• 제목/요약/키워드: CTV

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Effects of Millimetric Shifts in Breast Cancer Radiotherapy on the Radiation Dose Distribution

  • Sanli, Yusuf Tolga;Cukurcayir, Funda;Abacigil, Fatma
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1197-1199
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    • 2016
  • Background: This study aimed to facilitate decision-making in cases of breast cancer radiotherapy shifts by simulating millimetric shifts and analyzing their effects on dose distribution. Methods: The study included 30 patients with left side breast cancer who were treated with three dimensional conformal radiotherapy (3D-CRT) in the Radiation Oncology Department in Hatay Public Hospital, between January 2013 and April 2015. A treatment plan shifting at three axes with six different measures was simulated. Results: The biggest difference in values was (+3mm shift) 476cGy, with a 7.7 % change for heart and 25.6% for spinal cord. The shifts in values respectively for CTV min, mean, max were -4.8%, 2.5%, 4%. The differences for lymphatic min, mean, max were 21.3%, 20.3%, -12.2%. Conclusion: The most important thing is not the treatment plan quality, but its practicality. The treatment plan must be practical and its practice must be controlled rigidly.

Characterizations of Disease Symptoms and Virus Replication Shown in the Interactions Between Arabidopsis (Arabidopsis ecotype에서 3종의 BCTV 분리주의 병증 및 복제 특성)

  • 박을용;박종범;이석찬
    • Korean Journal Plant Pathology
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    • v.14 no.5
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    • pp.507-512
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    • 1998
  • Molecular analysis has been done for characterization of the interactions between three beet curly top virus (BCTV) strains and two Arabidopsis ecotypes in terms of virus inducible disease symptoms and infectivities. The total DNA was isolated from three tissues (shoot tips, infection origins and roots) of virus infected plants and this DNA was analyzed by quantitatively and qualitatively to elucidate virus movement and symptom development. CTV-Worland infected Col-O and Sei-O showed only symptom shown in hypersusceptible ecotype Sei-O by BCTV-worland was shoot tip stunting. Kinetics of virus DNA accumulation of three different viruses indicated that roots contained more virus DNA than shoot tips or infection origins, and that disease symptom severity was strongly correlated with virus DNA accumulation. These results suggest that the mild and Worland-specific symptoms shown in Sei-O by BCTV-worland are caused by the interactions of host factors provided by hypersusceptible ecotype and viral factors of mild strain.

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The Application of 3D Bolus with Neck in the Treatment of Hypopharynx Cancer in VMAT (Hypopharynx Cancer의 VMAT 치료 시 Neck 3D Bolus 적용에 대한 유용성 평가)

  • An, Ye Chan;Kim, Jin Man;Kim, Chan Yang;Kim, Jong Sik;Park, Yong Chul
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.41-52
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    • 2020
  • Purpose: To find out the dosimetric usefulness, setup reproducibility and efficiency of applying 3D Bolus by comparing two treatment plans in which Commercial Bolus and 3D Bolus produced by 3D Printing Technology were applied to the neck during VMAT treatment of Hypopahrynx Cancer to evaluate the clinical applicability. Materials and Methods: Based on the CT image of the RANDO phantom to which CB was applied, 3D Bolus were fabricated in the same form. 3D Bolus was printed with a polyurethane acrylate resin with a density of 1.2g/㎤ through the SLA technique using OMG SLA 660 Printer and MaterializeMagics software. Based on two CT images using CB and 3D Bolus, a treatment plan was established assuming VMAT treatment of Hypopharynx Cancer. CBCT images were obtained for each of the two established treatment plans 18 times, and the treatment efficiency was evaluated by measuring the setup time each time. Based on the obtained CBCT image, the adaptive plan was performed through Pinnacle, a computerized treatment planning system, to evaluate target, normal organ dose evaluation, and changes in bolus volume. Results: The setup time for each treatment plan was reduced by an average of 28 sec in the 3D Bolus treatment plan compared to the CB treatment plan. The Bolus Volume change during the pretreatment period was 86.1±2.70㎤ in 83.9㎤ of CB Initial Plan and 99.8±0.46㎤ in 92.2㎤ of 3D Bolus Initial Plan. The change in CTV Min Value was 167.4±19.38cGy in CB Initial Plan 191.6cGy and 149.5±18.27cGy in 3D Bolus Initial Plan 167.3cGy. The change in CTV Mean Value was 228.3±0.38cGy in CB Initial Plan 227.1cGy and 227.7±0.30cGy in 3D Bolus Initial Plan 225.9cGy. The change in PTV Min Value was 74.9±19.47cGy in CB Initial Plan 128.5cGy and 83.2±12.92cGy in 3D Bolus Initial Plan 139.9cGy. The change in PTV Mean Value was 226.2±0.83cGy in CB Initial Plan 225.4cGy and 225.8±0.33cGy in 3D Bolus Initial Plan 224.1cGy. The maximum value for the normal organ spinal cord was the same as 135.6cGy on average each time. Conclusion: From the experimental results of this paper, it was found that the application of 3D Bolus to the irregular body surface is more dosimetrically useful than the application of Commercial Bolus, and the setup reproducibility and efficiency are excellent. If further case studies along with research on the diversity of 3D printing materials are conducted in the future, the application of 3D Bolus in the field of radiation therapy is expected to proceed more actively.

Comparison of Three Different Helmet Bolus Device for Total Scalp Irradiation (Total Scalp의 방사선 치료 시 Helmet Bolus 제작방법에 관한 연구)

  • Song, Yong-Min;Kim, Jong-Sik;Hong, Chae-Seon;Ju, Sang-Gyu;Park, Ju-Young;Park, Su-Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.31-37
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    • 2012
  • Purpose: This study evaluated the usefulness of Helmet bolus device using Bolx-II, paraffin wax, solid thermoplastic material in total scalp irradiation. Materials and Methods: Using Rando phantom, we applied Bolx-II (Action Products, USA), paraffin wax (Densply, USA), solid thermoplastic material (Med-Tec, USA) on the whole scalp to make helmet bolus device. Computed tomography (GE, Ultra Light Speed16) images were acquired at 5 mm thickness. Then, we set up the optimum treatment plan and analyzed the variation in density of each bolus (Philips, Pinnacle). To evaluate the dose distribution, Dose-homogeneity index (DHI, $D_{90}/D_{10}$) and Conformity index (CI, $V_{95}/TV$) of Clinical Target Volume (CTV) using Dose-Volume Histogram (DVH) and $V_{20}$, $V_{30}$ of normal brain tissues. we assessed the efficiency of production process by measuring total time taken to produce. Thermoluminescent dosimeters (TLD) were used to verify the accuracy. Results: Density variation value of Bolx-II, paraffin wax, solid thermoplastic material turned out to be $0.952{\pm}0.13g/cm^3$, $0.842{\pm}0.17g/cm^3$, $0.908{\pm}0.24g/cm^3$, respectively. The DHI and CI of each helmet bolus device which used Bolx-II, paraffin wax, solid thermoplastic material were 0.89, 0.85, 0.77 and 0.86, 0.78, 0.74, respectively. The result of Bolx-II was the best. $V_{20}$ and $V_{30}$ of brain tissues were 11.50%, 10.80%, 10.07% and 7.62%, 7.40%, 7.31%, respectively. It took 30, 120, 90 minutes to produce. The measured TLD results were within ${\pm}7%$ of the planned values. Conclusion: The application of helmet bolus which used Bolx-II during total scalp irradiation not only improves homogeneity and conformity of Clinical Target Volume but also takes short time and the production method is simple. Thus, the helmet bolus which used Bolx-II is considered to be useful for the clinical trials.

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Difference in the Set-up Margin between 2D Conventional and 3D CT Based Planning in Patients with Early Breast Cancer (조기유방암환자의 이차원치료계획과 삼차원치료계획의 방사선조사범위의 차이)

  • Jo, Sun-Mi;Chun, Mi-Son;Kim, Mi-Hwa;Oh, Young-Taek;Kang, Seung-Hee;Noh, O-Kyu
    • Radiation Oncology Journal
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    • v.28 no.3
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    • pp.177-183
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    • 2010
  • Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

Effects of Arc Number or Rotation Range upon Dose Distribution at RapidArc Planning for Liver Cancer (간암환자를 대상으로 한 래피드아크 치료계획에서 아크수 및 회전범위가 선량분포에 미치는 영향)

  • Park, Hae-Jin;Kim, Mi-Hwa;Chun, Mi-Son;Oh, Yeong-Teak;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.21 no.2
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    • pp.165-173
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    • 2010
  • In this paper, we evaluated the performance of 3D CRT, IMRT and three kind of RA plannings to investigate the clinical effect of RA with liver cancer case. The patient undergoing liver cancer of small volume and somewhat constant motion were selected. We performed 3D CRT, IMRT and RA plannings such as 2RA, limited triple arcs (3RA) and 3MRA with Eclipse version 8.6.15. The same dose volume objectives were defined for only CTV, PTV and body except heart, liver and partial body in IMRT and RA plannings. The steepness of dose gradient around tumor was determined by the Normal Tissue Objective function with the same parameters in place of respective definitions of dose volume objectives for the normal organs. The approach between the defined dose constraints and the practical DVH of CTV, PTV and Body was the best in 3MRA and the worst in IMRT. The DVHs were almost the same among RAs. Plans were evaluated using Conformity Index (CI), Homogeneity Index (HI) and Quality of coverage (QoC) by RTOG after prescription with dose level surrounding 98% of PTV in the respective plans. As a result, 3MRA planning showed the better favorable indices than that of the others and achieved the lowest MUs. In this study, RA planning is a technique that is possible to obtain the faster and better dose distribution than 3D CRT or IMRT techniques. Our result suggest that 3MRA planning is able to reduce the MUs further, keeping a similar or better targer dose homogeneity, conformity and sparing normal tissue than 2RA or 3RA.

Current status and prospects of molecular marker development for systematic breeding program in citrus (감귤 분자육종을 위한 분자표지 개발 현황 및 전망)

  • Kim, Ho Bang;Kim, Jae Joon;Oh, Chang Jae;Yun, Su-Hyun;Song, Kwan Jeong
    • Journal of Plant Biotechnology
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    • v.43 no.3
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    • pp.261-271
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    • 2016
  • Citrus is an economically important fruit crop widely growing worldwide. However, citrus production largely depends on natural hybrid selection and bud sport mutation. Unique botanical features including long juvenility, polyembryony, and QTL that controls major agronomic traits can hinder the development of superior variety by conventional breeding. Diverse factors including drastic changes of citrus production environment due to global warming and changes in market trends require systematic molecular breeding program for early selection of elite candidates with target traits, sustainable production of high quality fruits, cultivar diversification, and cost-effective breeding. Since the construction of the first genetic linkage map using isozymes, citrus scientists have constructed linkage maps using various DNA-based markers and developed molecular markers related to biotic and abiotic stresses, polyembryony, fruit coloration, seedlessness, male sterility, acidless, morphology, fruit quality, seed number, yield, early fruit setting traits, and QTL mapping on genetic maps. Genes closely related to CTV resistance and flesh color have been cloned. SSR markers for identifying zygotic and nucellar individuals will contribute to cost-effective breeding. The two high quality citrus reference genomes recently released are being efficiently used for genomics-based molecular breeding such as construction of reference linkage/physical maps and comparative genome mapping. In the near future, the development of DNA molecular markers tightly linked to various agronomic traits and the cloning of useful and/or variant genes will be accelerated through comparative genome analysis using citrus core collection and genome-wide approaches such as genotyping-by-sequencing and genome wide association study.

Production of Citrus Plants from Ovule Cell Culture and Verification of CTV - free Plants (배주배양 세포로부터 감귤 식물체의 획득 및 감귤 트리스테자 바이러스 무병주 검증)

  • Jin, Seong Beom;Park, Jae Ho;Park, Suk Man;Lee, Dong Hoon;Yun, Su Hyun
    • Horticultural Science & Technology
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    • v.35 no.1
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    • pp.121-130
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    • 2017
  • This study was carried out to investigate a method for producing cultured virus - free ovules for breeding high - quality Citrus cultivars. Ovules from the immature fruits of three citrus cultivars native to Jeju (Dongjeongkyool, Cheongkyool, and Jikak) and two cultivars of Citrus unshiu Marc. (Miyagawa wase and Haryejosaeng) that were thought to be infected with Citrus tristeza virus (CTV) were cultured on MS2 medium (Murashige - Skoog [MS] basal medium containing $500mg{\cdot}L^{-1}$ malt extract, $50g{\cdot}L^{-1}$ sucrose, $1.0 mg{\cdot}L^{-1}$ kinetin, and $8g{\cdot}L^{-1}$ agar). After four weeks of culture, 10, 21, 13, 5, and 7 somatic embryos and 2, 4, 2, 4, and 5 white callus cells (surrounding green somatic embryos) were obtained from Dongjeongkyool, Cheongkyool, Jikak, Miyagawa wase, and Haryejosaeng, respectively. After six weeks of culture, somatic embryos were obtained from cultured cells grown on MT basal medium supplemented with malt extract ($500mg{\cdot}L^{-1}$), lactose ($70g{\cdot}L^{-1}$), and agar ($16g{\cdot}L^{-1}$). Over 60% of the somatic embryos from citrus cultivars native to Jeju developed into normal plants on MS basal medium supplemented with malt extract ($500mg{\cdot}L^{-1}$), sucrose ($50g{\cdot}L^{-1}$), and agar ($8g{\cdot}L^{-1}$) after 10 weeks of culture. Normal plants were regenerated from two Citrus unshiu Marc. cultivars on MT basal medium supplemented with sorbitol (1.0 M), galactose (1.0 M), $GA_3$ ($1.0mg{\cdot}L^{-1}$), and Gelrite ($3g{\cdot}L^{-1}$). The absence of virus in plants generated from cultured ovules was confirmed by RT - PCR and antigen - antibody reactions. Therefore, virus - free Citrus cells can be obtained for breeding high - quality citrus cultivars using the biotechnological technique evaluated in this study.

Preliminary Results of Phase I/II Study of Simultaneous Modulated Accelerated (SMART) for Nasopharyngeal Carcinoma (비인강암의 치료에서 동시차등조사가속치료를 적용한 제1상/2상 연구의 예비적 결과)

  • Park Jin-Hong;Back Geum-Mun;Yi Byong-Yong;Choi Eun-Kyung;Ahn Seung-Do;Shin Seong-Soo;Kim Jung-Hun;Kim Sang-Yoon;Lee Bong-Jae;Nam Soon-Yuhl;Choi Seung-Ho;Kim Seung-Bae;Lee Sang-Wook
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.1-10
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    • 2006
  • Puroose: To present preliminary results of intensity-modulated radiotherapy (IMRT) using the simultaneous modulated accelerated radiation therapy (SMART) boost technique in patients with nasopharyngeal carcinoma (NPC). Materials and Methods: Twenty patients who underwent IMRT for non-metastatic NPC at the Asan Medical Center between September 2001 and December 2003 were prospectively evaluated. IMRT was delivered using the 'step and shoot' SMART technique at prescribed doses of 72 Gy (2.4 Gy/day) to the gross tumor volume (GTV), 60 Gy (2 Gy/day) to the clinical target volume (CTV) and metastatic nodal station, and 46 Gy (2 Gy/day) to the clinically negative neck region. Eighteen patients also received concurrent chemotherapy using cisplatin once per week. Results: The median follow-up period was 27 months. Nineteen patients completed the treatment without interruption; the remaining patient interrupted treatment for 2 weeks owing to severe pharyngitis and malnutrition. Five patients (25%) had RTOG grade 3 mucositis, whereas nine (45%) had grade 3 pharyngitis. Seven patients (35%) lost more than 10% of their pretreatment weight, whereas 11 (55%) required intravenous fluids and/or tube feeding. There was no grade 3 or 4 chronic xerostomia. All patients showed complete response. Two patients had distant metastases and loco-regional recurrence, respectively. Conclusion: IMRT using the SMART boost technique allows parotid sparing, as shown clinically and by dosimetry, and may also be more effective biologically. A larger population of patients and a longer follow-up period are needed to evaluate ultimate tumor control and late toxicity.

Interobserver variation in target volume for salvage radiotherapy in recurrent prostate cancer patients after radical prostatectomy using CT versus combined CT and MRI: a multicenter study (KROG 13-11)

  • Lee, Eonju;Park, Won;Ahn, Sung Hwan;Cho, Jae Ho;Kim, Jin Hee;Cho, Kwan Ho;Choi, Young Min;Kim, Jae-Sung;Kim, Jin Ho;Jang, Hong-Seok;Kim, Young-Seok;Nam, Taek-Keun
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.11-16
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    • 2018
  • Purpose: To investigate interobserver variation in target volume delineations for prostate cancer salvage radiotherapy using planning computed tomography (CT) versus combined planning CT and magnetic resonance imaging (MRI). Materials and Methods: Ten radiation oncologists independently delineated a target volume on the planning CT scans of five cases with different pathological status after radical prostatectomy. Two weeks later, this was repeated with the addition of planning MRI. The volumes obtained with CT only and combined CT and MRI were compared, and the effect of the addition of planning MRI on interobserver variability was assessed. Results: There were large differences in clinical target volume (CTV) delineated by each observer, regardless of the addition of planning MRI ($9.44-139.27cm^3$ in CT only and $7.77-122.83cm^3$ in CT plus MRI) and no significant differences in the mean and standard deviation of CTV. However, there were decreases in mean volume and standard deviation as a result of using the planning MRI. Conclusion: This study showed substantial interobserver variation in target volume delineation for salvage radiotherapy. The combination of planning MRI with CT tended to decrease the target volume and the variation.