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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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Postoperative Radiotherapy in Malignant Tumors of the Parotid Gland (이하선 악성종양의 수술 후 방사선 치료)

  • Chung Woong-Ki;Ahn Sung Ja;Nam Taek Ken;Chung Kyung-Ae;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.251-258
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    • 1998
  • Purpose : This study was performed to analyze the factors affecting local control in malignant tumors of the parotid gland treated with surgery and postoperative radiation. Materials and methods : Twenty-six patients were treated for malignant tumors of the parotid gland from 1986 to 1995 at Department of Therapeutic Radiology, Chonnam University Hospital. Age of the patients ranged from 14 to 72 years (median : 55 years). Histologically 10 patients of mucoepidermoid carcinoma, 7 of squamous cell carcinoma, 4 of acinic cell carcinoma, 4 of adenoid cystic carcinoma and 1 of adenocarcinoma were treated. Total parotidectomy was performd in 15 of 26 patients, superficial in 7, subtotal in 4. Facial nerve was sacrificed in 5 patients. Postoperatively 4 patients had residual disease, 4 had positive resection margin. Radiation was delivered through an ipsilateral wedged pair of photon in 11 patients. High energy electron beam was mixed with photon in 15 patients. Electron beam dose ranged from 900 cGy to 3800 cGy (median 1700 cGy). Total radiation dose ranged from 5000 cGy to 7560 cGy (median : 6020 cGy). Minimum follow-up period was 2 years. Local control and survival rate were calculated using Kaplan-Meier method. Generalized Wilcoxon test and Cox proportional hazard model were used to test factors affecting local control. Results : Five (19$\%$) of 26 patients had local recurrence. Five year local control rate was 77$\%$. Overall five year survival rate was 70$\%$. Sex, age, tumor size, surgical involvement of cervical lymph node, involvement of resection margin, surgical invasion of nerve, and total dose were analyzed as suggested factors affecting local control rate. Among them patients with tumor size less than 4 cm (p=0.002) and negative resection margin (p=0.011) were associated with better local control rates in univariate analysis. Multivariate analysis showed only tumor size factor is associated with local control rate (p=0.022). Conclusion : This study suggested that tumor size is important in local control of malignant tumors of parotid gland.

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Study on the beam properties of small field sizes (소조사면 전량분포의 특성에 관한 고찰)

  • Cho JeongHee;Lee SangKyu;An SeungKwon;Park Jell
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.1
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    • pp.1-9
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    • 2004
  • Purpose : The aim of this study is to investigate the properties of small field size and to measure the penumbra and central axis depth dose varying to the jaw setting and off axis distance for indicate this data to small field sizes radiation therapy. Material and methods : The percentage depth dose, beam profile and central axis output dose was measured by farmer type ion chamber and pinpoint chamber using Primart linac with 6MV energy. Beam quality and penumbra variations according to the central axis shift, from center to every 2cm outside increment, and field size, from $1{\times}1cm$ to $10{\times}10cm$ was investigated and compared with that of the standard geometrical condition's results Results : The differences of measured values between two ion chamber was about $37\%$ at 10cm depth with $1{\times}1cm$ field sizes but as field size increased this differences was diminished gradually. Measured data from various off axis distance with the different asymmetric collimations are not changed significantly but as size decreased the dose variation was increased and at $1{\times}1cm$ field size dose difference among off axis distance was as much as $13\%$, and as shallower the measured depth the central axis dose variations among the OAD was increased, penumbra was not changed noticeably depending on off axis distance but the percentage of penumbra from its initial field sizes was strongly dependant on field sizes and penumbra occupation rates of its own field sizes ranging from $6\%$ at $10{\times}10cm$ to $50\%$ at $1{\times}1cm$ field size. Conclusion : For imrt treatment, there are several numbers of different gentry angles with beams of nonuniform fluences are required and several complex factors involved. Among them the characteristics of beam output varying to the geometrical setting and design of collimators are of important to attaining a good treatment results. As mentioned in results the differences of measured values are changed significantly depends on ion chamber volume, depths and field size. For providing quality radiation treatment, especially at small field size, those factor's should have considering deliberately.

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Longest First Binary Search on Prefix Length for IP Address Lookup (최장 길이 우선 검색에 기초한 프리픽스 길이에 따른 이진 IP 검색 구조)

  • Chu Ha-Neul;Lim Hye-Sook
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.31 no.8B
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    • pp.691-700
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    • 2006
  • Based on the destination IP address of incoming packets, the Internet routers determine next hops and forward packets toward final destinations through If address lookup. The bandwidth of communication links increases exponentially fast as well as the routing table size grows significant as the number of single host networks attached to the Internet increases. Since packets should be processed at wire-speed, the increased link speed reduces the processing time of a packet in routers, and hence more efficient and fast IP address lookup algorithms and architectures are required in the next generation routers. Most of the previous IP lookup schemes compare routing prefixes of shorter length first with a given input IP address. Since IP address lookup needs to find the most specific route of the given input, search continues until the longest matched prefix is found while it keeps remembering the current test matching prefix. In this paper, based on binary search on prefix length, we proposed a new IP address lookup algorithm which compares longer prefixes first. The proposed scheme is consisted of multiple tries with prefixes on leaves only. The trie composed of the longest prefixes is primarily searched whether there is a match with the given input. This processing is repeated for the trio of the next longer prefixes until there finds a match. Hence the proposed algorithm provides the fast search speed. The proposed algorithm also provides the incremental update of prefixes while the previous binary search on length scheme does not provide the incremental update because of pre-processing requirement. In this paper, we performed extensive simulations and showed the performance comparisons with related works.

Consideration about LINAC movable range by H&N patient immobilization device manufacture (두경부환자 고정기구제작을 통한치료기 가동범위에 관한 고찰)

  • Jung DoHyung;Shim JinSeop;Youm DuSeok;Choi GyeSuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.63-67
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    • 2004
  • Purpose : New therapy technique appeared in 3D-CRT or IMRT according to a radiation treatment developing and worked. Such treatment technique requires the radiation irradiation of many direction. It has many restriction at radiation irradiation of many direction to the linear acceleration deception of now actually. Consequently We make new fix device and measure consequently the improvement of the activate range. Method and Material : We upload the fix device on a linear accelerator Couch. We fixed Gantry at 45, 90, 135 and Couch is spin and measure the clearance of the equipment. Couch is fixed at 0 45 90 and measures the clearance of Gantry. We upload the Extended head holder(EHH) on a linear accelerator Couch. and We measure with the experiment of the front. Result : The action range did not have big difference to increase Gantry45. but The activate range of Couch increases the angle in Gantry 90 and Gantry 135 when it uses EHH. The activate range of Gantry increases the angle in Couch 45 when it uses EHH. We showed good activate situation all in Couch 0 and Couch 90. The utility of EHH could keep a behind radiation diminution. Conclusion : The radiation irradiation of many direction comes to be possible the utility of the fix instrument(EHH). The safety space between the patient and equipment or between equipment and equipment increased the utility of the fix device. Also, The manufacture is possible imports to rather cheap price. and We could bring the frugality of the treatment expendable supplies.

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Comparison of Thyroid Doses for Shielding Material Changes in Neck Computed Tomography (Neck CT에서 차폐체 재료 변화에 따른 Thyroid 선량 비교 연구)

  • Kang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.65-71
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    • 2019
  • With regard to current Neck CT, Bismuth shielding boards are often being used to reduce exposure to superficial organs such as the thyroid. However, beam hardening often occurs near superficial organs with Bismuth shielding boards and variations in CT Number, Noise, and Uniformity values occur severely. This study looked into the usefulness of shielding boards made from aluminum and silicone that can be easily obtained and have good machinability by comparing them to the existing Bismuth shielding board. An Aluminum 7.3mm and a Silicone 21.5mm were made with shielding ratios similar to that of the Bismuth(0.06 mmPb). TLD (TLD-100) was placed on the thyroid area of the Phantom (RS-108T) and 5 doses were measured for each. To compare image quality, CT Number and Noise variations in axial images of the thyroid area in Neck CT images were compared. Also, variations in CT Number, Noise, and Uniformity were measured in the AAPM phantom images and compared. In the results, when thyroid doses for each shielding board were compared, the Bismuth shielding board showed a 14% reduction, the Silicone 21.5mm showed a 15% reduction, and the Aluminum 7.3mm showed a 13% reduction compared to the Non-Shield. Statistically, there were no significant differences in comparison with the Bismuth shielding board. In CT Number variations of thyroid area images, variations were largest for the Bismuth shielding board. With Uniformity evaluations of the AAPM phantom, the Bismuth shielding board was found unsuitable and the Aluminum 7.3mm and Silicone 21.5mm satisfied the acceptance criteria. Research results show that the Aluminum 7.3mm and Silicone 21.5mm have a similar shielding ratio to the high-priced Bismuth shielding board that is currently being used clinically and in comparison tests of CT Number attenuation coefficient variations, Noise, and Uniformity which are phantom image evaluation items, they proved to be better than Bismuth shielding boards. If various shielding boards are made using aluminum and silicone, sized appropriately for superficial organs, it would be useful in decreasing patient doses.

Basic Study to Establish Marine Activity Criteria Based on the Seakeeping Performance of Less Than 10-tons Fishing Vessels(I) (내항성능 기반 10톤 미만 어선의 해양활동 기준 마련 기초 연구(I))

  • Choi, Gwang-Young;Song, Chae-Uk;Park, Young-Soo;Park, Jun-Bum
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.28 no.6
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    • pp.965-972
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    • 2022
  • This is a basic study to establish marine activity criteria based on the seakeeping performance of less than 10-tons fishing vessels. These vessels account for approximately 95% of Korea's currently registered fishing vessels, and accidents and loss of life are also occurring during marine activities such as navigation, and fishing. Accordingly, the Ministry of Oceans and Fisheries has set a regulation of vessel traf ic control to restrict the operation of fishing vessels when the high seas watch takes effect, but it is applied equally without criteria according to the ship ton level and wave height; therefore, many differences may exist in ship fluctuations. Because the fluctuation of the ship owing to the wave height can be a factor in marine accidents by reducing the sense of boarding and performance of equipment, the seakeeping performance must be reviewed during waves to secure safe marine activities such as navigation and fishing. However, the review for the fishing vessel of established marine activity criteria based on the seakeeping performance is insufficient. Accordingly, the seakeeping performance was evaluated for a 10-ton class (G/T 9.77 tons) fishing vessel in Korea, and the level of marine activity according to the significant wave height and ship speed was interpreted by applying the operation and survival of the established seakeeping performance criteria. The analysis results indicated that the roll of the ship exceeded the operation criteria from 0.4m and the survival criteria from 2.2m. The pitch of the ship exceeded the operation criteria from 1.7m and did not exceed the survival criteria until 3.0m. However, the rolling exceeding the survival criteria from 2.2m may not be safe. Therefore, fishing vessels with less than 10-tons can leave before the high seas watch takes effect. However, they did not satisfy the criteria for evaluating the performance of the sea in relation to marine activities. Although this study was limitedly evaluated for 10-ton fishing vessels, it is expected to be of great help in preparing marine activity criteria.

The evaluation of contralateral breast's dose and shielding efficiency by breast size about breast implant patient for radiation therapy (인공 유방 확대술을 받은 환자의 유방암 치료 시 크기에 따른 반대 측 유방의 피폭 선량 및 차폐 효율 평가)

  • Kim, Jong Wook;Woo, Heon;Jeong, Hyeon Hak;Kim, Kyeong Ah;Kim, Chan Yong;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.329-336
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    • 2014
  • Purpose : To evaluate the dose on a contralateral breast and the usefulness of shielding according to the distance between the contralateral breast and the side of the beam by breast size when patients who got breast implant receive radiation therapy. Materials and Methods : We equipped 200 cc, 300 cc, 400 cc, and 500 cc breast model on the human phantom (Rando-phantom), acquired CT images (philips 16channel, Netherlands) and established the radiation treatment plan, 180 cGy per day on the left breast (EclipseTM ver10.0.42, Varian Medical Systems, USA) by size. We set up each points, A, B, C, and D on the right(contralateral) breast model for measurement by size and by the distance from the beam and attached MOSFET at each points. The 6 MV, 10 MV and 15 MV X-ray were irradiated to the left(target) breast model and we measured exposure dose of contralateral breast model using MOSFET. Also, at the same condition, we acquired the dose value after shielding using only Pb 2 mm and bolus 3 mm under the Pb 2 mm together. Results : As the breast model is bigger from 200 cc to 500 cc, The surface of the contralateral breast is closer to the beam. As a result, from 200 cc to 500 cc, on 180 cGy basis, the measurement value of the scattered ray inclined by 3.22 ~ 4.17% at A point, 4.06 ~ 6.22% at B point, 0.4~0.5% at C point, and was under 0.4% at D point. As the X-ray energy is higher, from 6 MV to 15 MV, on 180 cGy basis, the measurement value of the scattered ray inclined by 4.06~5% at A point, 2.85~4.94% at B point, 0.74~1.65% at C point, and was under 0.4% at D point. As using Pb 2 mm for shield, scattered ray declined by average 9.74% at A and B point, 2.8% at C point, and is under 1% at D point. As using Pb 2 mm and bolus together for shield, scattered ray declined by average 9.76% at A and B point, 2.2% at C point, and is under 1% at D point. Conclusion : Commonly, in case of patients who got breast implant, there is a distance difference by breast size between the contralateral breast and the side of beam. As the distance is closer to the beam, the scattered ray inclined. At the same size of the breast, as the X-ray energy is higher, the exposure dose by scattered ray tends to incline. As a result, as low as possible energy wihtin the plan dose is good for reducing the exposure dose.