• Progress in Medical Physics
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• v.3 no.1
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• pp.53-62
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• 1992

Stereotactic implantation of intracranial lesions, and the development of stereotactic convergent irradiation, radiosurgery, techniques have to obtain the accurate coordinates of the tumor locations and that of critical organ. Computed tomography(CT) provides relatively precise imformations of tumor localization and surround the normal organs for conventional radiotherapy. This CT image use to extend for stereotactic radiosurgery procedures. Since the convergent irradiation technique in linear accelerator requires the target center coincident with gantry isocenter or radosurgery frame, the target coordinates must be described in accurately. We used the BRW stereotactic system for describing the target position in CT images This algorithm provides the coordinate conversions for orthogonal or non-orthogonal CT scan image. In this experiments, the target positions have shown the small discripancy within :to.3mm uncertanty in several known target positions in the phantom through the provided programs and it compared to that of BRW stereotactic systems.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.122-128
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• 2018

Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

• Progress in Medical Physics
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• v.31 no.3
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• pp.63-70
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• 2020

Stereotactic radiosurgery is one of the most sophisticated forms of modern advanced radiation therapy. Unlike conventional fractionated radiotherapy, stereotactic radiosurgery uses a high dose of radiation with steep gradient precisely delivered to target lesions. Lars Leksell presented the principle of radiosurgery in 1951. Gamma Knife^® (GK) is the first radiosurgery device used in clinics, and the first patient was treated in the winter of 1967. The first GK unit had 179 cobalt 60 sources distributed on a hemispherical surface. A patient could move only in a single direction. Treatment planning was performed manually and took more than a day. The latest model, Gamma Knife^® Icon^TM, shares the same principle but has many new dazzling characteristics. In this article, first, a brief history of radiosurgery was described. Then, the physical properties of modern radiosurgery machines and physicists' endeavors to assure the quality of radiosurgery were described. Intrinsic characteristics of modern radiosurgery devices such as small fields, steep dose distribution producing sharp penumbra, and multi-directionality of the beam were reviewed together with the techniques to assess the accuracy of these devices. The reference conditions and principles of GK dosimetry given in the most recent international standard protocol, International Atomic Energy Agency TRS 483, were shortly reviewed, and several points needing careful revisions were highlighted. Understanding the principles and physics of radiosurgery will be helpful for modern medical physicists.

• Journal of Veterinary Clinics
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• v.40 no.2
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• pp.139-146
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• 2023

Three dogs were referred with epistaxis and facial deformity. Computed tomography (CT) scan identified masses in the bilateral nasal cavity with soft tissue attenuation and contrast enhancement. These masses had caused adjacent bones lysis, especially lysis of cribriform plate that extended to the intracranial region. Base on histopathology and CT imaging results, tumors were diagnosed as nasal carcinomas at stage 4. Three dogs were treated with stereotactic radiation therapy (SRT). These dogs received 30-35 Gy from 3-5 daily treatments (7-10 Gy per treatment). The sizes of tumors decreased the most on follow-up CT images at one month after treatment. Recurrence was confirmed between 3 and 5 months after completing SRT. The survival time of dogs treated with SRT were 110, 190, and 210 days, respectively. This study confirmed that SRT could treat canine nasal carcinomas with cribriform plate lysis without causing serious radiation toxicities. Follow-up CT examination is considered at 1 month and 3 to 6 months after SRT to accurately evaluate the prognosis and the timing of recurrence.

• Journal of radiological science and technology
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• v.39 no.3
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• pp.391-397
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• 2016

Stereotactic body radiotherapy is effective technic in radiotherapy for low stage lung cancer. But lung cancer is affected by respiratory so accurately concentrate high dose to the target is very difficult. In this study, evaluated the target volume according to how to take the image. And evaluated the dose by photoluminescence glass dosimeter according to how to contour the volume and respiratory range. As a result, evaluated the 4D CT volume was 10.4 cm3 which was closest value of real size target. And in dose case is internal target volume dose was 10.82, 16.88, 21.90 Gy when prescribed dose was 10, 15, 20 Gy and it was the highest dose. Respiratory gated radiotherapy dose was more higher than internal target volume. But it made little difference by respiratory range. Therefore, when moving cancer treatment, acquiring image by 4D CT, contouring internal target volume and respiratory gated radiotherapy technic would be the best way.

• Journal of Korean Neurosurgical Society
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• v.57 no.6
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• pp.469-472
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• 2015

Undifferentiated sarcomas are rarely identified in the intracranial region. A 23-year-old man was admitted with a chief complaint of headache. Initial magnetic resonance images showed signs of low-grade glioma in the frontal lobe. Stereotactic biopsy was performed, and a diagnosis of diffuse astrocytoma was confirmed. Three months later, the patient presented with a high-grade tumor as seen on imaging studies. He underwent total resection of the tumor and histopathological tests identified an undifferentiated sarcoma. The patient died eight months later due to massive tumor bleeding. To the best of our knowledge, this is the first report of undifferentiated sarcoma arising from low-grade glioma without any chemotherapy or radiotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1901-1906
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• 2015

Background: Brain metastases occur in about 20-40% of patients with non-small-cell lung carcinoma (NSCLC), and are usually associated with a poor outcome. Whole brain radiotherapy (WBRT) is widely used but increasingly, more aggressive local treatments such as surgery or stereotactic radiosurgery (SRS) or stereotactic radiotherapy (SRT) are being employed. In our study we aimed to describe the various factors affecting outcomes in NSCLC patients receiving local therapy for brain metastases. Materials and Methods: The case records of 125 patients with NSCLC and brain metastases consecutively treated with radiotherapy at two tertiary centres from January 2006 to June 2012 were analysed for patient, tumour and treatment-related prognostic factors. Patients receiving SRS/SRT were treated using Cyberknife. Variables were examined in univariate and multivariate testing. Results: Overall median survival was 3.4 months (95%CI: 1.7-5.1). Median survival for patients with multiple metastases receiving WBRT was 1.5 months, 1-3 metastases receiving WBRT was 3.6 months and 1-3 metastases receiving surgery or SRS/SRT was 8.9 months. ECOG score (${\leq}2$ vs >2, p=0.001), presence of seizure (yes versus no, p=0.031), treatment modality according to number of brain metastases (1-3 metastases+surgery or $SRS/SRT{\pm}WBRT$ vs 1-3 metastases+WBRT only vs multiple metastases+WBRT only, p=0.007) and the use of post-therapy systemic treatment (yes versus no, p=0.001) emerged as significant on univariate analysis. All four factors remained statistically significant on multivariate analysis. Conclusions: ECOG ${\leq}2$, presence of seizures, oligometastatic disease treated with aggressive local therapy (surgery or SRS/SRT) and the use of post-therapy systemic treatment are favourable prognostic factors in NSCLC patients with brain metastases.

• Progress in Medical Physics
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• v.13 no.1
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• pp.9-14
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• 2002

We invented the newly developed Fractionated Stereotactic Radiotherapy(F.S.R.T) system using combined techniques of couch mounting and pedestal mounting system. Head fixation frame consists of a milled alluminium alloy(duralumin) and is placed to the couch. This frame immobilized patient head using the dental bite, 3.2 mm frontal and occipital thermoplastic mask. To evaluate the coordinate of target isocenter, Brown-Revert-Walls C.T localizer can be attached to this frame. And also, we developed the frame mounting system by developing the modification of pedestal mounting system. This system is fixed to couch floor and can be used to evaluate the isocenteric accuracy of gantry, couch and collimator in Q.A procedure. In order to measure the relocation accuracy, the acrylic phantom and the accurate pointers have been made. The repositioning of the targets in the phantom were estimated by comparing C.T coordinates and E.C.L portal films taken with anterior-posterior and right-left direction. From the results of experiments, the average distance errors between the target isocenter and its mean position were 0.71$\pm$0.19 for lateral, 0.45$\pm$0.15 for inferior-superior, 0.63$\pm$0.18 for anterior-posterior. And the maximum distance error was less than 1.3 mm. The new head fixation frame and frame mounting system were non-invasive, accurately relocatable, easy to use, very light and well tolerable by the results of phantom tests. The major advantage of using this frame mounting system is complete access to any point in the Patients cranium especially posterior direction

• Radiation Oncology Journal
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• v.20 no.2
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• pp.179-185
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• 2002

Purpose : For the purpose of quality assurance of self-developed stereotactic radiosurgery system, a multi-purpose phantom was fabricated, and accuracy of radiation dose distribution during radiosurgery was measured using this phantom. Materials and Methods : A farmer chamber, a 0.125 cc ion chamber and a diode detector were used for the dosimetry. Six MV x-ray from a linear accelerator (CL2100C, Varian) with stereotactic radiosurgery technique (Green Knife) was used, and multi-purpose phantom was attached to a stereotactic frame (Fisher type). Dosimetry was done by combinations of locations of the detectors in the phantom, fixed or arc beams, gantry angles $(20^{\circ}\~100^{\circ})$, and size of the circular tertiary collimators (inner diameters of $10\~40\;mm$). Results : The measurement error was less than $0.5\%$ by Farmer chamber, $0.5\%$ for 0.125 cc ion chamber, and less than $2\%$ for diode detector for the fixed beam, single arc beam, and 5-arc beam setup. Conclusion : We confirmed the accuracy of dose distribution with the radiosurgery system developed in our institute and the data from this study would be able to be effectively used for the improvement of quality assurance of stereotactic radiosurgery or fractionated stereotactic radiotherapy system.

• Proceedings of the Korean Society of Medical Physics Conference
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• 1999.11a
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• pp.79-79
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• 1999