• 대한치과교정학회지
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• 제47권4호
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• pp.238-247
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• 2017

Objective: The aim of this study was to compare recycled and unused orthodontic miniscrews to determine the feasibility of reuse. The comparisons included both miniscrews with machined surfaces (MS), and those with etched surfaces (ES). Methods: Retrieved MS and ES were further divided into three subgroups according to the assigned recycling procedure: group A, air-water spray; group B, mechanical cleaning; and group C, mechanical and chemical cleaning. Unused screws were used as controls. Scanning electron microscopy, energy-dispersive X-ray spectrometry, insertion time and maximum insertion torque measurements in artificial bone, and biological responses in the form of periotest values (PTV), bone-implant contact ratio (BIC), and bone volume ratio (BV) were assessed. Results: Morphological changes after recycling mainly occurred at the screw tip, and the cortical bone penetration success rate of recycled screws was lower than that of unused screws. Retrieved ES needed more thorough cleaning than retrieved MS to produce a surface composition similar to that of unused screws. There were no significant differences in PTV or BIC between recycled and unused screws, while the BV of the former was significantly lower than that of the latter (p < 0.05). Conclusions: These results indicate that reuse of recycled orthodontic miniscrews may not be feasible from the biomechanical aspect.

• 한국의학물리학회지:의학물리
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• 제13권2호
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• pp.104-108
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• 2002

세기조절방사선치료(Intensity Modulated Radiation Therapy, IMRT)는 기존의 방사선치료에 비해 암조직에는 더 많은 선량을 조사하면서, 주위 정상조직과 중요 장기에는 더 적은 선량이 조사되게 하는 가장 이상적인 치료법 중 하나로 알려져 있다. 뇌종양에서 치료계획자의 의도대로 세기조절방사선치료계획을 시행하여 4 MV, 6 MV, 15 MV의 에너지에 따른 선량분포 특성과 DVH를 살펴보았다. 종양 표적이 있는 오른쪽 뇌간에서 최대 조사선량은 4 MV, 6 MV, 15 MV에서 4 MV에 대해 10.1％, 8.4％의 차이를, 오른쪽 눈에서는 5.2％, 2.7％의 차이를 나타내고 있지만, 왼쪽 뇌간과 눈, 그리고 시신경 교차와 뇌간은 1.7％에서 5.2％의 차이를 나타내었다. 뇌종양에서 세기조절방사선치료계획을 수행한 결과 4 MV, 6 MV, 15 MV의 에너지의 차이에 따른 선량분포특성과 DVH를 비교검토 해본 결과 PTV와 특정 장기에 조사되는 방사선량이 1.7％에서 10.1％ 까지 차이를 나타내었지만, 이것은 한 지점에 조사되는 선량이며, 전체적인 비교에서 본다면 세기방사선치료계획을 시행한 9문 조사에서 에너지의 의존성이 없는 것으로 사료된다.

• 한국의학물리학회지:의학물리
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• 제29권4호
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• pp.157-163
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• 2018

Plans converted using dose-volume-histogram-based plan conversion (DPC) were evaluated by comparing them to the original plans. Changes in the dose volumetric (DV) parameters of five volumetric modulated arc therapy (VMAT) plans for head and neck (HN) cancer and five VMAT plans for prostate cancer were analyzed. For the HN plans, the homogeneity indices (HIs) of the three planning target volumes (PTV) increased by 0.03, 0.02, and 0.03, respectively, after DPC. The maximum doses to the PTVs increased by 1.20, 1.87, and 0.92 Gy, respectively, after DPC. The maximum doses to the optic chiasm, optic nerves, spinal cord, brain stem, lenses, and parotid glands increased after DPC by approximately 4.39, 3.62, 7.55, 7.96, 1.77, and 6.40 Gy, respectively. For the prostate plans after DPC, the HIs for the primary and boost PTVs increased by 0.05 and 0.03, respectively, and the maximum doses to each PTV increased by 1.84 and 0.19 Gy, respectively. After DPC, the mean doses to the rectum and femoral heads increased by approximately 6.19 and 2.79 Gy, respectively, and those to the bladder decreased by 0.20 Gy when summing the primary and boost plans. Because clinically unacceptable changes were sometimes observed after DPC, plans converted by DPC should be carefully reviewed before actual patient treatment.

• 대한방사선기술학회지:방사선기술과학
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• 제44권6호
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• pp.663-669
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• 2021

The purpose of this study was to evaluate the usefulness of the rice bolus for upper-lower extremity radiation therapy by Tomotherapy. The computed tomography images were obtained for air, water, and rice bolus. The average and standard deviation of the Hounsfield unit (HU) were measured for image evaluation. The conformity index (CI) and homogeneity index (HI) were calculated for dose distribution of the planning target volume (PTV) which was treated by direct mode with gantry angle (90 and 270 angle). The point dose of a total of ten axial planes was measured to confirm the different regions. The mean of HU was -999.72 ± 0.72 at the air. The water and rice bolus were -0.13 ± 1.65 and -170 ± 27.2, respectively. The CI (HI) of PTV was 0.96 (1.36) at the air. 0.95 (1.04) at the water bolus, and 0.95 (1.04) at the rice bolus. The maximum dose for air was 136 cGy which is about 32% higher than 103 cGy for water and 104 cGy for rice bolus. There was a statistical difference for point dose between air and water including rice bolus (p=0.04), however, no statistical difference between water and rice bolus (p=0.579).The rice bolus phantom for extremities radiation therapy could be not only the optimized dose distribution but also the convenience and equipment safety at Tomotherapy. However, additional research will be necessary to more accurately verify the clinical usefulness of rice bolus phantom due to not enough examination.

• 한국의학물리학회지:의학물리
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• 제32권4호
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• pp.130-136
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• 2021

Purpose: The Halcyon radiotherapy platform at Groote Schuur Hospital was delivered with a factory-configured analytical anisotropic algorithm (AAA) beam model for dose calculation. In a recent system upgrade, the Acuros XB (AXB) algorithm was installed. Both algorithms adopt fundamentally different approaches to dose calculation. This study aimed to compare the dose distributions of cervical carcinoma RapidArc plans calculated using both algorithms. Methods: A total of 15 plans previously calculated using the AAA were retrieved and recalculated using the AXB algorithm. Comparisons were performed using the planning target volume (PTV) maximum (max) and minimum (min) doses, D95%, D98%, D50%, D2%, homogeneity index (HI), and conformity index (CI). The mean and max doses and D2% were compared for the bladder, bowel, and femoral heads. Results: The AAA calculated slightly higher targets, D98%, D95%, D50%, and CI, than the AXB algorithm (44.49 Gy vs. 44.32 Gy, P=0.129; 44.87 Gy vs. 44.70 Gy, P=0.089; 46.00 Gy vs. 45.98 Gy, P=0.154; and 0.51 vs. 0.50, P=0.200, respectively). For target min dose, D2%, max dose, and HI, the AAA scored lower than the AXB algorithm (41.24 Gy vs. 41.30 Gy, P=0.902; 47.34 Gy vs. 47.75 Gy, P<0.001; 48.62 Gy vs. 50.14 Gy, P<0.001; and 0.06 vs. 0.07, P=0.002, respectively). For bladder, bowel, and left and right femurs, the AAA calculated higher mean and max doses. Conclusions: Statistically significant differences were observed for PTV D2%, max dose, HI, and bowel max dose (P>0.05).

• 대한방사선치료학회지
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• 제31권2호
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• pp.51-63
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• 2019

목 적: 유방암 방사선치료 시 호흡이나 부종으로 인한 유방 변화를 고려하여 치료계획을 하여야 한다. 본 연구는 부분절제술을 시행한 좌측 유방암 환자의 세기조절 방사선치료 시 치료 용적의 변화에 따른 Virtual Bolus(VB) 기법의 유용성을 평가하고자 하였다. 대상 및 방법: 본원에서 유방보존술 후 방사선치료를 받은 환자 10명을 대상으로 하였고 VMAT 과 IMRT에서 VB를 적용한 치료계획과 적용하지 않은 치료계획을 각각 수립하여 유방의 변화에 따른 선량을 비교하였다. 유방에 변화가 없을 경우 VMAT_NoVB와 VMAT_VB에서 치료 용적의 V95%, HI, CI와 Ipsilateral Lung의 Dmean, V5, V20, V30, Heart의 Dmean을 비교 분석하였고 IMRT도 동일한 방법으로 진행하였다. 또한 치료 용적에 1cm 변화가 있을 경우 각 치료계획의 TCP, NTCP를 분석하였다. 결 과: 유방에 변화가 없을 경우 처방선량의 95%를 받는 PTV_NoVB 체적의 비율은 VMAT_NoVB와 VMAT_VB에서는 99.80±0.17%, 99.75±0.12%였고, IMRT_NoVB와 IMRT_VB에서는 99.67±0.26%, 99.51±0.15%였다. 각 환자에 따른 수치를 비교해 보면, VMAT_VB의 PTV_NoVB에 대한 V95%는 VMAT_NoVB의 PTV_NoVB에 대한 V95% 보다 0.08±0.22배 낮았다. 또한 IMRT_VB에서 PTV_NoVB에 대한 V95%는 IMRT_NoVB 보다 0.24±0.36배 낮았지만 큰 차이를 보이지 않았다. HI와 CI는 3% 이내의 차이를 보였다. OAR에서는 대부분 VB Plan에서 선량이 높게 나타났지만 가이드라인을 초과하지 않았다. 유방에 1cm의 변화가 있을 경우 NoVB Plan의 TCP는 유방에 변화가 없을 때보다 90% 이상 감소하는 것으로 나타났지만, VB Plan은 비슷한 수준의 치료 효과를 유지하는 것으로 나타났다. 결 론: Virtual Bolus를 적용한 치료계획은 기존의 치료계획과 비슷한 Plan Quality를 가지면서 움직임으로 발생하는 선량 오차를 줄여줄 수 있는 방법이다. 유방암의 세기조절 방사선치료 시 유방의 움직임이나 부종이 예상된다면 VB를 적용한 치료계획이 매우 유용할 것이라 사료된다.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2004년도 추계학술대회
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• pp.1558-1563
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• 2004

A measurement technique for the void fraction and the bubble dynamics in gas-liquid two-phase flows has been proposed using a time-resolved two-phase PIV system. For the three-dimensional evaluation of the bubble information, both the images from the front and side views are simultaneously recorded into a high speed CCD camera by reflecting the side image into the front view with the help of a $45^{\circ}$ oriented mirror. Then, a stereo-matching technique is applied to calculate the void fraction, bubble size and shape. To obtain the rising bubble velocities, the 2-frame PTV method was applied. Consequently, the present technique shows good feasibility for the measurements of the volume fractions, mean diameters, aspect ratios and velocities of the bubbles at the three-dimensional point of view.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.61-64
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• 2002

As intensity modulated radiation therapy compared with conventional radiation therapy, tumor target dose increased and normal tissues and critical organs dose reduced. In brain tumor, treatment planning of intensity modulated radiation therapy was practiced in 4MV, 6MV, 15MV X-ray energy. In these X-ray energy, was considered the dose distribution and dose volume histogram. As 4MV X-ray compared with 6MV and 15MV, maximum dose of right optic-nerve increased 10.1 %, 8.4%. Right eye increased 5.2%, 2.7%. And left optic-nerve, left eye, optic chiasm and brainstem incrased 1.7% - 5.2%. Even though maximum dose of PTV and these critical organs show different from 1.7% - 10.1% according to X-ray energies, these are a piont dose. Therefore in brain tumor, treatment planning of intensity modulated radiation therapy in 9 treatment field showed no relation with energy dependency.

• Radiation Oncology Journal
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• 제33권4호
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• pp.320-327
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• 2015

Purpose: To investigate the treatment outcome and the toxicity of helical tomotherapy (HT) in patients with metastatic colorectal cancer (mCRC). Materials and Methods: We retrospectively reviewed 18 patients with 31 lesions from mCRC treated with HT between 2009 and 2013. The liver (9 lesions) and lymph nodes (9 lesions) were the most frequent sites. The planning target volume (PTV) ranged from 12 to 1,110 mL (median, 114 mL). The total doses ranged from 30 to 70 Gy in 10-30 fractions. When the ${\alpha}/{\beta}$ value for the tumor was assumed to be 10 Gy for the biologically equivalent dose (BED), the total doses ranged from 39 to $119Gy_{10}$ (median, $55Gy_{10}$). Nineteen lesions were treated with concurrent chemotherapy (CCRT). Results: With a median follow-up time of 16 months, the median overall survival for 18 patients was 33 months. Eight lesions (26%) achieved complete response. The 1- and 3-year local progression free survival (LPFS) rates for 31 lesions were 45% and 34%, respectively. On univariate analysis, significant parameters influencing LPFS rates were chemotherapy response before HT, aim of HT, CCRT, PTV, BED, and adjuvant chemotherapy. On multivariate analysis, $PTV{\leq}113mL$ and $BED>48Gy_{10}$ were associated with a statistically significant improvement in LFPS. During HT, four patients experienced grade 3 hematologic toxicities, each of whom had also received CCRT. Conclusion: The current study demonstrates the efficacy and tolerability of HT for mCRC. To define optimal RT dose according to tumor size of mCRC, further study should be needed.

• Radiation Oncology Journal
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• 제36권1호
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• pp.54-62
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• 2018

Purpose: To investigate set-up errors, suggest the adequate planning target volume (PTV) margin and image-guided radiotherapy frequency in head and neck (H&N) cancer treated with intensity-modulated radiotherapy (IMRT) assessed by kV cone-beam computed tomography (CBCT). Methods: We analyzed 360 CBCTs in 60 patients with H&N cancer treated with IMRT. The target delineation was contoured according to ICRU62. PTVs were generated by adding a 3-5 mm margin in all directions to the respective clinical target volumes. The kV CBCT images were obtained at first three days of irradiation and weekly thereafter. The overall mean displacement, range, systematic (${\Sigma}$) and random (${\sigma}$) errors were calculated. Adequate PTV margins were calculated according to the van Herk formula ($2.5{\Sigma}+0.7r$). Results: The mean of set-up errors was less than 2 mm in any direction. The overall frequency of set-up displacements greater than 3 mm was 3.9% in medial-lateral (ML) direction, 8% in superior-inferior (SI) direction, and 15.5% in anterior-posterior (AP) direction. The range of translations shifts was 0-9 mm in ML direction, 0-5 mm in SI direction and 0-10 mm in AP direction, respectively. After systematic set-up errors correction, the adequate margin to overcome the problem of set-up errors was found to be less than 3 mm. Conclusion: Image-guided kV CBCT was effective for the evaluation of set-up accuracy in H&N cancer. The kV CBCT at first three fractions and followed-by weekly appears adequate for reducing significantly set-up errors in H&N cancer treated with IMRT technique. Finally, 3-5 mm PTV margins appear adequate and safe to overcome the problem of set-up errors.