• Radiation Oncology Journal
• /
• v.22 no.1
• /
• pp.25-32
• /
• 2004

Purpose : Evaluate the efficacies and toxicities of concurrent chemoradiotherapy (CCRT), with or without intraluminal brachytherapy (ILB), using a retrospective analysis in esophageal carcinomas with respect to survival. Materials and Methods : From April 1995 to July 2001, a total of 65 patients, diagnosed with an esophageal carcinoma, were treated by CCRT, with 21 also treated by ILB after CCRT. External radiotherapy was peformed using 6 or 10 MV X-rays, with a dose range of $46.8~\69.6$ Gy (median; 59.4). The ILB was peformed using high-dose-rate brachytherapy with Ir-192. The fractionation of ILB was 3 Gy by 4, or 5 Gy by 2 fractions. Cisplatin $(75\;mg/m^2)$ was given on each first day of weeks 1, 5, 9 and 13, and 5-FU $(1,000\;mg/m^2)$ as a continuous infusion for the first 4 days of each course. Results : The median survival time of all patients was 15 months, and the 1, 2 and 3-year survival rates were 55.4, 29.2 and $20.7\%$, respectively. The 2-year survival rates of the patients with and without ILB were 33.3 and $27.3\%$, respectively (p=0.80). The 2-year survival rates of the patients with a complete, partial and no response were 44.1, 13.8 and $0\%$, respectively (p=0.02). The response to treatment was the only significant factor affecting the overall survival from a multivariate analysis. Conclusion : This study has shown that the survival outcomes of CCRT were much better than previous results with radiotherapy alone. However, the addition of ILB after CCRT showed no advantage over that of CCRT alone.

• Progress in Medical Physics
• /
• v.25 no.3
• /
• pp.128-138
• /
• 2014

In gated radiation therapy (gRT), due to residual motion, beam delivery is intended to irradiate not only the true extent of disease, but also neighboring normal tissues. It is desired that the delivery covers the true extent (i.e. clinical target volume or CTV) as a minimum, although target moves under dose delivery. The objectives of our study are to validate if the intended dose is surely delivered to the true target in gRT and to quantitatively understand the trend of dose delivery on it and neighboring normal tissues when gating window (GW), motion amplitude (MA), and CTV size changes. To fulfill the objectives, experimental and computational studies have been designed and performed. A custom-made phantom with rectangle- and pyramid-shaped targets (CTVs) on a moving platform was scanned for four-dimensional imaging. Various GWs were selected and image integration was performed to generate targets (internal target volume or ITV) for planning that included the CTVs and internal margins (IM). The planning was done conventionally for the rectangle target and IMRT optimization was done for the pyramid target. Dose evaluation was then performed on a diode array aligned perpendicularly to the gated beams through measurements and computational modeling of dose delivery under motion. This study has quantitatively demonstrated and analytically interpreted the impact of residual motion including penumbral broadening for both targets, perturbed but secured dose coverage on the CTV, and significant doses delivered in the neighboring normal tissues. Dose volume histogram analyses also demonstrated and interpreted the trend of dose coverage: for ITV, it increased as GW or MA decreased or CTV size increased; for IM, it increased as GW or MA decreased; for the neighboring normal tissue, opposite trend to that of IM was observed. This study has provided a clear understanding on the impact of the residual motion and proved that if breathing is reproducible gRT is secure despite discontinuous delivery and target motion. The procedures and computational model can be used for commissioning, routine quality assurance, and patient-specific validation of gRT. More work needs to be done for patient-specific dose reconstruction on CT images.

• Radiation Oncology Journal
• /
• v.24 no.4
• /
• pp.237-242
• /
• 2006

$\underline{Purpose}$: We evaluated retrospectively the outcome of locally advanced non-small cell lung cancer patients treated with definitive radiotherapy to find out prognostic factros affecting survival. $\underline{Materials\;and\;Methods}$: 216 cases of stage IIIB non-small cell lung cancer were with treated radiotherapy at our Hospital between 1991 to 2002 and reviewed retrospectively. Cases were classified by mode of treatment and response to treatment. Patients showing complete response or partial response to treatment were included in the "response group", while those showing stable or progressive cancer were included in the "non-response group". $\underline{Results}$: 30 patients completed the planned radiotherapy treatments and 39 patients completed combined treatments or chemoradiotherapy. Median survival was 4.6 months for patients treated with radiotherapy and 9.9 months for those undergoing combined radiotherapy and chemotherapy. Survival rates for the first year were 13.3% with radiotherapy and 35.9% with chemoradiotherapy. In the second year, 3.3% of the radiotherapy patients survived and 20.5% of the patients receiving chemoradiotherapy survived. By the third year, 15.4% of the patients receiving the combined treatments survived. None of the patients treated with radiotherapy alone lived to the third year, however. Overall survival was significantly different between the radiotherapy patients and the combined chemoradiotherapy patients (p<0.001). In the response group, median survival was 7.2 months with radiotherapy and 16.5 months with combined therapy. In the non-response group, median survival was 4.4 months with radiotherapy and 6.7 months with combined treatments. Severe acute complications (grade 3) occurred in 2 cases using radiotherapy, and in 7 cases using combined therapy. $\underline{Conclusion}$: When the patients with stage IIIB non-small cell lung cancer received chemoradiotherapy, treatment response rate and overall survival was greater than with radiation alone.

• Journal of the Korean Society of Radiology
• /
• v.14 no.3
• /
• pp.193-201
• /
• 2020

The purpose of this study is to evaluate the photon characteristics according to the material and thickness of the electrons incidented through a linear accelerator. The computer simulation design is a linear accelerator target consisting of a 2 mm thick tungsten single material and a 1.8 mm and 2.3 mm thick tungsten and copper composite material. In the research method, First, the behavior of primary particles in the target was evaluated by electron fluence and electron energy deposition. Second, photons occurring within the target were evaluated by photon fluence. Finally, the photon angle-energy distribution at a distance of 1 m from the target was evaluated by photon fluence. As a result, first, electrons, which are primary particles, were not released out of the target for electron fluence and energy deposition in the target of a single material and a composite material. Then, electrons were linearly attenuated negatively according to the target thickness. Second, it was found that the composite material target had a higher photon generation than the single material target. This confirmed that the material composition and thickness influences photon production. Finally, photon fluence according to the angular distribution required for shielding analysis was calculated. These results confirmed that the photon generation rate differed depending on the material and thickness of the linear accelerator target. Therefore, this study is necessary for designing and operating a linear accelerator use facility for container security screening that is being introduced in the country. In addition, it is thought that it can be used as basic data for radiation protection.

• Journal of the Korean Society of Radiology
• /
• v.14 no.2
• /
• pp.169-178
• /
• 2020

The number of CT scans is increasing every year due to the improvement of the medical standards of the public, and thus the annual dose of medical radiation is also increasing. In this study, we evaluated the effective dose of the human body exposed to CT scans and estimated LAR. First, five region were selected from the CT diagnostic reference level guideline, and the effective dose of human body exposed to each examination was evaluated by clinical CT device. Second, the human organs and effective dose were calculated using the ALARA-CT program under the same conditions. Third, lifetime attributable risk (LAR) estimated by the effective dose exposed through the previous CT scan was estimated. As a result, the most effective dose was 21.18 mSv during the abdomen 4 phase scan, and the dose level was below DRL for all other tests except for the abdominal examination. As a result of evaluating effective dose using a dose calculation program under the same conditions, the results showed about 1.1 to 1.9 times higher results for each examination. In the case of organ dose, the closer the organ to the scan site, the higher the scattering ray. The lifetime attributable risk to CT radiation dose in adults was gradually decreased with age, and the results were somewhat different according to gender.

• Journal of radiological science and technology
• /
• v.37 no.2
• /
• pp.125-134
• /
• 2014

This study is to provide basic information regarding photoneutron doses in terms of radiation treatment techniques and the number of portals in intensity-modulated radiation therapy (IMRT) by measuring the photoneutron doses. Subjects of experiment were 10 patients who were diagnosed with prostate cancer and have received radiation treatment for 5 months from September 2013 to January 2014 in the department of radiation oncology in S hospital located in Seoul. Thus, radiation treatment plans were created for 3-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric-Modulated Arc Radiotherapy (VMAT), IMRT 5, 7, and 9 portals. The average difference of photoneutron dose was compared through descriptive statistics and variance analysis, and analyzed influence factors through correlation analysis and regression analysis. In summarized results, 3D-CRT showed the lowest average photoneutron dose, while IMRT caused the highest dose with statistically significance (p <.01). The photoneutron dose by number of portals of IMRT was $4.37{\pm}1.08mSv$ in average and statistically showed very significant difference among the number of portals (p <.01). Number of portals and photoneutron dose are shown that the correlation coefficient is 0.570, highly statistically significant positive correlation (p <.01). As a result of the linear regression analysis of number of portals and photoneutron dose, it showed that photoneutron dose significantly increased by 0.373 times in average as the number of portals increased by 1 stage. In conclusion, this study can be expected to be used as a quantitative basic data to select an appropriate IMRT plans regarding photoneutron dose in radiation treatment for prostate cancer.

• Restorative Dentistry and Endodontics
• /
• v.35 no.6
• /
• pp.436-444
• /
• 2010

Objectives: This study aimed to assess prospectively the clinical outcome of nonsurgical endodontic treatment and identify patient- and tooth-related factors, rather than treatment-related factors, that were the best predictors of this outcome. Materials and Methods: The inception cohort comprised 441 teeth (320 patients) and 175 teeth (123 patients) were followed up for 1-2 years. Age, gender, presence of medical disease, number of canals, previous endodontic treatment, presence of sensitivity and pain, pulp vitality, swelling or sinus tract of pulpal origin on the gingiva, periapical radiolucency and tendency of unilateral bite on the affected tooth were recorded at treatment start. Results: The outcome was classified on the basis of periapical radiolucency as healed or non healed. The overall healed rate in these cases, including nonsurgical retreatment, was 81.1%. Four tooth-related factors had a negative impact in the bivariate analysis: previous endodontic treatment, necrotic pulp, preoperative gingival swelling or sinus tract of pulpal origin, and preoperative periapical radiolucency. Stepwise logistic regression analysis including patient-, tooth-related factors and level of the root canal filling as a treatment-related factor showed that preoperative gingival lesion (odds ratio [OR]: 4.4; p = 0.005), preoperative periapical radiolucency (OR: 3.6; p = 0.011), and $\leq$ 1-2 mm under root filling length (OR: 9.6; p = 0.012) were significant predictors of failure. Conclusions: A preoperative gingival lesion of pulpal origin can influence the outcome of nonsurgical endodontic treatment in addition to preoperative periapical radiolucency.

• Journal of Radiation Protection and Research
• /
• v.38 no.4
• /
• pp.202-207
• /
• 2013

Bioimpedance involves a lot of information related to living tissue. If there is alteration in bio tissue, its electrical characteristics also change. It is to study electrical characteristics of pork tenderlion in using a HP-4194A Impedance/Gain-phase analyzer instrument and electrical characteristics changes by graded radiation exposure dose. The results were as follow 1. Electrical characteristics of pork tenderlion in repeated measurement had high precision within ${\pm}5$% of coefficiency of variability. 2. During the measurement impedance absolute value and phase alteration did not show statistically significant difference.(p>0.05) 3. While impedance phase of electrical characteristics associated with frequency change was almost stable, impedance absolute value was in inverse proportion to frequency that means high inverse correlation of -0.096(r). 4. Impedance absolute value dropped in radiation exposure dose. The alteration of the value did not show statistically significant difference in 1 Gy, 2 Gy and 4 Gy.(p>0.05) However in radiation exposure dose of 10 Gy, the decrease of impedance absolute value was significantly different.(p<0.05) 5. Impedance phase according to radiation exposure dose change did not show statistically significant difference in 1 Gy, 2 Gy, 4 Gy, and 10 Gy(p>0.05).

• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
• /
• v.11 no.3
• /
• pp.245-251
• /
• 2013

The energy band and the G-factor method were compared to determine the exposure rate from the measured spectrum using a NaI(Tl) scintillation detector. First, G-factors of a 3"${\Phi}X3$" NaI(Tl) detector mounted to a EFRD 3300, which means the environmental radiation monitor, in Korea Atomic Energy Research Institute (KAERI) were calculated for several directions of incident photons through the MCNP modeling, and the optimum G-factor applicable to that monitor was then determined by comparing the results both the energy band method and the G-factor method. The results for these spectrometric determinations were also compared with the dose rate from a HPIC radiation monitor around a EFRD 3300. The measured value at the EFRD 3300 based on a 3"${\Phi}X3$" NaI(Tl) detector was $7.7{\mu}R/h$ and its difference was shown about $3{\mu}R/h$, when compared with the results from a HPIC radiation moditor. Since a HPIC is known to be able to measure cosmic rays with the relatively high energy, the difference between them was caused by cosmic rays which were not detected in a 3"${\Phi}X3$" NaI(Tl) detector.

• Journal of the Korean Society of Radiology
• /
• v.18 no.2
• /
• pp.145-151
• /
• 2024

Through classes conducted using the Shift+N teaching method developed by H University for students taking major courses in radiology, the factors that influence teaching methods on learning outcomes and satisfaction with major courses were identified based on a survey of students. The analysis results were described. Compared to the existing major class method, pre-study was conducted through non-face-to-face lectures in advance and face-to-face lectures were conducted for the main class. After the lecture, related keywords corresponding to the parking lot were presented and class contents related to the keywords were applied. A possible problem was presented. In the next week, we proceeded with problem solving and explaining again the difficult or insufficient parts related to the students' review. As a result, the Shift+N teaching method showed high student participation and satisfaction due to the new class progress, which is different from the existing theory major class. Based on the results of this study, in order to efficiently deliver learning content to strengthen major competencies, we must improve existing major classes and develop teaching methods tailored to major subjects to improve students' knowledge and satisfaction through more effective and innovative teaching methods. A plan must be found.