• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.117-123
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• 2021

This paper is to establish a basis for a dose reduction strategy by confirming correlations with the factors that may affect the radiation dose based on the dose records in low-dose chest CT and abdominal non-contrast CT. In order to find out the causes of unnecessary exposure, the correlation between seven factors (age, gender, height, weight, BMI, patient status [inpatient and outpatient], and use of dose modulation) and CT dose were identified. Logistic regression was used as the statistical analysis for correlation verification. In the low dose chest CT, as the higher values of height and BMI and dose modulation off were associated with lowering the risk exceeding Diagnostic Reference Levels(DRL) (odds ration<1, p<0.05). However, as woman compared to man and the higher values of weight were associated with highering the risk exceeding DRL (odds ration>1, p<0.05). In the abdomen CT, as dose modulation off were associated with lowering the risk exceeding DRL (odds ration<1, p<0.05). Therefore It is necessary to conduct research on the relationship between various factors affecting radiation exposure and patient radiation dose for reducing the dose.

• Progress in Medical Physics
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• v.26 no.4
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• pp.267-272
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• 2015

In this study, the reduction of dose and risk was evaluated from using automatic mA control in 4D CT scan of patients whose organ movement was considered for gated radiotherapy. The organ doses, CTDI, effective doses from 4D CT with and without using automatic mA control were evaluated using CT-Expo program for each 10 patients of liver and lung cancer, and the risk of exposure induced death and loss of life expectancy were evaluated using PCXMC program. It was founded that there were 26.8%, and 15.5% dose reduction in organ doses and CTDI for liver and lung cancer patients and 16.5% and 19.8% risk reduction in liver and lung cancer patients. The organ doses and effective doses were evaluated for the parameter of each patient used in CT scans, and risks considering age and gender could be evaluated. It was founded that there were 21.2% dose reduction and 18.2% risk reduction in 4D CT scan using AEC for liver and lung cancer patients.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.933-943
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• 2021

Objective : Percutaneous pedicle screw (PPS) fixation is a needle based procedure that requires fluoroscopic image guidance. Consequently, radiation exposure is inevitable for patients, surgeons, and operation room staff. We hypothesize that reducing the production of radiation emission will result in reduced radiation exposure for everyone in the operation room. Research was performed to evaluate reduction of radiation exposure by modifying imaging manner and mode of radiation source. Methods : A total of 170 patients (680 screws) who underwent fusion surgery with PPS fixation from September 2019 to March 2020 were analyzed in this study. Personal dosimeters (Polimaster Ltd.) were worn at the collar outside a lead apron to measure radiation exposure. Patients were assigned to four groups based on imaging manner of fluoroscopy and radiation modification (pulse mode with reduced dose) : continuous use without radiation modification (group 1, n=34), intermittent use without radiation modification (group 2, n=54), continuous use with radiation modification (group 3, n=26), and intermittent use with radiation modification (group 4, n=56). Post hoc Tukey Honest significant difference test was used for individual comparisons of radiation exposure/screw and fluoroscopic time/screw. Results : The average radiation exposure/screw was 71.45±45.75 µSv/screw for group 1, 18.77±11.51 µSv/screw for group 2, 19.58±7.00 µSv/screw for group 3, and 4.26±2.89 µSv/screw for group 4. By changing imaging manner from continuous multiple shot to intermittent single shot, 73.7% radiation reduction was achieved in the no radiation modification groups (groups 1, 2), and 78.2% radiation reduction was achieved in the radiation modification groups (groups 3, 4). Radiation source modification from continuous mode with standard dose to pulse mode with reduced dose resulted in 72.6% radiation reduction in continuous imaging groups (groups 1, 3) and 77.3% radiation reduction in intermittent imaging groups (groups 2, 4). The average radiation exposure/screw was reduced 94.1% by changing imaging manner and modifying radiation source from continuous imaging with standard fluoroscopy setting (group 1) to intermittent imaging with modified fluoroscopy setting (group 4). A total of 680 screws were reviewed postoperatively, and 99.3% (675) were evaluated as pedicle breach grade 0 (<2 mm). Conclusion : The average radiation exposure/screw for a spinal surgeon can be reduced 94.1% by changing imaging manner and modifying radiation source from real-time imaging with standard dose to intermittent imaging with modified dose. These modifications can be instantly applied to any procedure using fluoroscopic guidance and may reduce the overall radiation exposure of spine surgeons.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.595-603
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• 2017

The study is to produced a brain phantom simulating corpus striatum, which can evaluate the progression of parkinson's disease, to investigate possibility of reducing the brain exposure dose to CT while maintaining optimal image quality during PET-CT examinations. CT scans were performed by varying tube voltage (100, 120 kVp) and tube current (80, 140, 200 mAs) with $^{18}F$ FP-CIT injected into the phantom's hot sphere and background (radioactivity ratio 3:1)(reference condition; 120 kVp, 140 mAs). Estimated effective dose was calculated by using conversion factor according to each condition, and image quality was evaluated by setting SNR and CRChot image evaluation factors. Experimental results showed that the predicted effective dose below the CT imaging reference condition was reduced by at least 10% and by up to 60%, and the predicted effective dose beyond the reference condition was increased by 40%. In addition, there was no significant difference between SNR and CRChot of PET images, and it was confirmed that brain dose decreased with decrease of tube voltage and tube current. At the same time, there was no significant change in the quality of the image in terms of SNR and CRChot despite the change in scan conditions. This fact suggests that the quality of the images acquired under the existing dose conditions can be obtained even at low dose conditions and it is expected that it will be possible to use the brain PET-CT scan as a basic data for the research on reduction of dose and improvement of image quality.

• The Journal of Korean Society for Radiation Therapy
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• v.8 no.1
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• pp.41-54
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• 1996

The secondary electrons developed by interaction between primary beam and a tray mounted for blocks in Megavoltage irradiation result in excess soft radiation dose to the surface layer. To reduce this electron contamination, electron filters have been used to be attached under a tray. Various filters with Cu and Al plates in six different thickness and Cu/Al combined plates in 3 different thickness were tested to measure the reduction rate of secondary electron contamination to the surface layer. The measurement to find optimal filter was performed on 6MV linear accelerator in $10 cm{\times}10 cm$ field size and fixed 78.5cm source to measurement points distance from surface to maximum build up point in 2mm intervals. The result was analyzed as the ratio of measured doses with using filters, to standard doses of measured open beam. The result of this study was fellowing : 1. The contaminated low energy radiation were mainly produced by blocking tray. 2. The surface absorbed dose was slowly increased by increasing irradiation field size but rapidly increased at field size above $15cm{\times}15cm$. 3. Al plate upto 2.5mm thickness used as a filter was found to be inadequate due to the failure of reduction of the surface absorbed dose below doses of the under surface upto the maximal build up. Cu 0.5mm plate and Cu 0.28mm/A1 1.5mm compound plate were found to be optimal filters. 4. By using these 2 filters, the absorbed dose to the surface were effectively reduced $5.5\%$ in field size $4cm{\times}4cm,\;11.3\%$ in field size $10cm{\times}10cm,\;22.3\%$ in field size $25cm{\times}25cm$. 5. In field size $10cm{\times}10cm$, the absorbed dose to the surface of irradiation was reduced by setting TSD 20cm at least,. but effective and enough dose reduction could be achieved by setting TSD 30cm as 2 optimal filters used. 6. More surface dose absorbed at TSD less than 7.4cm with a tray and filters together indicated that soft radiation was also developed by filters. 7. The variation of PDD by the different size of irradiation field was minimal as 2 optimal filters used. There was also not different in variation of PDD according to using any of two different filters. 8. PDD was not effected either by various TSD or by using the different filter among two.

• Progress in Medical Physics
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• v.14 no.4
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• pp.240-248
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• 2003

The Monte Carlo calculation is the most accurate means of predicting radiation dose, but its accuracy is accompanied by an increase in the amount of time required to produce a statistically meaningful dose distribution. In this study, the effects on calculation time by introducing variance reduction techniques and increasing computing power, respectively, in the Monte Carlo dose calculation for a 6 MV photon beam from the Varian 600 C/D were estimated when maintaining accuracy of the Monte Carlo calculation results. The EGSnrc­based BEAMnrc code was used to simulate the beam and the EGSnrc­based DOSXYZnrc code to calculate dose distributions. Variance reduction techniques in the codes were used to describe reduced­physics, and a computer cluster consisting of ten PCs was built to execute parallel computing. As a result, time was more reduced by the use of variance reduction techniques than that by the increase of computing power. Because the use of the Monte Carlo dose calculation in clinical practice is yet limited by reducing the computational time only through improvements in computing power, introduction of reduced­physics into the Monte Carlo calculation is inevitable at this point. Therefore, a more active investigation of existing or new reduced­physics approaches is required.

• Radiation Oncology Journal
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• v.35 no.1
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• pp.90-100
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• 2017

Purpose: To Study the dosimetric advantage of the Jaw tracking technique in intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) for Head and Neck Cancers. Materials and Methods: We retrospectively selected 10 previously treated head and neck cancer patients stage (T1/T2, N1, M0) in this study. All the patients were planned for IMRT and VMAT with simultaneous integrated boost technique. IMRT and VMAT plans were performed with jaw tracking (JT) and with static jaw (SJ) technique by keeping the same constraints and priorities for a particular patient. Target conformity, dose to the critical structures and low dose volumes were recorded and analyzed for IMRT and VMAT plans with and without JT for all the patients. Results: The conformity index average of all patients followed by standard deviation (${\bar{x}}{\pm}{\sigma}_{\bar{x}}$) of the JT-IMRT, SJ-IMRT, JT-VMAT, and SJ-VMAT were $1.72{\pm}0.56$, $1.67{\pm}0.57$, $1.83{\pm}0.65$, and $1.85{\pm}0.64$, and homogeneity index were $0.059{\pm}0.05$, $0.064{\pm}0.05$, $0.064{\pm}0.04$, and $0.064{\pm}0.05$. JT-IMRT shows significant mean reduction in right parotid and left parotid shows of 7.64% (p < 0.001) and 7.45% (p < 0.001) compare to SJ-IMRT. JT-IMRT plans also shows considerable dose reduction to thyroid, inferior constrictors, spinal cord and brainstem compared to the SJ-IMRT plans. Conclusion: Significant dose reductions were observed for critical structure in the JT-IMRT compared to SJ-IMRT technique. In JT-VMAT plans dose reduction to the critical structure were not significant compared to the SJ-IMRT due to relatively lesser monitor units.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.415-428
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• 2002

Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

• Journal of radiological science and technology
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• v.41 no.2
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• pp.115-122
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• 2018

We aims to perform comparative analysis on the dose area and image qualities varying on the slice thickness when using Automatic Exposure Controller (AEC) and manual exposure; thus, it wants to suggest a measure to reduce exposure dose by setting the optimal examination condition for each slice thickness. The method was to set the thickness as Thin, Normal, and Heavy adult and evaluate the dose area, spatial resolution, low contrast resolution, Signal to Noise Ratio (SNR) and Contrast to Noise Ratio (CNR) according to each slice thickness by using the AEC and the manual exposure controller. The dose area according to each slice thickness all increased both when using the AEC and the manual exposure. However, the manual exposure showed lower dose area product than the AEC. Spatial resolutions and low contrast resolutions were all observed to be higher than the evaluation standard. Also, the SNR and CNR of each thickness all increased when using the AEC. When using the manual exposure, SNR and CNR increased in all cases other than the Heavy Adult. Consequently, the Thin and Normal Adult showed dose reduction about 2 times when using the manual exposure controller, while ensuring the image quality. Heavy adult was able to maintain good image quality by using AEC.

• Nuclear Engineering and Technology
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• v.52 no.10
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• pp.2410-2414
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• 2020

Heavy ions have a high potential for destroying deep tumors that carry the highest dose at the peak of Bragg. The peak caused by a single-energy carbon beam is too narrow, which requires special measures for improvement. Here, carbon-12 (¹²C) ion with different energies has been used as a source for calculating the dose distribution in the water phantom, soft tissue and bone by the code of Monte Carlobased FLUKA code. By increasing the energy of the initial beam, the amount of absorbed dose at Bragg peak in all three targets decreased, but the trend for this reduction was less severe in bone. While the maximum absorbed dose per bone-mass unit in energy of 200 MeV/u was about 30% less than the maximum absorbed dose per unit mass of water or soft tissue, it was merely 2.4% less than soft tissue in 400 MeV/u. The simulation result showed a good agreement with experimental data at GSI Darmstadt facility of biophysics group by 0.15 cm average accuracy in Bragg peak positioning. From 200 to 400 MeV/u incident energy, the Bragg peak location increased about 18 cm in soft tissue. Correspondingly, the bone and soft tissue revealed a reduction dose ratio by 2.9 and 1.9. Induced neutrons did not contribute more than 1.8% to the total energy deposited in the water phantom. Also during ¹²C ion bombardment, secondary fragments showed 76% and 24% of primary 200 and 400 MeV/u, respectively, were present at the Bragg-peak position. The combined treatment of carbon ions with neutron or electron beams may be more effective in local dose delivery and also treating malignant tumors.