Purpose : Multileaf collimator(MLC) is very suitable tool for conformal radio-therapy and commissioning measurements for a multileaf collimator installed on a dual energy accelerator with 6 and 10MV photons are required, For modeling the collimator with treament planning software, detailed dosimetric characterization of the multileaf collimator including the penumbra width, leaf transmission between leaf leakage and localization of the leaf ends and sides is an essential requirement. materials and Methods : Measurement of characteristic data of the MLC with 26 pair block leaves installed on CLINAC 2100C linear accelerator was performed. Low sensitive radiographic film(X-omatV) was used for the penumbra measurement and separate experiments using radiographic film and thermoluminescent dosimeters were performed to verify the dose distribution, Measured films were analized with a photodensitometer of WP700i scanner. Results : For 6 & 10 MV x-ray energies, approximately $2.0\%$ of photons incident on the multileaf collimator were transmitted and an additional $0.5\%$ leakage occurs between the leaves. Localizing the physical end of the leaves showed less than 1mm deviation from the $50\%$ decrement line and this difference is attributed to the curved shaped end on the leaves One side of a sin히e leaf corresponded to the $50\%$ decrement line, but the opposite face was aligned with a lower value. This difference is due to the tongue and groove used to decrease between leaf leakage. Alignment of the leaves to form a straight edge resulted larger penumbra at far position from isocenter as compare with divergent alloy blocks. When the MLC edge is stepped by sloping field, the isodose lines follow the leaf pattern and Produce scalloping isodose curves in tissue. The effective penumbra by 45 degree stepped MLC is about 10mm at 10cm depth for 6MV x-ray. The difference of effective penumbra in deep tissue between MLC and divergent alloy blocks is small (5mm). Conclusion : Using the characteristic data of MLC, the MLC has the clinlical acceptability and suitability for 3-D conformal radiotherapy except small field size.
Purpose: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. Methods and materials: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients($68\%$) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, $82\%$ of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). Results: Complete response(CR) was achieved in 18 patients($54\%$). Five of eighteen patients($28\%$) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was $43\%$ and the disease free survival was $31\%$. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation, The principal cause of death was lung metastasis($36\%$). Conclusion: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well.
Huh, Hyun Do;Cho, Kwang Hwan;Cho, Sam Ju;Choi, Sang Hyoun;Kim, Dong Wook;Hwang, Ui-Jung;Kim, Ki Hwan;Min, Chul Kee;Choi, Tae Jin;Oh, Young Kee;Lee, Seoung Jun;Park, Dahl;Park, Sung-Kwang;Ji, Young Hoon
Progress in Medical Physics
/
v.24
no.4
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pp.315-322
/
2013
The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.
The Journal of Korean Society for Radiation Therapy
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v.16
no.2
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pp.19-24
/
2004
Introduction : The Vaginal, the urethra, the vulva and anal cancer avoid the many dose to femur head and the additional treatment is necessary in inguinal LN. The partial transmission block to use inguinal LN addition there is to a method which it treats and produce partial transmission block a method and the MLC which to it analyzes. Material & Methode : The Inguinal the LN treatment patient partial transmission it used block and the MLC in the object and with solid water phantom with the patient it reappeared the same depth. In order to analyze the error of the junction the EDR2 (Extended dose range, the Kodak and the U.S) it used the Film and it got film scanner it got the beam profile. The partial transmission block and the MLC bias characteristic, accuracy and stability of production for, it shared at hour and comparison it analyzed. Result : The partial the transmission block compares in the MLC and the block production is difficult and production hour also above 1 hours. The custom the block the place where it revises the error of the junction is a difficult problem. If use of the MLC the fabrication will be break and only the periodical calibration of the MLC it will do and it will be able to use easily. Conclusion : The Inguinal there is to LN treatment and partial transmission block and the MLC there is efficiency of each one but there is a place where the junction of block for partial transmission block the production hour is caught long and it fixes and a point where the control of the block is difficult. like this problem it transfers with the MLC and if it treats, it means the effective treatment will be possible.
This study was performed to evaluate the effect of intravenous administration of glycopyrrolate on cardiovascular and respiratory system in dogs given intravenous medetomidine (20 ${\mu}g$/kg) and intramuscular midazolam (0.3 mg/kg) (MM). Prior to administration of MM, glycopyrrolate was administered intravenously at doses of 5 ${\mu}g$/kg (Gly-5), 10 ${\mu}g$/kg (Gly-10) or 20 ${\mu}g$/kg (Gly-20), respectively. For the control group saline was administered intravenously. In the cardiovascular system, HR, BP, RAP, PAWP, CI, SI, SVR, and PVR were measured. RR, $V_T$, $P_{ETCO2}$, and arterial blood gas analysis were measured for respiratory system. Although rapid and satisfied depth of sedation was obtained by MM, life-threatening bradycardia, the outstanding side-effect on cardiovascular system in dogs were observed. This combination also decreased CO and increased SVR, RAP, and PAWP significantly. The bradycardia could be prevented in all the glycopyrrolate treated groups, but tachycardia was observed in Gly-10 and Gly-20 groups. Significant increases in blood pressure were shown in glycopyrrolate treated groups. Also, tachycardia depends on dose of glycopyrrolate, compensating the CO. However, these were not fully reserved. In conclusion, MM combination could induce rapid and satisfied depth of sedation but was not the suitable method for the deep sedation of dogs with cardiovascular or circulatory problems.
Kim, Jong-Min;Kim, Dae-Sup;Hong, Dong-Ki;Back, Geum-Mun;Kwak, Jung-Won
The Journal of Korean Society for Radiation Therapy
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v.24
no.1
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pp.23-30
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2012
Purpose: There was a problem with using MU verification programs for the reasons that there were errors of MU when using MU verification programs based on Pencil Beam Convolution (PBC) Algorithm with radiation treatment plans around lung using Analytical Anisotropic Algorithm (AAA). On this study, we studied the methods that can verify the calculated treatment plans using AAA. Materials and Methods: Using Eclipse treatment planning system (Version 8.9, Varian, USA), for each 57 fields of 7 cases of Lung Stereotactic Body Radiation Therapy (SBRT), we have calculated using PBC and AAA with dose calculation algorithm. By developing MU of established plans, we compared and analyzed with MU of manual calculation programs. We have analyzed relationship between errors and 4 variables such as field size, lung path distance of radiation, Tumor path distance of radiation, effective depth that can affect on errors created from PBC algorithm and AAA using commonly used programs. Results: Errors of PBC algorithm have showned $0.2{\pm}1.0%$ and errors of AAA have showned $3.5{\pm}2.8%$. Moreover, as a result of analyzing 4 variables that can affect on errors, relationship in errors between lung path distance and MU, connection coefficient 0.648 (P=0.000) has been increased and we could calculate MU correction factor that is A.E=L.P 0.00903+0.02048 and as a result of replying for manual calculation program, errors of $3.5{\pm}2.8%$ before the application has been decreased within $0.4{\pm}2.0%$. Conclusion: On this study, we have learned that errors from manual calculation program have been increased as lung path distance of radiation increases and we could verified MU of AAA with a simple method that is called MU correction factor.
Any detector inserted into a phantom should have such a geometry that it caused as small as possible perturbation of the electron fluence. Plane parallel chambers meet this requirement better than other chambers of configurations. IAEA protocol recommends the use of plane parallel chambers for this reason. However, the cylindrical chambers are widely used for convenient. The purpose of this study is to evaluate the absorbed dose due to the differences of four different dosimetry protocols such as IAEA protocol using cylindrical chamber, TG 21 protocol using cylindrical chamber, Markus protocol using plane parallel chamber, and TG 39 report for the calibration of plane parallel chamber in electron beams. Depth-ionization measurements for the electron beams of nominal energy 6, 9, 12, 15, and 18 MeV from Siemens accelerator with a 10$\times$10 cm$^2$ field size were made using a radiation field analyser with 0.125 cc ion chamber. Dosimetric measurements by IAEA and TG 21 protocol were made with a farmer type ionization chamber in solid water for each electron energy, respectively. Dosimetric measurements by Markus protocol were made with a plane parallel ionization chamber in solid water for each electron energy, respectively. The cavity-gas calibration factor for the plane parallel chamber was obtained with the use of 18 MeV electron beam as guided by TG 39 report. Dosimetric measurements by TG 39 were performed with a plane parallel ionization chamber in solid water for each electron energy, respectively. For all the energies and protocols, measurements were made along the central axis of the distance of 100 cm (SSD = 100 cm) with 10$\times$10 cm$^2$ field size at the depth of d$_{max}$ for each electron beam, respectively. In the case of 18 MeV, the discrepancy of 0.9 % between IAEA and TG 21 was found and the two protocols were agreed within 0.7 % for other energies. In the case of 18 MeV and 6 MeV, the discrepancies of $\pm$ 0.8 % between Markus and TG 39 was found, respectively and the two protocols were agreed within 0.5 % for other energies. Since the discrepancy of 1.6 % between cylindrical and plane parallel chamber was found for 18 MeV, it is suggested to get the calibration factor using other method as guided. by TG 39.9.
Kim Dae Young;Kim Won Taek;Lee Hwa Jung;Lee Kang Hyeok
The Journal of Korean Society for Radiation Therapy
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v.15
no.1
/
pp.1-9
/
2003
I. Purpose The multileaf collimator(MLC) has many advantages, but use of the MLC increased effective penumbra and isodose undulation in dose distribution compared with that of an alloy block. In this work, we introduced the HD-270 MLC, which can improve the above disadvantages of MLC, and reported its feasibility study. II. Method and Materials The HD-270 MLC is a technique which combines the use of the existing Siemens multileaf collimator(3D MLC) with patient translation perpendicular to the leaf plane. The technique produces a smoothed isodose distribution with the reduced isodose undulation and effective penumbra. To assess the efficacy of the HD-270 technique and determine the appropriate resolution, a polygonal shaped MLC field was made to produce field edge angles from 0 degree to 75 degree with a step of 15 degree. Each HD-270 group was generated according to the allowed resolution, i. e., 5, 3, and 2mm. The experiment was carried out on Primus, a Siemens linear accelerator configured with HD-270 MLC. The total 60 MU of 6 MV photon beam was delivered to X-Omat film(Kodak, USA) at a SAD of 100 cm and 1.5 cm depth in solid water phantom. Exposed films were scanned by Lumiscan75(LUMISYS) and analyzed using RIT113 software(Radiological Imaging Technology Inc., USA). To test the mechanical accuracy of table movement, the transverse, longitudinal, and vertical positions were controlled by a consol with ${\pm}5\;mm,\;{\pm}4\;mm,\;{\pm}3\;mm,\;and\;{\pm}2\;mm$ steps, and then measured using a dial gauge with an accuracy of 0.001 inch. During the experiments, the table loaded with about 50Kg human phantom to simulate the real treatment situation. III. Results The effective penumbra and isodose undulation became larger with increase the resolution and field edge angle. The accuracy of the table movement on each direction is good within the ${\pm}1\;mm$. IV. Conclusion Clinical use of the MLC can be increased by using of the HD-270 MLC which complements to the disadvantages of the MLC.
$\^$137/Cs gamma ray induced thermoluminescenc(TL) from Na$\^$+/ ion implanted Al$_2$O$_3$ and unimplanted Al$_2$O$_3$ and the TL from Na$\^$+/ ion implanted Al$_2$O$_3$ are measured over the temperature range of 340K~620K. The TL curve of Na$\^$+/ ion implanted Al$_2$O$_3$ induced by $\^$137/Cs gamma ray is split into iolated TL peak located at 415K, 452K, 508K, and 568K. Because that the concentration of trapped char he carries of $\^$137/Cs gamma ray induced Al$_2$O$_3$ implanted with Na$\^$+/ ion is larger than that of Na$\^$+/ ion only implanted Al$_2$O$_3$, and the trap concentration of Na$\^$+/ ion implanted Al$_2$O$_3$ is much than that of $\^$137/Cs gamma ray only irradiated Al$_2$O$_3$, the TL intensity of Na$\^$+/ ion implanted Al$_2$O$_3$ induced by $\^$137/Cs gamma ray is about 20 times and 5 times higher than that of Al$_2$O$_3$ only implanted with Na$\^$+/ ion and Al$_2$O$_3$ only irradiated with $\^$137/Cs gamma ray, respectively. In proportion as ion implantation does and energy are incresed, the number of generated defects and the rate of defect creation are incresed, respectively. Therefore the TL intensity of ion implanted Al$_2$O$_3$ is depend on ion dose and energy. Acccrding to increse of incident ion mass, the TL intensity of ion implanted Al$_2$O$_3$ is abruptly decresce. This result showes that the TL intensity of ion implanted Al$_2$O$_3$ is closely related to ion depth range as wll as rate of defect creatin. The TL intensity of ion implanted Al$_2$O$_3$ is found to be related with defects generated by ion implantation. Table Caption
Recent evidence has revealed that the intratesticular injection of hypertonic saline(20%) resulted in a chemically castrated state such as nadir testosterone levels in rats. To confirm the efficacy of this simple saline-injection method further, we investigated the changes in the gross and microscopic anatomy of testis. Our study comprised three groups; intact(control) group, orchidectomy group and saline-injection (experimental) group. Single dose of hypertonic saline (sterilized, $750{\mu}{\ell}/testis$) were directly administered into both testis of adult rats (about 300 g BW). Bilateral orchidectomy was performed at the same day of saline injection. Following 30 days post-injection, reproductive tissues were surgically removed, weighed and fixed for histological examination. The body weights were not changed in both orchidectomy group and saline-injection group when compared to those in intact group. The wet weights of testis were significantly decreased in saline-injection group when compared to those in intact group. The wet weights of epididymis and seminal vesicle and prostate were significantly decreased in orchidectomy group and saline-injection group when compared to those in intact group. Macroscopically, the testes exerted slight atrophy and the tunica albuginea seemed to be intact in saline injection group. Histologically, however, larger parts of testicular tissue underwent necrosis and were barely recognizable after hematoxylin-eosin staining. In the same section, only the opposite part of the injection site was stained showing abnormal state of cell layers mostly fibrosis and infiltrated leukocytes. Sloughing of immature germ cells from the basement membrane along with shedding cells in the intraluminal space was notable in most seminiferous tubules from the saline injected testis. The present study confirmed that the direct injection of hypertonic saline into testis can induce a castration-like, testosterone-depriving effects on accessory sex organs. Our findings suggest that the efficacy of this less expensive and minimally invasive method seems to be almost even with that of conventional orchidectomy and chemical castration, though more in-depth evaluation should be supported.
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