• Progress in Medical Physics
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• v.24 no.3
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• pp.145-153
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• 2013

Stereotactic body radiation therapy (SBRT) is increasingly used to treat spinal metastases. To achieve the highest steep dose gradients and conformal dose distributions of target tumors, intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques are essential to spine radiosurgery. The purpose of the study was to qualitatively compare IMRT and VMAT techniques with International Spine Radiosurgery Consortium (ISRC) contoured consensus guidelines for target volume definition. Planning target volume (PTV) was categorized as TB, $T_{BPT}$ and $T_{ST}$ depending on sectors involved; $T_B$ (vertebral body only), $T_{BPT}$ (vertebral body+pedicle+transverse process), and $T_{ST}$ (spinous process+transverse process). Three patients treated for spinal tumor in the cervical, thoracic, and lumbar region were selected. Eacg tumor was contoured by the definition from the ISRC guideline. Maximum spinal cord dose were 12.46 Gy, 12.17 Gy and 11.36 Gy for $T_B$, $T_{BPT}$ and $T_{ST}$ sites, and 11.81 Gy, 12.19 Gy and 11.99 Gy for the IMRT, RA1 and RA2 techniques, respectively. Average fall-off dose distance from 90% to 50% isodose line for $T_B$, $T_{BPT}$, and $T_{ST}$ sites were 3.5 mm, 3.3 mm and 3.9 mm and 3.7 mm, 3.7 mm and 3.3 mm for the IMRT, RA1 and RA2 techniques, respectively. For the most complicated target $T_{BPT}$ sites in the cervical, thoracic and lumbar regions, the conformity index of the IMRT, RA1 and RA2 is 0.621, 0.761 and 0.817 and 0.755, 0.796 and 0.824 for rDHI. Both IMRT and VMAT techniques delivered high conformal dose distributions in spine stereotactic radiosurgery. However, if the target volume includes the vertebral body, pedicle, and transverse process, IMRT planning resulted in insufficient conformity index, compared to VMAT planning. Nevertheless, IMRT technique was more effective in reducing the maximum spinal cord dose compared to RA1 and RA2 techniques at most sites.

• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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• pp.403-409
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• 2000

Objectives: Due to the heterogeneous receptor distribution and changes of receptor status over time, the biochemical measurement of estrogen receptor status of biopsy specimens is not sufficient to diagnose breast cancer. As a result, I-123 labeled estradiols have been applied for the diagnosis. The purpose of this study was to develop a suitable radioligand for imaging estrogen receptor-positive human breast tumors. Methods: Among the various estradiol derivatives, $17{\alpha}-[^{123}I]$iodovinyl estradiol ($[^{123}I]$IVE) has been prepared from $17{\alpha}$-ethynyl estradiol. Labeling of $E-17{\alpha}-[^{123}I]$iodovinyl estradiol (E-$[^{123}I]$IVE) was carried out using peracetic acid with $[^{123}I]NaI\;and\;Z-[^{123}I]IVE$ labelling was archived using chloamine-T/HCl solution with $[^{123}I]$NaI. Labeling yield was determined by silica thin-layer chromatography (TLC) and radiochemical purity was measured by high performance liquid chromatography (HPLC). The biodistribution of E-$[^{123}I]$IVE was measured in immature female rats at 60 min, 120 min and 300 min after injection. Results: The labeling yield of two isomers was 92% and 94% ($E-[^{123}I]IVE\;and\;Z-[^{123}I]IVE$, respectively). The radiochemical purity was more than 98% after purification. The highest uptake was observed at 120 min in uterus (3.11% ID/g for E-$[^{123}I]$IVE). Conclusion: These results suggest the possibility of using E-$[^{123}I]$IVE as an imaging agent for the evaluation of the evaluation of the presence of estrogen receptor in patients with breast cancer.

• Investigative Magnetic Resonance Imaging
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• v.18 no.1
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• pp.52-58
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• 2014

Purpose : To establish a pH measurement system for a mouse tumor study using a clinical scanner, to develop the $^1H$ and 31P radio frequency (RF) coil system and to test pH accuracy with phantoms. Materials and Methods: The $^1H$ and the $^{31}P$ surface coils were designed to acquire signals from mouse tumors. Two coils were positioned orthogonally for geometric decoupling. The pH values of various pH phantoms were calculated using the $^1H$ decoupled $^{31}P$ MR spectrum with the Henderson-Hasselbalch equation. The calculated pH value was compared to that of a pH meter. Results: The mutual coil coupling was shown in a standard $S_{12}$. Coil coupling ($S_{12}$) were -73.0 and -62.3 dB respectively. The signal-to-noise ratio (SNR) obtained from the homogeneous phantom $^1H$ image was greater than 300. The high resolution in vivo mice images were acquired using a $^{31}P$-decoupled $^1H$ coil. The pH values calculated from the $^1H$-decoupled $^{31}P$ spectrum correlated well with the values measured by pH meter ($R^2$=0.97). Conclusion: Accurate pH values can be acquired using a $^1H$-decoupled $^{31}P$ RF coil with a clinical scanner. This two-surface coil system could be applied to other nuclear MRS or MRI.

• The Journal of Korean Society for Radiation Therapy
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• v.18 no.1
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• pp.7-12
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• 2006

Purpose: This is for the purpose to help the bill related to technologists be systematic and unitary by carefully analyzing a legislation, an enforcement ordinance, and enforcement regulations in the connection with the radiological worker and the radiation workers from the law and regulations related to technologists. Materials and Methods: Concerning technologists, a legislation, an enforcement ordinance, and enforcement regulations for a sort of medical technician, regarding the radiological worker, the rules of diagnosis radiation equipment safety management, and concerning the radiation workers, atomic energy law, an enforcement ordinance and enforcement regulations were gathered, compared with one another, and analyzed. Results: Among technologists, in the case of working in the department of diagnosis radiation, the title 'Radiological Worker' is used by the Medical Service Law, and in the case of working in the department of radiation tumors or the one of nucleus medicine, the title 'Radiation Workers' is used by the Atomic Energy Law. Conclusion: Besides the technical term that is used by characteristic tasks, unification of the terms that can be used in common is necessary for sure. And when a legislation, an enforcement ordinance, enforcement regulations, and notification, things like that in the radiation field are amended, certainly they should be done by mutual agreement through negotiation between the organization related to radiation and the governmental organization.

• Radiation Oncology Journal
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• v.8 no.1
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• pp.7-15
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• 1990

The ultimate objective of our experiment is to obtain the precise distribution of temperature in malignant tumors occurring in cerebral parenchyme of human beings when we will carry out interstitial hyperthermia in the near future. To achieve this purpose, first of all, it is necessary to make an attempt at performing interstitial hyperthermia in vivo under the similar condition of human beings. Therefore, we chose cats as materials much alike tissue characteristics of human beings. Moreover, it is also necessary to get the basic data from dynamic phantom in order to standardize and compare results obtained from interstitial hyperthermia carried out in cats. By having performed these experiments we got the following results. 1) On doing interstitial hyperthermia with 915 MHz microwave, the possible treated volume was 2 cm by 2 cm by 6 cm according to $50\%$ specific absorption rate (SAR). 2) The distribution of temperature within non-circulated static phantom was much the same as power density in air, but we observed that the temperature, within $5\~10$ minutes, rose to more higher than $55^{\circ}C$ not measured with Ga-As fiberoptic thermistor which was not impeded by microwave after performing interstitial hyperthermia. 3) Within dynamic phantom in which normal saline was circulating, temperature reached steady state which was maintained for more than 45 minutes through transit period in 5 minutes after starting interstitial hyperthermia. 4) When we interrupted circulation in the dynamic phantom, we observed that temperature rose to the same level as in the static phantom. 5) We could carry out interstitial hyperthermia safely when we used the generating power below 5 watts. Abrupt interruption of circulation caused a rapid increase in temperature. Times taking to rise to maximum $55^{\circ}C$ were 15.2 minutes (SE 0.4),9.7 minutes (SE 0.3), and 6.3 min-utes (SE 0.4) respectively with generating powers of 5,10, and 15 watts.

• 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.

• Radiation Oncology Journal
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• v.19 no.1
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• pp.40-44
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• 2001

Purpose : To evaluate effect and tolerance of external beam radiotherapy for carcinoma of the prostate and define the optimal radiotherapeutic regimen. Materials and methods : We retrospectively analyzed the records of 60 patients with prostate cancer who were treated with external beam radiotherapy with curative intent in our institution between September, 1987 and March, 2000. Histologic diagnosis was established by transurethral resection or ultrasonography guided biopsy. The major presenting symptoms were a nodule at routine prostatic examination and frequency and urgency of urination, along with dysuria. The median age was 63 years with range of 51 to 87 years. There were 6 patients in Stage A, 20 in Stage 8, 26 in Stage C, and 8 in Stage Dl. All patients were treated with megavoltage equipment producing 10 MV photons. The 4 field pelvic brick technique was used to a dose of 45 Gy or 50.4 Gy at 1.8 Gy per day in 5 to 6 weeks, after which a small boost field was delivered 2.0 Gy per day to a total dose of 66 to 70 Gy. The follow-up period ranged from 1 to 8 years. Results : Actuarial 5-year and 7-year survival rates for Stage A, B, C, and D1 were $100\%\;and\;84\%$, $83\%\;and\;72\%$, $67\%\;and\;54\%$, and $v$, respectively. The corresponding 5-year and 7-year relapse free survival rates were $84\%\;and\;84\%$, $77\%\;and\;67\%$, $48\%\;and\;40\%$, and $33\%\;and\;25\%$, respectively. Relapse free 5-year survival rates for Stage B were $80\%,\;80\%,\;and\;50\%$ for well, moderately, and poorly differentiated tumors, respectively. These were $64\%,\;44\%,\;and\;33\%$ for Stage C, respectively. The local control rates at 5 years were $84\%,\;85\%,\;78\%,\;and\;60\%$ for Stage A, B, C, and D1, respectively. Mild to moderate complications were observed in $22\%$ of patients. Severe complications requiring surgical procedures were documented in only $3\%$ of patients. Conclusion : This study confirms that external beam irradiation is an effective and safe treatment for prostatic cancer, providing long-term local control and good survival with acceptable complications.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.150-156
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• 2000

Purpose : Stereotactic radiation therapy (SRT) can deliver highly focused radiation to a small and spherical target lesion with very high degree of mechanical accuracy. For non-spherical and large lesions, however, inclusion of the neighboring normal structures within the high dose radiation volume is inevitable in SRT This is to report the beam shaping using the partial closure of the independent jaw in SRT and the verification of dose calculation and the dose display using a home-made soft ware. Materials and Methods : Authors adopted the idea to partially close one or more independent collimator jaw(5) in addition to the circular collimator cones to shield the neighboring normal structures while keeping the target lesion within the radiation beam field at all angles along the arc trajectory. The output factors (OF's) and the tissue-maximum ratios (TMR's) were measured using the micro ion chamber in the water phantom dosimetry system, and were compared with the theoretical calculations. A film dosimetry procedure was peformed to obtain the depth dose profiles at 5 cm, and they were also compared with the theoretical calculations, where the radiation dose would depend on the actual area of irradiation. Authors incorporated this algorithm into the home-made SRT software for the isodose calculation and display, and was tried on an example case with single brain metastasis. The dose-volume histograms (DVH's) of the planning target volume (PTV) and the normal brain derived by the control plan were reciprocally compared with those derived by the plan using the same arc arrangement plus the independent collimator jaw closure. Results : When using 5.0 cm diameter collimator, the measurements of the OF's and the TMR's with one independent jaw set at 30 mm (unblocked), 15.5 mm, 8.6 mm, and 0 mm from th central beam axis showed good correlation to the theoretical calculation within 0.5% and 0.3% error range. The dose profiles at 5 cm depth obtained by the film dosimetry also showed very good correlation to the theoretical calculations. The isodose profiles obtained on the home-made software demonstrated a slightly more conformal dose distribution around the target lesion by using the independent jaw closure, where the DVH's of the PTV were almost equivalent on the two plans, while the DVH's for the normal brain showed that less volume of the normal brain receiving high radiation dose by using this modification than the control plan employing the circular collimator cone only. Conclusions : With the beam shaping modification using the independent jaw closure, authors have realized wider clinical application of SRT with more conformal dose planning. Authors believe that SRT, with beam shaping ideas and efforts, should no longer be limited to the small spherical lesions, but be more widely applied to rather irregularly shaped tumors in the intracranial and the head and neck regions.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.193-200
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• 2007

Purpose: This study evaluated the pretreatment expression patterns of MDM2, p53, and pRb proteins to determine if the expression patterns could predict the outcome of concurrent chemoradiotherapy (CCRT) for esophageal squamous cell carcinoma and aid in the decisions for the selection of treatment modalities. Materials and Methods: Fifty-one patients that were treated with definitive chemoradiotherapy for stage $I{\sim}IVa$ esophageal squamous cell carcinoma were selected for this study. Radiotherapy was administered with daily $1.8{\sim}2\;Gy$ fractions up to a median dose of 54 Gy for primary tumors, and with four cycles of cisplatin/5-fluorouracil chemotherapy that was administered every 4 weeks, the first two cycles of which were administered concurrently with radiotherapy. Expression of MDM2, p53, and pRb was investigated by immunohistochemical analysis using pretreatment biopsy specimens. Results: MDM2, p53, and pRb were detected with high immunoreactivity in 19.6%, 27.5%, and 66.7% of the patients, respectively. However, there was no significant correlation between expression of these factors and clinical outcome. By the use of multivariate analysis with nine covariates-age, tumor location, tumor length, stage, pathological response, clinical response, MDM2 expression, p53 expression, and pRb expression, only pathological response and stage were significant factors for cause-specific survival. Conclusion: Expression of MDM2, p53, and pRb was not found to be clinically significant for predicting outcomes after CCRT in this study. Further studies with a larger patient population and longer follow-up periods are needed to re-evaluate the expression pattern and to identify new predictors for CCRT response.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.201-205
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• 2007

Purpose: This retrospective study was conducted to assess outcome and to determine the prognostic factors in patients with a desmoid tumor treated with postoperative radiotherapy. Materials and Methods: Twenty-seven patients with a desmoid tumor who were treated with postoperative radiotherapy between June 1984 and October 2005 were analyzed. There were 13 male and 14 female patients. The age of the patients ranged from 3 to 79 years (median age, 28 years). Tumors were located in an extra-abdominal area (21 cases), and in the abdominal walls (6 cases). The tumor size ranged from 2.5 to 25 cm (median size, 7.5 cm) in the largest linear dimension. Thirteen cases received radiotherapy after initial surgery, and 14 recurrent cases received radiotherapy after additional surgery. The total radiation dose given was $45{\sim}66$ Gy (median dose, 59.4 Gy), and the fraction size was $1.8{\sim}2.0$ Gy. Results: The median follow-up period was 61 months (range, $12{\sim}203$ months). Two patients developed local progression and six patients experienced local recurrence. The 5-year disease-free survival rate and the 5-year progression-free survival rate were 61 % and 70%, respectively. Wide local excision was associated with better disease free survival with statistical significance (p=0.028). Radiotherapy after initial surgery (p=0.046) and a higher radiation dose of more than 60 Gy (p=0.049) were associated with better progression free survival with statistical significance. At the time of the last follow-up, the number of additional surgeries was higher in patients that received radiotherapy after reoperation (p<0.001). Conclusion: Radiotherapy after the initial operation improved local control and decreased the number of subsequent operations. Thus, postoperative radiotherapy after an initial operation is recommended in patients with a high risk of recurrence for a desmoid tumor.