• Progress in Medical Physics
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• v.27 no.2
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• pp.93-97
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• 2016

In this study, we evaluate the effect of respiration on the dose distribution in patient target volume (PTV) during intensity-modulated radiation therapy (IMRT) and research methods to reduce this impact. The dose distributions, homogeneity index (HI), coverage index (CVI), and conformity index of the PTV, which is calculated from the dose-volume histogram (DVH), are compared between the maximum intensity projection (MIP) image-based plan and other images at respiration phases of 30%, 60% and 90%. In addition, the reducing effect of complication caused by patient respiration is estimated in the case of a bolus and the expended PTV on the skin. The HI is increased by approximately twice, and the CVI is relatively decreased without the bolus at other respiration phases. With the bolus and expended PTV, the change in the dose distribution of the PTV is relatively small with patient respiration. Therefore, the usage of the bolus and expended PTV can be considered as one of the methods to improve the accuracy of IMRT in the treatment of breast cancer patients with respiratory motion.

• Journal of radiological science and technology
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• v.40 no.1
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• pp.57-62
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• 2017

The purpose of this study is to reconstruct the treatment plan by applying CBCT and DIR to dose changes according to the change of the patient's motion and breast shape in the large breast cancer patients and to compare the doses using TWF, FIF and IMRT. CT and CBCT were performed with MIM6 to create DIRCT and each treatment plan was made. The patient underwent computed tomography simulation in both prone and supine position. The homogeneity index (HI), conformity index (CI), coverage index (CVI) to the left breast as planning target volume (PTV) were determined and the doses to the lung, heart, and right breast as organ at risk (OAR) were compared by using dose-volume histogram and the unique property of each organ. The value of HI of the PTV breast increased in all treatment planning methods using DIRCT, and CVI and CI were decreased in the treatment planning methods using DIRCT.

• Progress in Medical Physics
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• v.32 no.3
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• pp.70-81
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• 2021

Purpose: This study was designed to investigate the dosimetric difference between intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) in head and neck cancer (HNC). The study primarily focuses on low-dose spillage evaluation between these two techniques. Methods: This retrospective study involved 45 patients with HNC. The treatment plans were generated using the IMRT and VMAT techniques for all patients. Dosimetric comparisons were performed in terms of target coverage, organ-at-risk (OAR) sparing, and various parameters, including conformity index, uniformity index, homogeneity index, conformation number, low-dose volumes, and normal tissue integral dose (NTID). Results: No significant (P>0.05) difference in planning target volume coverage (D_95%) was observed between IMRT and VMAT plans for supraglottic larynx, hard palate, and tongue cancers. A decrease in dose volumes ranging from 1 Gy to 30 Gy was observed for VMAT plans compared with those for IMRT plans, except for V_1Gy and V_30Gy for supraglottic larynx cancer and V_1Gy for tongue cancer. Moreover, decreases (P<0.05) in NTID were observed for VMAT plans compared with that for IMRT plans in supraglottic larynx (4.50%), hard palate (12.80%), and tongue (7.76%) cancers. In contrast, a slight increase in monitor units for VMAT compared with those for IMRT in supraglottic larynx (0.46%), hard palate (2.54%), and tongue (7.56%) cancers. Conclusions: For advanced-stage HNC, both IMRT and VMAT offer satisfactory clinical plans. VMAT offers a conformal and homogeneous dose distribution with comparable OAR sparing and higher dose falloff outside the target volume than IMRT, which provides an edge to reduce the risk of secondary malignancies for HNC over IMRT.

• Korean Journal of Artificial Intelligence
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• v.7 no.1
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• pp.23-59
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• 2019

The purpose of this study is to develop a measure of service quality in the traditional market by examining previous research on the service quality of the traditional market studied so far. After defining basic concepts through definition of traditional market and existing studies, 5 categories of configuration items for SERVQUAL measurement in traditional market were made up based on existing researches related to definition of service quality and service quality of traditional market. A survey was conducted on the items that fit the intention of this study and various statistical analyzes were conducted. Statistical analysis was performed using SPSS 22.0 and AMOS 22.0. The reliability of the items was measured by the reliability test, and the predictability and accuracy of the items were examined. The validity of the measured variables was verified through confirmatory factor analysis. Reliability, empathy, responsiveness, certainty, and tangibility were the most important factors in this study. Responsiveness factors include communication, time reduction, real time, promptness. Assurance factors include the assurance of delivery, prompt answers, product knowledge items. Tangibility factors include, convenient device systems, location information, presence as a fact, and as a result, the latest modern items are adopted. The quality of service in the traditional market developed in this study was found to be good in reliability and validity test. Confirmatory factor analysis result using structural equation model also met the conformity index standard. If service satisfaction is measured based on this research, basic data can be presented to policy makers who implement policies on traditional markets to make the right decisions. In addition, it will be able to provide traditional market operators with operational strategy and marketing data. In the future, based on the traditional market service quality scale developed in this study, it is necessary to grasp the factors to be continuously managed to improve the service quality of the traditional market, user satisfaction, and intention to use.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.15 no.6
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• pp.138-149
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• 2016

The study reviewed the effects of the variable speed limit under adverse weather conditions by using a driving simulator. The study assumed that the display of the reduced speed limit without any change of the weather condition and the display of the same speed limit under the change of the weather conditions violate the expectancy of drivers, so it brings the negative effects on the safety. The study regards drivers conformance as the index of the degree of the compliance of driver expectancy, and utilizes the cumulative probability density within the certain range of the speed including displayed speed limit as the quantitative measure of effectiveness. The study reviewed this assumptions by using a driving simulator. As the results, the cases assumed to violate the expectancy of drivers showed the negative effects on the driving behaviour of driver relatively.

• Journal of radiological science and technology
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• v.41 no.3
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• pp.209-214
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• 2018

The results of CBCT was obtained using image guided radiation therapy for radiation therapy in 5 prostate cancer patients. Using these results, we compared and evaluated the dose changes according to the treatment plan depending on the volume and position of bladder, rectum, and prostate. The 28 images of CBCT were acquired using On-Board Imaging device before radiotherapy. After the outline of bladder, rectum, and PTV, pCT images and CBCT images for radiotherapy were treated respectively. The volume of the bladder was increased by 105.6% and decreased by 45.2%. The volume of the rectum was increased by 30.5% and decreased by 20.3%. Prostate volume was increased by 6.3% and decreased by 12.3%. The mean dose of the rectum was higher in the CBCT than in the pCT, and V40 (equivalent to 40 Gy) of the bladder showed a reduction in all treatment regimens in the CBCT than in the pCT. Conformity treatment and homogeneity index of PTV showed better results in all treatment regimens using pCT than CBCT. It was found that the dose distribution of the pelvic internal organs varied greatly according to the patient 's condition and pretreatment.

• Radiation Oncology Journal
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• v.36 no.1
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• pp.63-70
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• 2018

Purpose: The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose. Materials and Methods: We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed. Results: Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart $V_{30}$ (p = 0.039), $V_{40}$ (p = 0.040), and $V_{50}$ (p = 0.032). Conclusion: Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung $V_{10}$, $V_{20}$, and $V_{30}$ than in 3D-CRT, but could not be proven superior in lung $V_5$. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1227-1232
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• 2014

Background: Given that there are many Iranian women who have never had a Pap smear, this study was designed to develop and validate a measurement tool based on the Protection Motivation Theory to assess factors influencing the Iranian women's intention to perform first Pap testing. Materials and Methods: In this psychometric research, to determine the Content Validity Index (CVI) and the Content Validity Ratio (CVR), a panel of experts (n=10) reviewed scale items. Reliability was estimated through the Intraclass Correlation Coefficient (n=30) and internal consistency (n=240). Also, factor analysis (exploratory and conformity) was performed on the data of the sample women who had never had a Pap smear test (n=240). Results: A 26-item questionnaire was developed. The CVI and CVR scores of the scale were 0.89 and 0.90, respectively. Exploratory factor analysis loaded a 26-item with seven factors questionnaire (perceived vulnerability and severity, fear, response costs, response efficacy, self-efficacy, and protection motivation (or intention)) that jointly accounted for 72.76% of the observed variance. Confirmatory factor analysis indicated a good fit for the data. Internal consistency (range 0.70-0.93) and test-retest reliability (range 0.72-0.96) of sub-scales were acceptable. Conclusions: This study showed that the designed instrument was a valid and reliable tool for measuring the factors influencing the women's intention to perform their first Pap testing.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.179-184
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• 2011

Objective : The aim of this study is to evaluate the therapeutic effects of gamma knife radiosurgery (GKRS) in patients with multiple brain metastases and to investigate prognostic factors related to treatment outcome. Methods : We retrospectively reviewed clinico-radiological and dosimetric data of 36 patients with 4-14 brain metastases who underwent GKRS for 264 lesions between August 2008 and April 2011. The most common primary tumor site was the lung (n=22), followed by breast (n=7). At GKRS, the median Karnofsky performance scale score was 90 and the mean tumor volume was 1.2 cc (0.002-12.6). The mean prescription dose of 17.8 Gy was delivered to the mean 61.1% isodose line. Among 264 metastases, 175 lesions were assessed for treatment response by at least one imaging follow-up. Results : The overall median survival after GKRS was $9.1{\pm}1.7$ months. Among various factors, primary tumor control was a significant prognostic factor ($11.1{\pm}$1.3 months vs. $3.3{\pm}2.4$ months, p=0.031). The calculated local tumor control rate at 6 and 9 months after GKRS were 87.9% and 84.2%, respectively. Paddick's conformity index (>0.75) was significantly related to local tumor control. The actuarial peritumoral edema reduction rate was 22.4% at 6 months. Conclusion : According to our results, GKRS can provide beneficial effect for the patients with multiple (4 or more) brain metastases, when systemic cancer is controlled. And, careful dosimetry is essential for local tumor control. Therefore, GKRS can be considered as one of the treatment modalities for multiple brain metastase.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.138-140
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• 2002

The spinal cord dose is the one of the limiting factor for the radiation treatment of the head & neck (H&N) or the thorax region. Due to the fact that the cord is the elongated shaped structure, it is not an easy task to maintain the cord dose within the clinically acceptable dose range. To overcome this problem, the spinal cord partial block technique (PBT) with the dynamic Multi-Leaf Collimator (dMLC) has been developed. Three dimension (3D) conformal beam directions, which minimize the coverage of the normal organs such as the lung and the parotid gland, were chosen. The PBT field shape for each field was designed to shield the spinal cord with the dMLC. The transmission factors were determined by the forward calculation method. The plan comparisons between the conventional 3D conformal therapy plan and the PTB plan were performed to evaluate the validity of this technique. The conformity index (CI) and the dose volume histogram (DVH) were used as the plan comparison indices. A series of quality assurance (QA) was performed to guarantee the reliable treatment. The QA consisted of the film dosimetry for the verification of the dose distribution and the point measurements. The PBT plan always generated better results than the conventional 3D conformal plan. The PBT was proved to be useful for the H&N and thorax region.