The individual (customized) immobilization has been used to reproduce the patients' set-up on daily base. There are many various devices available commercially. To evaluate dosimetric characteristics of vacuum cushion, we analysed the surface dose and transmission factor for d$_{max}$ when patient is immobilized with vacuum cushion. Experiments were performed with 4 MV (Varian 4/100, USA), 6 MV, 15 MV (Varian CL2100C/D, USA) photon beams and five field sizes (5$\times$5, 10$\times$10, 20$\times$20, 30$\times$30, 40$\times$40 $\textrm{cm}^2$) on each occasion. Outputs were measured from surface of polysterene phantom to d$_{max}$ with four different thicknesses of cushion, which is 12, 32, 48 mm and only vinyl without styroforms. As results, the transmission factor for thicknesses of vacuum cushion was ranged from 0.9953 to 1.0043. The more the thickness of vacuum cushion is thick, the more surface dose delivered to patient is increased. The surface dose vary with the thickness of vacuum cushion for energy and field size. The skin reactions may result. But the variation is not serious in the clinic.
The Journal of Korean Society for Radiation Therapy
/
v.24
no.2
/
pp.189-196
/
2012
Purpose: The sufficiency of skin dose and the reemergence of patient set-up position to the success of skin cancer radiation treatment is a very important element. But the conventional methods to increase the skin dose were used to vacuum cushion, bolus and water tank have several weak points. For this reason, we producted Foxtail Millet Vacuum Cushion and evaluated the efficiency of the Foxtail Millet Vacuum Cushion in skin cancer Radiation treatment. Materials and Methods: We measured absolute dose for 3 materials (Foxtail Millet Vacuum Cushion, bolus and solid water phantom) and compared each dose distribution. We irradiated 6 MV 100 MU photon radiation to every material of 1 cm, 2 cm, 3 cm thickness at three times. We measured absolute dose and compared dose distribution. Finally we inspected the CT simulation and radiation therapy planing using the Foxtail Millet Vacuum Cushion. Results: Absolute dose of Foxtail Millet Vacuum Cushion was similar to absolute dose of bolus and solid water phantom's result in each thickness. it Showed only the difference of 0.1~0.2% between each material. Also the same result in dose distribution comparison. About 97% of the dose distribution was within the margin of error in the prescribed ranges ($100{\pm}3%$), and achieved the enough skin dose (Gross Tumor Volume dose : $100{\pm}5%$) in radiation therapy planing. Conclusion: We evaluated important fact that Foxtail Millet Vacuum Cushion is no shortage of time to replace the soft tissue equivalent material and normal vacuum cushion at the low energy radiation transmittance. Foxtail Millet Vacuum Cushion can simultaneously achieve the enough skin dose in radiation therapy planing with maintaining normal vacuum cushion' function. Therefore as above We think that Foxtail Millet Vacuum Cushion is very useful in skin cancer radiation treatment.
Kim Ki-Hwan;Cho Moon-June;Kang No-Hyun;Kim Dong-Wuk;Kim Jun-Sang;Jang Ji-Young;Kim Jae-Sung
Radiation Oncology Journal
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v.19
no.3
/
pp.287-292
/
2001
Prupose : We analyzed setup errors induced by using air-vacuum cushion as immobilization device in patients with rectal cancer. Materials and methods : We had treated the twenty patients with rectal cancer by 6 MV, 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at prone position. They were separated to two groups, control group, 10 patients using styrofoam, and test group, 10 patients using styrofoam and air-vacuum cushion. We measured errors of posterior field for x, y axis and lateral field for z, y axis with simulation film and EPID image using a matching technique. Results : In control group, the mean displacement values of pelvic bone landmark for x axis and y axis were 0.02 mm. 0.78 mm, respectively and the standard deviations of systematic error were 2.13 mm, 2.40 mm, respectively and the standard deviation of random error were 1.46 mm. 1.51 mm, respectively. In test group, the mean displacement values of x axis and y axis were -0.33 mm. 0.81 mm, respectively and the standard deviations of systematic error were 1.71 mm, 3.08 mm, respectively and the standard deviations of random errors were 1.40 mm. 1.88 mm, respectively. The mean displacement values of z axis and y axis were 2.98 mm. 0.74 mm, respectively and the standard deviations of systematic error were 4.75 mm, 2.65 mm, respectively and standard deviations of random error were 2.69 mm. 1.86 mm, respectively. The statistical difference of field size by using air vacuum cushion between two groups in posterior direction and lateral direction was not shown. Conclusion : We think that use of air-vacuum cushion may not be an advantage for improving setup accuracy in rectal cancer patients.
The Journal of Korean Society for Radiation Therapy
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v.17
no.2
/
pp.95-103
/
2005
Purpose : In the radiosurgery, to obtain CT image to find more accurate tumor position during respiration, and using them, to increase the accuracy of radiation treatment by applying image guided. Materials and Methods : Using the self-made vacuum cushion for the body SRS, CT images were obtained three for each patient during respiration (shallow, inhalation, exhalation). They were transformed to the RTP computer and then were fused. Global GTVs were delineated on the fused images and more appropriated treatment planning was established. Results : We can find the tumor position is moving toward cranio-caudal with max 10 mm margin and volume is transformed. As a result from the comparision of DVH (pre & post radio surgery), we observed about 100% dose to tumor. Conclusion : BSRS was skeptical due to the tumor movement during respiration. More accurate by the combination of the development of immobilization devices and BSRS based on Image Guide, it will be applied to more cases for BSRS.
Magazine of the Korean Society of Agricultural Engineers
/
v.6
no.2
/
pp.816-825
/
1964
1. Outline: The flow of the siphon spillway is very intricate and affected by vacuous condition. It is an intresting problem to make vacuum rapidly in_siphon, i.e, to provoke the perfect siphonaoge with the lowest water-level of overflow. The hydraulic experiments of siphon spillway have practiced at the Masan Lake, Haenam, the province of Junnam and gained rational and economical results which cannot be odtained by calculation. 2. Experiment: The model scale was a half of that of the prototype. 3. Results and discussion: In the experiments of 14 runs, washing, overflow water level, outlet, water level of cushion, phenomenon of water flying and water pressure of every part, etc. were studied. a) The relation of overflow water-level at siphon inlet and deflector When the elevation of the deflector is 10. 65m and the form of deflector O.4m long is the hypotenuse of an $45^{\circ}$ isosceles triangle, the over flow water-level is the minimum, i. e. the siphonage was excellent. There is no effect by the rising of overflow water-Ievel between 11.95m to 1O.65m of deflector elevation (in the first plan, it is 11.05m). But the overflow water-level rises remarkably in the outside region of the above limits. b) The relation of overflow water-level, the length of cushion and standard height of the base. The reduction of the length of cushion brings the rising of overflow waterlevel, and the rising of the standard height of the base brings the rising of overflow water level. For the long cushion length and low standard height of the base, it cannot be expeted to have the falling of overflow water-level. The most satisfactory data were obtained at 5.20m of the base standard height and 6.1m of the length of cushion. The first vah,le planned was 5.70 m and 4.30m.
The vacuum preloading method has been used in many countries for ground improvement and land reclamation works. A sand cushion is required as a horizontal drainage channel for conventional vacuum preloading. In terms of the dredged-fill foundation soil, the treatment effect of the conventional vacuum preloading method is poor, particularly in Tianjin, China, where a shortage of sand exists. To solve this problem, straight-line vacuum preloading without sand is widely adopted in engineering practice to improve the foundation soil. Based on the engineering properties of dredged fill in Lingang City, Tianjin, this paper presents field instrumentation in five sections and analyzes the effect of a prefabricated vertical drain (PVD) layout and a vacuum pumping method on the soft soil ground treatment. Through the arrangement of pore water pressure gauges, settlement marks and vane shear tests, the settlement, pore water pressure and subsoil bearing capacity are analyzed to evaluate the effect of the ground treatment. This study demonstrates that straight-line vacuum preloading without sand can be suitable for areas with a high water content. Furthermore, the consolidation settlement and consolidation degree system is developed based on the grey model to predict the consolidation settlement and consolidation degree under vacuum preloading; the validity of the system is also verified.
Minimizing patient movement during CT-guided lung biopsy is an important factor in the procedure. To minimize movement, a vacuum cushion was used to evaluate its effectiveness. The subjects of this study were 116 patients aged 40 years or older who had good coordination with postural fixation and breathing control. Posture measurements were performed in the supine position, prone position, oblique position, and lateral position according to each position of the lung lesion biopsy lesion. Measurement positions were measured in the anterior, posterior, right, and left positions based on the anatomical posture. In the prone position, the mean difference between the non-use and the use of the posterior was 1.7905, and t=2.913 (p<0.01), and the mean difference between the non-use/use was statistically significant. The difference between the unused and used averages of left was 2.4105, and the difference between the left averages was also significant with t=3.684 (p<0.01). The difference between the unused and used averages of the right was 2.3263, with t=3.791 (p<0.01). The mean difference between unused and used is statistically significant. As a result of statistical analysis, the biopsy of the lung lesion using a fixation device showed less movement in all postures. It is considered that it is meaningful in that it is possible to conduct a more accurate biopsy procedure and minimize the patient's posture movement by using a fixation device during the CT-guided biopsy of the lung lesion.
Purpose: To develop a whole body frame for the purpose of reducing patient motion and minimizing setup error for extra-cranial stereotactic radiotherapy, and to evaluate the repositioning setup error of a patient in the frame. Materials and Methods: The developed whole body frame is composed of a base plate, immobilizer, vacuum cushion, ruler and belts. The dimension of the base plate is 130 cm in length, 50 cm in width and 1 cm in thickness. The material used in the base plate of the frame was bakelite and the immobilizer was made of acetal. In addition, Radiopaque angio-catheter wires were engraved on the base plate for a coordinate system to determine the target localization. The measurement for radiation transmission and target localization is peformed in order to test the utilization of the frame. Also, a Matlab program analyzed the patients setup error by using the patient's setup images obtained from a CCTV camera and digital record recorder (DVR). Results: A frame that is useful for CT simulation and radiation treatment was fabricated. The frame structure was designed to minimize collisions from the changes in the rotation angle of the gantry and to maximize the transmission rate of the Incident radiation at the lateral or posterior oblique direction. The lightening belts may be used for the further reduction of the patient motion, and the belts can be adjusted so that they are not in the way of beam direction. The radiation transmission rates of this frame were measured as 95% and 96% at 10 and 21 MV, respectively. The position of a test target on the skin of a volunteer is accurately determined by CT simulation using the coordinate system in the frame. The estimated setup errors by Matlab program are shown 3.69$\pm$1.60, 2.14$\pm$0.78 mm at the lateral and central chest, and 7.11 $\pm$2.10, 6.54$\pm$2.22 mm at lateral and central abdomen, respectively. The setup error due to the lateral motion of breast is shown as 6.33$\pm$ 1.55 mm. Conclusion: The development and test of a whole body frame has proven very useful and practical in the radiosurgery for extra-cranial cancers. It may be used in determining target localization, and it can be used as a patient immobilization tool. More experimental data should be obtained in order to improve and confirm the results of the patient setup error.
The Journal of Korean Society for Radiation Therapy
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v.33
/
pp.137-144
/
2021
Purpose : The usability of X-Jaw split VMAT was evaluated by comparative analysis of the dose distribution between the treatment plan divided by X-Jaw and Full field VMAT treatment plan in left breast cancer treatment including supraclavicular lymph nodes. Materials and Methods : 10 patients with left breast cancer, including supraclavicular lymph nodes, were simulated using vacuum cushion, and 2 Full field Arc VMAT and 4 X-Jaw split Arc VMAT were planned The treatment plan was designed to include more than 95% of the Planning Target Volume (PTV) and to be minimally irradiated in the surrounding Organ at risk (OAR). Dose analysis of PTV and OAR was performed through dose volume histogram (DVH). Results : The Full field VMAT treatment plan and the X-Jaw split VMAT treatment plan of 10 patients were expressed as average values and compared. The difference between the two treatment plans was not large, with a Conformity index (CI) of 1.05±0.04, 1.04±0.03, and a Homogeneity index (HI) of 1.07±0.008, 1.07±0.009. For OAR, V5 in the left lung is 56.1±6.50%, 50.4±6.30%, and V20 is 20.0±4.15%, 13.52±3.61%. Compared to Full field VMAT, V5 decreased by 10.0% V20 by 32.6% in X-Jaw split VMAT. The V30 of the heart is 3.68±1.85%, 2.23±1.52%, and the Mean dose is 8.93±1.65 Gy, 7.67±1.52 Gy. In the X-Jaw split VMAT, V30 decreased by 39.3% and the Mean dose decreased by 14.1%. The left lung and heart, which are normal tissues, were found to have a statistical significance of that p-value is less than 0.05. Conclusion : In the case of left breast cancer treatment, which includes Supraclavicular lymph nodes with a large PTV volume and a length of X Jaw of 15 cm or more, the X-Jaw split VMAT shows improved dose distribution, which can reduce radiation dose of OAR such as lungs and heart, while maintaining similar PTV coverage with HI and CI equivalent to Full field VMAT. It is thought to be effective in reducing radiation complications.
Kim Jae-Gyoun;Lee Dong-Han;Lee Dong-Hoon;Kim Mi-Sook;Cho Chul-Koo;Yoo Seong-Yul;Yang Kwang-Mo;Oh Won-Yong;Ji Young-Hoon
Progress in Medical Physics
/
v.15
no.4
/
pp.179-185
/
2004
To deal with tumor motion from respiration is one of the important issues for the advanced treatment techniques, such as the intensity modulated radiation therapy (IMRT), the image guided radiation therapy (IGRT), the three dimensional conformal therapy (3D-CRT) and the Cyber Knife. Studies including the active breath control (ABC) and the gated radiation therapy have been reported. Authors have developed the device for reducing the respiration effects and the diaphragm motions with this device were observed to determined the effectiveness of the device. The device consists of four belts to immobilize diaphragm motion and the vacuum cushion. Diaphragm motions without and with device were monitored fluoroscopically. Diaphragm motion ranges were found to be 1.14 ~ 3.14 cm (average 2.14 cm) without the device and 0.72~1.95 cm (average 1.16 cm) with the device. The motion ranges were decreased 20 ~ 68.4% (average 44.9%.) However, the respiration cycle was increased from 4.4 seconds to 3.7 seconds. The CTV-PTV margin could be decreased significantly with the device developed in this study, which may be applied to the treatments of the tumor sited diaphragm region.
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