organ outer wall contour and organ wall delineation for bladder and rectum, and to compare the doses to these organs with the absorbed doses at the bladder and rectum. Material and methods: Individual CT based brachytherapy treatment planning was performed in 13 patients with cervical cancer as part of a prospective comparative trial. The external contours and the organ walls were delineated for the bladder and rectum in order to compute the corresponding dose volume histograms. The minimum dose in 0.1 $cm^3$, 1 $cm^3$, 2 $cm^3$, 5 $cm^3$, 10 $cm^3$ volumes receiving the highest dose were compared with the absorbed dose at the rectum and bladder reference point. Results: The bladder and rectal doses derived from organ outer wall contour and computed for volumes of 2 $cm^3$, provided a good estimate for the doses computed for the organ wall contour only. This correspondence was no longer true when large volumes were considered. Conclusion: For clinical applications, when volumes smaller than 5 $cm^2$ are considered, the dose-volume histograms computed from external organ contours for the bladder and rectum can be used instead of dose -volume histograms computed for the organ walls only. External organ contours are indeed easier to obtain. The dose at the ICRU rectum reference point provides a good estimate of the rectal dose computed for volumes smaller than 2 $cm^2$ only for a midline position of the rectum. The ICRU bladder reference point provides a good estimate of the dose computed for the bladder wall only in cases of appropriate balloon position.
In gated radiation therapy (gRT), due to residual motion, beam delivery is intended to irradiate not only the true extent of disease, but also neighboring normal tissues. It is desired that the delivery covers the true extent (i.e. clinical target volume or CTV) as a minimum, although target moves under dose delivery. The objectives of our study are to validate if the intended dose is surely delivered to the true target in gRT and to quantitatively understand the trend of dose delivery on it and neighboring normal tissues when gating window (GW), motion amplitude (MA), and CTV size changes. To fulfill the objectives, experimental and computational studies have been designed and performed. A custom-made phantom with rectangle- and pyramid-shaped targets (CTVs) on a moving platform was scanned for four-dimensional imaging. Various GWs were selected and image integration was performed to generate targets (internal target volume or ITV) for planning that included the CTVs and internal margins (IM). The planning was done conventionally for the rectangle target and IMRT optimization was done for the pyramid target. Dose evaluation was then performed on a diode array aligned perpendicularly to the gated beams through measurements and computational modeling of dose delivery under motion. This study has quantitatively demonstrated and analytically interpreted the impact of residual motion including penumbral broadening for both targets, perturbed but secured dose coverage on the CTV, and significant doses delivered in the neighboring normal tissues. Dose volume histogram analyses also demonstrated and interpreted the trend of dose coverage: for ITV, it increased as GW or MA decreased or CTV size increased; for IM, it increased as GW or MA decreased; for the neighboring normal tissue, opposite trend to that of IM was observed. This study has provided a clear understanding on the impact of the residual motion and proved that if breathing is reproducible gRT is secure despite discontinuous delivery and target motion. The procedures and computational model can be used for commissioning, routine quality assurance, and patient-specific validation of gRT. More work needs to be done for patient-specific dose reconstruction on CT images.
Kim Yon Lae;Chung Jin Bum;Chung Won Kyun;Hong Semie;Suh Tae Suk
Progress in Medical Physics
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v.16
no.2
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pp.89-96
/
2005
In this study, we investigated the effect of time gating threshold on the delivered dose at a organ with internal motion by respiration. Generally, the internal organs have minimum motion at exhalation during normal breathing. Therefore to compare the dose distribution time gating threshold, in this paper, was determined as the moving region of target during 1 sec at the initial position of exhalation. The irradiated fields were then delivered under three conditions; 1) non-moving target 2) existence of the moving target in the region of threshold (1sec), 3) existence of the moving target region out of threshold (1.4 sec, 2 sec). And each of conditions was described by the moving phantom system. It was compared with the dose distributions of three conditions using film dosimetry. Although the treatment time increased when the dose distributions was obtained by the internal motion to consider the TGT, it could be obtained more exact dose distribution than in the treatment field that didn't consider the internal motion. And it could be reduced the unnecessary dose at the penumbra region. When we set up 1.4 sec of threshold, to reduce the treatment time, it could not be obtained less effective dose distribution than 1 sec of threshold. Namely, although the treatment time reduce, the much dose was distributed out of the treatment region. Actually when it is treated the moving organ, it would rather measure internal motion and external motion of the moving organ than mathematical method. If it could be analyzed the correlation of the internal and external motion, the treatment scores would be improved.
This study discussed the validity and necessity of compulsory recording of radiographic examination performed by radiological technologist on patients in medical institutions related to radiation exposure. Also, this study provided reasonable evidence of radiographic examination related medical records can contribute to the improvement of public health. Based on overseas cases of implementing a radiographic examination record system, the essential items to be included in medical record are the exposure date, exposure time, exposure method, exposure conditions that is tube voltage, tube current. Name and license number of the radiological technologist who performed the examination should be include in medical record. It is expected that the medical record of the total amount of radiation exposure per year would be in giving the maximum benefit with the minimum exposure to the medical radiation examination of the patient. In addition, interventional radiography medical record should also include exposure time, type and dose of the contrast medium.
Because the MIRD phantom, the representative mathematical phantom was developed for the calculation of internal radiation dose, and simulated by the simplified mathematical equations for rapid computation, the appropriateness of application to external dose calculation and the closeness to real human body should be justified. This study was intended to modify the MIRD phantom according to the comparison of the organ absorbed doses in the two phantoms exposed to monoenergetic broad parallel photon beams of the energy between 0.05 MeV and 10 MeV. The organ absorbed doses of the MIRD phantom and the Zubal yokel phantom were calculated for AP and PA geometries by MCNP4C, general-purpose Monte Carlo code. The MIRD phantom received higher doses than the Zubal phantom for both AP and PA geometries. Effective dose in PA geometry for 0.05 MeV photon beams showed the difference up to 50%. Anatomical axial views of the two phantoms revealed the thinner trunk thickness of the MIRD phantom than that of the Zubal phantom. To find out the optimal thickness of trunk, the difference of effective doses for 0.5 MeV photon beams for various trunk thickness of the MIRD phantom from 20 cm to 36 cm were compared. The optimal thunk thickness, 24 cm and 28 cm for AP and PA geometries, respectively, showed the minimum difference of effective doses between the two phantoms. The trunk model of the MIRD phantom was modified and the organ doses were recalculated using the modified MIRD phantom. The differences of effective dose for AP and PA geometries reduced to 7.3% and the overestimation of organ doses decreased, too. Because MIRD-type phantoms are easier to be adopted in Monte Carlo calculations and to standardize, the modifications of the MIRD phantom allow us to hold the advantage of MIRD-type phantoms over a voxel phantom and alleviate the anatomical difference and consequent disagreement in dose calculation.
Shin Hyun Soo;Kim Gwi Eon;Lee Hyung Sik;Suh Chang Ok;Loh John JK;Lee Jong Tae
Radiation Oncology Journal
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v.9
no.2
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pp.253-263
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1991
Twenty-seven patients with unresectable extrahepatic bile duct carcinoma (n=21) or with microscopic evidence of tumor rest after aggressive surgery for extrahepatic bile duct carcinoma (n=6) between 1985 and 1990 were given radiotherapy consisting intentionally external radiotherapy and/or intraluminal therapy using Gamma-Med 12i (192-Ir) high dose rate (HDR) remote control afterloading system following bile drainage procedures and Gianturco stent insertion. The objectives of this study has been to assess the feasibility and effects on survival of a combination of external radiotherapy and brachytherapy with which we hope to achieve optimal loco-regional control for patients with unresectable extrahepatic bile duct tumors. Sixteen patients were men and eleven were women, and the mean age was 58 years (34-70). 10MV X-ray was used for radiation therapy, with the total dose ranging from 45 Gy to 55 Gy, and intraluminal brachytherapy performed after external radiotherapy, with the dose of total 15 Gy. The minimum follow up was 12 months. Failure were predominantly local-regional, without distant failure. Median survival was 10 months; 2-year actuarial survival rates was $21\%$. Median survival for common hepatic duct (CHD) cancer was 9 months; for common bile duct (CBD) cancer, was 16 months. And median survival for incomplete surgery/external radiotherapy group and external/intraluminal radiotherapy group was 10 months; for external radiotherapy alone group, was 6 months. Use of chemotherapy and/or hyperthermia were not affected in survival. Therefore, our result is that the survival rates in the group of external/intraluminal radiotherapy were comparable with ones in the group of incomplete resection/external radiotherapy, and so we believe that the aggressive local and regional radiotherapy can improve the quality of life and the survival length.
The purpose of this study is to develop the optimization method for adjusting the film isocenter shift and to suggest the quantitative acceptable criteria for film dosimetry after optimization In the dynamic conformal arc radiation therapy (DCAR). The DCAR planning was peformed In 7 patients with brain metastasis. Both absolute dosimetry with ion chamber and relative film dosimetry were peformed throughout the DCAR using BrainLab's micro-multileaf collimator. An optimization method for obtaining the global minimum was used to adjust for the error in the film isocenter shift, which is the largest pan of systemic errors. The mean of point dose difference between measured value using ion chamber and calculated value acquired from planning system was $0.51{\pm}0.43\%$ and maximum was $1.14\%$ with absolute dosimetry These results were within the AAPM criteria of below $5\%$. The translation values of film isocenter shift with optimization were within ${\pm}$1 mm in all patients. The mean of average dose difference before and after optimization was $1.70{\pm}0.35\%$ and $1.34{\pm}0.20\%$, respectively, and the mean ratios over $5\%$ dose difference was $4.54{\pm}3.94\%$ and $0.11{\pm}0.12\%$, respectively. After optimization, the dose differences decreased dramatically and a ratio over $5\%$ dose difference and average dose difference was less than $2\%$. This optimization method is effective in adjusting the error of the film isocenter shift, which Is the largest part of systemic errors, and the results of this research suggested the quantitative acceptable criteria could be accurate and useful in clinical application of dosimetric verification using film dosimetry as follows; film isocenter shift with optimization should be within ${\pm}$1 mm, and a ratio over $5\%$ dose difference and average dose difference were less than $2\%$.
Baykara, Meltem;Buyukberber, Suleyman;Ozturk, Banu;Coskun, Ugur;Unsal, Diclehan Kilic;Demirci, Umut;Dane, Faysal;Kaplan, Muhammet Ali;Bora, Huseyin;Benekli, Mustafa
Asian Pacific Journal of Cancer Prevention
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v.14
no.4
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pp.2557-2561
/
2013
Background: Chemoradiation (CRT) using cisplatin-based regimens has become the standard of care in the treatment of squamous cell head and neck cancers (SCHNC). The impact of taxanes as radiosensitizing agents with concurrent CRT regimens is unknown. We therefore retrospectively evaluated the efficacy and tolerability of a weekly cisplatin+docetaxel combination with CRT in locally advanced SCHNC. Methods: Sixty-six patients with locally advanced SCHNC (39.4% stage IV, 53% stage III, and 7.6% stage II) were assessed retrospectively. Total radiation dose to the PTV of gross disease (primary and/or node) was 70 Gy/35 fractions, 5 fractions per week. Minimum doses of 60 Gy and 50 Gy were administered to PTVs of elective high risk and low risk disease, respectively. Chemotherapy (CT) consisted of weekly cisplatin (20 $mg/m^2$)+docetaxel (20 $mg/m^2$) concurrently with RT. Results: The median age of the patients was 58 years (range, 32-77). Objective response rate was 83.3%. The 2-year progression-free survival (PFS) and overall survival (OS) were 75.7% and 78.3%, respectively. The most common grade 3 and 4 toxicities were mucositis (36.4%), nausea and vomiting (12.1%), neutropenia (4.5%). Conclusion: Weekly cisplatin and docetaxel concurrent with RT for locally advanced SCHNC was found tolerable with high efficacy.
Yoo, Jin Hee;Kim, Jong Keun;Yang, Hee Jin;Park, Ki Moon
Food Science of Animal Resources
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v.35
no.1
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pp.58-70
/
2015
This study was conducted to examine the effect of egg shell membrane hydrolysates (ESMH) on wrinkle, UV, and moisture protection for cosmetic use. ESMH were fragmented as whole ESMH (before fractioning), Fraction I (> 10 kDa), Fraction II (3-10 kDa), and Fraction III (< 3 kDa). In order to test whether fractionated ESMH can be used for functional cosmetic materials, we examined not only the level of hyaluronic acid and collagen production, but also the MMP-1 activity using a HaCaT and CCD-986Sk cell line. Our study treated each sample of fractionated ESMH with different concentrations (0.01, 0.1, 1 mg/mL). In our in vivo research, we used hairless mice that had been exposed to UV-B to induce wrinkles for 7 wk, then applied Fraction I to the treatment group for 5 wk and then tested skin thickness, minimum erythema dose and moisture content. In addition, Fraction I was high in collagen and HA biosynthesis and it was better than TGF-${\beta}$ in improving of the skin. When TNF-${\alpha}$ caused MMP-1 activity in the CCD-986Sk cells, the whole ESMH and Fraction I proved to be effective in hindering the induction of collagenase depending on the concentration, and also showed outstanding effects in the suppression of skin aging. We found that the treatment group mice's UV-B radiation-induced skin damage was largely mitigated compared to that of the non-treatment group mice. Thus, we have concluded that EMSH helps to mitigate UV-B radiation-induced wrinkles, collagen, HA, MMP-1 activity and can be used for functional cosmetic materials.
The peripheral dose, defined as the dose outside therapeutic photon fields, was estimated for 6MV X-ray linear accelerator. The measurements were performed using silicon diode detectors controlled by automatic controlled water phantom. The effects of field size, collimator position, presence or absence of wedge filter, and wedge angle were analyzed. The results were as follows 1. The peripheral dose decreases as the distance from field margin increases and it is more than 2.4% of central axis maximum dose even at 15cm distance from field margin. 2. Maximum build-up of peripheral dose is at 2-3 mm from the water surface and drops to a minimum at 1.5cm depth and then the dose increase again. 3. The peripheral dose increases as the field size. increases. At the short distance from field margin, the difference of peripheral dose between 5 $\times\;5cm^2$ and 20 $\times\;20cm^2$ field size reaches more than 2 fold. 4. The peripheral dose is higher along the upper collimator than along the lower collimator. The differences is less than 1%. 5. The presence of wedge filter increases peripheral dose. And the peripheral dose is higher along the blade side of wedge filter than along the ridge side. The difference is about 3% at 5cm distance from the field margin for 15 $\times\;15cm^2$ field size and 60$^{\circ}$ wedge filter. 6. The Peripheral dose of wedge filter increases as the wedge filter angle increases and the increasing ratio is about 2 fold in 60$^{\circ}$wedge filter compared with open field.
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