• Journal of radiological science and technology
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• v.40 no.1
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• pp.57-62
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• 2017

The purpose of this study is to reconstruct the treatment plan by applying CBCT and DIR to dose changes according to the change of the patient's motion and breast shape in the large breast cancer patients and to compare the doses using TWF, FIF and IMRT. CT and CBCT were performed with MIM6 to create DIRCT and each treatment plan was made. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) were determined and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram and the unique property of each organ. The value of HI of the PTV breast increased in all treatment planning methods using DIRCT, and CVI and CI were decreased in the treatment planning methods using DIRCT.

• The Journal of the Korea Contents Association
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• v.10 no.6
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• pp.336-343
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• 2010

Coronary artery CT angiography has short scanning length, the exposure dose is high. Therefore, it is required to study on the organ dose when using MDCT. We compared the differences between the absorbed dose and effective dose in the major organs assessing the absorbed dose in the major organs by 16-MDCT and 64-MDCT in the subjects with coronary artery CT angiography, the same protocol by 16-MDCT and 64-MDCT. As a result, the great orders of absorbed dose when conducting coronary artery CT angiography had been shown as heart, stomach, liver, pancreas, kidney, spleen, large intestine, lung, small intestine, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.538{\pm}0.026(Mean{\pm}SD,\;p<0.05)mGy{\sim}71.316{\pm}4.316mGy$ in 16-MDCT, and heart, stomach, pancreas, spleen, liver, kidney, small intestine, large intestine, lung, thyroid gland, ovary, bladder, and orbit with the absorbed dose distribution of $0.87{\pm}0.01mGy{\sim}115.26{\pm}1.59mGy$ in 64-MDCT, demonstrating some different distributions. The exposed doses to the patient per one time scanning with coronary artery CT angiography were $71.316{\pm}4.316mGy$ in 16-MDCT as the absorbed dose based on the heart and $115.26{\pm}1.59mGy$ in 64-MDCT. The effective doses were 7.41 mSv and 12.11 mSv in 16 and 64-MDCT, respectively. Taking into account the results of brain CT with 2.8 mSv that has comparatively large scanning length and size, facial CT 0.8 mSv, chest CT 5.7 mSv, pelvic CT 7.2 mSv, and abdominal and pelvic CT 14.4 mSv, it is very high considering the scanning length of 13 cm limited to the heart for the scanning range.

• Radiation Oncology Journal
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• v.21 no.1
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• pp.82-93
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• 2003

Purpose : To reduce the Irradiation dose to the lungs and heart in the case of chest wail irradiation using an oppositional electron beam, we used an Individualized custom bolus, which was precisely designed to compensate for the differences In chest wall thickness. The benefits were evaluated by comparing the normal tissue complication probablilties (NTCPS) and dose statistics both with and without boluses. Materials and Methods : Boluses were made, and their effects evaluated in ten patients treated using the reverse hockey-stick technique. The electron beam energy was determined so as to administer 80% of the irradiation prescription dose to the deepest lung-chest wall border, which was usually located at the internal mammary lymph node chain. An individualized custom bolus was prepared to compensate for a chest wall thinner than the prescription depth by meticulously measuring the chest wall thickness at 1 emf intervals on the planning CT Images. A second planning CT was obtained overlying the individuailzed custom bolus for each patient's chest wall. 3-D treatment planning was peformed using ADAC-Pinnacle$^{3}$ for all patients with and without bolus. NTCPS based on 'the Lyman-Kutcher' model were analyzed and the mean, maximum, minimum doses, V$_{50}$ and V$_{95}$ for 4he heari and lungs were computed. Results .The average NTCPS in the ipsliateral lung showed a statistically significant reduction (p<0.01), from 80.2${\pm}$3.43% to 47.7${\pm}$4.61%, with the use of the individualized custom boluses. The mean lung irradiation dose to the ipsilateral iung was also significantly reduced by about 430 cGy, Trom 2757 cGy to 2,327 cGy (p<0.01). The V$_{50}$ and V$_{95}$ in the ipsilateral lung markedly decreased from the averages of 54.5 and 17.4% to 45.3 and 11.0%, respectively. The V$_{50}$ and V$_{95}$ In the heart also decreased from the averages of 16.8 and 6.1% to 9.8% and 2.2%, respectively. The NTCP In the contralateral lung and the heart were 0%, even for the cases with no bolus because of the small effective mean radiation volume values of 4.4 and 7.1%, respectively Conclusion : The use of an Individualized custom bolus in the radiotherapy of postrnastectorny chest wall reduced the NTCP of the ipsilateral lung by about 24.5 to 40.5%, which can improve the complication free cure probability of breast cancer patients.

• Journal of the Korean Society of Radiology
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• v.8 no.6
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• pp.279-285
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• 2014

This study is to have dose reduction and minimization of excessive use of contrast medium in the pediatric cardiac computed tomography and to suggest the optimization plan to acquire the enhancement image of the 4 chambers at the same time by formulating scan delay time in empirical method with considering variables such as contrast medium injection velocity and cardiac approaching time. Quantitative, qualitative and dose assessment were carried out for 30 pediatric patients who had taken the cardiac examination. In conclusion, image enhancement in 4 chambers of the cardiac shows over 300 HU which is proper to pediatric cardiac reading by applying the empirical method with calculating scan delay time according to weight and contrast medium volume and injection velocity. Qualitative image assessments in confidence sharpness and noise have excellence qualitatively. Exposure dose to pediatrics also decreases precisely. Therefore this study is judged to take a important role of making optimization images with advantages of dose reduction and less side effects caused by it's excessive use in clinic.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.535-541
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• 2016

This study aimed to identify dose reduction measures by retrospectively analyzing the entrance surface dose at computed tomography and angiography in cardiovascular examination and to contribute the patients with renal impairmend and a high probability of side effects to determine the inspection's direction by measuring the contrast usages actually to active actions for the dose by actually measuring the contrast medium dose. The CTDIvol value and air kerma value, which are the entrance surface doses of the two examinations, and the contrast medium dose depending on the number of slides were compared and analyzed. This study was conducted in 21 subjects (11 males; 10 females) who underwent Cardiac Computed Tomographic Angiography (CCTA) and Coronary Angiography (CAG) in this hospital during the period from May 2014 to May 2016. The subject's age was 48~85 years old (mean $65{\pm}10$ years old), and the weight was 37.6~83.3 kg (mean $63{\pm}6kg$). Dose reduction could be expected in the cardiovascular examination using CCTA rather than in the examination using CAG. In terms of contrast medium dose, CAG used a smaller dose than CCTA. In particular, as the number of slides increases at CAG, the contrast medium dose increases. Therefore, in order to reduce the contrast medium dose, the number of slides suitable for the scan range must be selected.

• Journal of the Korean Society of Radiology
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• v.10 no.4
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• pp.271-278
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• 2016

This study was fulfilled to evaluate the absorbed dose of breast and adjacent organs using MIRD type phantom in brachytherapy of breast cancer. The absorbed dose was analyzed assuming left or right breast is source organ which is $^{103}Pd$ or $^{192}Ir$. As a result, $^{192}Ir$ dose is higher than $^{103}Pd$ in source organ and also in contralateral breast. Particularly, significant adjacent organs are lung, liver, heart and contralateral breast in brachytherapy of breast cancer.

• The Journal of the Korea Contents Association
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• v.14 no.8
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• pp.225-232
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• 2014

Underwent on modified radical mastectomy(MRM) and radiation therapy, it affects increasing rates of chronic morbidity, because of including chest wall and internal mammary nodes(IMNs). It causes the high absorbed dose on heart and ipsilateral lung. Thus in this study, we compared dose distributions through utilizing the intensity modulated radiation therapy(IMRT) and the volumetric modulated arc therapy(VMAT). We selected 10 breast cancer patients at random who took MRM and radiation therapy. Treatment plannings were done by using IMRT and VMAT from each patient ranging supraclavicular lymphnodes(SCL) and IMNs. After that we analysed the planning target volume(PTV)'s conformity and absorbed doses on heart and lungs. As a results, PTV conformities were indicated the same patten(p<0.05) in both plans. In case of Lt breast cancer patients, the dose maximum regions of the heart were more lesser in VMAT technique rather than the IMRT(p<0.05). Also, the maximum dose areas of lungs were lesser in VMAT technique rather than the IMRT(p<0.05). Therefore, it would be safe to say that it is more effective way to adapt the VMAT technique than IMRT in such cases like involve IMNs in breast cancer patients.

• Progress in Medical Physics
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• v.25 no.4
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• pp.199-204
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• 2014

The purpose of this study is to evaluate the dosimetric outcome of the field-in-field (FIF) plans compared with tangential wedged beams (TWB) plans for whole breast irradiation of breast cancer patients. Twenty patients with right-sided breast cancer and 10 patients with left-sided breast cancer were retrospectively enrolled in this study. We generated a FIF plan and a TWB plan for each patient to compare dosimetric outcomes. The dose the homogeneity index (HI), the conformity index (CI) and the uniformity index (UI) were defined and used for comparison of the dosimetric outcome of the planning target volume (PTV). To compare the dosimetric outcome of the organs at risk, the mean dose ($D_{mean}$) and the percentage of volumes receiving more than 10, 20 and 30 Gy of the ipsilateral lung and heart were used. The FIF plans had significantly lower HI (p=0.002), higher UI (p=0.000) and CI (p=0.000) than those of the TWB plans, which means that the FIF plans were better than the TWB plans in the dosimetric comparisons of the PTV. The $V10_{lung}$ ($17.1{\pm}7.1$ vs. $18.6{\pm}6.6%$, p=0.020) and $V30_{lung}$ ($10.3{\pm}5.1%$ vs. $10.7{\pm}5.2%$, p=0.000) were lower with the FIF plans compared with those of the TWB plans, with statistical significance. For the left-sided breast cancer patients, $D_{mean}$ of the heart ($2.6{\pm}1.3$ vs. $3.2{\pm}1.4$ Gy, p=0.000), $V20_{heart}$ ($3.4{\pm}2.6$ vs. $3.6{\pm}2.8%$, p=0.005) and $V30_{heart}$ ($2.6{\pm}2.3%$ vs. $2.9{\pm}2.4%$, p=0.004) were significantly lower for the FIF plans in comparison with those of the TWB plans. The FIF plans increased the dose homogeneity, conformity and uniformity of the target volume for the whole-breast irradiation compared with the TWB plans. Moreover, FIF plans reduced the doses to the ipsilateral lung and heart.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.3-12
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• 2011

Purpose: With increasing medical use of radiation and radioactive isotopes, there is a need to better manage the risk of radiation exposure. This study aims to grasp and analyze the individual radiation exposure situations of radiation-related workers in a medical facility by specific job, in order to instill awareness of radiation danger and to assist in safety and radiation exposure management for such workers. Materials and Methods: From January 1, 2010 December 31, 2010, medical practitioners working in the radiation is classified as a regular personal radiation dosimetry, and subsequently one year 540 people managed investigation department to target workers, dose sectional area, working period, identify the job function-related tasks for a deep dose, respectively, the annual average radiation dose were analyzed. Frequency analysis methods include ANOVA was performed. Results: Medical radiation workers in the department an annual radiation dose of Nuclear and 4.57 mSv a was highest, dose zone-specific distribution of nuclear medicine and in the 5.01~19.05 mSv in the high dose area distribution showed departmental radiation four of the annual radiation dose of Nuclear and 7.14 mSv showed the highest radiation dose. More work an average annual radiation dose according to the job function related to the synthesis of Cyclotron to 17.47 mSv work showed the highest radiation dose, Gamma camera Cinema Room 7.24 mSv, PET/CT Cinema Room service is 7.60 mSv, 2.04 mSv in order of intervention high, were analyzed. Working period, according to domain-specific average annual dose of radiation dose from 10 to 14 in oral and maxillofacial radiology practitioners as high as 1.01~3.00 mSv average dose showed the Department of Radiology, 1-4 years, 5-9 years, respectively, 1.01 workers~8.00 mSv in the range of the most high-dose region showed the distribution, nuclear medicine, and the 1-4 years, 5-9 years 3.01~19.05 mSv, respectively, workers of the highest dose showed the distribution of the area in the range of 10 to 14 years, Workers at 15-19 3.01~15.00 mSv, respectively in the range of the high-dose region were distributed. Conclusion: These results suggest that medical radiation workers working in Nuclear Medicine radiation safety management of the majority of the current were carried out in the effectiveness, depending on job characteristics has been found that many differences. However, this requires efforts to minimize radiation exposure, and systematic training for them and for reasonable radiation exposure management system is needed.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.669-675
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• 2018

This study aimed to investigate the difference of X-ray exposure by comparing and analyzing entrance surface dose and absorbed dose according to the frame change in coronary angiography using an X-ray machine. Moreover, appropriate frame selection measures for examination, including the effect of frame change on the image quality, were sought by measuring and analyzing the SNR and CNR of the image through image J. The study was conducted on 30 patients (19 males and 11 females) who underwent CAG at this hospital from June 2017 to October 2017. In regard to the patients, their age range was 49-82 years (mean of $65{\pm}9$ years), body weight was 45-91 kg (mean of $67{\pm}8.9kg$), height was 150-179cm (mean of $165.1{\pm}8.9kg$), and BMI was 19.5-30.5(mean of $24.5{\pm}2.9$). For the entrance surface dose and absorbed dose, air kerma value and DAP were obtained and analyzed retrospectively. The SNR and CNR were measured and analyzed through imageJ, and the result values were derived by applying the values to the formula. As for the statistical analyses, the correlations between the entrance surface dose and absorbed dose, and between the SNR and CNR were analyzed by using the SPSS statistical program. The relationship between the entrance surface dose and absorbed dose was not statistically significant for both 10 f/s and 15 f/s (p>0.05). In terms of the relationship between the SNR and CNR, the SNR ($3.374{\pm}2.1297$) and CNR ($0.234{\pm}0.2249$) in 10 f/s were $1.43{\pm}0.4861$ and $0.132{\pm}0.0555$ lower, respectively, than the SNR ($4.929{\pm}2.8532$) and CNR ($0.391{\pm}0.3025$) in 15 f/s, which were not statistically significant (p>0.05). In the correlation analysis, statistically significant results were obtained among the BMI, air kerma, and DAP; between air kerma and DAP; and between SNR and CNR (p<0.001, p<0.001). In conclusion, there was no significant difference between the entrance surface dose and absorbed dose even when the images were taken by changing the frame from 10 f/s to 15 f/s at the time of the coronary angiography. SNR and CNR increased at 15 f/s than at 10 f/s, but they were not statistically significant. Therefore, this study suggests that the concern of the patient and practitioner regarding image quality degradation, as well as the problem of X-ray exposure caused by imaging at 10 f/s and 15 f/s, may be reduced.