• Journal of the Korean Society of Radiology
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• v.16 no.1
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• pp.7-13
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• 2022

This study compared the aortic root image by using the ECG gating and non-ECG gating methods. We observed the presence or absence of progression of the aortic root image in the images examined by the high pitch (flash) chest pain protocol method and in the patients tested without ECG gating by the conventional method. The AAPM phantom was scanned by using high pitch (flash) chest pain protocol and general chest pain protocol. CTDI values were compared. By ECG gating, the blurring of ascending aorta was significantly reduced compared to the existing non-ECG gating test method, and the image quality of the aortic root was improved. Within the parametar range that did not show differences in noise, uniformity, and high contrast resolution, CTDI values were lower when tested with the high-pitch chest pain protocol. It was found that there is an advantage in dose reduction, and if it is applied and applied to diagnostic fields such as dissection using the dose reduction mode in the cardiac field, it is a very important test for patients who need rapid diagnosis and prompt treatment as well as a dramatic reduction in exposure dose. It is presumed to be a method.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.871-877
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• 2022

This study was conducted to improve the problems of exposure dose and image reading applied to patients due to the incorrect use of AEC during chest radiography. Images were acquired by dividing the case where AEC was used as the test condition and the case where AEC was not used. As a result of the study, the dose was reduced by 1.17% in 110 kVp without AEC than with AEC, 17.2% decrease at 100 kVp, 30.19% decrease at 90 kVp, and 46.45% decrease at 80 kVp. There was a significant difference in the statistical values according to the tube voltage change in the lung, trachea, and heart SNR average values with AEC and without AEC 110 kVp, but the difference in image quality was insignificant in actual images. When AEC was not applied at the same tube voltage, the dose could be reduced by 17.2% while maintaining the image quality similar to that of with AEC at 100 kVp without AEC. Therefore, rather than relying on AE conditions during chest radiographic examination, it is considered that the conditions should be considered for the examination while lowering the dose by selecting an appropriate tube voltage.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.59-66
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• 2011

Purpose: Investigation of the clinical use of tangential fields technique using TOMO direct in comparison to conventional LINAC based radiation therapy after breast partial mastectomy. Materials and Methods: Treatment plans were created for 3 left-sided breast cancer patients who had radiation therapy after breast partial mastectomy by using wedged tangential fields technique, field in field technique (FIF), TOMO Direct, TOMO Direct intensity modulated radiation therapy (IMRT) under the normalized prescription condition ($D_{90%}$: 50.4 Gy/28 fx within CTV). Dose volume histogram (DVH) and isodose curve were used to evaluate the dose to the clinical target volume (CTV), organ at risk (OAR). We compared and analyzed dosimetric parameters of CTV and OAR. Dosimetric parameters of CTV are $D_{99}$, $D_{95}$, Dose homogeneity index (DHI: $D_{10}/D_{90}$) and $V_{105}$, $V_{110}$. And dosimetric parameters of OAR are $V_{10}$, $V_{20}$, $V_{30}$, $V_{40}$ of the heart and $V_{10}$, $V_{20}$, $V_{30}$ of left lung. Results: Dosimetric results of CTV, the average value of $D_{99}$, $D_{95}$ were $47.7{\pm}1.1Gy$, $49.4{\pm}0.1Gy$ from wedged tangential fields technique (W) and FIF (F) were $47.1{\pm}0.6Gy$, $49.2{\pm}0.4Gy$. And it was $49.2{\pm}0.4$ vs. $48.6{\pm}0.8Gy$, $49.9{\pm}0.4$ vs. $49.5{\pm}0.3Gy$ Gy for the TOMO Direct (D) and TOMO Direct IMRT (I). The average value of dose homogeneity index was W: $1.1{\pm}0.02$, F: $1.07{\pm}0.02$, D: $1.03{\pm}0.001$, I: $1.05{\pm}0.02$. When we compared the average value of $V_{105}$, $V_{110}$ using each technique, it was the highest as $34.6{\pm}9.3%$, $7.5{\pm}7.9%$ for wedged tangential fields technique and the value dropped for FIF as $16.5{\pm}14.8%$, $2.1{\pm}3.5%$, TOMO direct IMRT as $7.5{\pm}8.3%$, $0.1{\pm}0.1%$ and the TOMO direct showed the lowest values for both as 0%. Dosimetric results of OAR was no significant difference among each technique. Conclusion: TOMO direct provides improved target dose homogeneity over wedged tangential field technique. It is no increase the amount of normal tissue volumes receiving low doses, as oppose to IMRT or Helical TOMO IMRT. Also, it simply performs treatment plan procedure than FIF. TOMO Direct is a clinical useful technique for breast cancer patients after partial mastectomy.

• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.252-259
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• 2011

To identify the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with the other two factors of body mass Index (BMI) and tube potential on radiation dose in cardiac CT. The patient receiving operation the cardiac CT examination was divided four groups into according to kVp.[A group(n=20), Non-ASIR, BMI < 25, 100 kVp; B group(n=20), Non-ASIR, BMI > 25, 120 kVp; C group(n=20), 40% ASIR BMI < 25, 100 kVp; D group(n=20), 40% ASIR, BMI > 25, 120 kVp] After setting up the region of interest in the main artery central part and right coronary artery and left anterior descending artery, the CT number was measured and an average and standard deviation were analyzed. There were A group and the difference which the image noise notes statistically between C. And A group was high so that the noise could note than C group (group A, 494 ${\pm}$ 32 HU; group C, 482 ${\pm}$ 48 HU: P<0.05) In addition, there were B group and the difference noted statistically between D. And B group was high so that the noise could note than D group (group B, 510 ${\pm}$ 45 HU; group D, 480 ${\pm}$ 82 HU: P<0.05). In the qualitative analysis of an image, there was no difference (p>0.05) which a group, B group, C group, and D as to average, A group 4.13${\pm}$0.2, B group 4.18${\pm}$0.1, and C group 4.1${\pm}$0.2 and D group note statistically altogether with 4.15${\pm}$0.1 as a result of making the clinical evaluation according to the coronary artery segments. And the inappropriate image was shown to the diagnosis in all groups. As to the radiation dose, a group 8.6${\pm}$0.9 and B group 14.9${\pm}$0.4 and C group 5.8${\pm}$0.5 and D group are 10.1${\pm}$0.6 mSv.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.341-349
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• 2011

This study was to measure the patient dose difference between 3D treatment planning CT and 4D respiratory gating CT. Study was performed with each 10 patients who have lung and liver cancer for measured patient exposure dose by using SOMATON SENSATION OPEN(SIMENS, GERMANY). CTDIvol and DLP value was used to analyze patient dose, and actual dose was measured in the location of liver and kidney for abdominal examination and lung, heart and spinal cord for chest examination. Rando phantom were used for the experiment. OSLD was used for in-vitro and in-vivo dosimetry. Increasing overall actual dose in 4D respiratory gated CT-simulation using OSLD increase the dose by 5.5 times for liver cancer patients and 6 times for lung cancer patients. In CT simulation of 10 lung cancer patients, CTDIvol value was increased by 5.7 times and DLP 2.4 times. For liver cancer patients, CTDIvol was risen by 3.8 times and DLP 1.6 times. The accuracy of treatment volume could be increased in 4D CT planning for position change due to the breaths of patient in the radiation therapy. However, patients dose was increased in 4D CT than 3D CT. In conclusion, constant efforts is required to reduce patients dose by reducing scan time and scan range.

• Progress in Medical Physics
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• v.25 no.4
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• pp.210-217
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• 2014

This study investigated the dosimetric effects of different dose calculation algorithm for lung stereotactic ablative radiotherapy (SABR) using flattening filter-free (FFF) beams. A total of 10 patients with lung cancer who were treated with SABR were evaluated. All treatment plans were created using an Acuros XB (AXB) of an Eclipse treatment planning system. An additional plans for comparison of different alagorithm recalcuated with anisotropic analytic algorithm (AAA) algorithm. To address both algorithms, the cumulative dose-volume histogram (DVH) was analyzed for the planning target volume (PTV) and organs at risk (OARs). Technical parameters, such as the computation times and total monitor units (MUs), were also evaluated. A comparison analysis of DVHs from these plans revealed the PTV for AXB estimated a higher maximum dose (5.2%) and lower minimum dose (4.2%) than that of the AAA. The highest dose difference observed 7.06% for the PTV $V_{105%}$. The maximum dose to the lung was also slightly larger in the AXB plans. The percentate volumes of the ipsilateral lung ($V_5$, $V_{10}$, $V_{20}$) receiving 5, 10, and 20 Gy were also larger in AXB plans than for AAA plans. However, these parameters were comparable between both AAA and AXB plans for the contralateral lung. The differences of the maximum dose for the spinal cord and heart were also small. The computation time of AXB plans was 13.7% shorter than that of AAA plans. The average MUs were 3.47% larger for AXB plans than for AAA plans. The results of this study suggest that AXB algorithm can provide advantages such as accurate dose calculations and reduced computation time in lung SABR plan using FFF beams, especially for volumetric modulated arc therapy technique.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.43-49
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• 2019

Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.129-138
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• 2018

Purpose : An aim of this study was to compare the effect of multi leaf collimator(MLC) types for high dimension radiotherapy in treatment sites used clinically. Material and Method : 70 patients with lung cancer, spine cancer, prostate cancer, whole pelvis, head and neck, breast cancer were included in this study. High definition(HD) MLC of TrueBeam STx (Varian Medical system, Palo Alto, CA) and millenium(M) MLC of VitalBeam (Varian Medical system, Palo Alto, CA) were used. Radiotherapy plans were performed for each patient under same treatment goals with Eclipse (Version 13.7, Varian Palo Alto USA, CA). To compare the indicators of the radiotherapy plans, planning target volume(PTV) coverage, conformity index(CI), homogeneity index(HI), and clinical indicators for each treatment sites in normal tissues were evaluated. To evaluate low dose distribution, $V_{30%}$ values were compared according to MLC types. Additionally, length and volume of targets for each treatment sites were investigated. Result : In stereotatictic body radiotherapy(SBRT) plan for lung, the average value of PTV coverage was reduced by 0.52 % with HD MLC. With SBRT plan using HD MLC for spine, the average value of PTV coverage decreased by 0.63 % and maximum dose decreased by 1.13 %. In the test of CI and HI, the values in SBRT plan with HD MLC for spine were 1.144, 1.079 and the values using M MLC were 1.160, 1.092 in SBRT plan for lung, The dose evaluation of critical organ was reduced by 1.48 % in the ipsilateral lung mean dose with HD MLC. In prostate cancer volumetric modulated arc therapy(VMAT) with HD MLC, the mean dose and the $V_{30}$ of bladder and the mean dose and the $V_{25}$ of rectum were reduced by 0.53 %, 1.42 %, 0.97 %, and 0.69 %, respectively (p<0.05). The average value of heart mean dose was reduced by 0.83 % in breast cancer VMAT with M MLC. Other assessment indices for treatment sites showed no significant difference between treatment plans with two types of MLC. Conclusion : Using HD MLC had a positive impact on the PTV coverage and normal tissue sparing in usually short or small targets such as lung and spine SBRT and prostate VMAT. But, there was no significant difference in targets with long and large such as lung, head and neck, and whole pelvis for VMAT.

• Radiation Oncology Journal
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• v.16 no.3
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• pp.265-274
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• 1998

Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy (3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aims of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis. Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy Seventy eight patients (82.1$\%$) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue complication Probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100$\%$ of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range; 0.17-0.43) was 68$\%$ of the mean NTCP with 2D treatment planning (range; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75 (79$\%$), showed major response including 25 (26$\%$) with complete responses and 50 (53$\%$) with partial responses. One and two rear overall survivals of stage III patients were 62.6$\%$ and 35.2$\%$ respectively. Twenty percent (19/95) of patients had pneumonitis; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for Patients without complication was 62$\%$ of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

• Journal of Life Science
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• v.15 no.5 s.72
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• pp.790-795
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• 2005

The effects of liquid culture of Coriolus (C) versicolor on weight gain, food intakes, food efficiency ratios, serum and hepatic lipid concentrations were investigated in male rats fed the high cholesterol diets. Eight weeks old Sprague-Dawley rats were given three different types of diet for six weeks, respectively: a control diet ($ 20\% fat +0.5 \% $ cholesterol), two kinds of C versicolor diet (control diet + $ 30\% or 40\%$C. versicozor in water) according to the levels of C. versicolor supplementation. The body weight gains of the rats fed $ 30\% or 40\% $ C. versicolor diets were lower than those in the rats fed the control diet. The food intake, food efficiency ratios, and liver, kidney, epididymal fat pad weights of the rats fed $ 30\% or 40\%$ C. versicoEer diets were similar to those of the rats fed the control diet. The concentrations of hepatic cholesterol and triglyceride in the rats fed $ 30\% or 40\% $ C. versicolor diets were significantly lower than those in the rats fed the control diet. The concentrations in serum total cholesterol, LDL-cholesterol, and atherogenic index ratios were significantly lower in the rats fed $ 30\% or 40\%$ C. versicolor diets compared to those fed the control diet. The HDL-cholesterol/total-cholesterol ratios was significantly higher in the rats fed $ 30\% or 40\% $ C. versicolor diets compared to those fed the control diet. The fecal excretion of total lipid and triglyceride in the rats fed $ 40\% $ C. versicolor diet was significantly higher than that of the rats fed the control diet. There were no significant difference found in the serum trigly-ceride, phospholipid and HDL-cholesterol concentrations among the experimental groups. These results showed that the C. versicolor feeding decreased the hepatic cholesterol, triglyceride, and the serum total cholesterol, LDL-cholesterol and atherogenic index, and increased the serum HDL-cholesterol/ total-cholesterol ratio of the rats.