• Title/Summary/Keyword: treatment plans

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Comparison of the Dose Distributions with Beam Arrangements in the Stereotactic Body Radiotherapy (SBRT) for Primary Lung Cancer (원발성 폐암에서 정위적 체부 방사선치료의 빔 배열에 따른 선량분포의 비교)

  • Yea, Ji Woon
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.110-115
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    • 2014
  • To compare 2 beam arrangements, circumferential equally angles (EA) beams or partially angles (PA) beams for stereotactic body radiation therapy (SBRT) of primary lung cancer for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) delivery techniques with respect to target, ipsilateral lung, contralateral lung, and organs-at-risk (OAR) dose-volume metrics, as well as treatment delivery efficiency. Data from 12 patients, four treatment plans were generated per data sets ($IMRT_{EA}$, $IMRT_{PA}$, $VMAT_{EA}$, $VMAT_{PA}$). The prescribed dose (PD) was 60 Gy in 4 fractions to 95% of the planning target volume (PTV) for a 6-MV photon beam. When compared with the IMRT and VMAT treatment plan for 2 beams, conformity index, homogeneity index, high dose spillage, D2 cm (Dmax at a distance ${\geq}2cm$ beyond the PTV), R50 (ratio of volume circumscribed by the 50% isodose line and the PTV), resulted in similar. But Dmax of the Organ at risk (OAR), spinal cord, trachea, resulted in differ between four treatment plans. Especially $HDS_{location}$ showed big difference in 21.63% vs. 26.46%.

Comparative Evaluation of Two-dimensional Radiography and Three Dimensional Computed Tomography Based Dose-volume Parameters for High-dose-rate Intracavitary Brachytherapy of Cervical Cancer: A Prospective Study

  • Madan, Renu;Pathy, Sushmita;Subramani, Vellaiyan;Sharma, Seema;Mohanti, Bidhu Kalyan;Chander, Subhash;Thulkar, Sanjay;Kumar, Lalit;Dadhwal, Vatsla
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4717-4721
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    • 2014
  • Background: Dosimetric comparison of two dimensional (2D) radiography and three-dimensional computed tomography (3D-CT) based dose distributions with high-dose-rate (HDR) intracavitry radiotherapy (ICRT) for carcinoma cervix, in terms of target coverage and doses to bladder and rectum. Materials and Methods: Sixty four sessions of HDR ICRT were performed in 22 patients. External beam radiotherapy to pelvis at a dose of 50 Gray in 27 fractions followed by HDR ICRT, 21 Grays to point A in 3 sessions, one week apart was planned. All patients underwent 2D-orthogonal and 3D-CT simulation for each session. Treatment plans were generated using 2D-orthogonal images and dose prescription was made at point A. 3D plans were generated using 3D-CT images after delineating target volume and organs at risk. Comparative evaluation of 2D and 3D treatment planning was made for each session in terms of target coverage (dose received by 90%, 95% and 100% of the target volume: D90, D95 and D100 respectively) and doses to bladder and rectum: ICRU-38 bladder and rectum point dose in 2D planning and dose to 0.1cc, 1cc, 2cc, 5cc, and 10cc of bladder and rectum in 3D planning. Results: Mean doses received by 100% and 90% of the target volume were $4.24{\pm}0.63$ and $4.9{\pm}0.56$ Gy respectively. Doses received by 0.1cc, 1cc and 2cc volume of bladder were $2.88{\pm}0.72$, $2.5{\pm}0.65$ and $2.2{\pm}0.57$ times more than the ICRU bladder reference point. Similarly, doses received by 0.1cc, 1cc and 2cc of rectum were $1.80{\pm}0.5$, $1.48{\pm}0.41$ and $1.35{\pm}0.37$ times higher than ICRU rectal reference point. Conclusions: Dosimetric comparative evaluation of 2D and 3D CT based treatment planning for the same brachytherapy session demonstrates underestimation of OAR doses and overestimation of target coverage in 2D treatment planning.

The Impact of Tissue Inhomogeneity Corrections in the Treatment of Prostate Cancer with Intensity-Modulated Radiation Therapy (전립선암의 세기조절 방사선 치료시 밀도보정의 효과)

  • Han Youngyih;Park Won;Huh Seung Jae
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.149-155
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    • 2004
  • Purpose: To investigate the effects of tissue inhomogeneity corrections on the dose delivered to prostate cancer patients treated with Intensity-Modulated Radiation Therapy (IMRT). Methods and Materials: For five prostate cancer patients, IMRT treatment plans were generated using 6 MV or 10 MV X-rays. In each plan, seven equally spaced ports of photon beams were directed to the isocenter, neglecting the tissue heterogeneity in the body. The dose at the isocenter, mean dose, maximum dose, minimum dose and volume that received more than 95% of the isocenter dose in the planning target volume ( $V_{p>95%}$) were measured. The maximum doses to the rectum and the bladder, and the volumes that received more than 50, 75 and 90% of the prescribed dose were measured. Treatment plans were then recomputed using tissue inhomogeneity correction maintaining the intensity profiles and monitor units of each port. The prescription point dose and other dosimetric parameters were remeasured. Results: The inhomogeneity correction reduced the prescription point dose by an average 4.9 and 4.0% with 6 and 10 MV X-rays, respectively. The average reductions of the $V_{p>95%}$ were 0.8 and 0.9% with the 6 and 10 MV X-rays, respectively. The mean doses in the PTV were reduced by an average of 4.2 and 3.4% with the 6 and 10 MV X-rays, respectively. The irradiated volume parameters in the rectum and bladder were less decreased; less than 2.1 % (1.2%) of the reduction in the rectum (bladder). The average reductions in the mean dose were 1.0 and 0.5% in the rectum and bladder, respectively. Conclusions: Neglect of tissue inhomogeneity in the IMRT treatment of prostate cancer gives rise to a notable overestimation of the dose delivered to the target, whereas the impact of tissue inhomogeneity correction to the surrounding critical organs is less significant.

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Analysis of the cause of dose delivery errors due to changes in abdominal gas volume during MRgART pancreatic cancer (췌장암 MRgART시 복부가스용적 변화에 의한 선량전달오류 원인 분석)

  • Ha, Min Yong;Son, Sang Jun;Kim, Chan Yong;Lee, Je Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.73-83
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    • 2020
  • Purpose: The purpose of this study is to confirm the matching of the electron density between tissue and gas due to variation of abdominal gas volume in MRgART (Magnetic Resonance-guided Adaptive Radiation Therapy) for pancreatic cancer patients, and to confirm the effect on the dose change and treatment time. Materials and Methods: We compared the PTV and OAR doses of the initial plan and the AGC(Abdominal gas correction) plans to one pancreatic cancer patient who treated with MRgART using the ViewRay MRIdian System (Viewray, USA) at this clinic. In the 4fx AGC plans, Beam ON(%) according to the patient's motion error was checked to confirm the effect of abdominal gas volume on treatment time. Results: Comparing the Initial plan with the average value of AGC plan, the dose difference was -7 to 0.1% in OAR and decreased by 0.16% on average, and in PTV, the dose decreased by 4.5% to 5.5% and decreased by 5.1% on average. In Adaptive treatment, as the abdominal gas volume increased, the Beam ON(%) decreased. Conclusion: Abdominal gas volume variation causes dose change due to inaccurate electron density matching between tissue and gas. In addition, if the abdominal gas volume increases, the Beam ON(%) decreases, and the treatment time may increase due to the motion error of the patient. Therefore, in MRgART, it is necessary to check the electron density matching and minimize the variability of the abdominal gas.

Factors Affecting Medical Treatment and Expenses for the Inpatients under Coverage of Car Insurance by Traffic Accident (교통사고로 인한 자동차보험 입원환자의 진료현황과 진료비 특성 분석)

  • Ko, Min-Seok;Choi, Joon-Young;Kim, Seung-Hee
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.274-285
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    • 2011
  • This study deals with an analysis into the details of medical treatment and expenses by items of treatment as well as the factors related to the ratio between the medical treatment and expenses for 1583 patients who were hospitalized in and discharged from 2 general hospitals located at a city under the coverage of car insurance during the year 2009. As a result, there was statistically significant difference in the details of medical treatment and expenses by items of treatment as well as their composition ratio depending on the individual characters as sex, age and the number of days staying in hospital. Each medical institution should conduct a close analysis of its patients under the car insurance program as well as the factors related to medical expenses with a view to utilize them as basic data for mapping out plans for effective operation of its organization in consideration of the characters as a medicalinstitution.

Clinical Implementation of an In vivo Dose Verification System Based on a Transit Dose Calculation Tool for 3D-CRT

  • Jeong, Seonghoon;Yoon, Myonggeun;Chung, Weon Kuu;Chung, Mijoo;Kim, Dong Wook
    • Journal of the Korean Physical Society
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    • v.73 no.10
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    • pp.1571-1576
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    • 2018
  • We developed and evaluated an algorithm to calculate the target radiation dose in cancer patients by measuring the transmitted dose during 3D conformal radiation treatment (3D-CRT) treatment. The patient target doses were calculated from the transit dose, which was measured using a glass dosimeter positioned 150 cm from the source. The accuracy of the transit dose algorithm was evaluated using a solid water phantom for five patient treatment plans. We performed transit dose-based patient dose verification during the actual treatment of 34 patients who underwent 3D-CRT. These included 17 patients with breast cancer, 11 with pelvic cancer, and 6 with other cancers. In the solid water phantom study, the difference between the transit dosimetry algorithm with the treatment planning system (TPS) and the measurement was $-0.10{\pm}1.93%$. In the clinical study, this difference was $0.94{\pm}4.13%$ for the patients with 17 breast cancers, $-0.11{\pm}3.50%$ for the eight with rectal cancer, $0.51{\pm}5.10%$ for the four with bone cancer, and $0.91{\pm}3.69%$ for the other five. These results suggest that transit-dosimetry-based in-room patient dose verification is a useful application for 3D-CRT. We expect that this technique will be widely applicable for patient safety in the treatment room through improvements in the transit dosimetry algorithm for complicated treatment techniques (including intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT).

Overview of Helicobacter pylori and Treatment Options (헬리코박터 파일로리(Helicobacter pylori) 감염 및 치료법 개요)

  • Song, Young Goo
    • Economic and Environmental Geology
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    • v.48 no.3
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    • pp.241-246
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    • 2015
  • Helicobacter pylori is an important transmissible human pathogen found on the luminal surface of the gastric epithelium. The organism can persist in the stomach indefinitely and causes gastroduodenal inflammation that may proceed to atrophic gastritis, peptic ulcer, gastric MALT lymphoma, and gastric cancer. Standard triple therapy which consists of proton pump inhibitor (PPI) plus two antibiotics (amoxicillin and clarithromycin) is now generally used in Korea, however, eradication rates of H. pylori has been decreasing due to increasing antibiotic resistance. In this review, current second-line treatment regimens, difficult problems on treatment, necessity of local target therapy, applicability of clay minerals as a drug delivery system (DDS), and a new therapeutic strategy and its study plans will be discussed.

The Detection of VOCs in Effluents from Several Wastewater Treatment Plants and Industry Drains in Nakdong River Basin (낙동강 유역 일부 폐수처리장 방류수 및 공단배수로의 휘발성유기화합물(VOCs)의 분포현황)

  • Bae, Hun-Kyun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.4
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    • pp.254-259
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    • 2012
  • The discharge characteristics of Volatile Organic Compounds (VOCs) from seven wastewater treatment plants and two industry drains at Nakdong River basin were investigated. Four Sampling campaigns were conducted between May 2008 and November 2008, and tested for 17 VOCs. As results, eight VOCs were detected at some sampling sites, but their concentration levels were low; 0.19~3.41 ${\mu}g/L$, dependent on each sampling location and substance. However, proper management plans such as supervising and monitoring systems for VOCs are needed to control those pollutants since VOCs might affect human health as well as aquatic ecosystems with extremely low concentration levels.

IMPLANTS IN PSYCHIATRIC PATIENTS (정신장애 환자의 임프란트 치료)

  • Moon, Sung-Yong;Kim, Su-Gwan
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.1
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    • pp.1-5
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    • 2007
  • Patients of mental disorder have more missing teeth than general population because of the difficulty of oral hygiene management. In addition, especially Down syndrome patients etc., congenital dental problems develop more frequently. Therefore, prosthetic rehabilitation treatments for missing teeth in mental disorder patients are required more urgently. In other words, a removable partial denture may be very difficult for such patients to wear and manage. So in this review article we reviewed implant therapeutic modes for mental disorder patients based on previous reports. It should be understood that implant treatments are not impossible for mental disorder patients, and if implants could be a good method that could provide them good quality care, so implant should be included in treatment plans before surgery. Before surgery it should be evaluated that patients ability to manage themselves their ability to manage themselves should be evaluated and also should be evaluated whether general anesthesia or sedative treatment is required for the treatment, and whether their cooperation is good enough.

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Current Status of Sewerage Technology Evalution Verification System and Direction for Improvement of the System (하수도 기술의 평가 인증제도 운영현황 및 방향)

  • Lee, Sang-Eun
    • 수도
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    • v.24 no.5 s.86
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    • pp.16-28
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    • 1997
  • As sewerage works has become one of the major public works in Korea, the employment of advanced and more appropriate sewerage technology has become essential to improve the efficiency of sewerage works. During last 10 years, the Korean Government has made tremendous amount of investment on sewerage works so that treatment plants in 58 cities have treatment capacity which is equivalent to 52.8% of total daily sewage generation in Korea. This remarkable development, however, has heavily depended on one technology, the conventional activated sludge process as more than 95% of the existing plants employ this process, Recently, the Korean Government and local authorities have plans to introduce more appropriate sewage treatment technologies and research and development in this area has become very active. To encourage employing new and appropriate technologies, however, the proper technology evaluation and verification program for new process is needed. The public sector should play a key role in this program since the sewerage works is one of the major public works. In this paper, the technology evaluation and verification programs related with sewerage facilities in the US and Japan are briefly reviewed. The Innovatived and Alternative Technology programs which was operated by US EPA until recently and Environmental Technology Verification(ETV) program which was commenced in 1995 are introduced. The technology verification programs operated in Japan and also in Korea are also reviewed in this paper to propose a future direction for development of the appropriate evaluation and verification system.

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