• 한국방사선학회논문지
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• 제9권5호
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• pp.287-293
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• 2015

식도암은 병변의 길이가 길고 깊이의 불균질성으로 인하여 방사선의 균일한 선량분포를 얻기 어렵다. 이러한 문제점을 개선해 보고자 Half beam 법을 이용하여 선량분포의 균질성을 극복해 보고자 환자의 영상을 바탕으로 하여 Normal beam과 Half beam을 이용하여 각각 치료계획을 세워 표적체적포함율과 선량체적곡선, 일치성지수와 균질성지수를 상호 비교하고, 인접정상장기인 심장, 척수, 폐를 비교해 보고자 한다. 실험결과 Half beam을 이용한 치료계획이 표적체적포함율과 선량체적곡선 그리고 일치성지수와 균질성지수가 우수하였으며 정상조직 보호측면에서도 미미하지만 우수한 것으로 나타났다. 하지만 정확한 환자자세가 확보되지 않으면 부작용이 발생할 수 있다. 따라서, 기하학적으로 정확한 환자의 위치잡이를 수반한 Half beam의 적용은 선량적으로 유용할 수 있을 것으로 사료된다.

• Radiation Oncology Journal
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• 제38권1호
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• pp.52-59
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• 2020

Purpose: To evaluate and compare the feasibilities of magnetic resonance (MR) image-based planning using synthetic computed tomography (sCT) versus CT (pCT)-based planning in helical tomotherapy for prostate cancer. Materials and Methods: A retrospective evaluation was performed in 16 patients with prostate cancer who had been treated with helical tomotherapy. MR images were acquired using a dedicated therapy sequence; sCT images were generated using magnetic resonance for calculating attenuation (MRCAT). The three-dimensional dose distribution according to sCT was recalculated using a previously optimized plan and was compared with the doses calculated using pCT. Results: The mean planning target volume doses calculated by sCT and pCT differed by 0.65% ± 1.11% (p = 0.03). Three-dimensional gamma analysis at a 2%/2 mm dose difference/distance to agreement yielded a pass rate of 0.976 (range, 0.658 to 0.986). Conclusion: The dose distribution results obtained using tomotherapy from MR-only simulations were in good agreement with the dose distribution results from simulation CT, with mean dose differences of less than 1% for target volume and normal organs in patients with prostate cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.2051-2054
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• 2015

Background: Radiation therapy is a key part of the combined modality treatment for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), which can achieve locoregional control of disease. The 3D-conformal radiation oncology can be extended-field (EFRT), involved-field (IFRT) and involved node (INRT). New techniques have resulted in a smaller radiation field and lower dose for critical organs such as lung heart and breast. Materials and Methods: In our research, we made a virtual simulation for one patient who was treated in four different radiotherapeutic techniques: mantle field (MFRT), EFRT, IFRT and INRT. After delineatiion we compared dose-volume histograms for each technique. The fusion of CT for planning radiotherapy with the initial PET/CT was made using Softver Xio 4.6 in the Focal program. The dose for all four techniques was 36Gy. Results: Our results support the use of PET/CT in radiation therapy planning. With IFRT and INRT, the burden on the organs at risk is less than with MFRT and EFRT. On the other hand, the dose distribution in the target volume is much better with the latter. Conclusions: The aim of modern radiotherapy of HL and NHL is to reduce the intensity of treatment and therefore PET/CT should be used to reduce and not increase the amount of tissue receiving radiation.

• 한국의학물리학회지:의학물리
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• 제21권4호
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• pp.354-359
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• 2010

뇌하수체 종양의 치료 계획 시 다양한 영상 융합 프로토콜이 실제 PTV (planning target volume) coverage 및 OAR (organ at risk) 보호에 미치는 선량학적 영향을 확인하고자 하였다. 선량 체적 히스토그램(DVH, dose volume histogram)을 이용하여 각 프로토콜 별 실제 PTV의 coverage 및 그 변화 그리고 시각경로(optic pathway) 및 뇌간(brainstem)의 최대 흡수 선량과 임계 선량을 초과한 체적을 획득하였고 축상면(axial plane)과 관상면(coronal) 영상을 함께 사용하여 S-I (superior-inferior) 방향의 불확정도를 보정한 영상 융합 프로토콜이 축상면 만을 이용한 경우보다 시각경로 및 뇌간의 최대 흡수 선량과 임계 선량을 초과한 체적 모두 감소된 수치를 보임을 확인 하였다. 본 case에 한해 축상면 그리고 관상면 영상을 함께 사용하는 것이 OARs 보호에 가중치를 둔 방사선 수술 치료 계획 수립에 도움을 줄 수 있다.

• Radiation Oncology Journal
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• 제22권1호
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• pp.55-63
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• 2004

목적 : 방사선치료계획용 전산화단층활영(computerized tomography, 이하 CT) 시 주사시간이 종양부피의 재현성에 미치는 영향을 살펴보고자 하였다. 대상 및 방법 : 인공호흡기의 환기작용에 의해 세로방향의 왕복 운동을 하는 N자형 모형을 제작하였고, 호흡주기를 T로 하였을 때 주사시간을 상대적으로 각각 0.33, 0.50, 0.67, 0.75, 1.00, 1.33, 그리고 1.53 T로 설정하고 CT촬영을 시행하였다. 또한 2002년 3월 19일부터 2002년 5월 21일까지 서울아산병원 방사선종양학과에서 정위방사선수술(stereotactic radiosurgery)을 시행받은 비소세포성 폐암 환자 3명을 대상으로, 주사시간이 빠른 CT (LightSpeed, GE Medical Systems, 주사시간 0.8초)와 느린 CT (IQ Premier, Picker, 주사시간 2.0초)를 각각 $1\~4$회 시행하였다. 각각의 slice에서, N자형 모형의 왕복 운동이 CT 영상에 반영된 좌우방향 선분의 길이를 측정하여 치료계획용 CT 촬영이 모형의 움직임을 반영하는 정도를 측정하였다. 환자를 대상으로 한 연구에서는 정위적 체부 고정틀을 이용하여, 빠른 CT 및 느린 CT의 종양을 하나의 CT 영상조합에서 재구성하여 종양의 체적과 장경을 측정하여 비교하였다. 결과 : 모형실험에서 주사시간에 비례하여, 세로방향 운동을 CT 촬영에서 반영하는 정도는 증가하였으며 1.00 T 이상에서는 일정한 양상을 보였다 주사시간 1.00 T 이상에서 얻어진 결과를 기준으로, 1.00 T 미만의 주사시간을 가지는 CT촬영에서 모형운동을 반영하지 못하는 비율이 각각 $0.33\;T:\;30\%,\;0.50\;T:\;27\%,\;0.67\;T:\;20\%,\;0.75\;T:\;7.0\%$로 측정되었다. 또한 투시검사로 측정한 종양의 세로 방향 움직임이 각각 3 mm, 5 mm, 10 mm이었던 각각의 환자에서 느린 CT에서 얻어진 종양의 세로방향 장경이 빠른 CT에 비해 $5.3\%\;17\%,\;23\%$ 증가하였다. 결론 : 주사시간을 환자의 호흡주기 이상으로 하는 경우 setup margin만을 고려하여 계획용표적체적(planning target volume, PTV)을 정의할 수 있으므로 정상 폐조직에 조사되는 방사선량을 줄여 치료효율을 향상시킬 수 있을 것으로 생각된다.

• 한국의학물리학회지:의학물리
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• 제33권4호
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• pp.121-128
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• 2022

Purpose: This study evaluated the quality of plans based on magnetic resonance-guided radiotherapy (MRgRT) tri-Co-60, linac, and conventional linac-based volumetric modulated arc therapy (linac-VMAT) for prostate cancer. Methods: Twenty patients suffering from prostate cancer with intermediate risk who were treated by MAT were selected. Additional treatment plans (primary and boost plans) were generated based on MRgRT-tri-Co-60 and MRgRT-linac. The planning target volume (PTV) of MRgRT-based plans was created by adding a 3 mm margin from the clinical target volume (CTV) due to high soft-tissue contrast and real-time motion imaging. On the other hand, the PTV of conventional linac was generated based on a 1 cm margin from CTV. The targets of primary and boost plans were prostate plus seminal vesicle and prostate only, respectively. All plans were normalized to cover 95% of the target volume by 100% of the prescribed dose. Dosimetric characteristics were evaluated for each of the primary, boost, and sum plans. Results: For target coverage and conformity, the three plans showed similar results. In the sum plans, the average value of V_65Gy of the rectum of MRgRT-linac (2.62%±2.21%) was smaller than those of MRgRT tri-Co-60 (9.04%±3.01%) and linac-VMAT (9.73%±7.14%) (P<0.001). In the case of bladder, the average value of V_65Gy of MRgRT-linac was also smaller. Conclusions: In terms of organs at risk sparing, MRgRT-linac shows the best value while maintaining comparable target coverage among the three plans.

• Radiation Oncology Journal
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• 제32권1호
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• pp.23-30
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• 2014

Purpose: The goal of this study is to determine whether the magnitude of overlap between planning target volume (PTV) and rectum ($Rectum_{overlap}$) or PTV and bladder ($Bladder_{overlap}$) in prostate cancer volumetric-modulated arc therapy (VMAT) is predictive of the dose-volume relationships achieved after optimization, and to identify predictive equations and cutoff values using these overlap volumes beyond which the Quantitative Analyses of Normal Tissue Effects in the Clinic (QUANTEC) dose-volume constraints are unlikely to be met. Materials and Methods: Fifty-seven patients with prostate cancer underwent VMAT planning using identical optimization conditions and normalization. The PTV (for the 50.4 Gy primary plan and 30.6 Gy boost plan) included 5 to 10 mm margins around the prostate and seminal vesicles. Pearson correlations, linear regression analyses, and receiver operating characteristic (ROC) curves were used to correlate the percentage overlap with dose-volume parameters. Results: The percentage $Rectum_{overlap}$ and $Bladder_{overlap}$ correlated with sparing of that organ but minimally impacted other dose-volume parameters, predicted the primary plan rectum $V_{45}$ and bladder $V_{50}$ with $R^2$ = 0.78 and $R^2$ = 0.83, respectively, and predicted the boost plan rectum $V_{30}$ and bladder $V_{30}$ with $R^2$ = 0.53 and $R^2$ = 0.81, respectively. The optimal cutoff value of boost $Rectum_{overlap}$ to predict rectum $V_{75}$ >15% was 3.5% (sensitivity 100%, specificity 94%, p < 0.01), and the optimal cutoff value of boost $Bladder_{overlap}$ to predict bladder $V_{80}$ >10% was 5.0% (sensitivity 83%, specificity 100%, p < 0.01). Conclusion: The degree of overlap between PTV and bladder or rectum can be used to accurately guide physicians on the use of interventions to limit the extent of the overlap region prior to optimization.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2007년도 춘계학술대회 논문집
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• pp.1913-1926
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• 2007

Number of highway lanes and level of service are based on the 30th, 60th or 100th highest hour volume of the target year. On the other hand, railroad design volume is generally expressed in average annual daily traffic (AADT). This procedure ignores attributes of railroad demand's concentration on peak days and hours. Actual data analysis represents railroad's peaking characteristics very similar to those of highways. Therefore it is necessary to set a procedure in selecting design volume for railroad planning. This study presents a concept and the calculating procedure for railroad design hourly volume to analyze effect of railroad investment.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2243-2248
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• 2013

Background: To compare the dosimetric coverage of target volumes and organs at risk in the radical treatment of nasopharyngeal carcinoma (NPC) between intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3DCRT). Materials and Methods: Data from 10 consecutive patients treated with IMRT from June-October 2011 in Penang General Hospital were collected retrospectively for analysis. For each patient, dose volume histograms were generated for both the IMRT and 3DCRT plans using a total dose of 70Gy. Comparison of the plans was accomplished by comparing the target volume coverage (5 measures) and sparing of organs at risk (17 organs) for each patient using both IMRT and 3DCRT. The means of each comparison target volume coverage measures and organs at risk measures were obtained and tested for statistical significance using the paired Student t-test. Results: All 5 measures for target volume coverage showed marked dosimetric superiority of IMRT over 3DCRT. V70 and V66.5 for PTV70 showed an absolute improvement of 39.3% and 24.1% respectively. V59.4 and V56.4 for PTV59.4 showed advantages of 18.4% and 16.4%. Moreover, the mean PTV70 dose revealed a 5.1 Gy higher dose with IMRT. Only 4 out of 17 organs at risk showed statistically significant difference in their means which were clinically meaningful between the IMRT and 3DCRT techniques. IMRT was superior in sparing the spinal cord (less 5.8Gy), V30 of right parotid (less 14.3%) and V30 of the left parotid (less 13.1%). The V55 of the left cochlea was lower with 3DCRT (less 44.3%). Conclusions: IMRT is superior to 3DCRT due to its dosimetric advantage in target volume coverage while delivering acceptable doses to organs at risk. A total dose of 70Gy with IMRT should be considered as a standard of care for radical treatment of NPC.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.83-85
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• 2002

Yonsei Cancer Center introduced an IMRT System at the beginning of February, 2002. The system consists of CORVUS(NOMOS) inverse planning machine, LANTIS(SIEMENS), PRIMEVIEW and PRIMART Linac(SIEMENS). The optimization of CORVUS planning system with PRIMART is an important work to get an efficient treatment plan. So, we studied two Finite Size Pencil Beams, 1.0 x 1.0 cm$^2$ and 0.5 x 1.0 cm$^2$, and four leaf transmission sets, 5%, 10%, 20%, 33%. We compared the dose distribution of target volume and delivery efficiency of the plan results.