Purpose: To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. Materials and Methods: A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. Results: In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. Conclusion: When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.
The Journal of Korean Society for Radiation Therapy
/
v.7
no.1
/
pp.15-31
/
1995
The radiosurgery treatment is one time, non surgical approach to the treatment of patients with intracranial disorders whose conditions would be difficult or dangerous to treat with conventional sugical procedures. The LINAC based radiosurgery is based on the combination of multiple isocentric arc irradiation with small fields centered in the stereotactic target. The absorption of the beam in a tissue equivalent medium, such as water, as well as the uniformity, or profile, of the beam must be precisely documented. The beam characteristics and dosimetric measurememts of the 6MV X-ray beam from a ML-6M linear accelerator are examined. The percent depth dose (PDD) and beam profile (including flatness, symmetry and penumbra) is calibrated with the radiosurgery cone in water phantom. The cone is made of lead which size is from $10{\times}10mm{\phi}$ to $30{\times}30mm{\phi}$ All of these dosimetric measurements sufficiently characterized the beam to permit safe clinical use.
The purpose of this study was to improve the accuracy of effective atomic number (EAN) and relative electron density (RED) using a polynomial-based calibration method using dual-energy CT images. A phantom composed of 11 tissue-equivalent materials was acquired with dual-energy CT to obtain low- and high-energy images. Using the acquired dual-energy images, the ratio of attenuation of low- and high-energy images for EAN was calibrated based on Stoichiometric, Quadratic, Cubic, Quartic polynomials. EAN and RED were extracted using each calibration method. As a result of the experiment, the average error of EAN using Cubic polynomial-based calibration was minimum. Even in the RED image extracted using EAN, the error of the Cubic polynomial-based RED was minimum. Cubic polynomial-based calibration contributes to improving the accuracy of EAN and RED, and would like to contribute to accurate diagnosis of lesions in CT examinations or quantification of various materials in the human body.
Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.
Purpose: Brain SPECT study is more sensitive to motion than other studies. Especially, when applying 1-day subtraction method for Diamox SPECT, it needs shorter study time in order to prevent reexamination. We were required to have new study condition and analysing method on dual detector system because triple head camera in Seoul National University Hospital is to be disposed. So we have tried to increase image quality and make the dual and triple head to have equivalent study time by using a new analysing program. Materials and Methods: Using IEC phantom, we estimated contrast, SNR and FWHM. In Hoffman 3D brain phantom which is similar with real brain, we were on the supposition that 5% of injected doses were distributed in brain tissue. To compare with existing FBP method, we used fan-beam collimator. And we applied 15 sec, 25 sec/frame for each SEPCT studies using LEHR and LEUHR. We used OSEM2D and Onco-flash3D reconstruction method and compared reconstruction methods between applied Gaussian post-filtering 5mm and not applied as well. Attenuation correction was applied by manual method. And we did Brain SPECT to patient injected 15 mCi of $^{99m}Tc$-HMPAO according to results of Phantom study. Lastly, technologist, MD, PhD estimated the results. Results: The study shows that reconstruction method by Flash3D is better than exiting FBP and OSEM2D when studied using IEC phantom. Flowing by estimation, when using Flash3D, both of 15 sec and 25 sec are needed postfiltering 5 mm. And 8 times are proper for subset 8 iteration in Flash3D. OSEM2D needs post-filtering. And it is proper that subset 4, iteration 8 times for 15sec and subset 8, iteration 12 times for 25sec. The study regarding to injected doses for a patient and study time, combination of input parameter-15 sec/frame, LEHR collimator, analysing program-Flash3D, subset 8, iteration 8times and Gaussian post-filtering 5mm is the most appropriate. On the other hands, it was not appropriate to apply LEUHR collimator to 1-day subtraction method of Diamox study because of lower sensitivity. Conclusions: We could prove that there was also an advantage of short study time effectiveness in Dual camera same as Triple gamma camera and get great result of alternation from existing fan-beam collimator to parallel collimator. In addition, resolution and contrast of new method was better than FBP method. And it could improve sensitivity and accuracy of image because lesser subjectivity was input than Metz filter of FBP. We expect better image quality and shorter study time of Brain SPECT on Dual detector system.
The Journal of Korean Society for Radiation Therapy
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v.18
no.2
/
pp.75-80
/
2006
Purpose: In radiation therapy, precise calculation of dose toward malignant tumors or normal tissue would be a critical factor in determining whether the treatment would be successful. The Radiation Treatment Planning (RTP) system is one of most effective methods to make it effective to the correction of dose due to CT number through converting linear attenuation coefficient to density of the inhomogeneous tissue by means of CT based reconstruction. Materials and Methods: In this study, we carried out the measurement of CT number and calculation of mass density by using RTP system and the homemade inhomogeneous tissue Phantom and the values were obtained with reference to water. Moreover, we intended to investigate the effectiveness and accuracy for the correction of inhomogeneous tissue by the CT number through comparing the measured dose (nC) and calculated dose (Percentage Depth Dose, PDD) used CT image during radiation exposure with RTP. Results: The difference in mass density between the calculated tissue equivalent material and the true value was ranged from $0.005g/cm^3\;to\;0.069g/cm^3$. A relative error between PDD of RTP and calculated dose obtained by radiation therapy of machine ranged from -2.8 to +1.06%(effective range within 3%). Conclusion: In conclusion, we confirmed the effectiveness of correction for the inhomogeneous tissues through CT images. These results would be one of good information on the basic outline of Quality Assurance (QA) in RTP system.
Purpose: The purpose of this study was to measure the absorbed dose and to calculate the effective dose for one periapical radiography using the portable and wall type dental X-ray machines. Materials and methods: Thermoluminescent chips were placed at 25 sites throughout the layers of the head and neck of a tissue-equivalent human skull phantom. The man phantom was exposed with the portable and wall type dental X-ray machines. For one periapical radiography taken by portable dental X-ray machine, the exposure setting was 60 kVp, 2 mA and 0.2 seconds, while for one periapical radiography taken by wall type dental X-ray machine, exposure setting was 70 kVp, 8 mA and 0.074 seconds. Absorbed dose measurements were performed and equivalent doses to individual organs were summed using ICRP 103 to calculate effective dose. Results: In the upper anterior periapical radiography using portable dental X-ray machine and in the lower posterior periapical radiography using both machines, the highest absorbed dose was recorded at the mandible body. The effective dose in upper anterior periapical radiography using portable and wall type dental X-ray machines was $4{\mu}Sv$, $2{\mu}Sv$, respectively. In the lower posterior periapical radiography, the effective dose for each portable and wall type dental X-ray machines was $6{\mu}Sv$, $2{\mu}Sv$. Conclusion: It was recommended that the operator use prudently potable dental X-ray machine because that the effective dose in the periapical radiography using wall type dental X-ray machine was lower than that in the periapical radiography using portable dental X-ray machine.
The perturbation of dose distribution adjacent to cavities in high energy electron has shown that the percentage of dose increase varies markedly as a function of the build-up layer, the length and thickness of the cavities, and the electron energy. The dose distribution showed that cavities similar in size to those encountered in the head and neck measured by industrial film dosimetry and corrected by ionization chambers. The most increased doses by measuring are resulted in a localized dose of up to 130% of that measured at the depth of maximum dose within a homogeneous tissue equivalent phantom. The measured values and correction factors of dose perturbation due to air cavities showed in diagrams and would be summarized as follows. 1. In $8{\sim}12MeV$ electron beams, the most marked dose is observed when the build-up layer thickness is 0.5cm and cavity volume is $2{\times}2{\times}2cm^3$. 2. The highest dose point is located under cavity when the energy is increased and cavity length is longer. 3. The cavity length at which the maximum percentage dose occurs decreases with increasing energy. 4. The highest percentage cavity doses are obtained when the energy is high, the build-up layer is thin, the thickness of the cavity is large, and the length of the cavity is approximately 1 to 3cm. 5. The doses of upper portion of cavity are less than the standard dose distribution as 5 to 10%. 6. The maximum range of electron beam are extended as much as thickness of cavity. 7. A cavity having a length of 5cm closely approximates a cavity of infinite length.
The time domain methods of estimating the attenuation coefficient are generally based on the analysis of statisical properties of the reflected echoes form an attenuating medium. Hence, it is often required to have a large number of data samples in order to obtain a statistically stable estimation result. In the attenuation estimation problem, this means that many different speckle patterns are required in the spatial resolution volume of an attenLlation image. In this paper, by using the fact that the speckle pattern Is sensitive to the point spread function of the ultrasound beam, we suggest a method to generate the statiscally uncorrelated or slightly correlated data samples in a given region by rotating a linear transducer and carrying out lateral scans for all rotating angles. This technique is applied to the entropy method for attenuation estimation proposed recently by the authors where the performance is verified by experiments using a tissue equivalent phantom.
Accurate measurement of the absorbed dose and the effective dose is required in dental panoramic radiography involving relatively low energy with a rotational X-ray tube system using long exposures. To determine the effectiveness of measuring the irradiation by using passive dosimetry, we compared the entrance skin doses by using a radiophotoluminescent glass dosimeter (RPL) and an optically stimulated luminescence detector (OSL) in a phantom model consisting of nine and 31 transverse sections. The parameters of the panoramic device were set to 80 kV, 4 mA, and 12 s in the standard program mode. The X-ray spectrum was applied in the same manner as the panoramic dose by using the SpekCalc Software. The results indicated a mass attenuation coefficient of $0.008226cm^2/g$, and an effective energy of 34 keV. The equivalent dose between the RPL and the OSL was calculated based on a product of the absorbed doses. The density of the aluminum attenuators was $2.699g/cm^3$. During the panoramic examination, tissue absorption doses with regard to the RPL were a surface dose of $75.33{\mu}Gy$ and a depth dose of $71.77{\mu}Gy$, those with regard to the OSL were surface dose of $9.2{\mu}Gy$ a depth dose of $70.39{\mu}Gy$ and a mean dose of $74.79{\mu}Gy$. The effective dose based on the International Commission on Radiological Protection Publication 103 tissue weighting factor for the RPL were $0.742{\mu}Sv$, $8.9{\mu}Sv$, $2.96{\mu}Sv$ and those for the OSL were $0.754{\mu}Sv$, $9.05{\mu}Sv$, and $3.018{\mu}Sv$ in the parotid and sublingual glands, orbit, and thyroid gland, respectively. The RPL was more effective than the OSL for measuring the absorbed radiation dose in low-energy systems with a rotational X-ray tube.
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