• Title/Summary/Keyword: treatment plan

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Impact of Smaller Gantry Arc Increments on Volumetric Modulated Arc Radiation Therapy in the Monaco Treatment Planning System

  • Seonghee Kang;Hyejo Ryu;Do Hoon Oh;Lee Yoo;Minsoo Chun
    • Progress in Medical Physics
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    • v.35 no.3
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    • pp.65-72
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    • 2024
  • Purpose: This study aims to evaluate the impact of smaller gantry arc increment (GAI) values on the plan quality and deliverability of volumetric modulated arc therapy (VMAT) for head and neck (HN) and prostate cancer cases using the Monaco treatment planning system. The study investigates whether a smaller GAI can enhance organ at risk (OAR) sparing without compromising target coverage or significantly increasing plan complexity. Methods: VMAT plans were created for 20 patients (10 HN and 10 prostate cancer) using GAI values of 15° and 30°. Dose-volumetric parameters, such as conformity number, homogeneity and gradient indices, were assessed alongside plan complexity metrics like the modulation complexity score for VMAT (MCSv) and monitor unit (MU). Statistical significance was determined using the Wilcoxon signed-rank test. Results: For HN cases, a 15° increment significantly reduced the D0.03cc for the spinal cord and the Dmean for both parotid glands compared to a 30° increment, improving OAR sparing. However, no significant differences were observed in the OAR doses for prostate cases. The 15° increment resulted in higher plan complexity, reflected by a lower MCSv, but the MU difference was not significant. Conclusions: Smaller GAI values, such as 15°, can significantly reduce OAR doses in HN VMAT plans, offering potential clinical benefits despite increased plan complexity. However, no substantial advantages were observed in prostate cases. These findings suggest that smaller GAI values may be particularly beneficial for cases requiring high modulation.

Dose rate measurement of Leksell Gamma Knife Perfexion using a 3D printed plastic scintillation dosimeter

  • Lee, Sangmin;Kim, Tae Hoon;Jeong, Jae Young;Son, Jaebum;Kim, Dong Geon;Cho, Gyu-Seok;Choi, Sang Hyoun;Chung, Hyun-Tai;Kim, Yong Kyun
    • Nuclear Engineering and Technology
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    • v.52 no.10
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    • pp.2334-2338
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    • 2020
  • In recent years, 3D printing technology has received significant research attention. Additionally, 3D printing technology is being applied to study radiation dosimeters of various materials. In this study, a plastic scintillator for 3D printing was developed in a laboratory and used to manufacture a plastic scintillation dosimeter (PSD) with a shape identical to that of the ionization chamber PTW31010. The 16-mm beam of Gamma Knife® Perfexion™ was irradiated to derive the absorbed dose rates of the PSD and PTW31010; they were subsequently compared with the dose rates of the treatment plan. The differences in the dose rates of the Gamma Knife treatment plan and the absorbed dose rates of PTW31010 were within 0.87%. The difference between the dose rates of the Gamma Knife treatment plan and the absorbed dose rates of the PSD were within 4.1%. A linear fit of the absorbed dose rates of four shots involving different dose rates and irradiation angles yielded an adjusted R-square value exceeding 0.9999. A total of 10 repeated measurements were conducted for the same shot to confirm its reproducibility, with a relative error of 0.56%.

A Study on Improved Allocations of Permissible Water Pollution Load at the Implementing Stage of Tatal Water Pollution Load Management Plan (수질오염총량관리계획의 시행단계에서 오염부하량 할당방안 개선에 관한 연구)

  • Kim Sie-Heon;Rim Jay-Myung
    • Journal of environmental and Sanitary engineering
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    • v.20 no.3 s.57
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    • pp.51-56
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    • 2005
  • Allocation of water pollution load from loading capacity can be much essential, controversial, and its standards can be applied case-by-case to the various situations. Allocation methods to point sources are generally 'Equal effluent concentration', 'Equal percent Treatment', Loading capacity at planning stage consists of basic pollution load, development pollution load, reserved pollution load and margin of safety. But at the implementing stage loading capacity can be consisted of allocatable load and margin of safety to give more flexibility in the total water pollution load management plan. In that case, we can re-adjust and altogether use the pollution load of point sources of series and non-point sources at the implementing stage.

Spinal Cord Partial Block Technique Using Dynamic MLC

  • Cho, Sam-Ju;Yi, Byong-Yong;Back, Geum-Mun;Lee, Sang wook;Ahn, Seung-Do;Kim, Jong-Hoon;Kwon, Soo-Il;Park, Eun-Kyung
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.138-140
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    • 2002
  • The spinal cord dose is the one of the limiting factor for the radiation treatment of the head & neck (H&N) or the thorax region. Due to the fact that the cord is the elongated shaped structure, it is not an easy task to maintain the cord dose within the clinically acceptable dose range. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. Three dimension (3D) conformal beam directions, which minimize the coverage of the normal organs such as the lung and the parotid gland, were chosen. The PBT field shape for each field was designed to shield the spinal cord with the dMLC. The transmission factors were determined by the forward calculation method. The plan comparisons between the conventional 3D conformal therapy plan and the PTB plan were performed to evaluate the validity of this technique. The conformity index (CI) and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan always generated better results than the conventional 3D conformal plan. The PBT was proved to be useful for the H&N and thorax region.

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From TMJ to 3D Digital Smile Design with Virtual Patient Dataset for diagnosis and treatment planning (가상환자 데이터세트를 기반으로 악관절과 심미를 고려한 진단 및 치료계획 수립)

  • Lee, Soo Young;Kang, Dong Huy;Lee, Doyun;Kim, Heechul
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.30 no.2
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    • pp.71-90
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    • 2021
  • The virtual patient dataset is a collection of diagnostic data from various sources acquired from a single patient into a coordinate system of three-dimensional visualization. Virtual patient dataset makes it possible to establish a treatment plan, simulate various treatment procedures, and create a treatment planning delivery device. Clinicians can design and simulate a patient's smile on the virtual patient dataset and select the optimal result from the diagnostic process. The selected treatment plan can be delivered identically to the patient using manufacturing techniques such as 3D printing, milling, and injection molding. The delivery of this treatment plan can be linked to the final prosthesis through mockup confirmation through provisional restoration fabrication and delivery in the patient's mouth. In this way, if the diagnostic data superimposition and processing accuracy during the manufacturing process are guaranteed, 3D digital smile design simulated in 3D visualization can be accurately delivered to the real patient. As a clinical application method of the virtual patient dataset, we suggest a decision-making method that can exclude occlusal adjustment treatment from the treatment plan through the digital occlusal pressure analysis. A comparative analysis of whole-body scans before and after temporomandibular joint treatment was suggested for adolescent idiopathic scoliosis patients with temporomandibular joint disease. Occlusal plane and smile aesthetic analysis based on the virtual patient dataset was presented when treating patients with complete dentures.

The evaluation of the feasibility about prostate SBRT by analyzing interfraction errors of internal organs (분할치료간(Interfraction) 내부 장기 움직임 오류 분석을 통한 전립선암의 전신정위적방사선치료(SBRT) 가능성 평가)

  • Hong, soon gi;Son, sang joon;Moon, joon gi;Kim, bo kyum;Lee, je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.179-186
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    • 2016
  • Purpose : To figure out if the treatment plan for rectum, bladder and prostate that have a lot of interfraction errors satisfies dosimetric limits without adaptive plan by analyzing MR image. Materials and Methods : This study was based on 5 prostate cancer patients who had IMRT(total dose: 70Gy) Using ViewRay MRIdian System(ViewRay, ViewRay Inc., Cleveland, OH, USA) The treatment plans were made on the same CT images to compare with the plan quality according to adaptive plan, and the Eclipse(Ver 10.0.42, Varian, USA) was used. After registrate the 5 treatment MR images to the CT images for treatment plan to analyze the interfraction changes of organ, we measured the dose volume histogram and the changes of the absolute volume for each organ by appling the first treatment plan to each image. Over 5 fractions, the total dose for PTV was $V_{36.25}$ Gy $${\geq_-}$$ 95%. To confirm that the prescription dose satisfies the SBRT dose limit for prostate, we measured $V_{100%}$, $V_{95%}$, $V_{90%}$ for CTV and $V_{100%}$, $V_{90%}$, $V_{80%}$ $V_{50%}$ of rectum and bladder. Results : All dose average value of CTV, rectum and bladder satisfied dose limit, but there was a case that exceeded dose limit more than one after analyzing the each image of treatment. After measuring the changes of absolute volume comparing the MR image of the first treatment plan with the one of the interfraction treatment, the difference values were maximum 1.72 times at rectum and maximum 2.0 times at bladder. In case of rectum, the expected values were planned under the dose limit, on average, $V_{100%}=0.32%$, $V_{90%}=3.33%$, $V_{80%}=7.71%$, $V_{50%}=23.55%$ in the first treatment plan. In case of rectum, the average of absolute volume in first plan was 117.9 cc. However, the average of really treated volume was 79.2 cc. In case of CTV, the 100% prescription dose area didn't satisfy even though the margin for PTV was 5 mm because of the variation of rectal and bladder volume. Conclusion : There was no case that the value from average of five fractions is over the dosimetric limits. However, dosimetric errors of rectum and bladder in each fraction was significant. Therefore, the precise delivery is needed in case of prostate SBRT. The real-time tracking and adaptive plan is necessary to meet the precision delivery.

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Evaluation of the Dose According to the Movement of Breath During Field-in-Field Technique Treatment of Breast Cancer Patients (유방암 환자의 Field-in-Field Technique 치료 시 호흡의 움직임에 따른 선량 평가)

  • Kwon, Kyung-Tae
    • Journal of radiological science and technology
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    • v.41 no.6
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    • pp.561-566
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    • 2018
  • Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ${\pm}2%$ in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

A Study on the Interior Design Characteristic of Skin Clinic (피부과 의원의 실내디자인 특성에 관한 연구)

  • 윤갑근;김양지;문희정
    • Korean Institute of Interior Design Journal
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    • v.13 no.4
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    • pp.110-117
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    • 2004
  • Recently the hospitals or clinics tend to get out of the functional and technological aspect so as to gradually emphasize service for patients. While qualitative rather than quantitative alteration is noticeable, the scale of clinics is getting larger. Especially, the opulence resulted from economic, social and cultural development has enabled more people to visit dermatology or plastic surgery besides treatment for disease. Responding to this tendency, dermatology is focusing on skin beauty, plastic operation, controlling obesity, etc. for women rather than ordinary treatment. Thus, dermatology is in need of space for skin control as well as ordinary treatment, which raises the immediate necessity of new plan for space and interior environment. In order to meet such necessity of dermatology, it is required to fully study and consider the plan for interior space. First, the purpose, scope and method of research will be defined in the introduction. Second, the concept of clinic as well at the characteristic of dermatology will be studied by theoretical investigation. Third, the general concept of dermatology will be analyzed by examining the characteristic of each room in dermatology, the moving line of nurses and patients, the color of dermatology and the design factor of finishing materials through general investigation on dermatology. Fourth, in order to look into the general case of dermatology, the object of examination will be selected for examination through literature and visiting. After examining data, the result will be analyzed and evaluated to prepare the ground for interior plan of dermatology.

Fixed hybrid prosthesis (고정성 하이브리드 수복)

  • Hyun, Dong Geun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.27 no.1
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    • pp.24-40
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    • 2018
  • Often there are edentulous patients with severe vertical resorption of the alveolar ridge so that implant placement in the mandibular posterior is impossible. In this case, implants can be placed in the anterior portion of the mandible and the patient can be treated with an implant assisted overdenture, but the inherent discomfort of the removable prosthesis can not be overcome. However, if implants are appropriately placed between the mental foramen of both sides and a fixed hybrid prosthesis is fabricated to the patient, the patient will be satisfied without the inconvenience of the removable prosthesis. However, the treatment plan should be well designed to prevent disadvantages and expected complications of fixed hybrid prosthesis. Based on my clinical experience, I will explain treatment plan and protocol in detail.