• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.36-38
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• 2016

Biliary tract cancer, a relatively rare disease, is usually found in an unresectable stage. Weekly cisplatin plus gemcitabine has been applied as a standard first-line therapy for advanced biliary tract cancer, but almost up to 3-5% patients experience drug induced renal impairment. Many anticancer medication guidelines recommend drug adjustment when kidneys are damaged, but weekly cisplatin is somewhat low dose so that there is a controversy on reducing the dose. And it is known that the cumulative dose of cisplatin is the most important factor contributing to renal impairment. Therefore, clinicians face troubles whether or not to maintain the chemotherapy. Here, we reported a patient whose renal function (eGFR) had been decreased as the number of chemotherapy increased, so her chemotherapy should be stopped. Since we held the chemotherapy on her, the disease progressed aggressively. Weekly cisplatin regimen is just 25 mg/m², so it may be meaningless to reduce this dose, and it is well known that cumulative dose of cisplatin is the most important factor contributing to renal impairment, it is better not to use cisplatin anymore. Therefore, we recommend that if the patient responds well to weekly cisplatin plus gemcitabine regimen, it would be beneficial to use gemcitabine alone.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.543-548
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• 2017

The aim of this study was to evaluate anteroposterior oblique(RPO, LPO) and posteroanterior oblique(LAO, RAO) projections of the cervical spine, at various kVp and mA s increments, in order to compare thyroid surface dose. Using Rando phantom, dosimeter was attached to the Cervical spine 4~5 to measure the surface dose in the same thyroid position. As a result, the surface dose was $595.08{\pm}215.01{\mu}Gy$ for anteroposterior oblique(RPO, LPO) projections and $64.21{\pm}33.49{\mu}Gy$ for posteroanterior oblique(LAO, RAO) projections by changing kVp increment. The surface dose was $445.20{\pm}230.90{\mu}Gy$ for anteroposterior oblique(RPO, LPO) projections and $44.51{\pm}22.77{\mu}Gy$ for posteroanterior oblique(LAO, RAO) projections by changing mAs increment. The posteroanterior oblique method could reduce about 90% the surface dose than the anteroposterior oblique method. There were statistically significant differences among the examinations(p<0.001). Change the direction of position to reduce the surface dose at oblique projection of cervical spine. Therefore, we consider posteroanterior oblique projections than anteroposterior oblique projections of cervical spine examination in other to reduce patient surface dose.

• 대한방사선치료학회:학술대회논문집
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• 2005.06a
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• pp.23-26
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• 2005

Introduction: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Methods and Materials: Modified MUPIT applicator basically consists of an acrylic cylinder with flexible brain applicator , an acrylic template with a predrilled array of holes that serve as guides for interstitial needles and interstitial needles. CT scan was performed to determine tumor volume and the position of interstitial needles. Modified MUPIT applicator was applied to patient in operation room and the accuracy for position of interstitial needles in tumor volume was confirmed by CTscan. Brachytherapy was delivered using modified MUPIT applicator and RALS (192-Ir HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3000cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Result: The application of modified MUPIT applicator improved dramatically dose distributions in tumor volume and follow-up of 3 month for this patient was clinically partial response without normal tissue complication, Rectal dose was measured 34.1cGy, 57.1cGy, 103.8cGy, 162.7cGy, 165.7cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1cGy, 57.1cGy Conclusion: Patients with locally recurrent tumor in uterine cervix cancer treated with modified MIUPIT applicator can expect reasonable rates of local control. The advantages of the system are the fixed geometry Provided by the template and cylinders, and improved dose distributions in irregular tumor volume without rectal complication

• Korean Journal of Radiology
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• v.24 no.7
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• pp.681-689
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• 2023

Objective: Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods: The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results: The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion: The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.63-68
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• 2017

To reduce the exposure dose in head CT, the use of low tube voltage is required. However, increasing noise may cause errors in the second data processing. In this study, we proposed a method to reduce noise by using low tube voltage. Experimental results show that the noise level is high at 100kVp and lowest at 140 kVp. The dose was lower at 100 kVp and higher at 140 kVp. As a result of applying the wavelet according to the threshold value, the noise value in the wavelet Th30 decreased to 4.51. Using the parameter condition(100 kVp, rotation time 0.5 sec, dose: 40.64 mGy) and the wavelet Th 30, the dose reduction of 65.3% was possible. We believe that applying the proposed method to head CT images will help to patient safety and interpret accurate information.

• Journal of Radiation Protection and Research
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• v.37 no.4
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• pp.231-236
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• 2012

This study derived measures to reduce exposure doses by identifying factors which affect the external radiation dose rate of patients treated with radiopharmaceuticals for PET-CT tests. The external radiation dose rates were measured on three parts of head, thorax and abdomen at a distance of 50cm from the surface of 60 PET-CT patients. It showed there are changes in factors affecting the external radiation dose rate over time after the administration of F-18 FDG. The external radiation dose rate was lower in the patients with more water intake than those with less water intake before the injection of radiopharmaceuticals at all three points: right after the injection of radiopharmaceuticals (average 4.17 mins), after the pre-PEET-CT urination step (average 77.47 mins), and right after the PET-CT test (average 114.15 mins). The study also found there is a need to increase the amount of water intake before the injection of radiopharmaceuticals in order to maintain a low external radiation dose rate in patients. This strategy is only possible under the assumption that the quality of the video has not changed after conducting this study on the relations between the image and quality. This study also found a need to use radiopharmaceuticals with the minimum amount needed for each patient because F-FDG doses affects the external radiation dose rate at the point right after the injection of radiopharmaceuticals. Urination frequency was the most significant factor to affect the external radiation dose rates at the point right after the PET-CT test and the point after the pre-PET-CT urination step. There is a need to realize the strategy to increase the urination frequency of patients to maintain the external radiation dose rate low (average 77.47 mins) before and after the injection of radiopharmaceuticals. In addition, at this point, there is a need to take advantage of personal strategies because the external radiation dose rate is lower if the fasting time is shorter, the contrast medium is used, and the amount of water intake is increased after the administration of radiopharmaceuticals. Finally this study found the need to be able to generalize these findings through an in-depth research on the factors affecting the external radiation dose rate, which includes radiopharmaceutical dose, urination frequency, the amount of water intake, fasting time and the use of contrast medium.

• Korean Journal of Digital Imaging in Medicine
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• v.11 no.1
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• pp.15-20
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• 2009

Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.245-253
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• 2011

The hazard level will be increased with the augmentation of the dose received by patients. Therefore, patients radiation dose have been analyzed by this study for the radiology clinics located at Seoul and Gyeongin area from August 2009 to September 2010. In the case of the front and rear directional inspection of skull, patient radiation dose was turned out to be 1.75mGy for radiology clinic, 3.00mGy for UK, 3.00mGy for Japan, and 5.00mGy for Germany, therefore, radiology clinic was the lowest. In the case of lateral directional inspection of skull, patient radiation dose was turned out to be 1.49mGy for radiology clinic, 1.50mGy for 3rd medical institution, therefore, radiology clinic was measured lower, and it was lower than 3.00mGy which is the recommended dose of IAEA. In order to reduce medical exposure of patient, optimization of efficient protection of radiation and reduction of medical radiation exposure are thought to be required by observing recommendation of international organization based on the result of this study.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.27-33
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• 2016

The use of cardiac angiography (CA) and the interventional procedures is rapidly increasing due to the increase in modern adult diseases. Cardiovascular intervention (CI) is an examination method where radiation is applied to the same area for a long period, and thus may cause skin injury. In this study, we investigate the diagnostic reference level (DRL) of the cardiovascular intervention (CI) carried out by medical institutions and use it as a tool to reduce patient exposure dose. In this study, the DRL was set by acquiring information about the cumulative fluoroscopy time, cumulative fluoroscopy dose-area product (DAP), radiography DAP, cumulative DAP, air kerma, number of video clips, and the total number of images from the cardiac angiography and interventional procedures performed on 147 patients. The DAPs corresponding to the DRL of cardiac angiography(CA) and that of the interventional procedures were shown to be $44.4Gy{\cdot}cm2$ and $298.6Gy{\cdot}cm2$, respectively; the corresponding DRLs of fluoroscopy time were shown to be 191.5s and 1935.3s, respectively. A DRL is not a strict upper bound for radiation exposure. However, the process of setting, enacting, and reviewing the DRLs for the dose by medical institutions will contribute to a reduction in the unnecessary exposure dose of patients.

• Progress in Medical Physics
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• v.27 no.4
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• pp.241-249
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• 2016

The present study used a digital angiography x-ray device to measure the space dose and exposure dose of patients and practitioners using x-ray tube shielding devices developed in our laboratory. The intent of the study was to reduce the space dose within the test room, and to reduce the exposure dose of patients and practitioners. The patient and practitioner exposure doses were measured in five configurations in a human body model. The glass dosimeter was placed on the eye lenses, thyroid glands, left shoulder, right shoulder, and gonads. The beam was collimated at full size and at a 48% reduction for a comparative analysis of the measurements. The space dose was measured with an ion chamber at distances of 50 cm, 100 cm, and 150 cm from the x-ray tube under the following conditions: no shielding device; a shielding device made of 3-mm-thick lead (Pb) [Pb 3 mm shield], and a shielding device made of 3-mm-thick Pb (outside) and 3-mm-thick aluminum (Al) (inside) [Pb 3 mm＋Al 3 mm shield]. The absorbed dose was the lowest when the 3-mm-thick Pb＋3-mm-thick Al shield was used. For measurements made with collimated beams with a 48% reduction, the dose was the lowest at $154{\mu}Gy$ when the 3-mm-thick Pb＋3-mm-thick Al shield was used, and was $9{\mu}Gy$ lower than the measurements made with no shielding device. If the space dose can be reduced by 20% in all situations where the C-arm is employed by using the x-ray tube shielding devices developed in our laboratory, this is expected to play an important role in reducing the annual exposure dose for patients, practitioners, and assistants.