• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.20-24
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• 2019

Purpose Molecular Breast Imaging (MBI) scan is used in nuclear medicine, for which $^{99m}Tc-sestaMIBI$ is administered by intravenous injection. However, the breast uptake rate of $^{99m}Tc-sestaMIBI$ is less than 1% of the total dose administered, relying on blood flow conditions of organs. The purpose of this study is to evaluate the impact of changes to body temperature on the uptake of $^{99m}Tc-sestaMIBI$ in breast tissue. Materials and Methods We investigated 30 breast cancer patients who performed more than one follow-up MBI scan. All scans were acquired by Discovery 750B (Genral Electric Healthcare, USA). $^{99m}Tc-sestaMIBI$ injected with 740 MBq (20 mCi), after 60 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. The follow-up examination was then classified into 15 body temperature control group and 15 body temperature non-control group, and gained breast image in the same way as before. The breast uptake rate was analyzed in the MLO View of the opposite side of the lesion, and blind images were evaluated. Results The breast uptake rate increased by 30.31% in the body temperature control group and it was statistically significant(P<0.05), and 0.96% in the body temperature non-control group, and it was not statistically significant(P=0.955). There was a significant difference in the uptake rate between the body temperature control and the non-control group of P value of 0.01. Evaluation of blind images showed significant results in terms of the quality of the images. Conclusion Increased breast tissue uptake was observed when the subject was kept warm. When the body temperature was raised after injection, dilation of the peripheral blood vessels can be achieved. As a result, the blood flow became smooth and the breast uptake rate increased. In addition, an increase in breast tissue uptake will improve the quality of images.

• 대한방사선치료학회:학술대회논문집
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• 2005.06a
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• pp.27-32
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• 2005

Electron is used for the treatment of skin cancer, breast cancer, and head and neck cancer in clinic. Our study is performed to check the isodose distribut ion in source surface distance(SSD) and source bolus distance(SBD) setup, nipple influence to isodose distribution of electron, junctional area isodose variation of photon and electron field. Dosimetry is carried out with phantom, acryl, and film as the same condition of treatment setup. $8\%$ of isodose difference is noted with the surface distance(SSD) and source bolus distance(SBD) setup. To reduce the influence of nipple. corresponding volume of bolus should be removed. And bolus covering all the electron field reduced hot and cold spot of junctional area of photon.

• Radiation Oncology Journal
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• v.10 no.2
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• pp.267-275
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• 1992

Remote afterloading high dose rate brachytherapy (HDRB) is a new technology and needs new biological principle for time and dose schedule. Here, authors attempt to evaluate the technique and clinical outcome in 116 patients, 590 procedures peformed at Asan Medical Center for 3 years. From Sep. 1989 to Aug 1992, 471 procedures of intracavitary radiation in 58 patients of cervical cancer and 26 of nasopharyngeal cancer,79 intraluminal radiation in 12 of esophageal cancer, 11 of endobronchial cancer and 1 Klatskin tumor and 40 interstitial brachytherapy in 4 of breast cancer, 1 sarcoma and 1 urethral cancer were performed. Median follow-up was 7 months with range $1\~31$ months. All procedures except interstitial were performed under the local anesthesia and they were all well tolerated and completed the planned therapy except 6 patients. 53/58 patients with cervical cancer and 22/26 patients with nasopharynx cancer achieved CR. Among 15 patients with palliative therapy, $80{\%}$ achieved palliation. We will describe the details of the technique and results in the text. To evaluate biologic effects of HDRB and optimal time/dose/fractionation schedule, we need longer follow-up. But authors feel that HDRB with proper fractionation schedule may yield superior results compared to the low dose rate brachytherapy considering the advantages of HDRB in safety factor for operator, better control of radiation dose and volume and patients comfort over the low dose brachytherapy.

• 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.

• 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.

• Radiation Oncology Journal
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• v.25 no.1
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• pp.7-15
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• 2007

[ $\underline{Purpose}$ ]: To determine the patterns of evaluation and treatment in patients with breast cancer after mastectomy and treated with radiotherapy. A nationwide study was performed with the goal of improving radiotherapy treatment. $\underline{Materials\;and\;Methods}$: A web- based database system for the Korean Patterns of Care Study (PCS) for 6 common cancers was developed. Randomly selected records of 286 eligible patients treated between 1998 and 1999 from 17 hospitals were reviewed. $\underline{Results}$: The ages of the study patients ranged from 20 to 80 years (median age 44 years). The pathologic T stage by the AJCC was T1 in 9.7% of the cases, T2 in 59.2% of the cases, T3 in 25.6% of the cases, and T4 in 5.3% of the cases. For analysis of nodal involvement, N0 was 7.3%, N1 was 14%, N2 was 38.8%, and N3 was 38.5% of the cases. The AJCC stage was stage I in 0.7% of the cases, stage IIa in 3.8% of the cases, stage IIb in 9.8% of the cases, stage IIIa in 43% of the cases, stage IIIb in 2.8% of the cases, and IIIc in 38.5% of the cases. There were various sequences of chemotherapy and radiotherapy after mastectomy. Mastectomy and chemotherapy followed by radiotherapy was the most commonly performed sequence in 47% of the cases. Mastectomy, chemotherapy, and radiotherapy followed by additional chemotherapy was performed in 35% of the cases, and neoadjuvant chemoradiotherapy was performed in 12.5% of the cases. The radiotherapy volume was chest wall only in 5.6% of the cases. The volume was chest wall and supraclavicular fossa (SCL) in 20.3% of the cases; chest wall, SCL and internal mammary lymph node (IMN) in 27.6% of the cases; chest wall, SCL and posterior axillary lymph node in 25.9% of the cases; chest wall, SCL, IMN, and posterior axillary lymph node in 19.9% of the cases. Two patients received IMN only. The method of chest wall irradiation was tangential field in 57.3% of the cases and electron beam in 42% of the cases. A bolus for the chest wall was used in 54.8% of the tangential field cases and 52.5% of the electron beam cases. The radiation dose to the chest wall was $45{\sim}59.4\;Gy$ (median 50.4 Gy), to the SCL was $45{\sim}59.4\;Gy$ (median 50.4 Gy), and to the PAB was $4.8{\sim}38.8\;Gy$, (median 9 Gy) $\underline{Conclusion}$: Different and various treatment methods were used for radiotherapy of the breast cancer patients after mastectomy in each hospital. Most of treatment methods varied in the irradiation of the chest wall. A separate analysis for the details of radiotherapy planning also needs to be followed and the outcome of treatment is needed in order to evaluate the different processes.

• Journal of radiological science and technology
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• v.30 no.2
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• pp.113-119
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• 2007

It is important to consider the contrast of object in Mammography because an absorption gap between tissues of body and breast in breast is low. This study is to evaluate MTF image with resolution chart according to change of combination of target and filter. The results were as follows : 1. There were significant differences in X-ray energy according to combination of filter(Mo/Mo, Mo/Rh. Mo/Al, Rh/Rh, Rh/Al) and acrylic thickness(2 cm, 3 cm, 4 cm). 2. The value of lp/mm on MTF to 0.5 showed that the sharpness in MTF curve was 2.4 compared to Mo/Mo and 2cm acryl, 2.63 in Mo/Rh and 4 cm acryl, and 2.9 in Rh/Rh and 6cm acryl. 3. The value of lp/mm on MTF showed that the resolution in MTF curve was 6.0 compared to Mo/Mo and 2 cm acryl, 4.60 in Rh/Al and 4cm acryl, and 6.03 in Rh/Al and 6 cm acryl. 4. The value of MTF on 2.5 lp/mm distinguishable visually was 0.48 compared to Mo/Mo and 2 cm acryl, 0.53 in Mo/Rh and 4cm acryl, and 0.59 in Rh/Rh and 6cm acryl. 5. For the evaluation of an image of the mammo-phantom, the score of Mo/Mo was 12 points, Mo/Rh 11, Rh/Rh 10.5, Mo/Al 10, Rh/Al 9.0, respectively.

• Journal of radiological science and technology
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• v.42 no.2
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• pp.131-135
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• 2019

The purpose of this study was to evaluate the efficacy of brachytherapy of breast cancer by dose assessment which a steady increased in Korea women. The dose assessment was performed using the MCNPX program, a MonteCarlo simulation technique. The sources used for brachytherapy was 192Ir. And nanoparticle which used for dose enhancement was gold. The density of nanoparticle was 7, 18 and 30 mg. Evaluation of absorbed dose according to distance is measured at a distance of 30, 50, 100 and 200 cm from the patient. As a result, The breast absorbed dose results increased in proportion to the density of nanoparticle. And the surrounding organs were not significantly different according to the density. But, in some organs, the absorbed dose decreased as the density of nanoparticles increased. Absorbed dose according to the distance was in inverse proportion to distance.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.109-117
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• 2007

[ $\underline{Purpose}$ ]: To evaluate the incidences and potential predictive factors for symptomatic radiation pneumonitis (SRP) and radiographic pulmonary toxicity (RPT) following adjuvant radiotherapy (RT) for patients with breast cancer. A particular focus was made to correlate RPT with the dose volume histogram (DVH) parameters based on three-dimensional RT planning (3D-RTP) data. $\underline{Materials\;and\;Methods}$: From September 2003 through February 2006, 171 patients with breast cancer were treated with adjuvant RT following breast surgery. A radiation dose of 50.4 Gy was delivered with tangential photon fields on the whole breast or chest wall. A single anterior oblique photon field for supraclavicular (SCL) nodes was added if indicated. Serial follow-up chest radiographs were reviewed by a chest radiologist. Radiation Therapy Oncology Group (RTOG) toxicity criteria were used for grading SRP and a modified World Health Organization (WHO) grading system was used to evaluate RPT. The overall percentage of the ipsilateral lung volume that received ${\geq}15\;Gy\;(V_{15}),\;20\;Gy\;(V_{20})$, and $30\;Gy\;(V_{30})$ and the mean lung dose (MLD) were calculated. We divided the ipsilateral lung into two territories, and defined separate DVH parameters, i.e., $V_{15\;TNGT},\;V_{20\;TNGT},\;V_{30\;TNGT},\;MLD_{TNGT}$, and $V_{15\;SCL},\;V_{20\;SCL},\;V_{30SCL},\;MLD_{SCL}$ to assess the relationship between these parameters and RPT. $\underline{Results}$: Four patients (2.1%) developed SRP (three with grade 3 and one with grade 2, respectively). There was no significant association of SRP with clinical parameters such as, age, pre-existing lung disease, smoking, chemotherapy, hormonal therapy and regional RT. When 137 patients treated with 3D-RTP were evaluated, 13.9% developed RPT in the tangent (TNGT) territory and 49.2% of 59 patients with regional RT developed RPT in the SCL territory. Regional RT (p<0.001) and age (p=0.039) was significantly correlated with RPT. All DVH parameters except for $V_{15\;TNGT}$ showed a significant correlation with RPT (p<0.05). $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory than $V_{15\;SCL}$ for the SCL territory. $\underline{Conclusion}$: The incidence of SRP was acceptable with the RT technique that was used. Age and regional RT were significant factors to predict RPT. The DVH parameter was good predictor for RPT for the SCL territory while $MLD_{TNGT}$ was a better predictor for RPT for the TNGT territory.

• Progress in Medical Physics
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• v.11 no.1
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• pp.59-71
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• 2000

It is possible to obtain a fast CT scan during breath holding with spiral technique. But the risk of radiation is increased due to detailed and repeated scans. However, the limitation of X-ray doses is not fully specified on CT, yet. Therefore, the purpose of the present study is to define the limitation of X-ray doses on CT The CT unit was somatom plus 4. Alderson Rando phantom, Solenoid water phantom, TLD, and reader were used. For determining adequate position and size of organs, the measurement of distance(${\pm}$2mm) from the midline of vertebral body was performed in 40 women(20~40 years). On the brain scan for 8:8(8mm slice thickness, 8mm/sec movement velocity of the table) and 10:10(10mm slice thickness, 10mm/sec movement velocity of the table) methods, the absorption doses of exposed area of the 10:10 were slightly higher than those of 8:8. The doses of unexposed uterus were negligible on the brain scan for both 8:8 and 10:10. On the chest scan for 8:8, 8:10(8mm slice thickness, 10mm/sec movement velocity of the table), 10:10, 10:12(10mm slice thickness, 12mm/sec movement velocity of the table) and 10:15(10mm slice thickness, 15mm/sec movement velocity of the table) methods, 8:8 method of the absorption doses of exposure area was the most highest and 10:15 method was the most lowest. The absorption doses of 8:10 method was relatively lower than those of the other methods. In conclusion, the 8:10 method is the most suitable to give a low radiation burden to patient without distorting image quality.