• Title/Summary/Keyword: Patients' radiation dose

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The Usefulness of Tc-99m MIBI SPECT in the Localization and the Assessment of Radiotherapy in Non-Small Cell Lung Cancer (비소세포 폐암의 국소화 및 방사선치료 판정에 있어 Tc-99m MIBI SPECT의 유용성)

  • Bom, Hee-Seung;Song, Ho-Chun;Kim, Ji-Yeul;Nam, Taek-Keum;Ahn, Sung-Ja;Chung, Woong-Ki;Nah, Byung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.2
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    • pp.186-191
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    • 1994
  • Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

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Relation between Ablation Execution Time and Radiation Exposure Effect in the Treatment of Atrial-fibrillation using Cryo-balloon and 3D Radio-frequency Ablation (냉각 풍선 절제술과 3D 고주파 절제술을 이용한 심방세동 치료 시 절제술 시행 시간과 방사선 피폭 영향과의 연관성)

  • Seo, Young-Hyun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.427-434
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    • 2022
  • Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m2, which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m2 by 921.56 uGy/m2, which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.

Comparison of Doses of Single Scan PBS and Layered Rescanning PBS Using Moving Phantom in Proton Therapy (양성자 치료에서 Moving Phantom을 이용한 Single Scan PBS와 Layered Rescanning PBS의 선량비교)

  • Kim, Kyeong Tae;Kim, Seon Yeong;Kim, Dae Woong;Kim, Jae Won;Park, Ji Yeon;Jeon, Sang Min
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.43-49
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    • 2019
  • Purpose : We apply the Layered Rescanning PBS designed to complement the Pencil Beam Scanning(PBS), which is vulnerable to moving organs with the Moving Phantom, and compare the homogeneity with the single scan PBS. Methods and materials: Matrix X (IBA, Belgium) and Moving Phantom (standard imaging, USA) were used. A dose of 200 cGy was measured in the AP direction on a hypothetical tumor $10{\times}10{\times}5cm$. The plan type was planned as 4 kinds of sinlge scan PBS, rescan number 4, 8, 12 times. Were measured three times for each types. During the measurement, the respiratory cycle of the Moving Phantom was generally set to 4 seconds per cycle, and the movement radius in the S-I direction was set to 2 cm. In addition, beam on time was measured. Results : The mean values of $D_{max}$ in the PTV were $246.47{\pm}18.8cGy$, $223.43{\pm}8.92cGy$, and $222.47{\pm}7.7cGy$, $213.9{\pm}6.11cGy$ and the mean values of $D_{min}$ were $165.53{\pm}4.32cGy$, $173.13{\pm}11.94cGy$, $184.13{\pm}8.04cGy$, $182.67{\pm}4.38cGy$ and the mean values of $D_{mean}$ $192.77{\pm}6.98cGy$, $196.7{\pm}4.01cGy$, $198.17{\pm}4.96cGy$, $195.77{\pm}3.15cGy$ respectively. As the number of rescanning increased, the Homogeneity Index converged to 1. The beam on time was measured as 2:15, 3:15, 4:30, 5:37 on average. In the measurement process, in the low dose layer of the MU, the problem was found that it was not rescanned as many times as the set number of rescan. Conclusions : In the treatment of tumors with long-term movements, the application of layered rescanning PBS showed a more uniform dose distribution than single scan PBS. And as the number of rescan increase, the distribution of homogeneity is uniform. Compared with single scan plan and 12 rescan plan, HI value was improved by 0.32. Further studies are expected to be applicable to patients who can not be treated with respiratory synchronous radiation therapy.

Radiotherapy Incidents Analysis Based on ROSIS: Tendency and Frequency (ROSIS 자료 기반 방사선 사고 사례 분석 : 경향과 빈도)

  • Koo, Jihye;Yoon, MyongGeun;Chung, Won Kuu;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.298-303
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    • 2014
  • In this study, we examine the trends and types of incidents frequently occur during radiation therapy by using the data from the radiation oncology safety information system (ROSIS), according to discovery method explores the development direction of future research accident cause factor control method. This study was carried out analysis of incident data in ROSIS nearly 1163 cases in last 11 years from 2003 to 2013. We categorized into treatment methods, found the time, discoverer of occupations and finding ways to analyze the data. Then, we calculate the percentage and the classification for each item. About 1163 cases of incident cases including the near miss cases, external radiation therapy, brachytherapy and other were 97%, 2% and 1%. In the case was improperly planned dose delivery was 44% (497 cases) which 429 cases (86%) was found before 3 fractions and 13 cases were found after 11 fractions. The investigation was found to be distributed in various a found times. Approximately 42% of found time was during treatment and 29% of patients were found the problem during inspection chart. Occupation to discover the most radiation accidents was the radiation therapist (53%) who works in treatment room. Among 1163 incidence cases, 24% cases were found the accident before the treatment, therefore most of accident were found after of during the treatment (70%, 813 cases). This trend is acquired through ROSIS analysis, is expected to be not significantly different in the case of Korea, so it is necessary more diverse and systematic research for the prevention and early detection by using the ROSIS data.

Efficacy of Lens Shielding Device to Prevent Cataract with Radiotherapy for Orbit or Ocular Adnexal Tumor (안와 및 안부속기 종양의 방사선치료에서 백내장의 예방을 위한 렌즈보호 장치의 효용성)

  • Cho, Jung-Keun;Cho, Hyun-Sang;Han, Tae-Jong
    • The Journal of the Korea Contents Association
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    • v.7 no.12
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    • pp.139-144
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    • 2007
  • Radiotherapy which is the most effective for orbit lymphoma has been used increasingly due to the increase of orbit or ocular adnexal tumor patients. Curative effects and convalescence have been being more satisfied thanks to remarkable development of cancer chemotherapy and medical treatments, but side effects such as cataract, dry eye and retinopathy still break out. Thus, in this study, a Lens Shielding Device (LSD hereafter) was designed to prevent occurring of cataract due to radiation therapy for orbit lymphoma and its efficacy through dosimetry were evaluated. And in this paper, its manufacturing process was also explained. LSD is composed of a cover body covering the lens and a side fixing part supporting the cover body. To measure radiation, the patient therapy conditions were simulated and the measurement of the radiation was conducted with Thermo Luminescence Detector (TLD) and Markus chamber. The average TLD value was 5.7% and the TLD value and Markus chamber value were acquired as 4.2% and 5.1% respectively at 6 mm depth where zero lens center was located. Only 1.5Gy ($300Gy{\times}\;5%$) or 5% of total 30Gy with 9 MeV electron beam is estimated to affect on patient's lens. That is smaller dose than the threshold value of cataract (2GY) or the value (5Gy) that was reported to cause cataract in clinical conditions. Thus, these findings suggest that LSD be very useful for prevention of cataract during radiotherapy for malignant lymphoma of orbit and ocular adnexa. Furthermore, it might be possible to reduce patient's discomfort caused by alien substances and to make it easier to fix the device with customized manufacturing manners.

Rhabdomyosarcoma Involving Maxillary Sinus and Orbit (상악동과 안와를 침범한 횡문근육종 1례)

  • Oh Yong-Suk;Kang Jin-Hyoung;Han Ji-Youn;Hong Young-Sun;Kim Hoon-Kyo;Lee Kyung-Shik;Kim Dong-Jip;Kim Min-Sik;Cho Seung-Ho;Suh Byung-Do;Yoon Sei-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.218-224
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    • 1994
  • Soft tissue sarcoma of the head and neck is not frequent neoplasm, accounting for less than 1% of all malignant neoplasm in the region. The histological varieties include osteogenic sarcoma, malignant fibrous histiocytoma, rhabdomyosarcoma, fibrosarcoma, tenosynovial sarcoma, angiosarcoma and chondrosarcoma. Rhabdomyosarcomas of the head and neck usually occur in children under the age of 10 years (over 70%) and rarely develop in adults over the age of 20 years. The prevalent sites of involvement include the orbit, nasal cavity, external ear, paranasal sinus and soft tissue of mouth and the primary location of tumor is considered to be one of the important prognostic factors. Before the 1960s, when surgical resection was the only method of treatment, the 5-year survival rate was less than 20%, but recently it has been greatly improved by the multimodality treatment, combining surgery with chemotherapy and radiation therapy. Here we treated a rhabdomyosarcoma woman with three cycles of high dose chemotherapy followed by radiation therapy. After the, completion of preoperative treatments, successful result of more than partial response was achieved. Three months later total maxillectomy and radical neck dissection was performed. There was no evidence of tumor infiltration in the resected tumor and regional lymphnodes but metastasized tumor cells in cervical lymphnodes were detected. Tumor cell infiltration was also found on the bone marrow biopsy to evaluate the pancytopenia which occurred during postoperative recovery. Two months later she died of secondary bone marrow failure. We think that this multimodality treatment combining pre-operative chemotherapy, radiotherapy and surgery might play an important role in curative resection and eyeball preservation in patients with rhabdomyosarcoma involving the eyeball.

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Effect of Gamma Irradiation on the Overall Quality of a Commercial Plain-type Yogurt Products (안전성 향상을 위해 감마선 조사한 시판 플레인 요구르트의 품질 특성)

  • Kim, Hyun-Joo;Song, Hyun-Pa;Ham, Jun-Sang;Lee, Ju-Woon;Kim, Kee-Hyuk;Jo, Cheor-Un
    • Food Science of Animal Resources
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    • v.28 no.5
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    • pp.574-579
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    • 2008
  • To develop a yogurt for sensitive consumer such as infants, children or immuno-compromised patients using gamma irradiation, the effects of gamma irradiation on the microbiological, chemical, and sensory quality in a commercial plain yogurt were investigated. No viable coliform bacteria were detected in the sample and approximately a 6 decimal reduction was achieved in the number of total aerobic bacteria by irradiation at 5 kGy. The initial population of lactic acid bacteria observed in the commercial plain yogurt was 8.95 log CFU/g. Gamma irradiation significantly reduced the initial microbial level to 6.47 and 2.85 log CFU/g after irradiation at 1 and 3 kGy, respectively (p<0.05). However, irradiation dose up to 5 kGy could not completely eliminate the lactic acid bacteria in commercial plain yogurt. pH, color, lactose and lactic acid content, and sensory quality were not affected by irradiation treatment and storage. Our results suggest that irradiation can improve the microbial quality of commercial plain yogurt without impairing the physicochemical and sensory quality.

Effect of Prophylactic Cranial Irradiation in Acute Lymphoblastic Leukemia in Children (소아 급성 임파구성 백혈병에서 예방적 전뇌 방사선조사의 효과)

  • Kim Il Han;Choi Doo Ho;Kim Jong Hoon;Ha Sung Whan;Park Charn Il;Ahn Hyo Seop
    • Radiation Oncology Journal
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    • v.7 no.2
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    • pp.269-277
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    • 1989
  • CNS prophylaxis with 18 or 24 Gy cranial irradiation plus intrathecal methotrexate was given to 134 childhood acute lymphoblastic leukemia patients who had got bone marrow remission (M1) after remission induction chemotherapy from August 1979 to December 1986. The rate of initial total CNS relapse was 14.2% (19/134), the rate of isolated CNS relapse was 5.2% (7/134), and the rate of CNS relapse concomittantly combined with bone marrow relapse or testicular relapse was 9% (12/134). Male sex or older age was accociated with higher CNS relapes and the initial peripheral leukocyte count over 50,000/ul had higher relapse rate. Relapse with radiation dose of 18Gy was somewhat lower than that with 24Gy. Within 4 years after CNS prophylaxis occurred 89% of the total CNS relapses, 100% of the isolated CNS relapses, and 83% of the combined CNS relapses. Adjusted to exposed cases to risk of CNS relapse, the total CNS relapse rate was 11.9% during maintenance chemotherapy and 4.9% after maintenance chemotherapy.

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Concurrent Docetaxel/Cisplatin and Thoracic Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer (국소 진행성 비소세포 폐암에서 Docetaxel Cisplatin을 사용한 화학-방사선 동시치료의 효과)

  • Jang, Tae Won;Park, Jung Pil;Kim, Hee Kyoo;Ok, Chul Ho;Jeung, Tae Sig;Jung, Maan Hong
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.257-264
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    • 2004
  • Background : There are many combinations of treatment for locally advanced non-small cell lung cancer (NSCLC). Recent studies have showed the efficacy of concurrent chemoradiotherapy (CCRT) in NSCLC. At present, however, there is no consensus about the optimal dosages and timing of radiation and chemotherapeutic agents. The aims of study were to determine the feasibility, toxicity, response rate, and survival rate in locally advanced NSCLC patients treated with doxetaxel and cisplatin based CCRT. Method : Sixteen patients with unresectable stage III NSCLC were evaluated from May 2000 until September 2001. Induction chemoradiotherapy consisted of 3 cycles of docetaxel (75 $mg/m^2/IV$ on day 1) and cisplatin (60 $mg/m^2/IV$ on day 1) chemotherapy every 3 weeks and concomitant hyperfractionated chest irradiation (1.15 Gy/BID, total dose of 69 Gy) in 6 weeks. Patient who had complete or partial response, and stable disease were applied consolidation chemotherapy of docetaxel and cisplatin. Results : All patients showed response to CCRT. Four patients achieved complete response (25%), partial responses in 12 patients (75%). The major common toxicities were grade III or more of neutropenia (87.3%), grade III esophagitis (68.8%), pneumonia (18.8%) and grade III radiation pneumonitis (12.5%). Thirteen patients were ceased during follow-up period. Median survival time was 19.9 months (95% CI; 4.3-39.7 months). The survival rates in one, two, and three years are 68.7%, 43.7%, and 29.1%, respectively. Local recurrence was found in 11 patients (66.8%), bone metastasis in 2, and brain metastasis in 1 patient. Conclusion : The response rate and survival time of CCRT with docetaxel/cisplatin in locally advanced NSCLC were encouraging, but treatment related toxicities were high. Further modification of therapy seems to be warranted.

Preliminary Result in Patients with Primary Hepatoma Treated by Stereotactic Radiotherapy (원발성 간암에 대한 정위방사선치료의 예비결과)

  • Kang Ki Mun;Choi Ihl Bohng;Kim In Ah;Choi Byung Ock;Kang Young Nam;Chai Gyu Young;Han Sung Tae;Chung Gyu Won
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.34-39
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    • 2001
  • Purpose : It is not common to evaluate the response of the fractionated stereotactic radiotherapy (SRT) to primary hepatoma as compared with conventional radiotherapy. The purpose of the study was to take the preliminary result on the clinical trial of primary hepatoma by SRT. Materials and Methods : From July 1999 to March 2000, thirty three patients were hospitalized in the St. Mary's Hospital, and treated with SRT for extracranial tumors. Among them, 13 patients were diagnosed to primary hepatoma and then applied by frameless SRT using 6 MV linac accelerator. There were 12 male and 1 female patients. They had the age of $ 44\~66$ year old (median : 59) and the tumor size of $10\~825\;cc$ (median : 185 cc). SRT was given to them $3\~5$ fractions a week (5 Gy/fraction, $90\%$ isodose line) for $2\~3$ weeks. Median dose of SRT was 50 Gy and the range was $30\~50\;Gy$. Results : Follow-up period ranged from 3 months to 13 months with median of 8 months. After treating SRT to thirteen patients with primary hepatoma, the response of the tumor was examined by abdominal CT : they are classified by 1 complete regression $(7.7\%)$, 7 partial regression $(53.8\%)$, 4 minimal regression $(30.8\%)$, 1 stable disease $(7.7\%)$. The positive responses more than partial remission were 8 patients $(61.5\%)$ after the treatment. The level of serum alpha-fetoprotein (AFP) after the treatment as compared with pretreatment had been $92.3\%$ decreased. There was no severe complication except dyspepsia $84.6\%$, mild nausea $69.2\%$, transient decreased of hepatic function $15.4\%$ and fever $7.7\%$. Conclusion : SRT to the patients with primary hepatoma was potentially suggested to become the safe and more effective tool than the conventional radiotherapy even though there were relatively short duration of follow-up and small numbers to be tested.

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