Journal of Radiation Protection and Research

The Korean Association for Radiation Protection (대한방사선방어학회)
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Target motion analysis of the respiratory gated guided radiotherapy in liver cancer patients using 4D-CT

4D-CT와 호흡동조시스템을 이용한 간암 환자의 방사선치료 표적 움직임 분석

  • Dong, Kyung-Rae (Department of Radiological Technology, Gwangju Health College University) ;
  • Park, Byung-Soo (Department of Radiation Oncology, Samsung Medical Center) ;
  • Kim, Sae-Sark (Department of Radiology, Seoul National University Hospital) ;
  • Kweon, Dae-Cheol (Department of Radiologic Science, Shin Heung College University) ;
  • Goo, Eun-Hoe (Department of Radiology, Seoul National University Hospital) ;
  • Chung, Woon-Kwan (Department of Nuclear Engineering, Chosun University)
  • 동경래 (광주보건대학 방사선과) ;
  • 박병수 (삼성의료원 방사선종양학과) ;
  • 김새싹 (서울대학교병원 영상의학과) ;
  • 권대철 (신흥대학 방사선과) ;
  • 구은회 (서울대학교병원 영상의학과) ;
  • 정운관 (조선대학교 원자력공학과)
  • Published : 2010.06.30
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Abstract

The ultimate goal of radiation treatment is to use enough radiation dosage in order to examine a tumor while protecting normal tissue. Respiratory guided radiotherapy is being clinically implemented to examine a given stabilized area in order to compensate for the problems of patient breathing. This study investigates the effects of breathing movements on 40 patients with liver cancer through the actual radiation therapy plan using 4D-CT and respiratory guided radiotherapy using RPM. Using a commercial RPM respiratory gating system 4D-CT, we acquired 4D CT on multislice helical CT scanners that use different approaches to 4D CT image reconstruction. The results from analyzing forty patients according to age and direction showed no relationship between gender and transition change. The mean left-right, anteroposterior, and craniocaudal total movements were $3.19{\pm}1.29$, $5.44{\pm}2.07$, and $12.54{\pm}4.70$ mm, respectively. Changes were the largest with CC directions and as patients advanced in age, movements were larger. Therefore, as changes occur in treatment areas because of movements caused from breathing, respiratory gating system is put into operation to revise movement and can increase the radiotherapeutics effects in treating liver cancer.

방사선치료의 최대 목표는 정상조직을 보호하고 종양부위에 방사선량을 충분히 조사하는 것이다. 그 중에서 환자호흡에 의한 문제점을 보안하기 위해 환자호흡에 따른 주기적 움직임을 분석하여 안정된 일정영역에서만 방사선이 조사되도록 하는 호흡동조방사선치료 방법이 임상에서 활용되고 있다. 본 논문은 특히 호흡에 의해 움직임 영향을 많이 받는 간암 환자 40명을 대상으로 실제 방사선 치료 계획에 이용되는 4D-CT와 호흡동조방사선 치료에 사용하는 RPM을 이용하여 간암의 움직임을 환자의 나이, 성별 및 움직임 방향으로 나누어 분석하였다. 움직임의 변화는 방향으로는 right-left($3.19{\pm}1.29$), anteroposterior($5.44{\pm}2.07$), craniocaudal($12.54{\pm}4.70mm$)이었고, 이는 성별과 관련이 없고 나이가 고령일수록 움직임이 크다는 것을 알 수 있다. 따라서 호흡에 의해 움직임으로 인한 치료부위의 방향이 변화가 생김으로 RPM 호흡동조방사선 치료로 움직임에 대한 보정을 실시하여 간암 치료에서 치료효과를 높일 수 있다.

Keywords

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