• Title/Summary/Keyword: breast cancers

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The Clinical Effect and Construction of a Stereotactic Whole Body Immobilization Device (전신 정위 고정장치 제작과 임상효과에 대한 연구)

  • 정진범;정원균;서태석;최경식;진호상;지영훈
    • Progress in Medical Physics
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    • v.15 no.1
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    • pp.30-38
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    • 2004
  • 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.

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Fusion of Gamma and Realistic Imaging (감마영상과 실사영상의 Fusion)

  • Kim, Yun-Cheol;Yu, Yeon-Uk;Seo, Young-Deok;Moon, Jong-Woon;Kim, Yeong-Seok;Won, Woo-Jae;Kim, Seok-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.78-82
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    • 2010
  • Purpose: Recently, South Korea has seen a rapidly increased incidence of both breast and thyroid cancers. As a result, the I-131 scan and lymphoscintigraphy have been performed more frequently. Although this type of diagnostic imaging is prominent in that visualizes pathological conditions, which is similar to previous nuclear diagnostic imaging techniques, there is not much anatomical information obtained. Accordingly, it has been used in different ways to help find anatomical locations by transmission scan, however the results were unsatisfactory. Therefore, this study aims to realize an imaging technique which shows more anatomical information through the fusion of gamma and realistic imaging. Materials and Methods: We analyzed the data from patients who were examined by the lymphoscintigraphy and I-131 additional scan by Symbia Gamma camera (SIEMENS) in the nuclear medicine department of the National Cancer Center from April to July of 2009. First, we scanned the same location in patients by using a miniature camera (R-2000) in hyVISION. Afterwards, we scanned by gamma camera. The data we obtained was evaluated based on the scanning that measures an agreement of gamma and realistic imaging by the Gamma Ray Tool fusion program. Results: The amount of radiation technicians and patients were exposed was generated during the production process of flood source and applied transmission scan. During this time, the radiation exposure dose of technicians was an average of 14.1743 ${\mu}Sv$, while the radiation exposure dose of patients averaged 0.9037 ${\mu}Sv$. We also confirmed this to matching gamma and realistic markers in fusion imaging. Conclusion: Therefore, we found that we could provide imaging with more anatomical information to clinical doctors by fusion of system of gamma and realistic imaging. This has allowed us to perform an easier method in which to reduce the work process. In addition, we found that the radiation exposure can be reduced from the flood source. Eventually, we hope that this will be applicable in other nuclear medicine studies. Therefore, in order to respect the privacy of patients, this procedure will be performed only after the patient has agreed to the procedure after being given a detailed explanation about the process itself and its advantages.

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Preparation of $^{125}I-Iodotyraminehemisuccinyltaxol\;(^{125}ITHT)$ for Competitive Taxol Radioimmunoassay (Taxol 방사면역측정을 위한 $^{125}I-Iodotyraminehemisuccinyltaxol\;(^{125}ITHT)$의 제조)

  • Lee, Tae-Sup;Awh, Ok-Doo;Choi, Tae-Hyun;Kim, Hyun-Suk;Hong, Jun-Pyo;Lee, Eun-Sook;Choi, Chang-Woon;Lim, Sang-Moo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.2
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    • pp.121-132
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    • 2002
  • Purpose : Taxol(Paclitaxel), an antineoplastic agent, has been used in the treatment of ovarian and breast cancers. The determination of optimal Taxol concentrations in human serum was required for enhancing therapeutic effect and maintaining the appropriate Taxol level in blood. This study was aimed to synthesizeradiolabeled Taxol derivatives as radiotracer in competitive radioimmunoassay for monitoring Taxol concentrations in blood and to determine the usefulness of its derivatives. Materials and Methods : Hemisucdcinyltaxol(HT) was synthesized by esterification of Taxol with succinic anhydride. Tyraminehemisuccinyltaxol(THT) was synthesized by coupling of HT with tyramine using isobutylchlormate as coupling agent and purified by HPLC. By using chloramine-T($5.25mg/ml,\;10{\mu}{\ell}$) as oxidant agent, THT($4mg/ml,\;30{\mu}{\ell}$) was labeled wity $^{125}I\;(37MBq,\;1mCi)$. To estimate the stability of purified THT, $^{125}I-iodotyraminehemisuccinyltaxol(^125}ITHT)$ was dissolved in 80% acetonitrile aqueous solution, and the solution was incubated at $4^{\circ}C\;and\;37^{\circ}C$ for 7 days. At various time intervals, the stability of THT and $^{125}ITHT$ was monitored. The titer of Taxol monoclonal antibody, 3G5A7, was determined by competitive radioimmunoassay using $^{125}ITHT$ as a labeled antigen. A standard dose-response curve was demonstated by Taxol competitive radioimmunoassay. Resulls : HT and THT were synthesized with 79.9% and 19.5% yield, respectively. The labeling yield of $^{125}ITHT$ was 93%. After 7 days, the chemical purity of THT was 96.5% at $4^{\circ}C$, and 97.5% at $37^{\circ}C$. After 3 days, $^{125}ITHT$ was stable with 94.7% at $4^{\circ}C$ and 93.4% at $37^{\circ}C$. After 7 days, fadiochemical purity was diminished to 88.1% at $37^{\circ}C$. The titer of Taxol monoclonal antibody, 3G5A7, was determined to 1:256. A standard dose-response curve demonstated good collinearity ($R^2=0.971$) as Taxol concentration-dependent manner. Conclusion : Competitive radioimmunoassay using $^{125}I-iodotyraminehemisuccinytaxol$ as radiotracer could be used to monitor for concentration of Taxol in the human serum.

Correlation of p53 Protein Overexpression, Gene Mutation with Prognosis in Resected Non-Small Cell Lung Cancer(NSCLC) Patients (비소세포폐암에서 p53유전자의 구조적 이상 및 단백질 발현이 예후에 미치는 영향)

  • Lee, Y.H.;Shin, D.H.;Kim, J.H.;Lim, H.Y.;Chung, K.Y.;Yang, W.I.;Kim, S.K.;Chang, J.;Roh, J.K.;Kim, S.K.;Lee, W.Y.;Kim, B.S.;Kim, B.S.
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.339-353
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    • 1994
  • Background : The p53 gene codes for a DNA-binding nuclear phosphoprotein that appears to inhibit the progression of cells from the G1 to the S phase of the cell cycle. Mutations of the p53 gene are common in a wide variety of human cancers, including lung cancer. In lung cancers, point mutations of the p53 gene have been found in all histological types including approximately 45% of resected NSCLC and even more frequently in SCLC specimens. Mutant forms of the p53 protein have transforming activity and interfere with the cell-cycle regulatory function of the wild-type protein. The majority of p53 gene mutations produce proteins with altered conformation and prolonged half life; these mutant proteins accumulate in the cell nucleus and can be detected by immunohistochemical staining. But protein overexpression has been reported in the absence of mutation. p53 protein overexpression or gene mutation is reported poor prognostic factor in breast cancer, but in lung cancer, its prognostic significance is controversial. Method : We investigated the p53 abnormalities by nucleotide sequencing, polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), and immunohistochemical staining. We correlated these results with each other and survival in 75 patients with NSCLC resected with curative intent. Overexpression of the p53 protein was studied immunohistochemically in archival paraffin- embedded tumor samples using the D07(Novocastra, U.K.) antibody. Overexpression of p53 protein was defined by the nuclear staining of greater than 25% immunopositive cells in tumors. Detection of p53 gene mutation was done by PCR-SSCP and nucleotide sequencing from the exon 5-9 of p53 gene. Result: 1) Of the 75 patients, 36%(27/75) showed p53 overexpression by immunohistochemical stain. There was no survival difference between positive and negative p53 immunostaining(overall median survival of 26 months, disease free median survival of 13 months in both groups). 2) By PCR-SSCP, 27.6%(16/58) of the patients showed mobility shift. There was no significant difference in survival according to mobility shift(overall median survival of 27 in patients without mobility shift vs 20 months in patients with mobility shift, disease free median survival of 8 months vs 10 months respectively). 3) Nucleotide sequence was analysed from 29 patients, and 34.5%(10/29) had mutant p53 sequence. Patients with the presence of gene mutations showed tendency to shortened survival compared with the patients with no mutation(overall median survival of 22 vs 27 months, disease free median survival of 10 vs 20 months), but there was no statistical significance. 4) The sensitivity and specificity of immunostain based on PCR-SSCP was 67.0%, 74.0%, and that of the PCR-SSCP based on the nucleotide sequencing was 91.8%, 96.2% respectively. The concordance rate between the immunostain and PCR-SSCP was 62.5%, and the rate between the PCR-SSCP and nucleotide sequencing was 95.3%. Conclusion : In terms of detection of p53 gene mutation, PCR-SSCP was superior to immunostaining. p53 gene abnormalities either overexpression or mutation were not a significant prognostic factor in NSCLC patients resected with curative intent. However, patients with the mutated p53 gene showed the trends of early relapse.

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