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Evaluating efficiency of Split VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes (골반 림프선을 포함한 전립선암 치료 시 Split VMAT plan의 유용성 평가)

  • Mun, Jun Ki;Son, Sang Jun;Kim, Dae Ho;Seo, Seok Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.145-156
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    • 2015
  • Purpose : The purpose of this study is to evaluate the efficiency of Split VMAT planning(Contouring rectum divided into an upper and a lower for reduce rectum dose) compare to Conventional VMAT planning(Contouring whole rectum) for prostate cancer radiotherapy involving pelvic lymph nodes. Materials and Methods : A total of 9 cases were enrolled. Each case received radiotherapy with Split VMAT planning to the prostate involving pelvic lymph nodes. Treatment was delivered using TrueBeam STX(Varian Medical Systems, USA) and planned on Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28), AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). Lower rectum contour was defined as starting 1cm superior and ending 1cm inferior to the prostate PTV, upper rectum is a part, except lower rectum from the whole rectum. Split VMAT plan parameters consisted of 10MV coplanar $360^{\circ}$ arcs. Each arc had $30^{\circ}$ and $30^{\circ}$ collimator angle, respectively. An SIB(Simultaneous Integrated Boost) treatment prescription was employed delivering 50.4Gy to pelvic lymph nodes and 63~70Gy to the prostate in 28 fractions. $D_{mean}$ of whole rectum on Split VMAT plan was applied for DVC(Dose Volume Constraint) of the whole rectum for Conventional VMAT plan. In addition, all parameters were set to be the same of existing treatment plans. To minimize the dose difference that shows up randomly on optimizing, all plans were optimized and calculated twice respectively using a 0.2cm grid. All plans were normalized to the prostate $PTV_{100%}$ = 90% or 95%. A comparison of $D_{mean}$ of whole rectum, upperr ectum, lower rectum, and bladder, $V_{50%}$ of upper rectum, total MU and H.I.(Homogeneity Index) and C.I.(Conformity Index) of the PTV was used for technique evaluation. All Split VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : Using DVH analysis, a difference between the Conventional and the Split VMAT plans was demonstrated. The Split VMAT plan demonstrated better in the $D_{mean}$ of whole rectum, Up to 134.4 cGy, at least 43.5 cGy, the average difference was 75.6 cGy and in the $D_{mean}$ of upper rectum, Up to 1113.5 cGy, at least 87.2 cGy, the average difference was 550.5 cGy and in the $D_{mean}$ of lower rectum, Up to 100.5 cGy, at least -34.6 cGy, the average difference was 34.3 cGy and in the $D_{mean}$ of bladder, Up to 271 cGy, at least -55.5 cGy, the average difference was 117.8 cGy and in $V_{50%}$ of upper rectum, Up to 63.4%, at least 3.2%, the average difference was 23.2%. There was no significant difference on H.I., and C.I. of the PTV among two plans. The Split VMAT plan is average 77 MU more than another. All IMRT verification gamma test results for the Split VMAT plan passed over 90.0% at 2 mm / 2%. Conclusion : As a result, the Split VMAT plan appeared to be more favorable in most cases than the Conventional VMAT plan for prostate cancer radiotherapy involving pelvic lymph nodes. By using the split VMAT planning technique it was possible to reduce the upper rectum dose, thus reducing whole rectal dose when compared to conventional VMAT planning. Also using the split VMAT planning technique increase the treatment efficiency.

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Study of East Asia Climate Change for the Last Glacial Maximum Using Numerical Model (수치모델을 이용한 Last Glacial Maximum의 동아시아 기후변화 연구)

  • Kim, Seong-Joong;Park, Yoo-Min;Lee, Bang-Yong;Choi, Tae-Jin;Yoon, Young-Jun;Suk, Bong-Chool
    • The Korean Journal of Quaternary Research
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    • v.20 no.1 s.26
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    • pp.51-66
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    • 2006
  • The climate of the last glacial maximum (LGM) in northeast Asia is simulated with an atmospheric general circulation model of NCAR CCM3 at spectral truncation of T170, corresponding to a grid cell size of roughly 75 km. Modern climate is simulated by a prescribed sea surface temperature and sea ice provided from NCAR, and contemporary atmospheric CO2, topography, and orbital parameters, while LGM simulation was forced with the reconstructed CLIMAP sea surface temperatures, sea ice distribution, ice sheet topography, reduced $CO_2$, and orbital parameters. Under LGM conditions, surface temperature is markedly reduced in winter by more than $18^{\circ}C$ in the Korean west sea and continental margin of the Korean east sea, where the ocean exposed to land in the LGM, whereas in these areas surface temperature is warmer than present in summer by up to $2^{\circ}C$. This is due to the difference in heat capacity between ocean and land. Overall, in the LGM surface is cooled by $4{\sim}6^{\circ}C$ in northeast Asia land and by $7.1^{\circ}C$ in the entire area. An analysis of surface heat fluxes show that the surface cooling is due to the increase in outgoing longwave radiation associated with the reduced $CO_2$ concentration. The reduction in surface temperature leads to a weakening of the hydrological cycle. In winter, precipitation decreases largely in the southeastern part of Asia by about $1{\sim}4\;mm/day$, while in summer a larger reduction is found over China. Overall, annual-mean precipitation decreases by about 50% in the LGM. In northeast Asia, evaporation is also overall reduced in the LGM, but the reduction of precipitation is larger, eventually leading to a drier climate. The drier LGM climate simulated in this study is consistent with proxy evidence compiled in other areas. Overall, the high-resolution model captures the climate features reasonably well under global domain.

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A Thermal Time-Driven Dormancy Index as a Complementary Criterion for Grape Vine Freeze Risk Evaluation (포도 동해위험 판정기준으로서 온도시간 기반의 휴면심도 이용)

  • Kwon, Eun-Young;Jung, Jea-Eun;Chung, U-Ran;Lee, Seung-Jong;Song, Gi-Cheol;Choi, Dong-Geun;Yun, Jin-I.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.8 no.1
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    • pp.1-9
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    • 2006
  • Regardless of the recent observed warmer winters in Korea, more freeze injuries and associated economic losses are reported in fruit industry than ever before. Existing freeze-frost forecasting systems employ only daily minimum temperature for judging the potential damage on dormant flowering buds but cannot accommodate potential biological responses such as short-term acclimation of plants to severe weather episodes as well as annual variation in climate. We introduce 'dormancy depth', in addition to daily minimum temperature, as a complementary criterion for judging the potential damage of freezing temperatures on dormant flowering buds of grape vines. Dormancy depth can be estimated by a phonology model driven by daily maximum and minimum temperature and is expected to make a reasonable proxy for physiological tolerance of buds to low temperature. Dormancy depth at a selected site was estimated for a climatological normal year by this model, and we found a close similarity in time course change pattern between the estimated dormancy depth and the known cold tolerance of fruit trees. Inter-annual and spatial variation in dormancy depth were identified by this method, showing the feasibility of using dormancy depth as a proxy indicator for tolerance to low temperature during the winter season. The model was applied to 10 vineyards which were recently damaged by a cold spell, and a temperature-dormancy depth-freeze injury relationship was formulated into an exponential-saturation model which can be used for judging freeze risk under a given set of temperature and dormancy depth. Based on this model and the expected lowest temperature with a 10-year recurrence interval, a freeze risk probability map was produced for Hwaseong County, Korea. The results seemed to explain why the vineyards in the warmer part of Hwaseong County have been hit by more freeBe damage than those in the cooler part of the county. A dormancy depth-minimum temperature dual engine freeze warning system was designed for vineyards in major production counties in Korea by combining the site-specific dormancy depth and minimum temperature forecasts with the freeze risk model. In this system, daily accumulation of thermal time since last fall leads to the dormancy state (depth) for today. The regional minimum temperature forecast for tomorrow by the Korea Meteorological Administration is converted to the site specific forecast at a 30m resolution. These data are input to the freeze risk model and the percent damage probability is calculated for each grid cell and mapped for the entire county. Similar approaches may be used to develop freeze warning systems for other deciduous fruit trees.