• Title/Summary/Keyword: 종양의 크기

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Analysis of Specificity for Tumor Marker CYFRA 21-1 in Patients with Pulmonary Tuberculosis (폐결핵 환자에서 종양표지자 CYFRA 21-1의 특이도 분석)

  • Ha, Hyun-Cheol;Lee, Jae-Sung;Song, Sun-Dae;Kim, Cheol-Min;Lee, Min-Gi;Kim, In-Joo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.290-300
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    • 1998
  • Background: CYFRA 21-1 is a tumor marker which measures a fragment of cytokeratin 19 expressed by epithelial cells in bronchus. It is known that cytokeratin 19 is abundant in squamous epithelial cell cancer of the lung. However, if the incidence of elevated serum CYFRA 21-1 level in patients with benign lung diseases or pulmonary tuberculosis with severe parenchymal damage is high the specificity of CYFRA 21-1 could be decreased. The purpose of this study is to investigate the changes of serum CYFRA 21-1 according to the degree of parenchymal damage and the usefulness of CYFRA 21-1 for diagnosing possibly combined lung cancer in patients with pulmonary tuberculosis. Method: We studied the changes of serum CYFRA 21-1 according to the sputum AFB stain, radiologic manifestation and history of treatment in 81 patients with pulmonary tuberculosis, and 20 healthy persons, 25 patients with lung cancer, as a control group. CYFRA 21-1 concentration in serum was quantified by the immunoradiometry assay(Centocor$^{(R)}$). Result: The results were as follow; Serum CYFRA 21-1 level was significantly lower in patients with pulmonary tuberculosis($1.54{\pm}1.19ng/mL$, p<0.01) as compared to patients with lung cancer($12.25{\pm}15.97ng/mL$), and was slightly higher than the level in heathy persons($0.90{\pm}0.49ng/mL$) but there was no significant difference. Serum CYFRA 21-1 level was below the cut-off value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis but it was above the cut-off value in 64 percent of patients with lung cancer. Serum CYFRA 21-1 level was significantly higher in the initial treatment group($1.91{\pm}1.55ng/mL$, p<0.05) as compared to the treatment. failure group ($0.92{\pm}0.30ng/mL$). According to the sputum AFB smear, serum CYFRA 21-1 level in patients with negative result was slightly higher than the level in patients with positive result but there was no significant difference. According to the radiologic manifestation, serum CYFRA 21-1 level was significantly higher in patients with infiltrative lesion ($2.15{\pm}1.63ng/mL$, p<0.01) as compared to patients with destructive lesion ($l.04{\pm}0.54ng/mL$). As the size of cavity or destructive lesion was larger, the level was significantly lower(p<0.05). Conclusion: As serum CYFRA 21-1 level was significantly higher in the initial treatment group and patients with infiltrative lesion, it suppose to be closely related with the degree of parenchymal damage of the lung of the pulmonary tuberculosis. However CYFRA 21-1 could be useful method for diagnosing lung cancer even in patients with pulmonary tuberculosis combined with lung cancer because of the fact that it was below the cutoff value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis.

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Comparison of Treatment Planning System(TPS) and actual Measurement on the surface under the electron beam therapy with bolus (전자선 치료 시 Bolus를 적용한 경우 표면선량의 Treatment Planning System(TPS) 계산 값과 실제 측정값의 비교)

  • Kim, Byeong Soo;Park, Ju Young;Park, Byoung Suk;Song, Yong Min;Park, Byung Soo;Song, Ki Weon
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.163-170
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    • 2014
  • Purpose : If electron, chosen for superficial oncotherapy, was applied with bolus, it could work as an important factor to a therapy result by showing a drastic change in surface dose. Hence the calculation value and the actual measurement value of surface dose of Treatment Planning System (TPS) according to four variables influencing surface dose when using bolus on an electron therapy were compared and analyzed in this paper. Materials and Methods : Four variables which frequently occur during the actual therapies (A: bolus thickness - 3, 5, 10 mm, B: field size - $6{\time}6$, $10{\time}10$, $15{\time}15cm2$, C: energy - 6, 9, 12 MeV, D: gantry angle - $0^{\circ}$, $15^{\circ}$) were set to compare the actual measurement value with TPS(Pinnacle 9.2, philips, USA). A computed tomography (lightspeed ultra 16, General Electric, USA) was performed using 16 cm-thick solid water phantom without bolus and total 54 beams where A, B, C, and D were combined after creating 3, 5 and 10 mm bolus on TPS were planned for a therapy. At this moment SSD 100 cm, 300 MU was investigated and measured twice repeatedly by placing it on iso-center by using EBT3 film(International Specialty Products, NJ, USA) to compare and analyze the actual measurement value and TPS. Measured film was analyzed with each average value and standard deviation value using digital flat bed scanner (Expression 10000XL, EPSON, USA) and dose density analyzing system (Complete Version 6.1, RIT, USA). Results : For the values according to the thickness of bolus, the actual measured values for 3, 5 and 10 mm were 101.41%, 99.58% and 101.28% higher respectively than the calculation values of TPS and the standard deviations were 0.0219, 0.0115 and 0.0190 respectively. The actual values according to the field size were $6{\time}6$, $10{\time}10$ and $15{\time}15cm2$ which were 99.63%, 101.40% and 101.24% higher respectively than the calculation values and the standard deviations were 0.0138, 0.0176 and 0.0220. The values according to energy were 6, 9, and 12 MeV which were 99.72%, 100.60% and 101.96% higher respectively and the standard deviations were 0.0200, 0.0160 and 0.0164. The actual measurement value according to beam angle were measured 100.45% and 101.07% higher at $0^{\circ}$ and $15^{\circ}$ respectively and standard deviations were 0.0199 and 0.0190 so they were measured 0.62% higher at $15^{\circ}$ than $0^{\circ}$. Conclusion : As a result of analyzing the calculation value of TPS and measurement value according to the used variables in this paper, the values calculated with TPS on 5 mm bolus, $6{\time}6cm2$ field size and low-energy electron at $0^{\circ}$ gantry angle were closer to the measured values, however, it showed a modest difference within the error bound of maximum 2%. If it was beyond the bounds of variables selected in this paper using electron and bolus simultaneously, the actual measurement value could differ from TPS according to each variable, therefore QA for the accurate surface dose would have to be performed.

Quality Assurance for Intensity Modulated Radiation Therapy (세기조절방사선치료(Intensity Modulated Radiation Therapy; IMRT)의 정도보증(Quality Assurance))

  • Cho Byung Chul;Park Suk Won;Oh Do Hoon;Bae Hoonsik
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.275-286
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    • 2001
  • Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

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HW/SW Partitioning Techniques for Multi-Mode Multi-Task Embedded Applications (멀티모드 멀티태스크 임베디드 어플리케이션을 위한 HW/SW 분할 기법)

  • Kim, Young-Jun;Kim, Tae-Whan
    • Journal of KIISE:Computer Systems and Theory
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    • v.34 no.8
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    • pp.337-347
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    • 2007
  • An embedded system is called a multi-mode embedded system if it performs multiple applications by dynamically reconfiguring the system functionality. Further, the embedded system is called a multi-mode multi-task embedded system if it additionally supports multiple tasks to be executed in a mode. In this Paper, we address a HW/SW partitioning problem, that is, HW/SW partitioning of multi-mode multi-task embedded applications with timing constraints of tasks. The objective of the optimization problem is to find a minimal total system cost of allocation/mapping of processing resources to functional modules in tasks together with a schedule that satisfies the timing constraints. The key success of solving the problem is closely related to the degree of the amount of utilization of the potential parallelism among the executions of modules. However, due to an inherently excessively large search space of the parallelism, and to make the task of schedulabilty analysis easy, the prior HW/SW partitioning methods have not been able to fully exploit the potential parallel execution of modules. To overcome the limitation, we propose a set of comprehensive HW/SW partitioning techniques which solve the three subproblems of the partitioning problem simultaneously: (1) allocation of processing resources, (2) mapping the processing resources to the modules in tasks, and (3) determining an execution schedule of modules. Specifically, based on a precise measurement on the parallel execution and schedulability of modules, we develop a stepwise refinement partitioning technique for single-mode multi-task applications. The proposed techniques is then extended to solve the HW/SW partitioning problem of multi-mode multi-task applications. From experiments with a set of real-life applications, it is shown that the proposed techniques are able to reduce the implementation cost by 19.0% and 17.0% for single- and multi-mode multi-task applications over that by the conventional method, respectively.

Optimization of Total Arc Degree for Stereotactic Radiotherapy by Using Integral Biologically Effective Dose and Irradiated Volume (정위방사선치료 시 적분 생물학적 유효선량 및 방사선조사용적을 이용한 Total Arc Degree의 최적화)

  • Lim Do Hoon;Lee Myung Za;Chun Ha Chung;Kim Dae Yong
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.199-204
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    • 2001
  • Purpoe : To find the optimal values of total arc degree to protect the normal brain tissue from high dose radiation in stereotactic radiotherapy planning. Methods and Materials : With Xknife-3 planning system & 4 MV linear accelerator, the authors planned under various values of parameters. One isocenter, 12, 20, 30, 40, 50, and 60 mm of collimator diameters, $100^{\circ},\;200^{\circ},\;300^{\circ},\;400^{\circ}C,\;500^{\circ},\;600^{\circ}$ or total arc degrees, and $30^{\circ}\;or\;45^{\circ}$ or arc intervals were used. After the completion of planning, the plans were compared each other using $V_{50}$ (the volume of normal brain that is delivered high dose radiation) and integral biologically effective dose. Results : At $30^{\circ}$ of arc interval, the values of $V_{50}$ had the decreased pattern with the increase of total arc degree in any collimator diameter. At 45 arc interval, up to $400^{\circ}$ of total arc degree, the values of $ V_{50}$ decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. At $30^{\circ}$ of arc interval, integral biologically effective dose showed the decreased pattern with the increase of total arc degree in any collimator diameter. At $45^{\circ}$ arc interval with less than 40 mm collimator diameter, the integral biologically effective dose decreased with the increase of total arc degree, but with n and n mm or collimator diameters, up to $400^{\circ}$ or total arc degree, integral biologically effective dose decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. Conclusion : In the stereotactic radiotherapy planning for brain lesions, planning with $400^{\circ}$ of total arc degree is optimal. Especially, when the larger collimator more than 50 mm diameter should be used, the uses of $500^{\circ}\;and\;600^{\circ}$ of total arc degrees make the increase of$V_{50}$ and integral biologically effective dose. Therefore stereotactic radiotherapy planning using $400^{\circ}$ of total arc degree can increase the therapeutic ratio and produce the effective outcome in the management of personal and mechanical sources in radiotherapy department.

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The Study of Volume Data Aggregation Method According to Lane Usage Ratio (차로이용률을 고려한 지점 교통량 자료의 집락화 방법에 관한 연구)

  • An Kwang-Hun;Baek Seung-Kirl;NamKoong Sung
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.4 no.3 s.8
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    • pp.33-43
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    • 2005
  • Traffic condition monitoring system serves as the foundation for all intelligent transportation system operation. Loop detectors and Video Image Processing are the most widely common technology approach to condition monitoring in korea Highways. Lane Usage is defined as the proportion of total link volume served by each lane. In this research, the lane Usage(LU) of two lane link for one day. Interval is 56% : 44%. The LU of three lane link is 39% : 37% : 24%. The LU of four lane link is 25% : 29% : 26% : 21%. These analysis reveal that each lane distributions of link are not same. This research investigates the general concept of lane usage by using collected loop detector data and the investigated that lane distribution is different by traffic lane and lane usage is consistent by time of day.

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Usefulness of Three-phasic Bone Scan in Young Male Patients Suspected of Post-traumatic Reflex Sympathetic Dystrophy Syndrome (외상후 교감신경 이영양증이 의심되는 젊은 남자 환자들에서 삼상 골스캔의 유용성)

  • Lee, Won-Woo;Kim, Tae-Uk;Kim, Tae-Hoon;Jung, Cheoul-Yun;Moon, Jin-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.52-60
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    • 2001
  • Purpose: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. Materials and Methods: Patients with narrow range of age (21-25. mean $22.8{\pm}1.3$, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed $21.2{\pm}7.3wks$ after trauma. Results: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight hearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). Conclusion: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.

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On-line Image Guided Radiation Therapy using Cone-Beam CT (CBCT) (콘빔CT (CBCT)를 이용한 온라인 영상유도방사선치료 (On-line Image Guided Radiation Therapy))

  • Bak, Jin-O;Jeong, Kyoung-Keun;Keum, Ki-Chang;Park, Suk-Won
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.294-299
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    • 2006
  • $\underline{Purpose}$: Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. $\underline{Materials\;and\;Methods}$: We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). $\underline{Results}$: In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 0.1 cm. $\underline{Conclusion}$: Through the on-line IGRT using cone beam CT, we could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients.

The Study of CYFRA 21-1 and Epidermal Growth Factor Receptor Levels in Cancer Tissue of Bronchogenic Carcinoma Patients (폐암환자의 암조직내 CYFRA 21-1과 Epidermal Growth Factor Receptor의 측정치에 대한 연구)

  • 김대연;김송명
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.854-861
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    • 1997
  • CYPRA 21-1 is known to be a cytokeratin 19 fragment, and it can be detected by using two specific monoclonal antibodies (KS 19-1 and BM 19-21) and can be clinically applied as a useful circulating tumor marker The epidermal growth factor receptor (EGF-R) expression was evaluated and characterized by its tyrosine protein kinase activity and by its ligand-stimulated autophosphorylation, a property shared with other peptide growth factor receptors. Autocrine or para'urine action was initiated by a growth factor, or by a transforming growth factor o, which had an extensive homology with EGP and which also stimulated tyrosine kinase activity on the EGF-R. The CYFRA 21-1 and the EGF-R levels in 30 patients with primary lung tumors were investigated. There were 24 patients with squamous cell carcinomas and 6 patients with adenocarcinomas. Specimen 5 mm3 in size were sampled at three different locations ; the main lesion, the boundary between the lesion and the unaffected tissue, and the unaffected tissue of the patients. The results were as follows 1. The CYPRA 21-1 concentration in the cancer boundary, the most malignant region,(348.6 : 89.9 ng/ml) was the lowest value. The CYFRA 21-1 concentration in unaffected tissue,(718.4$\pm$77.8 ng/ml) was higher than that in the main lesion. which had intact cellularity. 2. The EGF-R concentration in the main lesion was higher than that in the unaffected tissue, and the EGF-R concentration in a squamous cell cacinoma was higher than that in an adenocarcinoma. also, the EGF-R concentration in the cancer b undary was highest at stage 1, ll. The EGF-R concentration was higher in the main cancer lesion that in the unaffected tissue at stage 111, IV. 3. The CYFRA 21-1 was a cytoplasmic skeleton and the EGF-R was a cell-wall component; there was no correlation. In conclusion, CYFRA 21-1 was abundant in the cytoplasm but had a higher concentration in the unaffected tissue than in the main cancer lesion. The CYFRA 21-1 concentration of the tissue did not reflect the amount of cancer activity, the EGP-R was located in the cell membrane, the level of tissue that reflects cancer activity, so the main cancer lesion had a higher concentration than the unaffected tissue. CYFRA 21-1 is not a useful tumor maker at the tissue level. Because the EGF-R concentration re(looted the cancer activity, its a useful tumor marker for lung cancer.

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The Dosimetric Data of 10 MV Linear Accelerator Photon Beam for Total Body Irradiation (전신 방사선조사를 위한 10MV 선형가속기의 선량측정)

  • Ahn Sung Ja;Kang Wee-Saing;Park Seung Jin;Nam Taek Keun;Chung Woong Ki;Nah Byung Sik
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.225-232
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    • 1994
  • Purpose : This study was to obtain the basic dosimetric data using the 10 MV X-ray for the total body irradiation. Materials and Methods : A linear accelerator photon beam is planned to be used as a radiation source for total body irradiation (TBI) in Chonnam University Hospital. The planned distance from the target to the midplane of a patient is 360cm and the maximum geometric field size is 144cm x 144cm. Polystyrene phantom sized $30{\times}30{\times}30.2cm^3$ and consisted of several sheets with various thickness, and a parallel plate ionization chamber were used to measure surface dose and percent depth dose (PDD) at 345cm SSD, and dose profiles. To evaluate whether a beam modifier is necessary for TBI, dosimetry in build up region was made first with no modifier and next with an 1cm thick acryl plate 20cm far from the polystyrene phantom surface. For a fixed sourec-chamber distance, output factors were measured for various depth. Results : As any beam modifier was not on the way of radiation of 10MV X-ray, the $d_{max}$ and surface dose was 1.8cm and $61\%$, respectively, for 345cm SSD. When an 1cm thick acryl plate was put 20cm far from polystyrene phantom for the SSD, the $d_{max}$ and surface dose were 0.8cm and $94\%$, respectively. With acryl as a beam spoiler, the PDD at 10cm depth was $78.4\%$ and exit dose was a little higher than expected dose at interface of exit surface. For two-opposing fields for a 30cm phantom thick phantom, the surface dose and maximum dose relative to mid-depth dose in our experiments were $102.5\%$ and $106.3\%$, respectively. The off-axis distance of that point of $95\%$ of beam axis dose were 70cm on principal axis and 80cm on diagonal axis. Conclusion: 1. To increase surface dose for TBI by 10MV X-ray at 360cm SAD, 1cm thick acrylic spoiler was sufficient when distance from phantom surface to spoiler was 20cm. 2. At 345cm SSD, 10MV X-ray beam of full field produced a satisfiable dose uniformity for TBI within $7\%$ in the phantom of 30cm thickness by two-opposing irradiation technique. 3. The uniform dose distribution region was 67cm on principal axis of the beam and 80cm on diagonal axis from beam axis. 4. The output factors at mid-point of various thickness revealed linear relation with depth, and it could be applicable to practical TBI.

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