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Usability assessment of thermoplastic Bolus for skin VMAT radiotherapy (피부 병변에 대한 VMAT 치료 시 열가소성 bolus의 유용성 평가: case review)

  • Kim, Min Soo;Kim, Joo Ho;Shin, Hyun Kyung;Cho, Min Seok;Park, Ga Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.85-92
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    • 2020
  • Purpose: To find out the advantages of thermoplastic bolus compared to conventional bolus, which is mainly used in clinical practice, We evaluated Two cases in terms of dose and location reproducibility to assess Usability of thermoplastic Bolus for skin VMAT radiotherapy. Materials and Methods: Two patient's treated with left breast skin lesion were simulated using thermoplastic Bolus and planned with 2arc VMAT. the prescription dose was irradiated to 95% or more of the target volume. We evaluated The reproducibility of the bolus position by measuring the length of the air gap in the CBCT (Cone Beam CT) image. to evaluate dose reproducibility, we compared The dose distribution in the plan and CBCT and measured in vivo for patient 2. Results: The difference between the air gap in patient 1's simulation CT and the mean air gap (M1) during 10 treatments in the CBCT image was -0.42±1.24mm. In patient 2, the difference between the average air gap between the skin and the bolus (M2) during 14 treatments was -1.08±1.3mm, and the air gap between the bolus (M3) was 0.49±1.16. The difference in the dose distribution between Plan CT and CBCT was -1.38% for PTV1 D95 and 0.39% for SKIN (max) in patient 1. In patient 2, PTV1 D95 showed a difference of 0.63% and SKIN (max) -0.53%. The in vivo measurement showed a difference of -1.47% from the planned dose. Conclusion: thermoplastic Bolus is simpler and takes less time to manufacture compared to those produced by 3D printer. Also compared to conventional bolus, it has high reproducibility in the set-up side and stable results in terms of dose delivery.

Optimal Region of Interest Location of Test Bolus Technique in Extra Cranial Carotid Contrast Enhanced Magnetic Resonance Angiography

  • Choi, Kwan-Woo;Na, Sa-Ra;Son, Soon-Yong;Jeong, Mi-Ae
    • Journal of Magnetics
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    • v.22 no.2
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    • pp.234-237
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    • 2017
  • This study is aimed to optimize a location of region of interest (ROI) in test bolus carotid contrast enhanced magnetic resonance angiography (CE-MRA) at 3.0T. A total of consecutive 270 patients with no cardiovascular and vessel diseases were selected. Patients underwent elliptical centric 3D CE-MRA with the test bolus technique to identify the individual arterial arrival time. Quantitative measurements were performed by drawing ROIs of $25mm^2$ and signal intensities (SI) were measured in the center of common carotid artery (CCA), internal carotid artery (ICA) and aortic arch (AA). As a result, ROIs located within AA showed a significantly clarified arterial peak and over three times increased SI, while no significant arterial peak time differences were observed compared to ROIs located within CCA. In conclusion, it was demonstrated that the aortic arch is the optimal position to locate ROI in test bolus images of the carotid CE-MRA.

Usefulness of Silicon Bolus Using 3D Printing of Head and Neck Patients (두경부 환자의 3D Printing을 이용한 Silicon Bolus의 유용성)

  • Kwon, Kyung-Tae;Lee, Yong-Ki;Won, Young-Jin
    • Journal of the Korean Society of Radiology
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    • v.13 no.7
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    • pp.909-916
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    • 2019
  • Radiation therapy of oral and head and neck cancers often involves skin in the therapeutic range, and the use of bolus is frequently used. Dose irregularities provide dose uncertainty in patient application. In this study, the physical properties of patients with gel bolus, poly lactic acid (PLA), and silicon using 3D printing were fabricated. Dose uncertainties arising from the actual radiation dose delivery were measured. As a result, PLA bolus was stable in the Common irregularities. Silicon bolus may be useful for patients with severe irregularities or frequent changes in patient's body shape.

The Effects of Nonmagnetic Bolus on Contralateral Breast Skin Dose during Tangential Breast Irradiation Therapy

  • Won, Young-Jin;Cho, Jae-Hwan;Kim, Sung-chul
    • Journal of Magnetics
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    • v.21 no.1
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    • pp.133-140
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    • 2016
  • In this study the contralateral breast skin dose was decreased. It was to apply the results to the clinical study after analysis of different radiation dose amounts to contralateral breast with nonmagnetic bolus and without nonmagnetic bolus. A Rando phantom was computed tomography (CT) simulated, five treatment plans were generated: open tangents, open field in field, wedge 15, wedge 30, and intensity-modulated radiotherapy (IMRT) plan with 50.4 Gy to cover sufficient breast tissue. Contralateral breast skin dose was measured at 8 points using a glass dosimeter. The average contralateral breast dose using nonmagnetic bolus showed better excellence in decreasing the absorbed dose in the order of $168{\pm}11.1$ cGy, $131{\pm}10.2$ cGy (29%), $112{\pm}9.7$ cGy (49%), and $102{\pm}9.5$ cGy (64%) than changing the treatment plan. This study focused on decreasing the effect of scattered dose by use of a nonmagnetic bolus on the contralateral breast during radiotherapy in breast cancer patients and an intriguingly significant decrease was observed parallel to the opposed beam.

Assessing Commercial CLEANBOLUS Based on Silicone for Clinical Use

  • Son, Jaeman;Jung, Seongmoon;Park, Jong Min;Choi, Chang Heon;Kim, Jung-in
    • Progress in Medical Physics
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    • v.32 no.4
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    • pp.159-164
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    • 2021
  • Purpose: We investigated the properties of CLEANBOLUS based on silicone with suitable characteristics for clinical use. Methods: We evaluated the characteristics of CLEANBOLUS and compared the results with the commercial product (Super-Flex bolus). Also, we conducted physical evaluations, including shore hardness, element composition, and elongation break. Transparency was investigated through the measured absorbance within the visible region (400-700 nm). Also, dosimetric characteristics were investigated with surface dose and beam quality. Finally, the volume of unwanted air gap was investigated based on computed tomography images for breast, chin, and nose using Super-Flex bolus and CELANBOLUS. Results: CLEANBOLUS showed excellent physical properties for a low shore hardness (000-35) and elongation break (>1,000%). Additionally, it was shown that CLEANBOLUS is more transparent than Super-Flex bolus. Dosimetric results obtained through measurement and calculation have an electron density similar to water in CLEANBOLUS. Finally, CLEANBOLUS showed that the volume of unwanted air gap between the phantom and each bolus is smaller than Super-Flex bolus for breast, chin, and nose. Conclusions: The physical properties of CLEANBOLUS, including excellent adhesive strength and lower shore hardness, reduce unwanted air gaps and ensure accurate dose distribution. Therefore, it would be an alternative to other boluses, thus improving clinical use efficiency.

Pharmacokinetics of 11-Hydroxyaclacinomycin X (ID-6105), a Novel Anthracycline, after i.v. Bolus Multiple Administration in Rats

  • Yoo Bo-Im;Ahan Kwang Bok;Kang Min Hee;Kwon Oh-Seung;Hong Young-Soo;Lee Jung Joon;Lee Hong Sub;Ryu Jung Su;Kim Tae Yong;Moon Dong-Cheul;Song Sukgil;Chung Youn Bok
    • Archives of Pharmacal Research
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    • v.28 no.4
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    • pp.476-482
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    • 2005
  • We investigated the pharmacokinetics of 11-hydroxyaclacinomycin X (ID-6105), a novel anthracycline, after intravenous (i.v.) bolus administration at a multiple dose every 24 h for 5 days in rats. To analyze ID-6105 levels in biological samples, we used an HPLC-based method which was validated in a pharmacokinetic study by suitable criteria. The concentrations of ID-6105 after the multiple administration for 5 days were not significantly different from the results after the single administration. The $t_{1/2\alpha}, t_{l/2\beta}, V_{dss}, and CL_{t}$ after the multiple administration were not significantly different from the values after the single administration. Moreover, the concentrations of ID-6105 1 min at day 1-5 after i.v. bolus multiple administration did not show the significant difference. Of the various tissues, ID-6105 mainly distributed to the kidney, lung, spleen, adrenal gland, and liver after i.v. bolus multiple administration. ID-6105 concentrations in the kidney or lung 2 h after i.v. bolus administration were comparable to the plasma concentration shortly after i.v. bolus administration. However, the ID-6105 concentrations in various tissues 48 h after i.v. bolus administration decreased to low levels. ID-6105 was excreted largely in the bile after i.v. bolus multiple administration at the dose of 3 mg/kg. The amounts of ID-6105 found in the bile by 12 h or in the urine by 48 h after the administration were calculated to be $14.1\% or 4.55\%$ of the initial dose, respectively, indicating that ID-6105 is mostly excreted in the bile. In conclusion, ID-6105 was rapidly cleared from the blood and transferred to tissues, suggesting that ID-6105 might not be accumulated in the blood following i.v. bolus multiple dosages of 3 mg/kg every 24 h for 5 days. By 48 h after i.v. bolus administration, ID-6105 concentrations in various tissues had decreased to very low levels. The majority of ID-6105 appears to be excreted in the bile.

A Study on the Reduction of Patient's Exposure Dose according to the Arrival Time of Contrast Media in Abdominal CT Scan using Bolus Tracking Technique (Bolus tracking 기법을 이용한 복부 CT 검사 시 조영제 도달시간에 따른 환자 피폭선량 감소에 관한 연구)

  • Lee, Seung yong;Han, Dong kyoon
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.93-100
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    • 2021
  • The purpose of this study is to find out the factors that affect the patient's exposure dose during the abdominal CT scan using the bolus tracking technique, and reducing the radiation exposure to the patient during the abdominal CT scan using the bolus tracking technique by adjusting the delay time according to the corresponding factor. The experiment was divided into two parts, and the first experiment was conducted with 300 patients There were 188 males and 112 females, and their average age was 58±12.18(19~85). In the second experiment, 150 subjects (100 males and 50 females) who were undergoing their follow-up examination among the first experiment subjects, and the difference in dose before and after was compared by applying the delay time according to the influencing factor. As a result of the first experiment, there was a relationship between the arrival time of the contrast media and the heart rate, and it was found that the arrival time decreased as the heart rate increased for both men and women. As a result of the second experiment, the average dose of CTDIvol and DLP before/after applying the delay time according to the heart rate decreased 4.98 mGy and 5.33 mGy·cm in the male group, and 3.54 mGy and 3.88 mGy·cm in the female group. By applying proper delay time according to the patient's heart rate during abdominal CT scan with the bolus tracking technique, the radiation exposure dose of the patient can be reduced.

Evaluation of Absorbed Dose according to the Use of Bolus in Opposite Breast during Radiation Therapy of Breast Cancer using VMAT (VMAT를 이용한 유방암 방사선치료 시 반대편 유방의 Bolus 사용에 따른 흡수선량 평가)

  • Kim, Jong-Bo;Shin, Sang-Hwa
    • Journal of the Korean Society of Radiology
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    • v.12 no.6
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    • pp.763-768
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    • 2018
  • Although the development of radiation therapy techniques has made the treatment more precise, exposure by radiation is unavoidable beyond the treatment site. In this study, we wanted to evaluate the absorbed dose according to the thickness of the bolus on the opposite side of the treatment in radiation treatment for breast cancer and to analyze the effect of dose reduction. An experiment was conducted on Rando phantom using VMAT treatment methods. Five points of A, B, C, D, and E were selected for the breast opposite the treatment, and when the dosimeters of 5, 10, 15, and 20 mm were used. The highest absorbed dose at point D closest to the treatment point was measured and lowest at point B furthest from the treatment point. The mean absorbed dose was 8.61 cGy When the bolus is not used and 8.10, 7.94, 8.06, and 8.10 cGy Depending on the thickness of the bolus. In this study, bolus was intended to be used to analyze the dose-reducing effects of breasts on the other side of the treatment. The results of the study showed the effect of dose reduction and the appropriate bolus thickness should be set up to reduce the dose in normal tissues.

The Usefulness of Bolus of Radiation Therapy in Patients with Whole Breast Cancer

  • Min, Jung-Whan;Son, Jin-Hyun;Park, Hoon-Hee;Dong, Kyung-Rae
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.3
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    • pp.99-103
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    • 2011
  • Radiation Therapy has been used in the treatment of breast cancer for over 80 years. Technically, it should include a part or all of such areas as chest wall or breast, axilla, internam mammary nodes and supraclavicular nodes. The purpose of this study is treated breast cancer patient to use 6 MV, 10 MV with bolus so that we observe changing of skin dose and evaluate those usefulness. Using woman's phantom, after CT simulate scanning, Through RTP system to make treatment plan, select three any place. And then, we measure that dose rate. After moving the phantom to linac, we put for TLD to three point same as RTP system which we put on the phantom. We exposed 6 MV, 10 MV with bolus and without so that it is measured dose by TLD device(4000 Harshaw). As a reult expose 6 MV,10 MV, it differences 10%, 15% according to bolus and withoout bolus where lateral point from RAO, LPO beam, other one is 20% where the furthest from both beams. To use bolus in the hospital is material to include closely part at skin among tissue of breast cancer. Acquired skin dose from RTP system is uncertainity. So it has to test another system likely TLD or other dosimetry system. Also exposed field of breast cancer is included inhomogeneity such as lung, bone and so on. Therefore it has to be accomplished a dose calculating of inhomogeneity part from treatment plan.

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Establishment of Injection Protocol of Test Bolus for Precise Scan Timing in Canine Abdominal Multi-Phase Computed Tomography

  • Choi, Sooyoung;Lee, In;Choi, Hojung;Lee, Kija;Park, Inchul;Lee, Youngwon
    • Journal of Veterinary Clinics
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    • v.35 no.3
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    • pp.93-96
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    • 2018
  • This study aimed to establish an injection protocol to determine the precise CT scan timing in canine abdominal multi-phase CT using the test bolus method. Three dynamic scans with different contrast injection parameters were performed using a crossover design in eight normal beagle dogs. A contrast material was administered at a fixed dose of 200 mg iodine/kg as a test bolus for dynamic scans 1 and 2, and 600 mg iodine/kg as a main bolus for dynamic scan 3. The contrast materials were administered with 1 ml/s in dynamic scan 1, and 3 ml/s in dynamic scan 2 and 3. The mean arrival time to the appearance of aortic enhancement in dynamic scan 3 was similar to that in dynamic scan 2, and different significantly to that in dynamic scan 1. The mean arrival time to the peak aortic and pancreatic parenchymal enhancement in dynamic scan 3 was similar to that in dynamic scan 1, and different significantly to that in dynamic scan 2. In multi-phase CT scan, a test bolus should be injected with the same injection duration of a main bolus, to obtain the precise arrival times to peak of arterial or pancreatic parenchymal enhancement.