• Radiation Oncology Journal
• /
• v.18 no.1
• /
• pp.67-72
• /
• 2000

Background :The authors have developed a Digital image chart(DIC) and digital Radiotherapy Record System (DRRS). We have evaluated the DIC and DRRS for reliability, usefulness, ease of use, and efficiency. Materials and Methods :The basic design of the DIC and DRRS was to build an digital image database of radiation therapy Patient records for a more efficient and timely flow of critical image information throughout the department. This system is a submit of comprehensive radiation oncology management system (C-ROMS) and composed of a picture archiving and communication system (PACS), a radiotherapy information database, and a radiotherapy imaging database. The DIC and DRRS were programmed using Delphi under a Windows 95 environment and is capable of displaying the digital images of patients identification photos, simulation films, radiotherapy setup, diagnostic radiology images, gross lesion Photos, and radiotherapy Planning isodose charts with beam arrangements. Twenty-three clients in the department are connected by Ethernet (10 Mbps) to the central image server (Sun Ultra-sparc 1 workstation). Results :From the introduction of this system in February 1998 through December 1999, we have accumulated a total of 15,732 individual images for 2,556 patients. We can organize radiation therapy in a 'paperless' environment in 120 patients with breast cancer. Using this system, we have succeeded in the prompt, accurate, and simultaneous access to patient care information from multiple locations throughout the department. This coordination has resulted in improved operational efficiency within the department. Conclusion :The authors believe that the DIC and DRRS has contributed to the improvement of radiation oncology department efficacy as well as to time and resource savings by providing necessary visual information throughout the department conveniently and simultaneously. As a result, we can also achieve the 'paperless' and 'filmless' practice of radiation oncology with this system.

• Radiation Oncology Journal
• /
• v.15 no.4
• /
• pp.305-313
• /
• 1997

Purpose : This is a retrospective study to evaluate the results of radiation therapy and prognostic factors influencing the results in nasopharyngeal carcinoma. Materials and Methods: From October 1989 to May 1996. 56 Patients were treated for nasopharyngeal carcinoma at Department of Radiation On-cology. According to stage, patients were distributed as follows : stage I (2), II (13). II (11), IV (30). Twenty-eight patients were treated with radiation therapy only, 7 patients were treated with neoadiuvant chemotherapy followed by radiation therapy. Twenty-one Patients were treated with radiation therapy and weekly CDDP. After external beam radiotherapy of 60Gy, 46Patients received boost dose with intracavitary radiation and 9 Patients with 3D conformal therapy. One patient received boost dose with 2 dimensional Photon beam therapy. The tumor dose ranged from 69.4Gy to 86.2Gy with median dose of 74.4Gy. The follow-up Period ranged from 5 months to 92 months with a median of 34 months. Results : Forty-seven patients achieved complete response and 8 Patients showed partial response. One Patient showed minimal response. Patterns of failure were as follows : locoregional recurrence (8) and distant metastasis (18). Among these patients, 2 patients failed locoregionally and distantly. The sites of distant metastasis were bone (8), lung (8) and liver (4). Five years survival rate was $67.2\%$ and 5 years disease-free survival rate was $53.6\%$. KPS (P=0.005) and response ol radiation therapy (P=0.0001) were significant prognostic factors for overall survival. KPS (P= 0.02) and response of radiation therapy (P=0.005) were significant Prognostic factors for disease-free survival. Conclusion : This retrospective study showed that distant metastasis was the Predominant pattern of relapse in nasopharyngeal cancer Neoadiuvant chemotherapy or weekly CDOP did not influence the distant metastasis-free survival. For advanced T stage, 3D conformal therapy Provided an improved dose coverage compared to ICR But further follow-up was needed in Patients with 3D conformal therapy to assess the efficacy of this therapy. Development of techniques of radiation therapy to improve locoregional control and of more effective systemic chemotherapy regimen are needed.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.18 no.1
• /
• pp.19-25
• /
• 2014

Purpose: Integrated PET/MRI has been developed recently has become a lot of help to the point oncologic, neological, cardiological nuclear medicine. By using this PET/MRI, a ${\mu}-map$ is created some special MRI sequence which may be divided parts of the body for attenuation correction. However, because an MRI contrast agent is necessary in order to obtain an more MRI information, we will evaluate to see an effect of SUV on PET image that corrected attenuation by MRI with contrast agent. Materials and Methods: As PET/MRI machine, Biograph mMR (Siemens, Germany) was used. For phantom test, 1mCi $^{18}F-FDG$ was injected in cylinderical uniformity phantom, and then acquire PET data about 10 minutes with VIBE-DIXON, UTE MRI sequence image for attenuation correction. T1 weighted contrast media, 4 cc DOTAREM (GUERBET, FRANCE) was injected in a same phatnom, and then PET data, MRI data were acquired by same methodes. Using this PET, non-contrast MRI and contrast MRI, it was reconstructed attenuation correction PET image, in which we evanuated the difference of SUVs. Additionally, for let a high desity of contrast media, 500 cc 2 plastic bottles were used. We injected $^{18}F-FDG$ with 5 cc DOTAREM in first bottle. At second bottle, only $^{18}F-FDG$ was injected. and then we evaluated a SUVs reconstructed by same methods. For clinical patient study, rectal caner-pancreas cancer patients were selected. we evaluated SUVs of PET image corrected attenuastion by contrast weighted MRI and non-contrast MRI. Results: For a phantom study, although VIBE DIXON MRI signal with contrast media is 433% higher than non-contrast media MRI, the signals intensity of ${\mu}-map$, attenuation corrected PET are same together. In case of high contrast media density, image distortion is appeared on ${\mu}-map$ and PET images. For clinical a patient study, VIBE DIXON MRI signal on lesion portion is increased in 495% by using DOTAREM. But there are no significant differences at ${\mu}-map$, non AC PET, AC-PET image whether using contrast media or not. In case of whole body PET/MRI study, %diff between contras and non contrast MRAC at lung, liver, renal cortex, femoral head, myocardium, bladder, muscle are -4.32%, -2.48%, -8.05%, -3.14%, 2.30%, 1.53%, 6.49% at each other. Conclusion: In integrated PET/MRI, a segmentation ${\mu}-map$ method is used for correcting attenuation of PET signal. although MRI signal for attenuation correciton change by using contrast media, ${\mu}-map$ will not change, and then MRAC PET signal will not change too. Therefore, MRI contrast media dose not affect for attenuation correction PET. As well, not only When we make a flow of PET/MRI protocol, order of PET and MRI sequence dose not matter, but It's possible to compare PET images before and after contrast agent injection.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.18 no.1
• /
• pp.3-9
• /
• 2014

Purpose: Our goals were to evaluate the effect of high dose radioiodine treatment for thyroid cancer by taking in laxatives. Materials and Methods: Twenty patients(M:F=13:7, age $46.3{\pm}8.1\;yrs$) who underwent high dose radioiodine treatment were seperated into Group 1 taking $^{131}I$ 5,500 MBq and Group 2 with the use of laxatives after taking $^{131}I$ 5,500 MBq. The whole body was scanned 16 hours and 40 hours after taking radioactive iodines by using gamma camera, the ROIs were drawn on the gastro-intestinal tract and thigh for calculation of reduction ratio. At particular time during hospitalization, the radioactivity remaining in the body was measured in 1 meter from patient by using survey meter (RadEye-G10, Thermo Fisher Scientific, USA). Schematic presentation of an Origin 8.5.1 software was used for spatial dose rate. Statistical comparison between groups were done using independent samples t-test. P value less than 0.05 was regarded as statistically significant. Results: The reduction ratio in gastro-intestinal 16 hours and 40 hours after taking laxatives is $42.1{\pm}6.3%$ in Group 1 and $72.1{\pm}6.4%$ in Group 2. The spatial dose rate measured when discharging from hospital was $23.8{\pm}6.7{\mu}Sv/h$ in Group 1 and $8.2{\pm}2.4{\mu}Sv/h$ in Group 2. The radioactivity remaining in the body is much decreased at the patient with laxatives(P<0.05). Conclusion: The use in combination with laxatives is helpful for decreasing radioactivity remaining in the body. The radioactive contamination could be decreased at marginal individuals from patients.

• Journal of Radiation Protection and Research
• /
• v.25 no.1
• /
• pp.31-36
• /
• 2000

In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

• The Journal of Korean Society for Radiation Therapy
• /
• v.16 no.2
• /
• pp.19-24
• /
• 2004

Introduction : The Vaginal, the urethra, the vulva and anal cancer avoid the many dose to femur head and the additional treatment is necessary in inguinal LN. The partial transmission block to use inguinal LN addition there is to a method which it treats and produce partial transmission block a method and the MLC which to it analyzes. Material & Methode : The Inguinal the LN treatment patient partial transmission it used block and the MLC in the object and with solid water phantom with the patient it reappeared the same depth. In order to analyze the error of the junction the EDR2 (Extended dose range, the Kodak and the U.S) it used the Film and it got film scanner it got the beam profile. The partial transmission block and the MLC bias characteristic, accuracy and stability of production for, it shared at hour and comparison it analyzed. Result : The partial the transmission block compares in the MLC and the block production is difficult and production hour also above 1 hours. The custom the block the place where it revises the error of the junction is a difficult problem. If use of the MLC the fabrication will be break and only the periodical calibration of the MLC it will do and it will be able to use easily. Conclusion : The Inguinal there is to LN treatment and partial transmission block and the MLC there is efficiency of each one but there is a place where the junction of block for partial transmission block the production hour is caught long and it fixes and a point where the control of the block is difficult. like this problem it transfers with the MLC and if it treats, it means the effective treatment will be possible.

• Radiation Oncology Journal
• /
• v.23 no.2
• /
• pp.71-77
• /
• 2005

Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

• Korean Journal of Clinical Laboratory Science
• /
• v.56 no.2
• /
• pp.147-155
• /
• 2024

Gallium-68-prostate-specific membrane antigen-11 (⁶⁸Ga-PSMA-11) is a positron emission tomography radiopharmaceutical that labels a Glu-urea-Lys-based ligand with ⁶⁸Ga, binding specifically to the PSMA. It is used widely for imaging recurrent prostate cancer and metastases. On the other hand, the preparation and quality control testing of ⁶⁸Ga-PSMA-11 in medical institutions takes over 60 minutes, limiting the daily capacity of ⁶⁸Ge/⁶⁸Ga generators. While the generator provides 1,110 MBq (30 mCi) nominally, its activity decreases over time, and the labeling yield declines irregularly. Consequently, additional preparations are needed, increasing radiation exposure for medical technicians, prolonging patient wait times, and necessitating production schedule adjustments. This study aimed to reduce the ⁶⁸Ga-PSMA-11 preparation time and optimize the automated synthesis system. By shortening the reaction time between ⁶⁸Ga and the PSMA-11 precursor and adjusting the number of purification steps, a faster and more cost-effective method was tested while maintaining quality. The final synthesis time was reduced from 30 to 20 minutes, meeting the standards for the HEPES content, residual solvent EtOH content, and radiochemical purity. This optimized procedure minimizes radiation exposure for medical technicians, reduces patient wait times, and maintains consistent production schedules, making it suitable for clinical application.

• Journal of the Korean Society of Radiology
• /
• v.82 no.2
• /
• pp.371-381
• /
• 2021

Purpose To evaluate the usefulness and effectiveness of bronchial occluders in the treatment of postoperative bronchopleural fistula (BPF). Materials and Methods The subjects of the study were six out of seven postoperative BPF patients who underwent surgery due to tuberculosis or lung cancer between 2009 and 2019. Each patient had a bronchial occluder inserted to treat BPF that occurred after surgery. Of the six patients, five had lung cancers and one had tuberculosis. Five were male and one was female; their ages ranged from 59 to 74 years, with an average of 69 years. The diagnosis of BPF was based on findings from bronchoscopy and CT, and treatment was initiated approximately 1 to 2 weeks after diagnosis. The technical and clinical success of the bronchial occluders in the treatment of BPF was evaluated. The study assessed the postoperative clinical effects of the occluders, survival duration, and additional treatments. Results All six patients were successfully treated. Clinical success was achieved in five patients, while partial clinical success was achieved in one; there was no clinical failure. No complications during the migration of the device or device perforations were observed. Two patients were diagnosed with BPF by CT, while four were diagnosed by bronchoscopy. Lobectomy, bilobectomy, and pneumonectomy were performed on two patients each. The periods between surgery and diagnosis ranged from 1 to 34 months; the average was 10 months. Four patients (59-103 days; an average of 80.5 days) died and two (313 days, 3331 days) survived. The causes of death were aggravation of the underlying disease (n = 2), pulmonary edema and pleural effusion (n = 1), and pneumonia (n = 1). Additional catheter drainage was performed in one patient, and a chest tube was maintained in two patients. Conclusion Bronchial occluders are useful and effective in the treatment of BPF after pulmonary resection.

• Radiation Oncology Journal
• /
• v.19 no.2
• /
• pp.127-135
• /
• 2001

Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.