• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.136-139
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• 2004

In this study, we used the rectal balloon to overcome the dose limit of the radiation therapy in the prostate cancer. Using the rectal balloon, we could minimize the planning target volume (PTV) by minimizing the internal motion of prostate and increased the gap between the rectum wall and the high dose region. To this purpose, we analyzed the position reproducibility of rectal balloon during the patient setup. Moreover, we studied the clinical feasibility of rectal balloon by performing the IMRT plan.

• The Journal of Korean Society for Radiation Therapy
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• v.14 no.1
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• pp.35-39
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• 2002

Introduction : It is essential to input patients external contour in 3D treatment plan. We would like to see changes in depth and dose when 3D RTP is operating auto contouring when windows value (Width/Level) differs in this process. Material & Methode : We have analyzed the results with 3D RTP after CT Scanning with round CT Phantom. We have compared and analyzed MU values according to depth changes to Isocenter changing external contour and inputting random Window value. We have watched change values according to dose optimization in 4 directions(LAO, LPO, RAO, RPO), We plan 100 case for exact analyzation. We have results changing window value random to each beam in 100 cans. Result : It showed change between minimum and maximum value in 4 beam is Depth 0.26mm, MU $1.2\%$ in LAO. It showed LPO-Depth 0.13mm, MU $0.9\%$, RAO-Depth 0.2mm MU $0.8\%$, RPO-Depth 0.27mm, MU $1.1\%$ Conclusion : Maximum change in depth 0.27 mm, MU error rate is $0.12\%$ according to Window change. As we can see in these results, it seems Window value change doesn't effect in treatment. However, it seems there needs to select appropriate Window value in precise treatment.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.121-125
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• 1989

Total 21 patients with airway obstruction from lung cancer treated with radiotherapy at Department of Therapeuctic Radiology, Yeungnam University College of Medicine, between April 1986 and December 1988 are retrospectively analysed by means of roentgenologic findings. Obtained results are as follows. 1. 15 out of 21 patients(71%) showed complete or partial response. 2. Patients with small cell lung cancer showed 100% response in spite of low dose(30GY/10 fractions). 3. Patients with non-small cell lung cancer treated with 50GY or over showed better response than below 45GY or below. 4. There is no relationship between the response and site of airway obstruction. These data suggested that high dose irradiation is more effective in the management of airway obstruction from lung cancer and meticulous radiotherapy planning with appropriate protection of normal lung and critical organs should be investigated in order to maximize radiation effect and minimize side effect, complication or sequelae.

• Journal of Korean Neurosurgical Society
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• v.37 no.4
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• pp.275-281
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• 2005

Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.

• Journal of Radiation Protection and Research
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• v.44 no.4
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• pp.149-155
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• 2019

Background: Magnetic resonance (MR) image guided radiation therapy system, enables real time MR guided radiotherapy (RT) without additional radiation exposure to patients during treatment. However, MR image lacks electron density information required for dose calculation. Image fusion algorithm with deformable registration between MR and computed tomography (CT) was developed to solve this issue. However, delivered dose may be different due to volumetric changes during image registration process. In this respect, synthetic CT generated from the MR image would provide more accurate information required for the real time RT. Materials and Methods: We analyzed 1,209 MR images from 16 patients who underwent MR guided RT. Structures were divided into five tissue types, air, lung, fat, soft tissue and bone, according to the Hounsfield unit of deformed CT. Using the deep learning model (U-NET model), synthetic CT images were generated from the MR images acquired during RT. This synthetic CT images were compared to deformed CT generated using the deformable registration. Pixel-to-pixel match was conducted to compare the synthetic and deformed CT images. Results and Discussion: In two test image sets, average pixel match rate per section was more than 70% (67.9 to 80.3% and 60.1 to 79%; synthetic CT pixel/deformed planning CT pixel) and the average pixel match rate in the entire patient image set was 69.8%. Conclusion: The synthetic CT generated from the MR images were comparable to deformed CT, suggesting possible use for real time RT. Deep learning model may further improve match rate of synthetic CT with larger MR imaging data.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.985-992
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• 2016

Objective of the study is to evaluate volumetric and dosimetric alterations taking place during radiotherapy for locally advanced head and neck cancer (LAHNC) and to assess benefit of replanning in them. Materials and Methods: Thirty patients with LAHNC fulfilling the inclusion and exclusion criteria were enrolled in a prospective study. Planning scans were acquired both pre-treatment and after 20 fractions (mid-course) of radiotherapy. Single plan (OPLAN) based on initial CT scan was generated and executed for entire treatment course. Beam configuration of OPLAN was applied to anatomy of interim scan and a hybrid plan (HPLAN30) was generated. Adaptive replanning (RPLAN30) for remaining fractions was done and dose distribution with and without replanning compared for remaining fractions. Results: Substantial shrinkage of target volume (TV) and parotids after 4 weeks of radiotherapy was reported (p<0.05). No significant difference between planned and delivered doses was seen for remaining fractions. Hybrid plans showed increase in delivered dose to spinal cord and parotids for remaining fractions. Interim replanning improved homogeneity of treatment plan and significantly reduced doses to cord (Dmax, D2% and D1%) and ipsilateral parotid (D33%, D50% and D66%) (p<0.05). Conclusions: Use of one or two mid-treatment CT scans and replanning provides greater normal tissue sparing along with improved TV coverage.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6133-6137
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• 2012

Purpose: To study the effect of bolus versus no bolus in the coverage of the nodal tumour volume with intensity-modulated radiotherapy (IMRT) for the treatment of nasopharyngeal carcinoma (NPC). Methods and Materials: This retrospective study used data from 5 consecutive patients with NPC who were treated with bolus for large neck nodes using IMRT from November 2011-January 2012 in our institute. All these patients were treated radically with IMRT according to our institution's protocol. Re-planning with IMRT without bolus for these patients with exactly the same target volumes were done for comparison. Comparison of the plans was done by comparing the V70 of PTV70-N, V66.5 of PTV70-N, V65.1 of PTV70-N and the surface dose of the PTV70-N. Results: The mean size of the largest diameter of the enlarged lymph nodes for the 5 patients was 3.9 cm. The mean distance of the GTV-N to the skin surface was 0.6 cm. The mean V70 of PTV70-N for the 5 patients showed an absolute advantage of 10.8% (92.4% vs. 81.6%) for the plan with bolus while the V66.5 of PTV70-N had an advantage of 8.1% (97.0% vs. 88.9%). The mean V65.1 also had an advantage of 7.1% (97.6% vs. 90.5%). The mean surface dose for the PTV70-N was also much higher at 61.1 Gy for the plans with bolus compared to only 23.5 Gy for the plans without bolus. Conclusion: Neck node bolus technique should be strongly considered in the treatment of NPC with enlarged lymph nodes treated with IMRT. It yields a superior dosimetry compared t o non-bolus plans with acceptable skin toxicity.

• Radiation Oncology Journal
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• v.30 no.1
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• pp.43-48
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• 2012

Purpose: To develop the dose volume histogram (DVH) management software which guides the evaluation of radiotherapy (RT) plan of a new case according to the biological consequences of the DVHs from the previously treated patients. Materials and Methods: We determined the radiation pneumonitis (RP) as an biological response parameter in order to develop DVH management software. We retrospectively reviewed the medical records of lung cancer patients treated with curative 3-dimensional conformal radiation therapy (3D-CRT). The biological event was defined as RP of the Radiation Therapy Oncology Group (RTOG) grade III or more. Results: The DVH management software consisted of three parts (pre-existing DVH database, graphical tool, and $Pinnacle^3$ script). The pre-existing DVH data were retrieved from 128 patients. RP events were tagged to the specific DVH data through retrospective review of patients' medical records. The graphical tool was developed to present the complication histogram derived from the preexisting database (DVH and RP) and was implemented into the radiation treatment planning (RTP) system, $Pinnacle^3$ v8.0 (Phillips Healthcare). The software was designed for the pre-existing database to be updated easily by tagging the specific DVH data with the new incidence of RP events at the time of patients' follow-up. Conclusion: We developed the DVH management software as an effective tool to incorporate the phenomenological consequences derived from the pre-existing database in the evaluation of a new RT plan. It can be used not only for lung cancer patients but also for the other disease site with different toxicity parameters.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.493-498
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• 1998

Computed tomography(CT) has become more widely available in recent years and is recognized as an important diagnostic tool for complex disease and condition of the orofacial structure in adults. In pediatric patients, especially in the mixed dentition period, the number of superimposing dental structures in the jaw bone is much greater than in the permanant dentition period. Therefore, in spite of radiation risk, computed tomography should sometimes be used in pediatric patients in order to obtain a precise and valid diagnosis. This case study presents clinical application of computed tomography on patients visiting department of pediatric dentistry in Seoul National University Dental Hospital. The results obtained through these cases were summarized as follow : 1. Localization of impacted teeth using CT allows for efficient treatment planning leading to reduced postoperative complications. 2. In orthodontic traction of impacted permanent teeth, utilization of CT made exact localization of window site and determination of prognosis possible. 3. Use of CT made possible definite diagnosis of lesions in the jaw that were only suspected on plain film radiographs. 4. Careful selection is necessary when applying CT on children due to increased radiation dose and high cost.

• Journal of Radiation Protection and Research
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• v.26 no.4
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• pp.433-440
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• 2001

Using the different procedures suggested by the recognized organizations including IAEA, FDA, WHO and CED, derived Intervention levels (DILs) against contamination of foodstuffs were evaluated for considerations in radiological emergency planning in Korea. Three radionuclides important in terms of the consequence due to accidents at a nuclear power plant, i.e., $^{137}Cs,\;^{90}Sr$ and $^{131}I$, were considered. Intervention level for dose based on new recommendation of the ICRP (ICRP-60) was applied. The DILs tot the same foodstuff differ by up to afactor of 10. In most cases, the DILs based on FDA and WHO approaches were more conservative than those based on IAEA and CEC approaches. A critical age group for milk was infant of 3 month for all radionuclides. In most foods except milk, a critical age group was adult, 15yr and 5yr for $^{137}Cs,\;^{90}Sr$ and $^{131}I$, respectively.