• Title/Summary/Keyword: Average Dose

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The Results of Curative Radiation Therapy for 49 Patients of the Uterine Cervical Carcinomas (자궁 경부암의 근치적 방사선 치료 효과 -49예의 분석 -)

  • Ryu Mi Ryeong;Kim Yeon Sil;Choi Byung Ock;Yoon Sei Chul;Shinn Kyung Sub;Namkoong Sung Eun;Kim Seung Jo
    • Radiation Oncology Journal
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    • v.10 no.2
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    • pp.219-225
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    • 1992
  • Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital from September, 1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to 11344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 ($12.2\%$) were in stage Ib, 6 ($12.2\%$) in stage IIa, 25 ($51\%$) in stage IIb, 7 ($14\%$) in stage III, and 5 ($10.2\%$) in stage IV. Age of the patients ranged from 33 to 76 years (median 60 years). Pathologically, fourty six ($94\%$) patients had squamous cell carcinoma, 2 ($4\%$) had adenocarcinoma, and 1 ($2\%$) had adenosquamous cell carcinoma. Overall response rate was $84\%$. 5-year survival rate was $49\%$ for entire group ($75\%$ for stage Ib, $83\%$ for Stage IIa, $42.5\%$ for stage IIb, $25\%$ for stage III, $40\%$ for stage IV). Complications were observed in 11 ($22.4\%$) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis (p<0.05).

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Intensity Modulated Radiation Therapy Commissioning and Quality Assurance: Implementation of AAPM TG119 (세기조절방사선치료(IMRT)의 Commissioning 및 정도관리: AAPM TG119 적용)

  • Ahn, Woo-Sang;Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.99-105
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    • 2011
  • The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

Clinical Efficacy of Combination Chemotherapy with Ifosfamide Cisplatin, and Etoposide(ICE) in Advanced Non-Small Cell Lung Cancer (진행성 비소세포 폐암 환자에서 Ifosfamide, Cisplatin Etoposide(ICE) 복합화학요법의 효과)

  • Lee, Gu;Kim, Byung Duk;Kang, Hee Jung;Lee, Sang Won;Oh, Hyun A;Bae, Sung Hwa;Lee, Jae Lyun;Lee, Kyung Hee;Hyun, Myung Soo;Shin, Kyeong Cheol;Jung, Jin Hong;Lee, Kwan Ho;Ryu, Hun Mo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.4
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    • pp.309-316
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    • 2002
  • Background: To evaluate the efficacy and toxicity of combination chemotherapy using ifosfamide, cisplatin, and etoposide in patients with advanced non-small cell lung cancer(NSCLC). Materials and methods: Thirty-three patients with inoperable NSCLC(stage IIIb+IV) who had measurable diseases, and had not been treated with chemotherapeutic drugs, were enrolled in this study(from March 1995 to December 1996). The patients received ifosfamide($1500mg/m^2/day$, a full drop with Mesna on days 1-5), Cisplatin ($80mg/m^2/day$ infusion with a hydration on day 2), and Etoposide ($100mg/m^2/day$ infusion for 2 hours on days 1-3). The treatment was repeated every 4 weeks. Results: Ten patients showed a partial responses (30.3%). The overall survival time of the responders was longer than that of the non-responders (median 55 vs 22 weeks, p=0.01). The toxicities of this treatment were tolerable. Grade 3 or 4 leukopenia was observed in 21%. There was 1 death related to febrile neutropenia. The non-hematologic toxicity was mild. The relative dose intensity given to the patients was 0.86 ifosfamide, 0.87 cisplatin, and 0.89 etoposide, showing an average dose intensity of 0.87. Conclusions: A combination regimen of ifosfamide, cisplatin, and etoposide is effective and tolerable for treating advanced non-small cell lung cancer.

A Study on the Use of Active Protocol Using the Change of Pitch and Rotation Time in PET/CT (PET/CT에서 Pitch와 Rotation Time의 변화를 이용한 능동적인 프로토콜 사용에 대한 연구)

  • Jang, Eui Sun;Kwak, In Suk;Park, Sun Myung;Choi, Choon Ki;Lee, Hyuk;Kim, Soo Young;Choi, Sung Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.67-71
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    • 2013
  • Purpose: The Change of CT exposure condition have a effect on image quality and patient exposure dose. In this study, we evaluated effect CT image quality and SUV when CT parameters (Pitch, Rotation time) were changed. Materials and Methods: Discovery Ste (GE, USA) was used as a PET/CT scanner. Using GE QA Phantom and AAPM CT Performance Phantom for evaluate Noise of CT image. Images are acquired by using 24 combinations that four stages pitch (0.562, 0.938, 1.375, 1.75:1) and six stages X-ray tube rotation time (0.5s-1.0s). PET images are acquired using 1994 NEMA PET Phantom ($^{18}F-FDG$ 5.3 kBq/mL, 2.5 min/frame). For noise test, noise are evaluated by standard deviation of each image's CT numbers. And then we used expectation noise according to change of DLP (Dose Length Product) to experimental noise ratio for index of effectiveness. For spatial resolution test, we confirmed that it is possible to identify to 1.0 mm size of the holes at the AAPM CT Performance Phantom. Finally we evaluated each 24 image's SUV. Results: Noise efficiency were 1.00, 1.03, 1.01, 0.96 and 1.00, 1.04, 1.02, 0.97 when pitch changes at the QA Phantom and AAPM Phantom. In case of X-ray tube rotation time changes, 0.99, 1.02, 1.00, 1.00, 0.99, 0.99 and 1.01, 1.01, 0.99, 1.01, 1.01, 1.01 at the QA Phantom and AAPM Phantom. We could identify 1.0 mm size of the holes all 24 images. Also, there were no significant change of SUV and all image's average SUV were 1.1. Conclusion: 1.75:1 pitch is the most effective value at the CT image evaluation according to pitch change and It doesn't affect to the spatial resolution and SUV. However, the change of rotation time doesn't affect anything. So, we recommend to use the effective pitch like 1.75:1 and adequate X-ray tube rotation time according to patient size.

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Effects of Gamma-Irradiation on the Sterilization of Primordial Germ Cells in Quail (메추리 원시생식세포 감소를 위한 감마선 조사의 효과)

  • Park, Kyung-Je;Kim, Tae-Min;Lee, Hyung-Chul;Jang, Hyun-Jun;Song, Gwon-Hwa;Han, Jae-Yong
    • Korean Journal of Poultry Science
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    • v.37 no.2
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    • pp.139-143
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    • 2010
  • Quail is a very useful animal model for studying vertebrate development because of its small body size and unique reproductive traits. This species is also ideal model for producing germline chimeras via transferring exogenous primordial germ cells (PGCs) into the recipient embryo. To increase the contribution efficiency of donor PGCs into recipients' tissues, decreasing the population of endogenous PGCs has been rate-limiting factor. We therefore conducted this study to investigate if gamma ($\gamma$)-irradiation depletes endogenous PGCs in developing quail embryo. Firstly, freshly laid stage X quail embryos were irradiated with various output of $\gamma$-irradiation and its teratogenic effect on the embryo was evaluated. Although a dose-dependent increase in the number of embryo showing malformation was found as the output increased (0, 250, 500, 750, and 1,000 rads), only a maximum of 10.1% of embryos were abnormal in 1,000 rads. Immunocytochemical analysis using the QCR1 antibody, which is specific marker for quail PGCs, was conducted to analyze the effect of sterilization. As results, $\gamma$-rays at a dose-rate of 500 rads/73 sec onto undeveloped stage X embryo significantly reduced the number of germ cells to an average of 75.55 % and 82.03 % in male and female embryos, respectively. We conclude that $\gamma$-ray selectively targets PGCs while affects minimally to the somatic development in quail embryo. Our results will not only provide important data for germline chimera production but can be used for analyzing the effect of ionized rays on the differentiating germ cells in various stages during animal development.

Fusion of Gamma and Realistic Imaging (감마영상과 실사영상의 Fusion)

  • Kim, Yun-Cheol;Yu, Yeon-Uk;Seo, Young-Deok;Moon, Jong-Woon;Kim, Yeong-Seok;Won, Woo-Jae;Kim, Seok-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.78-82
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    • 2010
  • Purpose: Recently, South Korea has seen a rapidly increased incidence of both breast and thyroid cancers. As a result, the I-131 scan and lymphoscintigraphy have been performed more frequently. Although this type of diagnostic imaging is prominent in that visualizes pathological conditions, which is similar to previous nuclear diagnostic imaging techniques, there is not much anatomical information obtained. Accordingly, it has been used in different ways to help find anatomical locations by transmission scan, however the results were unsatisfactory. Therefore, this study aims to realize an imaging technique which shows more anatomical information through the fusion of gamma and realistic imaging. Materials and Methods: We analyzed the data from patients who were examined by the lymphoscintigraphy and I-131 additional scan by Symbia Gamma camera (SIEMENS) in the nuclear medicine department of the National Cancer Center from April to July of 2009. First, we scanned the same location in patients by using a miniature camera (R-2000) in hyVISION. Afterwards, we scanned by gamma camera. The data we obtained was evaluated based on the scanning that measures an agreement of gamma and realistic imaging by the Gamma Ray Tool fusion program. Results: The amount of radiation technicians and patients were exposed was generated during the production process of flood source and applied transmission scan. During this time, the radiation exposure dose of technicians was an average of 14.1743 ${\mu}Sv$, while the radiation exposure dose of patients averaged 0.9037 ${\mu}Sv$. We also confirmed this to matching gamma and realistic markers in fusion imaging. Conclusion: Therefore, we found that we could provide imaging with more anatomical information to clinical doctors by fusion of system of gamma and realistic imaging. This has allowed us to perform an easier method in which to reduce the work process. In addition, we found that the radiation exposure can be reduced from the flood source. Eventually, we hope that this will be applicable in other nuclear medicine studies. Therefore, in order to respect the privacy of patients, this procedure will be performed only after the patient has agreed to the procedure after being given a detailed explanation about the process itself and its advantages.

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The Effects of Image Quality due to Scattering X-ray according to increasing Patient Thickness (피사체 두께에 따른 산란선 발생이 화질에 미치는 영향)

  • Park, Ji-Koon;Yang, Sung-Woo;Jun, Jae-Hoon;Cho, Su-Yeon;Kim, Kyo-Tae;Heo, Ye-Ji;Kang, Sang-Sik
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.671-677
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    • 2017
  • In this study, scattering factors affecting the quality of medical images were quantitatively analyzed and investigated. MCNPX simulation was conducted by using ANSI phantom, made of tissue equivalent materials, to calculate the scattering ratio occurred by the increase of the object thickness. Then, the result of the simulation was compared with the result of actual radiation measurement. In addition, we evaluated the image quality by the RMS evaluation, RSD and NPS analysis using X-ray images acquired with increasing object thickness. Furthermore, the scattering ratio was analyzed by increasing the thickness of acrylic phantom on chest phantom. The result showed that the scattering ratio was increased to 57.2%, 62.4%, and 66.8% from 48.9%, respectively, when the acrylic phantom thickness was increased by 1 inch from 6.1 inches. The results of MCNPX simulation and the actual measured scattering dose showed similar results. Also, as a result of RMS measurement from acquired x-ray images, the standard deviation decreased as the object thickness increased. However, in the RSD analysis considering the average incident dose, the results were increased from 0.028 to 0.039, 0.051, 0.062 as the acrylic phantom thickness was increased from 6.1 inches to 7.1 inch, 8.1 inch, and 9.1 inch, respectively. It can be seen that the increase of the scattering effect due to the increase of the object thickness reduces the SNR. Also, the NPS results obtained by measuring scattered radiation incident on the detector resulted in the increase of the noise as the object thickness increased.

The Study of Intravenous-gammaglobulin Therapy in Acute phase of Measles (급성기 홍역 환자의 정주용 인면역글로부린 치료 효과에 대한 연구)

  • Kim, Min Shik;Cha, Yoon Hwa
    • Pediatric Infection and Vaccine
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    • v.8 no.1
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    • pp.101-106
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    • 2001
  • Purpose : The outbreaks of measles in infants and school children have been reported recently, but there are no specific treatment of these patients except symptomatic therapy. This study was performed to evaluate the effectiveness of intravenous gammaglobulin(IVGG) therapy in acute febrile phase of measles. Methods : The 68 cases in measles were treated with single dose of IVGG(400~500 mg/kg), and 44 cases were treated with only symptomatic treatment during the periods of 14 months from Jan. 2000 to Feb. 2001. They were compared to duration of fever, rash, the levels of CRP and days of admission on both groups after treatment. Results : The results obtained follows. The average of age was $7.9{\pm}3.6$ year old, and male to female was 1.0 : 1.6. The duration of fever after admission was $2.4{\pm}1.2$ days in treated group and $5.7{\pm}2.4$ days in control group. The period of disappearance of systemic erythematous maculopapular rash was $4.5{\pm}1.3$ days in treated group, and $6.9{\pm}2.4$ days in control group. The durations of admission day were also shown significantly shorter duration of period in treated group(P<0.05). The levels of CRP were no significant difference between two groups before treatment. However, treated group was significantly shown by improved within 5 days after IVGG therapy(P<0.05). Conclusions : The single dose of IVGG(400~500 mg/kg) therapy is one of rapid and effective therapy for clinical symptoms and signs in acute high febrile phase of measles.

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On decrease program of Radioactive Wastewater and Sewages in High Dose Radioiodine Therapy Ward (고용량 방사성옥소 치료병실의 오.폐수 저감화를 위한 연구)

  • Ryu, Jae-Kwang;Jung, Woo-Young;Shin, Sang-Ki;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.19-26
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    • 2008
  • Purpose: In general, We discharged radioactive wastewater and sewages less than $8.1{\times}10^{-13}$ Ci/ml in a exclusive water-purifier tank. Our hospital operating three exclusive water-purifier tank for radioactive wastewater and sewages of 60 tons capacity respectively. In order to meet the criteria it need a enough decay more than 125 days per each exclusive tank. However, recently we fell into the serious situation that decay period was decreased remarkably, owing to the wastewater amount increased rapidly by enlarge the therapy ward. For that reason, in this article, I'd like to say the way that reducing of radioactive wastewater and sewages rationally. Materials and Methods: From January, 2006 to October, four hundred and two cases were analyzed. They were all hospitalized during 3 days and 2 nights. We calculated the average amount of water used (include toilet water used, shower water used, washstand water used, $\cdots$), each exclusive water-purifier tank's decay period, as well as try to search the increased factors about water-purifier tank inflow flux by re-analysis of the procedure of radioisotope therapy step by step. Results: We could increase each exclusive water-purifier tank's decay period from 84 days to 130 days through the improvement about following cause: (1) Improvement of conventional toilet stool for excessive water waste $\rightarrow$ Replacement of water saving style toilet stool (2) Prevention of unnecessary shower and wash (3) Stop the diuretics taking during hospitalization (4) Analysis of relationship between water intakes and residual dose of body (5) Education about outside toilet utilization before the administration (6) Changed each water-purifier tank's maximum level from85% to 90% Conclusion: The originality of our efforts are not only software but hardware performance improvements. Incidentally the side of software's are change of therapy procedures and protocols, the side of hardware's are replacement of water saving style toilet stool and change of each water-purifier tank's maximum level. Thus even if a long lapse of time, problem such as return to the former conditions may not happen. Besides, We expect that our trials become a new reasonable model in similar situation.

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Study on Optimized Dispensing of F-18 FDG Auto Dispenser (F-18 FDG 자동분주기의 분주 최적화에 관한 연구)

  • Ji, Bong-Geun;Lee, Sang-Hun;Kim, Jong-Eon;Kim, Won-Tae;Ji, Tae-Jeong
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.377-384
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    • 2016
  • This is a study on the optimized dispensing of the auto dispenser used for the purpose of reducing the exposure dose and accurate radiation dose of radioisotope with regard to the PET/CT practitioners. The research method was to find the optimized dispensing method through evaluating the results according to the syringe type, dispensing rate, and vial pressure and through the application of corrected values. As a result of this study, 9.38 mCi has been dispensed on average in the case of 5 ml syringe, and the reproducibility close to 10 mCi was shown at the dispense of 9.55 mCi in the case of 3 ml syringe. In the evaluation according to the dispensing rate, the quantity of radioisotope close to 10 mCi was dispensed at the rate of 5 mm/min when the measurement was carried out by increasing the rate by 5 mm/min units in the order of 5, 10, 15 and 20 mm/min. In the evaluation result according to the vial pressure before/after the use of Needle filter, it was measured to be 9.53 mCi before use and 9.84 mCi after use confirming that the dispensing after using Needle filter showed the optimal value. In addition, in the evaluation of radioactivity before/after the application of corrected values according to the increase in dispense frequency, it was measured 9.53 mCi before correction and 10.07 mCi after correction confirming that the value with correction applied was closer to the quantitative value. Thus, a good optimized method was confirmed to use a 3 ml syringe with dispensing rate of 5 mm/min, to use a Needle filter at dispensing, and to set the corrected value of [$y=0.097{\times}x$] according to the dispensing frequency of equipment.