• 제목/요약/키워드: liver volume

검색결과 289건 처리시간 0.025초

간원개에 위치한 종양에 대한 Anisotropic Analyticalal Algorithm과 Pencil Beam Convolution 알고리즘에 따른 전달선량 비교 (Comparison of Dose Distributions Calculated by Anisotropic Analytical Algorithm and Pencil Beam Convolution Algorithm at Tumors Located in Liver Dome Site)

  • 박병도;정상훈;박성호;곽정원;김종훈;윤상민;안승도
    • 한국의학물리학회지:의학물리
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    • 제23권2호
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    • pp.106-113
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    • 2012
  • 본 연구에서는 종양이 간원개에 위치한 환자들을 대상으로 Eclipse 치료계획시스템(treatment planning system V8.9 : TPS, Varian)에서 쓰이는 두 종류의 선량계산 알고리즘(pencil beam convolution : PBC, anisotropic Analytical algorithm : AAA)들을 적용하여 육안적종양체적(gross tumor volume : GTV), 내부표적체적(internal target volume : ITV), 계획용표적체적(planning target volume : PTV) 및 주요 관심장기에 전달되는 선량의 변화를 정량적으로 평가하고, 선량분포에 영향을 미칠 수 있는 인자들을 분석하고자 하였다. 본원에서 치료받은 간암환자 20명을 대상으로 하였고 그 중 10명의 환자들에 대해서는 정위적 방사선치료(stereotactic body radiation therapy : SBRT) 기술을 적용, 다른 10명의 환자들에 대해서는 3차원 입체조형 방사선치료(three-dimensional conformal radiation therapy : 3DCRT) 기술을 적용하여 치료하였다. 조사선량은 우선적으로 PBC 알고리즘을 적용하여 선량계산을 하였고 동일한 빔 정렬 및 콜리메이터(Collimator), Monitor Unit (MU) 그리고 Field 가중치를 적용시켜서 AAA 선량계산법으로 다시 계산 한 후, 두 알고리즘에 대한 처방선량 100%에 해당하는 체적(V100)의 lesion coverage factor (CVF) 들을 비교하였다. SBRT 기술을 이용한 환자들의 치료계획에서 전체 PTV에 대한 CVF의 경우, 두 선량계산 알고리즘사이 통계학적으로 유의한 상관관계(p=0.018)를 보였다. 또한, 3DCRT 기술을 이용한 환자들의 치료계획에서는 전체 PTV (p=0.006), 간원개에 위치한 PTV (p=0.013), 전체 ITV (p=0.024)에 대하여 각각 통계학적으로 유의한 상관관계를 보였다. 복부에 위치한 주요 관심장기에 대하여 SBRT 기술을 이용한 환자들의 치료계획에서 정상 간과 신장에 조사되는 최대선량에 대하여 통계학적으로 각각 유의한 상관관계(정상간: p=0.009, 신장: p=0.037)를 보였다. 본 연구에서 선택한 선량변화 예측인자들에 대하여 대응표본 T-검정(paired T-test)을 시행한 결과, 전체 PTV에 대한 간원개에만 위치하는 PTV의 비율($PTV_{dome}$/PTV)과 두 알고리즘에 의한 CVF 비율의 상관관계에 있어서 통계학적으로 유의미한 상관관계를 보였다(p<0.01). 또한, 종양의 크기에 대한 두 알고리즘의 CVF 비율에 있어서 통계학적으로 의미가 있는 상관관계를 보였다(SRS환자 p=0.017, 3DCRT환자 p=0.023). 본 연구에서는 15MV x-ray beam으로 선량을 계산할 때 PBC와 AAA간의 선량계산 차이를 분석하여 선택한 선량변화 예측인자 중 간원개에 위치한 종양의 크기와 계획용 표적체적에 대한 관계성을 알아내었다. 일반적으로 15MV x-ray beam에 의한 선량분포를 정확하게 알아내는 것은 AAA으로도 불충분하다는 것이 일반적인 사실로 받아들여지고 있어 이를 AAA와 PBC간의 차이로 그 정확성을 간접적으로 유추하여 실질적인 선량분포에 대한 치료계획단계에서의 선량분포의 차이의 경향성을 보고자 하였다.

Effect of Low Magnetic Field on Dose Distribution in the SABR Plans for Liver Cancer

  • Son, Jaeman;Chun, Minsoo;An, Hyun Joon;Kang, Seong-Hee;Chie, Eui Kyu;Yoon, Jeongmin;Choi, Chang Heon;Park, Jong Min;Kim, Jung-in
    • 한국의학물리학회지:의학물리
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    • 제29권2호
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    • pp.47-52
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    • 2018
  • To investigate the effect of low magnetic field on dose distribution in SABR plans for liver cancer, we calculated and evaluated the dose distribution to each organ with and without magnetic fields. Ten patients received a 50 Gy dose in five fractions using the $ViewRay^{(R)}$ treatment planning system. For planning target volume (PTV), the results were analyzed in the point minimum ($D_{min}$), maximum ($D_{max}$), mean dose ($D_{mean}$) and volume receiving at least 90% ($V_{90%}$), 95% ($V_{95%}$), and 100% ($V_{100%}$) of the prescription dose, respectively. For organs at risk (OARs), the duodenum and stomach were analyzed with $D_{0.5cc}$ and $D_{2cc}$, and the remained liver except for PTV was analyzed with $D_{mean}$, $D_{max}$, and $D_{min}$. Both inner and outer shells were analyzed with the point $D_{min}$, $D_{max}$, and $D_{mean}$, respectively. For PTV, the maximum change in volume due to the presence or absence of the low magnetic field showed a percentage difference of up to $0.67{\pm}0.60%$. In OAR analysis, there is no significant difference for the magnetic field. In both shell structure analyses, although there are no major changes in dose distribution, the largest value of deviation for $D_{max}$ in the outer shell is $2.12{\pm}2.67Gy$. The effect of low magnetic field on dose distribution by a Co-60 beam was not significantly observed within the body, but the dose deposition was only appreciable outside the body.

간암에서 호흡주기를 고려한 2-차원 방사선 치료 방법과 3-차원 입체조형 치료방법에서 방사선 간염 예측의 비교연구 (Comparative Study Between Respiratory Gated Conventional 2-D Plan and 3-D Conformal Plan for Predicting Radiation Hepatitis)

  • 이상욱;김귀언;정갑수;이창걸;성진실;서창옥
    • Radiation Oncology Journal
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    • 제16권4호
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    • pp.455-467
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    • 1998
  • 목적 : 방사선치료계획시 호흡에 의한 장기의 움직임이 고려하는 경우 호흡이 방사선치료에 따른 합병증 발생에 미치는 영향을 분석하고자 하였다. 대상 및 방법 : 3차원 입체조형치료를 받은 간암 환자 4례를 대상으로 하여 방사선치료 계획용컴퓨터상에서 재분석을 하였다. 호흡주기에 따라 방사선치료를 시행 받는다고 가정하여 계획용표적체적의 상하 범위를 줄여 기존의 2-차원 치료계획을 시행한 경우와 자유롭게 호흡하면서 계획된 3-차원 입체조형치료에서 정상간과 주변정상장기의 선량체적히스토그람과 normal tissue complication probability(NTCP)를 비교하였다. 결과 : 간의 호흡에 의한 상하 운동범위는 2-3cm 이었고 호흡주기에 따른 기존의 2차원 방사선치료 방법과 자유롭게 호흡하면서 시행된 3-차원적 입체조형치료 간의 계획용표적체적과 잔여정상간, 주변정상장기의 선량체적히스토그람의 뚜렷한 차이는 관찰할 수 없었다. 또한 정상잔여간의 NTCP의 차이도 관찰할 수 없었다. 결론 : 간에 대한 방사선치료시 호흡에 의해 장기의 움직임을 고려한 방사선치료계획은 방사선치료에 따른 합병증 발생에 매우 중요한 역할을 할 것으로 생각되었고 향후 이 문제점을 극복할 수 있는 많은 연구가 필요 할것으로 생각된다.

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Benefit of volumetric-modulated arc therapy over three-dimensional conformal radiotherapy for stage I-II extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue in the stomach: a dosimetric comparison

  • Chung, Joo-Hyun;Na, Kyoungsu;Kim, Il Han
    • Radiation Oncology Journal
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    • 제36권4호
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    • pp.332-340
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    • 2018
  • Purpose: To retrospectively analyze dosimetric parameters of volumetric-modulated arc therapy (VMAT) and three-dimensional conformal radiotherapy (3D-CRT) delivered to extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue in the stomach (gastric MALT lymphoma) to find out advantages of VMAT and conditions for definite benefits of VMAT. Materials and Methods: Fifty patients with stage I-II gastric MALT lymphoma received VMAT (n = 14) or 3D-CRT (n = 36) between December 2005 and April 2018. Twenty-seven patients were categorized according to whether the planning target volume (PTV) overlaps kidney(s). Dosimetric parameters were analyzed by dose-volume histogram. Results: Radiation dose to the liver was definitely lower with VMAT in terms of mean dose (p = 0.026) and V15 (p = 0.008). The V15 of the left kidney was lower with VMAT (p = 0.065). For those with PTV overlapping kidney(s), the left kidney V15 was significantly lower with VMAT. Furthermore, the closer the distance between the PTV and kidneys, the less the left kidney V15 with VMAT (p = 0.037). Delineation of kidney(s) by integrating all respiratory phases had no additional benefit. Conclusions: VMAT significantly increased monitor units, reduced treatment time and radiation dose to the liver and kidneys. The benefit of VMAT was definite in reducing the left kidney V15, especially in geometrically challenging conditions of overlap or close separation between PTV and kidney(s).

복부 자기공명영상 고급 기법과 문제 해결 전략 (Advanced Abdominal MRI Techniques and Problem-Solving Strategies)

  • 이윤희;윤성진;박소현
    • 대한영상의학회지
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    • 제85권2호
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    • pp.345-362
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    • 2024
  • 자기공명영상(이하 MRI)은 복부 영상에서 국소 병변의 감지와 특성을 찾을 수 있는 것 때문에 중요한 역할을 한다. 그러나 MRI 검사에 상대적으로 긴 검사 시간과 호흡 유지 기법에서 움직임 관리와 같은 몇 가지 힘든 요인이 있다. 최근에는 검사 시간을 줄이면서 적절한 이미지 품질을 유지하는 기법인 평행 이미징, 압축 감지(compressed sensing) 및 최첨단 딥 러닝(deep learning) 기술이 등장하여 문제 해결 전략을 가능하게 하고 있다. 또한, 역동적 조영증강 영상에서 자유 호흡 기법은, 추가 차원(extra-dimensional)-부피 보간 호흡 유지 검사(volumetric interpolated breath-hold examination) 및 황금 각도 방사형 희소 병렬(golden-angle radial sparse parallel), 간 가속 볼륨 획득(liver acceleration volume acquisition) 스타와 같은, 심한 호흡곤란이나 마취 중인 환자에게서 복부 MRI를 시행하는 것을 돕는다. 이 임상화보에서는 시간을 줄이면서도 이미지 품질을 유지하기 위한 다양한 고급 복부 MRI 기술과 역동적 영상을 위한 자유 호흡 기술을 제시하고 또한 이를 통한 예시들을 보여주고자 한다. 이러한 첨단 기법들의 고찰은 적용된 시퀀스의 적절한 해석에 도움을 줄 것이다.

성체 수컷 생쥐에서 간장과 신장의 혈관 확장 및 세포 형태에 미치는 Propyl Pyrazole Triol의 영향 (Effects of Propyl Pyrazole Triol on the Blood Vessel-Dilation and Cellular Morphology of Liver and Kidney in Adult Male Mouse)

  • 이은정;이유미;최은상;성치남;조현욱
    • Toxicological Research
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    • 제22권4호
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    • pp.365-373
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    • 2006
  • The present study was designed to characterize the effects of estrogen receptor agonist (4,4',4'-(4-Propyl-[1H]-pyrazole-1,3,5-triyl) trisphenol, PPT) on liver and kidney in male mouse using a light microscopic analysis. PPT was subcutaneously given to adult male mice at a weekly dosage of 178.6mg/kg in a volume 0.08 ml of vehicle for 3, 5 and 8 weeks. There were differences in body and organ weights between control and the treated groups. Body and kidney weights were decreased in treated group whereas, liver weight was increased. In microscopic observations, sinusoidal diameter in liver of treated group was increased 156%, 216% and 255% on week 3, 5 and 8 respectively. Compared to the control, diameter of proximal convoluted tubules in kidney was increased 37% and 43% or week 5 and 8 in treated group. Whereas, height of epithelial cells in the proximal tubules was reduced at all time points. These results suggest that microstructure of liver and kidney was changed by treatment of estrogen receptor agonist PPT in the male mice.

간정격 및 간승격 자침이 정상 성인의 맥파에 미치는 영향 비교 연구 (The Effects of Sa-am Acupuncture on Radial Pulse in Healthy Human Subjects: A Comparative Study of Liver Tonifying and Sedating)

  • 육동일;전주현;김영일;김정호
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.169-185
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    • 2015
  • Objectives : The purpose of this study is to find the effects of Sa-am liver tonifying and sedating acupuncture on radial pulse. Methods : Sixty healthy people were divided into a liver tonifying acupuncture(LTA) group, liver sedating acupuncture(LSA) group, and control group. The LTA group and LSA group received acupuncture for 20 minutes with a supine position. The Control group took a rest without receiving acupuncture. Radial pulse was measured by three dimensional pulse imaging system(DMP-3000) at four different time points (before, right after, 30 minutes after, and 60 minutes after acupuncture). We compared the three groups and figure out determined the parameters which significantly changed after acupuncture treatment. Results : 1. Pulse period, T1/T, T4/T, (T-T4)/T, T4/(T-T4), T5/T significantly changed after acupuncture. 2. H4, pulse area, systolic pulse area, diastolic pulse area, radial augmentation index(RAI), and pulse power volume / min significantly changed after acupuncture. 3. Frequency of Fourier components, ratio of frequencies of Fourier components, magnitude of Fourier components, and ratio of magnitudes of Fourier components significantly changed after acupuncture. Conclusions : LTA and LSA have an effect on the radial pulse parameters. Further studies on radial pulse change using Sa-Am acupuncture are needed.

한.양약 복용이 간기능에 미치는 영향-피부과치료 한약복용 환자를 중심으로- (Effects of Liver Function in Blood of Drug Users(Herbal and Western) in Koreans)

  • 이정석;이선동
    • 대한예방한의학회지
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    • 제8권1호
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    • pp.59-74
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    • 2004
  • We have conducted questionnaire and measured serum liver function tests on 153 patients whom have received a treatment at a local Oriental medicine clinic in Seoul from Sept. 1, 2002 to Dec. 31, 2002. Patients were categorized into the groups of control(10), decoction group(41), herbal group(5), western medicine group(45), and the group taking both herbal and western medicines(55) concurrently or separately. This study was conducted to investigate how these treatment methods can affect the liver functions. Following results were obtained : 1) Most of the research subjects were male(l03 individuals) living in large urban area, with drinking habit, highly educated, and with normal marriage. For the treatment history, 45 individuals received western medicine treatment(28.85%), 46 with Oriental medicine (29.49%), and 55 patients(35.26%) experienced both forms of treatment. 2) Measuring SD of serum liver functions for all the research subjects, T-protein was 6.95(0.73)g/dl, 4.07(0.51)g/dl for albumin, 0.44(0.19)mg/dl for T-bilirubin, 23.18(18.68)U/L for ALT, 27.42(27.43)U/L for AST, and 22l.27(64.58)mg/dl for LDH. 3) Among the research subjects with the liver functions outside of normal range were 0.64% for T-protein, 3.21% for T-bilirubin and ALT, 36.62% for AST, 0.64% for LDH, and none for Albumin. 4) Confusion variables which may affect the liver functions such as age, smoking, drinking, occupation, and residence were eliminated in calculation and no significant differences were witnessed between the control and experiment groups. 5) In measuring affects of treatment duration on the liver functions, no statistical significances were shown in multiple regression's ,${\beta}$(SE) values. 6) The values of odd ratio in the experiment groups compared to the control were in the range of $0.26(0.22){\sim}0.62(1.23)$. but T-bilirubin of the group receiving both Oriental and western medicine was 1.47(1.90) which showed statistical increase(p<0.001). 7) Factors affecting the liver functions are drinking volume per round duration of alcohol intake, western medicine treatment, gender, and age difference caused significant influences. 8) 57 individuals with serum liver functions out of normal range were mostly male, living in large urban area, median age of 38.89, with normal marriage, highly educated drinking less than once a week with less than 2 bottles per round, and with prior treatment in either western or Oriental medicine. Summarizing above results, we can carefully deduce that taking herbal medicine (both decoction and pills) or western medicine doesn't cause much affect in the liver functions. But taking two forms of medication simultaneously or altering dosage affect significant increase in the T-bilirubin level, thus one needs to take precaution when taking both. Further research is needed in this field to verify this evidence.

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관절염 백서의 염증과 간기능에 대한 목과.백굴채.위영선(木瓜.白屈菜.威靈仙)의 효능연구 (Study on the Effect of Chaenomelis Fructus.Herba Chelidonii.Clematis Florida Thunb on Inflammation and Liver Function of Rats with Arthritis)

  • 박재석;김연섭
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1610-1614
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    • 2005
  • The purpose of this study is to observe the effects of Chaenomelis Fructus Herba Chelidonii Clematis Florida Thunb mixed water extract on the inflammatory edema induced by Found's complete adjuvant and on different blood volume, and then to demonstrate its efficiencies as well as its safety. We injected Chaenomelis Fructus Herba Chelidonii Clematis Florida Thunb mixed water extract on the inflammatory edema induced by Found's complete adjuvant once daily at the same time for a week, then observed the paw-edema, the counts of the blood WBC, Serum total protein, Serum total bilirrubin, SGOT and SGPT The result obtained is as follows : Inflammatory edema on the right plantar in both sample groups showed a significant reduce compared with that in the control group. The counts of WBC in both sample groups showed a significant decrease compared with that in the control group. The volume of serum total protein in the Sample A group showed a significant decrease compared with that in the control group. The volume of serum total bilirrubin, GOT and GPT in both sample groups was not changed compared with that in the control group. As a result of this experiment, it is concluded that Chaenomelis Fructus Herba Chelidonii Clematis Florida Thunb mixed water extract showed that therapeutic effect on the anti-inflammation on arthritis; otherwise it showed non-toxic effect on the liver function.

배양산삼 추출액의 Doxorubicin 독성 완화 효과 (Protective Effect of the Water Extract of Tissue Cultured Root of Wild Ginseng Against Doxorubicin Toxicity)

  • 최경운;이평재;김호현
    • 대한본초학회지
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    • 제24권3호
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    • pp.13-19
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    • 2009
  • Objectives : This study was aimed to define the protective effect of Tissue Cultured Root of Wild Ginseng (CWG) against doxorubicin (Doxo) toxicity, and investigate the anti-tumor synergic effect of CWG in combination with Doxo in tumor-bearing C57BL/6 mice. Methods : Tumor-bearing mice were established by single inoculation with B16/F10 melanoma cells (2$\times$10$^6$/ml) subcutaneously. Tumor-bearing mice (tumor volume between 50-100 mm$^3$) were selected and divided them into control, Doxo, and Doxo+CWG group. Mice of Doxo group were received with Doxo (4 mg/kg of B.W.) intraperitoneally at 0, 4, 8 days after starting the experiment. Mice of Doxo+CWG group were received CWG water extract during 12 days in combination with Doxo treatment. The body weight, tumor volume, tumor weight, and organ weight (heart, liver, kidney, and testis) were measured. And serum SPK, GOT and creatinine values were analysed. Results : The volume and weights of tumor masses in Doxo group were decreased significantly compared with the those of control group. And the those of Doxo+CWG group were not significantly different from the those of Doxo group. Whereas the weight of body, liver, kidney and testis in Doxo+CWG group were increased significantly compared with the those of Doxo group. The level of serum CPK and GOT in Doxo group were increased compared with the those of control group. But the value of Doxo+CWG group were decreased significantly compared with the values of Doxo group. Conclusions : These results suggest that CWG has protective effect against doxorubicin toxicity. And these effect is guessed that is caused in augmentation of vital energy.