• Radiation Oncology Journal
• /
• v.34 no.4
• /
• pp.313-321
• /
• 2016

Purpose: Total scalp irradiation (TSI) is a rare but challenging indication. We previously reported that non-coplanar intensity-modulated radiotherapy (IMRT) was superior to coplanar IMRT in organ-at-risk (OAR) protection and target dose distribution. This consecutive treatment planning study compared IMRT with volumetric-modulated arc therapy (VMAT). Materials and Methods: A retrospective treatment plan databank search was performed and 5 patient cases were randomly selected. Cranial imaging was restored from the initial planning computed tomography (CT) and target volumes and OAR were redelineated. For each patients, three treatment plans were calculated (coplanar/non-coplanar IMRT, VMAT; prescribed dose 50 Gy, single dose 2 Gy). Conformity, homogeneity and dose volume histograms were used for plan. Results: VMAT featured the lowest monitor units and the sharpest dose gradient (1.6 Gy/mm). Planning target volume (PTV) coverage and homogeneity was better in VMAT (coverage, 0.95; homogeneity index [HI], 0.118) compared to IMRT (coverage, 0.94; HI, 0.119) but coplanar IMRT produced the most conformal plans (conformity index [CI], 0.43). Minimum PTV dose range was 66.8%-88.4% in coplanar, 77.5%-88.2% in non-coplanar IMRT and 82.8%-90.3% in VMAT. Mean dose to the brain, brain stem, optic system (maximum dose) and lenses were 18.6, 13.2, 9.1, and 5.2 Gy for VMAT, 21.9, 13.4, 14.5, and 6.3 Gy for non-coplanar and 22.8, 16.5, 11.5, and 5.9 Gy for coplanar IMRT. Maximum optic chiasm dose was 7.7, 8.4, and 11.1 Gy (non-coplanar IMRT, VMAT, and coplanar IMRT). Conclusion: Target coverage, homogeneity and OAR protection, was slightly superior in VMAT plans which also produced the sharpest dose gradient towards healthy tissue.

• Progress in Medical Physics
• /
• v.11 no.1
• /
• pp.85-90
• /
• 2000

In radiation therapy, the effects of radiation are decided total dose, total treatment times and number of radiation dose fractions. We considered that total dose, total treatment times and number of radiation dose fractions in intensity modulation radiation therapy(IMRT) infuence tumor cell killing. The goal of three dimensional conformal radiation therapy(3DCRT) in radiation therapy is to conform the partial distribution of the prescribed radiation dose to the precise 3D configuration of the tumor, and at the same time, to minimize the dose to the surrounding normal tissues. To optimize treatment volume of tumor, treatment volume will be same tumor volume. All IMRT compare to conventional treatment plus boost IMRT when total dose irradiated 75 - 90 Gy. Because of biological effect, total dose are decreased 12.5 - l5Gy in all IMRT.

• Radiation Oncology Journal
• /
• v.30 no.1
• /
• pp.27-35
• /
• 2012

Purpose: To evaluate the effect of common three photon energies (6-MV, 10-MV, and 15-MV) on intensity-modulated radiation therapy (IMRT) plans to treat prostate cancer patients. Materials and Methods: Twenty patients with prostate cancer treated locally to 81.0 Gy were retrospectively studied. 6-MV, 10-MV, and 15-MV IMRT plans for each patient were generated using suitable planning objectives, dose constraints, and 8-field setting. The plans were analyzed in terms of dose-volume histogram for the target coverage, dose conformity, organs at risk (OAR) sparing, and normal tissue integral dose. Results: Regardless of the energies chosen at the plans, the target coverage, conformity, and homogeneity of the plans were similar. However, there was a significant dose increase in rectal wall and femoral heads for 6-MV compared to those for 10-MV and 15-MV. The $V_{20Gy}$ of rectal wall with 6-MV, 10-MV, and 15-MV were 95.6%, 88.4%, and 89.4% while the mean dose to femoral heads were 31.7, 25.9, and 26.3 Gy, respectively. Integral doses to the normal tissues in higher energy (10-MV and 15-MV) plans were reduced by about 7%. Overall, integral doses in mid and low dose regions in 6-MV plans were increased by up to 13%. Conclusion: In this study, 10-MV prostate IMRT plans showed better OAR sparing and less integral doses than the 6-MV. The biological and clinical significance of this finding remains to be determined afterward, considering neutron dose contribution.

• Journal of radiological science and technology
• /
• v.42 no.6
• /
• pp.455-460
• /
• 2019

This study compared the radiation transmission and image quality of polymethylmethacrylate (PMMA), polycarbonate (PC), and carbon, which are common components of the compression plates currently used during breast imaging. In addition to measuring the transmitted dose and the intensity without the use of a compression paddle, the four different compression paddles were evaluated according to the material and thickness of each paddle. Radiation transmittance, maximum intensity, and plot profile type w ere all evaluated for each material, and for each factor evaluated the follow ing order w as noted, from best to w orst: carbon 4 mm, PMMA 3 mm, PMMA 4 mm, and PC 4 mm. It is necessary to study a variety of materials and thicknesses in order to find the optimal combination of material and thickness, because not only does the material have a large influence in reducing the radiation exposure during mammography, but the thickness of the compression plate also has a great influence.

• Journal of the Korean Physical Society
• /
• v.73 no.9
• /
• pp.1289-1294
• /
• 2018

The present study aims to investigate experimentally and theoretically thermal ablation in soft tissues by using high intensity focused ultrasound (HIFU) to assess tissue damage during HIFU thermotherapy. The HIFU field was calculated by solving the axisymmetric Khokhlov-Zabolotskaya-Kuznetsov equation from the frequency-domain perspective. The temperature field was calculated by solving Pennes' bioheat transfer equation, and the thermal dose required to create a thermal lesion was calculated by using the thermal dose formula based on the thermal dose of a 240-min exposure at $43^{\circ}C$. In order to validate the simulation results, we performed thermal ablation experiments in a tissue-mimicking phantom and ex-vivo porcine liver for two different HIFU source conditions by using a 1.1-MHz, single-element, spherically focused HIFU transducer. The small difference between the measured and the predicted lesion sizes suggests that the implementation of the numerical model used here should be modified to iteratively allow for temperature-dependent changes in the physical properties of tissues.

• The Journal of Korean Society for Radiation Therapy
• /
• v.29 no.1
• /
• pp.27-35
• /
• 2017

Purpose: On the left side, breast cancer patients have more side effects than those on the right side because of unnecessary doses in normal organs such as heart and lung. DIBH is performed to reduce this. To evaluate the dose of peripheral organs in the left breast cancer including supraclavicular lymph nodes and internal mammary lymph nodes according to the treatment planning method of Conventional Radiation Therapy, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy. Materials and Methods: We performed CT-simulation using free breathing and deep inspiration breath-hold technique for 8 patients including left supraclavicular lymph nodes and internal mammary lymph nodes. Based on the acquired CT images, the contour of the body is drawn and the convention is performed so that $95%{\leftarrow}PTV$, $Dmax{\leftarrow}110%$. Conventional Radiation Therapy used a one portal technique on the supraclavicular lymph node and used a field in field technique tangential beam on the breast. Intensity Modulated Radiation Therapy was composed of 7 static fields. Volumetric Modulated Arc Therapy was planned using 2 ARC with a turning radius of $290^{\circ}$ to $179^{\circ}$. The peripheral normal organs dose was analyzed by referring to the dose volume of Eclipse. Results: By applying the deep inspiration breath-hold technique, the mean interval between the heart and chest wall increased $1.6{\pm}0.6cm$. The mean dose of lung was $19.2{\pm}1.0Gy$, which was the smallest value in Intensity Modulated Radiation Therapy. The V30 (%) of the heart was $2.0{\pm}1.9$, which was the smallest value in Intensity Modulated Radiation Therapy. In the left anterior descending coronary artery, the dose was $25.4{\pm}5.4Gy$, which was the smallest in Intensity Modulated Radiation Therapy. The maximum dose value of the Right breast was $29.7{\pm}4.3Gy$ at Intensity Modulated Radiation Therapy. Conclusion: When comparing the values of surrounding normal organs, Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy were applicable values for treatment. Among them, Intensity Modulated Radiation Therapy is considered to be a suitable treatment planning method.

• Progress in Medical Physics
• /
• v.11 no.2
• /
• pp.147-155
• /
• 2000

Patient dose verification is one of the most important parts in quality assurance of the treatment delivery for radiation therapy. The dose distributions may be meaningfully improved by modulating two dimensional intensity profile of the individual high energy radiation beams In this study, a new method is presented for the pre-treatment dosimetric verification of these two dimensional distributions of beam intensity by means of a charge coupled device video camera-based fluoroscopic device (henceforth called as CCD-VCFD) as a radiation detecter with a custom-made software for dose calculation from fluorescence signals. This system of dosimeter (CCD-VCFD) could reproduce three dimensional (3D) relative dose distribution from the digitized fluoroscopic signals for small (1.0$\times$1.0 cm$^2$ square, ø 1.0 cm circular ) and large (30$\times$30cm$^2$) field sizes used in intensity modulated radiation therapy (IMRT). For the small beam sizes of photon and electron, the calculations are performed In absolute beam fluence profiles which are usually used for calculation of the patient dose distribution. The good linearity with respect to the absorbed dose, independence of dose rate, and three dimensional profiles of small beams using the CCD-VCFD were demonstrated by relative measurements in high energy Photon (15 MV) and electron (9 MeV) beams. These measurements of beam profiles with CCD-VCFD show good agreement with those with other dosimeters such as utramicro-cylindrical (UC) ionization chamber and radiographic film. The study of the radiation dosimetric technique using CCD-VCFD may provide a fast and accurate pre-treatment verification tool for the small beam used in stereotactic radiosurgery (SRS) and can be used for verification of dose distribution from dynamic multi-leaf collimation system (DMLC).

• Progress in Medical Physics
• /
• v.8 no.2
• /
• pp.27-34
• /
• 1997

In radiation therapy, the goal of three dimensional conformal radiation therapy(3DCRT) is to conform the apatial distribution of the prescribed radiation dose to the precise 3D configuration of the tomor, and at the same time, to minimize the dose to the surrounding normal tissues. To optimize treatment volume of tomor, treatment volume will be same tomor volume. Biological considerations need to be incorporated in the intensity modulation optimization process. Planning of intensity modulated treatment can irradiate more 20％ in tomor compare to conventional 3DCRT. In lung cancer and rectal cancer, planning of intensity modulated treatment showed optimizing dose distribution.

• Korean Journal of Head & Neck Oncology
• /
• v.37 no.1
• /
• pp.1-10
• /
• 2021

Intensity-modulated radiation therapy (IMRT) using X-rays is a standard technique implemented for treating head and neck cancer (HN C). Compared to 3D conformal RT, IMRT can significantly reduce the radiation dose to surrounding normal tissues by using a highly conformal dose to the tumor. Proton therapy is a type of RT that uses positively charged particles named protons. Proton therapy has a unique energy deposit (i.e., Bragg peak) and greater biological effectiveness than that of therapy using X-rays. These inherent properties of proton therapy make the technique advantageous for HNC treatment. Recently, advanced techniques such as intensity-modulated proton therapy have further decreased the dose to normal organs with a higher conformal dose to the tumor. The usage of proton therapy for HNC is becoming widespread as the number of operational proton therapy centers has increased worldwide. This paper aims to present the current clinical evidence of proton therapy utility to HNC clinicians through a literature review. It also discusses the challenges associated with proton therapy and prospective development of the technique.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.11
• /
• pp.4727-4732
• /
• 2014

Background: Breast cancers are becoming more frequently diagnosed at early stages with improved long term outcomes. Late normal tissue complications induced by radiotherapy must be avoided with new breast radiotherapy techniques being developed. The aim of the study was to compare dosimetric parameters of planning target volume (PTV) and organs at risk between conformal (CRT) and intensity-modulated radiation therapy (IMRT) after breast-conserving surgery. Materials and Methods: A total of 20 patients with early stage left breast cancer received adjuvant radiotherapy after conservative surgery, 10 by 3D-CRT and 10 by IMRT, with a dose of 50 Gy in 25 sessions. Plans were compared according to dose-volume histogram analyses in terms of PTV homogeneity and conformity indices as well as organs at risk dose and volume parameters. Results: The HI and CI of PTV showed no difference between 3D-CRT and IMRT, V95 gave 9.8% coverage for 3D-CRT versus 99% for IMRT, V107 volumes were recorded 11% and 1.3%, respectively. Tangential beam IMRT increased volume of ipsilateral lung V5 average of 90%, ipsilateral V20 lung volume was 13%, 19% with IMRT and 3D-CRT respectively. Patients treated with IMRT, heart volume encompassed by 60% isodose (30 Gy) reduced by average 42% (4% versus 7% with 3D-CRT), mean heart dose by average 35% (495cGy versus 1400 cGy with 3D-CRT). In IMRT minimal heart dose average is 356 cGy versus 90cGy in 3D-CRT. Conclusions: IMRT reduces irradiated volumes of heart and ipsilateral lung in high-dose areas but increases irradiated volumes in low-dose areas in breast cancer patients treated on the left side.