• Radiation Oncology Journal
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• v.31 no.2
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• pp.104-110
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• 2013

Purpose: Intensity modulated arc therapy (IMAT) is a form of intensity modulated radiation therapy (IMRT) that delivers dose in single or multiple arcs. We compared IMRT plans versus single-arc field (1ARC) and multi-arc fields (3ARC) IMAT plans in high-risk prostate cancer. Materials and Methods: Sixteen patients were studied. Prostate ($PTV_P$), right pelvic ($PTV_{RtLN}$) and left pelvic lymph nodes ($PTV_{LtLN}$), and organs at risk were contoured. $PTV_P$, $PTV_{RtLN}$, and $PTV_{LtLN}$ received 50.40 Gy followed by a boost to $PTV_B$ of 28.80 Gy. Three plans were per patient generated: IMRT, 1ARC, and 3ARC. We recorded the dose to the PTV, the mean dose ($D_{MEAN}$) to the organs at risk, and volume covered by the 50% isodose. Efficiency was evaluated by monitor units (MU) and beam on time (BOT). Conformity index (CI), Paddick gradient index, and homogeneity index (HI) were also calculated. Results: Average Radiation Therapy Oncology Group CI was 1.17, 1.20, and 1.15 for IMRT, 1ARC, and 3ARC, respectively. The plans' HI were within 1% of each other. The $D_{MEAN}$ of bladder was within 2% of each other. The rectum $D_{MEAN}$ in IMRT plans was 10% lower dose than the arc plans (p < 0.0001). The GI of the 3ARC was superior to IMRT by 27.4% (p = 0.006). The average MU was highest in the IMRT plans (1686) versus 1ARC (575) versus 3ARC (1079). The average BOT was 6 minutes for IMRT compared to 1.3 and 2.9 for 1ARC and 3ARC IMAT (p < 0.05). Conclusion: For high-risk prostate cancer, IMAT may offer a favorable dose gradient profile, conformity, MU and BOT compared to IMRT.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.214-219
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• 1998

Objectives: To assess the effectiveness of the low-dose(30mCi) I-131 ablation therapy for remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer. Methods: Between March 1995 and December 1997, forty-eight patients were given ablative doses(30mCi) of I-131 after total thyroidectomy for differentiated thyroid cancer in the presence of I-131 uptake in remnant thyroid tissue. Effective ablation of remnant thyroid tissue was determined by following I-131 whole body scan. if remnant thyroid tissue remained, we repeated the same management at 6 months interval. Results: Thirty-eight(79.1%) patients had papillary, 8(16.7%) follicular, 1(2.1%) medullary and 1(2.1%) Hurthle cell type cancer. Forty-eight patients underwent total thyroidectomy, among those central neck dissection was performed in 35 cases, and modified radical neck dissection in 14 cases. Postoperative complication developed in 8 cases, which included 4 cases of transient hypoparathyroidism, 1 case of permanent hypoparathyroidism, 2 cases of transient recurrent laryngeal nerve palsy, and 1 case of wound hematoma. There were significant remnant thyroid tissue in 46 cases(95.8%) of patients after total thyroidectomy, which could be ablated by low dose(30mCi) I-131. There were no statistical difference between operative procedures and number of treatment of I-131. Conclusions: These results suggested that repeated low-dose(30mCi) I-131 therapy would be needed, therefore, high -dose I-131 therapy could be considered as ablation therapy for the remnant thyroid tissue after total thyroidectomy for differentiated thyroid cancer.

• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.175-186
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• 2002

The purpose of this study is directly measure and evaluate about absorbed dose change according to nominal energy and electron cone or medical accelerator on isodose curve, percentage depth dose, contaminated X-ray, inhomogeneous tissue, oblique surface and irradiation on intracavitary that electron beam with high energy distributed in tissue, and it settled standard data of hish energy electron beam treatment, and offer to exactly data for new dote distribution modeling study based on experimental resuls and theory. Electron beam with hish energy of $6{\sim}20$ MeV is used that generated from medical linear accelerator (Clinac 2100C/D, Varian) for the experiment, andwater phantom and Farmer chamber md Markus chamber und for absorbe d dose measurement of electron beam, and standard absorbed dose is calculated by standard measurements of International Atomic Energy Agency(IAEA) TRS 277. Dose analyzer (700i dose distribution analyzer, Wellhofer), film (X-OmatV, Kodak), external cone, intracavitary cone, cork, animal compact bone and air were used for don distribution measurement. As the results of absorbed dose ratio increased while irradiation field was increased, it appeared maximum at some irradiation field size and decreased though irradiation field size was more increased, and it decreased greatly while energy of electron beam was increased, and scattered dose on wall of electron cone was the cause. In percentage depth dose curve of electron beam, Effective depth dose(R80) for nominal energy of 6, 9, 12, 16 and 20 MeV are 1.85, 2.93, 4.07, 5.37 and 6.53 cm respectively, which seems to be one third of electron beam energy (MeV). Contaminated X-ray was generated from interaction between electron beam with high energy and material, and it was about $0.3{\sim}2.3\%$ of maximum dose and increased with increasing energy. Change of depth dose ratio of electron beam was compared with theory by Monte Carlo simulation, and calculation and measured value by Pencil beam model reciprocally, and percentage depth dose and measured value by Pencil beam were agreed almost, however, there were a little lack on build up area and error increased in pendulum and multi treatment since there was no contaminated X-ray part. Percentage depth dose calculated by Monte Carlo simulation appeared to be less from all part except maximum dose area from the curve. The change of percentage depth dose by inhomogeneous tissue, maximum range after penetration the 1 cm bone was moved 1 cm toward to surface then polystyrene phantom. In case of 1 cm and 2 cm cork, it was moved 0.5 cm and 1 cm toward to depth, respectively. In case of air, practical range was extended toward depth without energy loss. Irradiation on intracavitary is using straight and beveled type cones of 2.5, 3.0, 3.5 $cm{\phi}$, and maximum and effective $80\%$ dose depth increases while electron beam energy and size of electron cone increase. In case of contaminated X-ray, as the energy increase, straight type cones were more highly appeared then beveled type. The output factor of intracavitary small field electron cone was $15{\sim}86\%$ of standard external electron cone($15{\times}15cm^2$) and straight type was slightly higher then beveled type.

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

• The Journal of the Korea Contents Association
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• v.16 no.1
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• pp.75-81
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• 2016

The recent radiation therapy field can provide treatment which guarantees a high degree of accuracy, due to patient set-up using various image guided radiation therapy(IGRT) instruments. But the additional absorbed dose to patient's normal tissues is increasing. Therefore, this study measured the absorbed dose to surrounding normal tissues which is caused by patient set-up using OBI, CBCT, ExacTrac, among various IGRT instruments. The absorbed dose to the head, the chest, the abdomen, and the pelvis from CBCT was 12.57 mGy, 20.82 mGy, 82.93 mGy, and 52.70 mGy, respectively. Also, the absorbed dose from OBI and ExacTrac ranged from 0.76 to 8.58 mGy and from 0.14 to 0.63 mGy, respectively. As a result, CBCT's absorbed dose was far higher than other instruments. CBCT's surface dose was far higher than others, too, but OBI's entrance skin dose was almost the same as CBCT's.

• Nuclear Engineering and Technology
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• v.54 no.3
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• pp.1016-1023
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• 2022

In proton therapy, a highly conformal proton dose can be delivered to the tumor by means of the steep distal dose penumbra at the end of the beam range. The proton beam range, however, is highly sensitive to range uncertainty, which makes accurately locating the proton range in the patient difficult. In-vivo range verification is a method to manage range uncertainty, one of the promising techniques being prompt gamma imaging (PGI). In earlier studies, we proposed gamma electron vertex imaging (GEVI), and constructed a proof-of-principle system. The system successfully demonstrated the GEVI imaging principle for therapeutic proton pencil beams without scanning, but showed some limitations under clinical conditions, particularly for pencil beam scanning proton therapy. In the present study, we upgraded the GEVI system in several aspects and tested the performance improvements such as for range-shift verification in the context of line scanning proton treatment. Specifically, the system showed better performance in obtaining accurate prompt gamma (PG) distributions in the clinical environment. Furthermore, high shift-detection sensitivity and accuracy were shown under various range-shift conditions using line scanning proton beams.

• Progress in Medical Physics
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• v.32 no.2
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• pp.25-39
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• 2021

Brachytherapy, along with external beam radiation therapy (EBRT), is an essential and effective radiation treatment process. In brachytherapy, in contrast to EBRT, the radiation source is radioisotopes. Because these isotopes can be positioned inside or near the tumor, it is possible to protect other organs around the tumor while delivering an extremely high-dose of treatment to the tumor. Brachytherapy has a long history of more than 100 years. In the early 1900s, the radioisotopes used for brachytherapy were only radium or radon isotopes extracted from nature. Over time, however, various radioisotopes have been artificially produced. As radioisotopes have high radioactivity and miniature size, the application of brachytherapy has expanded to high-dose-rate brachytherapy. Recently, advanced treatment techniques used in EBRT, such as image guidance and intensity modulation techniques, have been applied to brachytherapy. Three-dimensional images, such as ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography are used for accurate delineation of treatment targets and normal organs. Intensity-modulated brachytherapy is anticipated to be performed in the near future, and it is anticipated that the treatment outcomes of applicable cancers will be greatly improved by this treatment's excellent dose delivery characteristics.

• Korean Journal of Clinical Pharmacy
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• v.27 no.3
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• pp.127-135
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• 2017

Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications. Methods: We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ${\geq}1$0 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group. Results: In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with high-dose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate). Conclusion: We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

• Nuclear Engineering and Technology
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• v.49 no.7
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• pp.1505-1512
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• 2017

Because accelerator-based boron neutron capture therapy (BNCT) systems are planned for use in hospitals, entry into the medical room should be controlled as hospitals are generally assumed to be public and safe places. In this paper, computational investigation of the medical staff effective dose during BNCT has been performed in different situations using Monte Carlo N-Particle (MCNP4C) code and two voxel based male phantoms. The results show that the medical staff effective dose is highly dependent on the position of the medical staff. The results also show that the maximum medical staff effective dose in an emergency situation in the presence of a patient is ${\sim}25.5{\mu}Sv/s$.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.11-14
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• 2012

Purpose: Anisotropic Analytical Algorithm (AAA) provides more accurate dose calculation regarding impact on scatter and tissue inhomogeneity in comparison to Pencil Beam Convolution (PBC) algorithm. This study tries to analyze the difference of dose distribution according to PBC algorithm and dose calculation algorithm of AAA on breast cancer tangential plan. Materials and Methods: Computerized medical care plan using Eclipse treatment planning system (version 8.9, VARIAN, USA) has been established for the 10 breast cancer patients using 6 MV energy of Linac (CL-6EX, VARIAN, USA). After treatment plan of Conventional Radiation Therapy plan (Conventional plan) and Field-in-Field Intensity Modulated Radiation Therapy plan (FiF plan) using PBC algorithm has been established, MU has been fixed, implemented dose calculation after changing it to AAA, and compared and analyzed treatment plan using Dose Volume Histogram (DVH). Results: Firstly, as a result of evaluating PBC algorithm of Conventional plan and the difference according to AAA, the average difference of CI value on target volume has been highly estimated by 0.295 on PBC algorithm and as a result of evaluating dose of lung, $V_{47Gy}$ and $V_{45Gy}$ has been highly evaluated by 5.83% and 4.04% each, Mean dose, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.6%, 0.29%, 6.35%, 10.23% each on AAA. Secondly, in case of FiF plan, the average difference of CI value on target volume has been highly evaluated on PBC algorithm by 0.165, and dose on ipsilateral lung, $V_{47Gy}$, $V_{45Gy}$, Mean dose has been highly evaluated 6.17%, 3.80%, 0.15% each on PBC algorithm, $V_{20Gy}$, $V_{5Gy}$, $V_{3Gy}$ has been highly evaluated 0.14%, 4.07%, 4.35% each on AAA. Conclusion: When calculating with AAA on breast cancer tangential plan, compared to PBC algorithm, Conformity on target volume of Conventional plan, FiF plan has been less evaluated by 0.295, 0.165 each. For the reason that dose of high dose region of ipsilateral lung has been showed little amount, and dose of low dose region has been showed much amount, features according to dose calculation algorithm need to be considered when we evaluate dose for the lungs.