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Evaluation of Difference between Skin Motion and Tumor Motion for Respiration Gated Radiotherapy (호흡조절방사선치료를 위한 피부움직임과 종양움직임 차이 평가)

  • Kwon, Kyung-Tae;Lim, Sang-Wook;Park, Sung-Ho;Kwon, Soo-Il;Shin, Sung-Soo;Lee, Sang-Wook;Ahn, Seung-Do;Kim, Jong-Hoon;Choi, Eun-Kyung
    • Progress in Medical Physics
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    • v.19 no.1
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    • pp.14-20
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    • 2008
  • Accounting for tumor motion in treatment planning and delivery is one of the most recent and significant challenges facing radiotherapy. The purpose of this study was to investigate the correlation and clarified the relationship between the motion of an external marker using the Real-Time Position Management (RPM) System and an internal organ motion signal obtained fluoroscope. We enrolled 10 patients with locally advanced lung cancer and liver cancer, retrospectively. The external marker was a plastic box, which is part of the RPM used to track the patient's respiration. We investigated the quantitatively correlation between the motions of an external marker with RPM and internal motion with fluoroscope. The internal fiducial motion is predominant in the caraniocaudal direction, with a range of $1.3{\sim}3.5cm$ with fluoroscopic unit. The external fiducial motion is predominant in the caraniocaudal direction, with a range of $0.43{\sim}2.19cm$ with RPM gating. The two measurements ratio is from 1.31 to 5.56. When the regularization guided standard deviation is from 0.08 to 0.87, mean 0.204 cm, except only for patients #3 separated by a mean 0.13 cm, maximum of 0.23 cm. This result is a good correlation between internal tumor motion imaged by fluoroscopic unit and external marker motion with RPM during expiration within 0.23 cm. We have demonstrated that gating may be best performed but special attention should be paid to gating for patients whose fiducials do not move in synchrony, because targeting on the correct phase difference alone would not guarantee that the entire tumor volume is within the treatment field.

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Clinical Application of in Vivo Dosimetry System in Radiotherapy of Pelvis (골반부 방사선 치료 환자에서 in vivo 선량측정시스템의 임상적용)

  • Kim, Bo-Kyung;Chie, Eui-Kyu;Huh, Soon-Nyung;Lee, Hyoung-Koo;Ha, Sung-Whan
    • Journal of Radiation Protection and Research
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    • v.27 no.1
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    • pp.37-49
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    • 2002
  • The accuracy of radiation dose delivery to target volume is one of the most important factors for good local control and less treatment complication. In vivo dosimetry is an essential QA procedure to confirm the radiation dose delivered to the patients. Transmission dose measurement is a useful method of in vivo dosimetry and it's advantages are non-invasiveness, simplicity and no additional efforts needed for dosimetry. In our department, in vivo dosimetry system using measurement of transmission dose was manufactured and algorithms for estimation of transmission dose were developed and tested with phantom in various conditions successfully. This system was applied in clinic to test stability, reproducibility and applicability to daily treatment and the accuracy of the algorithm. Transmission dose measurement was performed over three weeks. To test the reproducibility of this system, X-tay output was measured before daily treatment and then every hour during treatment time in reference condition(field size; $10 cm{\times} 10 cm$, 100 MU). Data of 11 patients whose pelvis were treated more than three times were analyzed. The reproducibility of the dosimetry system was acceptable with variations of measurement during each day and over 3 week period within ${\pm}2.0%$. On anterior- posterior and posterior fields, mean errors were between -5.20% and +2.20% without bone correction and between -0.62% and +3.32% with bone correction. On right and left lateral fields, mean errors were between -10.80% and +3.46% without bone correction and between -0.55% and +3.50% with bone correction. As the results, we could confirm the reproducibility and stability of our dosimetry system and its applicability in daily radiation treatment. We could also find that inhomogeneity correction for bone is essential and the estimated transmission doses are relatively accurate.

The Properties of Beam Intensity Scanner (BInS) for Dose Verification in Intensity Modulated Radiation Therapy (방사선 세기 조절 치료에서 선량을 규명하는 데 사용된 BlnS System의 특성)

  • 박영우;박광열;박경란;권오현;이명희;이병용;지영훈;김근묵
    • Progress in Medical Physics
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    • v.15 no.1
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    • pp.1-8
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    • 2004
  • Patient dose verification is one of the most Important responsibilities of the physician in the treatment delivery of radiation therapy. For the task, it is necessary to use an accurate dosimeter that can verify the patient dose profile, and it is also necessary to determine the physical characteristics of beams used in intensity modulated radiation therapy (IMRT) The Beam Intensity Scanner (BInS) System is presented for the dosimetric verification of the two dimensional photon beam. The BInS has a scintillator, made of phosphor Terbium-doped Gadolinium Oxysulphide (Gd$_2$O$_2$S:Tb), to produce fluorescence from the irradiation of photon and electron beams. These fluoroscopic signals are collected and digitized by a digital video camera (DVC) and then processed by custom made software to express the relative dose profile in a 3 dimensional (3D) plot. As an application of the BInS, measurements related to IWRT are made and presented in this work. Using a static multileaf collimator (SMLC) technique, the intensity modulated beam (IMB) is delivered via a sequence of static portals made by controlled leaves. Thus, when static subfields are generated by a sequence of abutting portals, the penumbras and scattered photons of the delivered beams overlap in abutting field regions and this results in the creation of “hot spots”. Using the BInS, inter-step “hot spots” inherent in SMLC are measured and an empirical method to remove them is proposed. Another major MLC technique in IMRT, the dynamic multileaf collimator (DMLC) technique, has different characteristics from SMLC due to a different leaf operation mechanism during the irradiation of photon and electron beams. By using the BInS, the actual delivered doses by SMLC and DMLC techniques are measured and compared. Even if the planned dose to a target volume is equal in our experimental setting, the actual delivered dose by DMLC technique is measured to be larger by 14.8% than that by SMLC, and this is due to scattered photons and contaminant electrons at d$_{max}$.

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Periventricular leukomalacia induced by in utero clamping of pregnant rat aorta in fetal rats (태아 백서에서 임신 백서의 자궁 내 대동맥 결찰로 유발한 뇌실주위 백질연화증)

  • Chang, Yun Sil;Sung, Dong Kyung;Kang, Saem;Park, Soo Kyung;Jung, Yu Jin;Seo, Hyun Joo;Choi, Seo Heui;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.874-878
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    • 2008
  • Purpose : This study was undertaken to develop an animal model of periventricular leukomalacia (PVL) induced by in utero clamping of pregnant rat aorta in fetal rats. Methods : A timed pregnanct Sprague-Dawley rat on embryonic day 21 just prior to delivery was sedated and anesthetized, and a Harvard ventilator for small animals was applied. Following laparotomy, the maternal aorta was clamped reversibly for 40 minutes using a surgical clip. The fetal rats were then delivered by Cesarean section, resuscitated if necessary, and reared by a surrogate mother rat until postnatal day 21 to obtain the brain specimen. After systemic perfusion and fixation, $10{\mu}m$ thick serial brain sections were obtained and stained for pathologic examination and assessment of ventriculomegaly. Ventriculomegaly was assessed by the measured ventricle to total brain volume ratio. Results : Eight out of eleven fetal rats (73%) survived in the ischemia group after induction of in utero ischemia by clamping maternal rat aorta, and all ten survived in the control group. Body and brain weights measured at postnatal day 21 were significantly lower in the ischemia group compared to the control group. In pathologic findings, significant ventriculomagaly ($3.67{\pm}1.21%$ vs. $0.23{\pm}0.06%$) was observed in the ischemia group compared to the control group; although cystic lesion was not observed, mild (n=6) and moderate (n=2) rerefaction of the brain tissue was observed. Conclusion : A fetal rat model of PVL induced by in utero clamping of pregnant rat aorta was developed.

Status of Agrometeorological Information and Dissemination Networks (농업기상 정보 및 배분 네트워크 현황)

  • Jagtap, Shrikant;Li, Chunqiang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.6 no.2
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    • pp.71-84
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    • 2004
  • There is a growing demand for agrometeorological information that end-users can use and not just interesting information. lo achieve this, each region/community needs to develop and provide localized climate and weather information for growers. Additionally, provide tools to help local users interpret climate forecasts issued by the National Weather Service in the country. Real time information should be provided for farmers, including some basic data. An ideal agrometeorological information system includes several components: an efficient data measuring and collection system; a modern telecommunication system; a standard data management processing and analysis system; and an advanced technological information dissemination system. While it is conventional wisdom that, Internet is and will play a major role in the delivery and dissemination of agrometeorological information, there are large gaps between the "information rich" and the "information poor" countries. Rural communities represent the "last mile of connectivity". For some time to come, TV broadcast, radio, phone, newspaper and fax will be used in many countries for communication. The differences in achieving this among countries arise from the human and financial resources available to implement this information and the methods of information dissemination. These differences must be considered in designing any information dissemination system. Experience shows that easy across to information more tailored to user needs would substantially increase use of climate information. Opportunities remain unexplored for applications of geographical information systems and remote sensing in agro meteorology.e sensing in agro meteorology.

A study to 3D dose measurement and evaluation for Respiratory Motion in Lung Cancer Stereotactic Body Radiotherapy Treatment (폐암의 정위적체부방사선치료시 호흡 움직임에 따른 3D 선량 측정평가)

  • Choi, Byeong-Geol;Choi, Chang-Heon;Yun, Il-Gyu;Yang, Jin-Seong;Lee, Dong-Myeong;Park, Ju-Mi
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.59-67
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    • 2014
  • Purpose : This study aims to evaluate 3D dosimetric impact for MIP image and each phase image in stereotactic body radiotherapy (SBRT) for lung cancer using volumetric modulated arc therapy (VMAT). Materials and Methods : For each of 5 patients with non-small-cell pulmonary tumors, a respiration-correlated four-dimensional computed tomography (4DCT) study was performed. We obtain ten 3D CT images corresponding to phases of a breathing cycle. Treatment plans were generated using MIP CT image and each phases 3D CT. We performed the dose verification of the TPS with use of the Ion chamber and COMPASS. The dose distribution that were 3D reconstructed using MIP CT image compared with dose distribution on the corresponding phase of the 4D CT data. Results : Gamma evaluation was performed to evaluate the accuracy of dose delivery for MIP CT data and 4D CT data of 5 patients. The average percentage of points passing the gamma criteria of 2 mm/2% about 99%. The average Homogeneity Index difference between MIP and each 3D data of patient dose was 0.03~0.04. The average difference between PTV maximum dose was 3.30 cGy, The average different Spinal Coad dose was 3.30 cGy, The average of difference with $V_{20}$, $V_{10}$, $V_5$ of Lung was -0.04%~2.32%. The average Homogeneity Index difference between MIP and each phase 3d data of all patient was -0.03~0.03. The average PTV maximum dose difference was minimum for 10% phase and maximum for 70% phase. The average Spain cord maximum dose difference was minimum for 0% phase and maximum for 50% phase. The average difference of $V_{20}$, $V_{10}$, $V_5$ of Lung show bo certain trend. Conclusion : There is no tendency of dose difference between MIP with 3D CT data of each phase. But there are appreciable difference for specific phase. It is need to study about patient group which has similar tumor location and breathing motion. Then we compare with dose distribution for each phase 3D image data or MIP image data. we will determine appropriate image data for treatment plan.

The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome (급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과)

  • Koh, Youn-Suck;Lim, Chae-Man;Lee, Ki-Man;Chin, Jae-Yong;Shim, Tae-Sun;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1223-1235
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    • 1998
  • Background and Objective : Although prone positioning has been reported to improve gas exchange, prone positioning alone does not seem to be sufficient to increase systemic oxygen transport in an acute lung injury. The objective of this study was to investigate whether the combined therapy of low dose nitric oxide (NO) inhalation and prone positioning has an additive effect on the oxygenation and hemodynamics in patients with severe ARDS. Patients and Methods : Twelve patients with ARDS were included. Prone positioning alone, later combined with nitric oxide inhalation (5~10 ppm) from the supine position (baseline) were performed with serial measurement of gas exchange, respiratory mechanics and hemodynamic at sequential time points. The patient was regarded as a responder to prone positioning if an increase in $PaO_2/FiO_2$ of more than 20 mm Hg at 30 min or 120 min intervals after prone positioning was observed compared to that of the baseline. The same criterion was applied during nitric oxide inhalation. Results : Eight patients (66.5%) responded to prone positioning and ten patients (83.3%) including the eight just mentioned responded to the addition of NO inhalation. The $AaDO_2$ level also decreased promptly with the combination of prone positioning and NO inhalation compared to that of prone positioning alone ($191{\pm}109$ mm Hg vs. $256{\pm}137$ mm Hg, P<0.05). Hemodynamic parameters and lung compliance did not change significantly during prone positioning only. Following the addition of NO inhalation to prone positioning, the mean pulmonary artery pressure and pulmonary artery occlusion pressure decreased and cardiac output, stroke volume and oxygen delivery increased (P < 0.05) compared to those of prone 120 min. Conclusion : These findings indicate that NO inhalation would provide additional improvement in oxygenation and oxygen transport to mechanically ventilated patients with ARDS who are in a prone position.

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Analysis on the Dosimetric Characteristics of Tangential Breast Intensity Modulated Radiotherapy (유방암의 접선 세기조절 방사선치료 선량 특성 분석)

  • Yoon, Mee Sun;Kim, Yong-Hyeob;Jeong, Jae-Uk;Nam, Taek-Keun;Ahn, Sung-Ja;Chung, Wong-Ki;Song, Ju-Young
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.219-228
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    • 2012
  • The tangential breast intensity modulated radiotherapy (T-B IMRT) technique, which uses the same tangential fields as conventional 3-dimensional conformal radiotherapy (3D-CRT) plans with physical wedges, was analyzed in terms of the calculated dose distribution feature and dosimetric accuracy of beam delivery during treatment. T-B IMRT plans were prepared for 15 patients with breast cancer who were already treated with conventional 3D-CRT. The homogeneity of the dose distribution to the target volume was improved, and the dose delivered to the normal tissues and critical organs was reduced compared with that in 3D-CRT plans. Quality assurance (QA) plans with the appropriate phantoms were used to analyze the dosimetric accuracy of T-B IMRT. An ionization chamber placed at the hole of an acrylic cylindrical phantom was used for the point dose measurement, and the mean error from the calculated dose was $0.7{\pm}1.4%$. The accuracy of the dose distribution was verified with a 2D diode detector array, and the mean pass rate calculated from the gamma evaluation was $97.3{\pm}2.9%$. We confirmed the advantages of a T-B IMRT in the dose distribution and verified the dosimetric accuracy from the QA performance which should still be regarded as an important process even in the simple technique as T-B IMRT in order to maintain a good quality.

A Study on the Intelligent Quick Response System for Fast Fashion(IQRS-FF) (패스트 패션을 위한 지능형 신속대응시스템(IQRS-FF)에 관한 연구)

  • Park, Hyun-Sung;Park, Kwang-Ho
    • Journal of Intelligence and Information Systems
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    • v.16 no.3
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    • pp.163-179
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    • 2010
  • Recentlythe concept of fast fashion is drawing attention as customer needs are diversified and supply lead time is getting shorter in fashion industry. It is emphasized as one of the critical success factors in the fashion industry how quickly and efficiently to satisfy the customer needs as the competition has intensified. Because the fast fashion is inherently susceptible to trend, it is very important for fashion retailers to make quick decisions regarding items to launch, quantity based on demand prediction, and the time to respond. Also the planning decisions must be executed through the business processes of procurement, production, and logistics in real time. In order to adapt to this trend, the fashion industry urgently needs supports from intelligent quick response(QR) system. However, the traditional functions of QR systems have not been able to completely satisfy such demands of the fast fashion industry. This paper proposes an intelligent quick response system for the fast fashion(IQRS-FF). Presented are models for QR process, QR principles and execution, and QR quantity and timing computation. IQRS-FF models support the decision makers by providing useful information with automated and rule-based algorithms. If the predefined conditions of a rule are satisfied, the actions defined in the rule are automatically taken or informed to the decision makers. In IQRS-FF, QRdecisions are made in two stages: pre-season and in-season. In pre-season, firstly master demand prediction is performed based on the macro level analysis such as local and global economy, fashion trends and competitors. The prediction proceeds to the master production and procurement planning. Checking availability and delivery of materials for production, decision makers must make reservations or request procurements. For the outsourcing materials, they must check the availability and capacity of partners. By the master plans, the performance of the QR during the in-season is greatly enhanced and the decision to select the QR items is made fully considering the availability of materials in warehouse as well as partners' capacity. During in-season, the decision makers must find the right time to QR as the actual sales occur in stores. Then they are to decide items to QRbased not only on the qualitative criteria such as opinions from sales persons but also on the quantitative criteria such as sales volume, the recent sales trend, inventory level, the remaining period, the forecast for the remaining period, and competitors' performance. To calculate QR quantity in IQRS-FF, two calculation methods are designed: QR Index based calculation and attribute similarity based calculation using demographic cluster. In the early period of a new season, the attribute similarity based QR amount calculation is better used because there are not enough historical sales data. By analyzing sales trends of the categories or items that have similar attributes, QR quantity can be computed. On the other hand, in case of having enough information to analyze the sales trends or forecasting, the QR Index based calculation method can be used. Having defined the models for decision making for QR, we design KPIs(Key Performance Indicators) to test the reliability of the models in critical decision makings: the difference of sales volumebetween QR items and non-QR items; the accuracy rate of QR the lead-time spent on QR decision-making. To verify the effectiveness and practicality of the proposed models, a case study has been performed for a representative fashion company which recently developed and launched the IQRS-FF. The case study shows that the average sales rateof QR items increased by 15%, the differences in sales rate between QR items and non-QR items increased by 10%, the QR accuracy was 70%, the lead time for QR dramatically decreased from 120 hours to 8 hours.

Usability assessment of thermoplastic Bolus for skin VMAT radiotherapy (피부 병변에 대한 VMAT 치료 시 열가소성 bolus의 유용성 평가: case review)

  • Kim, Min Soo;Kim, Joo Ho;Shin, Hyun Kyung;Cho, Min Seok;Park, Ga Yeon
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.85-92
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    • 2020
  • Purpose: To find out the advantages of thermoplastic bolus compared to conventional bolus, which is mainly used in clinical practice, We evaluated Two cases in terms of dose and location reproducibility to assess Usability of thermoplastic Bolus for skin VMAT radiotherapy. Materials and Methods: Two patient's treated with left breast skin lesion were simulated using thermoplastic Bolus and planned with 2arc VMAT. the prescription dose was irradiated to 95% or more of the target volume. We evaluated The reproducibility of the bolus position by measuring the length of the air gap in the CBCT (Cone Beam CT) image. to evaluate dose reproducibility, we compared The dose distribution in the plan and CBCT and measured in vivo for patient 2. Results: The difference between the air gap in patient 1's simulation CT and the mean air gap (M1) during 10 treatments in the CBCT image was -0.42±1.24mm. In patient 2, the difference between the average air gap between the skin and the bolus (M2) during 14 treatments was -1.08±1.3mm, and the air gap between the bolus (M3) was 0.49±1.16. The difference in the dose distribution between Plan CT and CBCT was -1.38% for PTV1 D95 and 0.39% for SKIN (max) in patient 1. In patient 2, PTV1 D95 showed a difference of 0.63% and SKIN (max) -0.53%. The in vivo measurement showed a difference of -1.47% from the planned dose. Conclusion: thermoplastic Bolus is simpler and takes less time to manufacture compared to those produced by 3D printer. Also compared to conventional bolus, it has high reproducibility in the set-up side and stable results in terms of dose delivery.