• Title/Summary/Keyword: Dose planning

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Comparison of Intensity-modulated Radiation Therapy (IMRT), Uniform Scanning Proton Therapy (USPT), and Intensity-modulated Proton Therapy (IMPT) for Prostate Cancer: A Treatment Planning Study (전립선 암 환자의 IMRT, USPT, 및 IMPT 기법에 따른 치료효과 비교)

  • Son, Kihong;Cho, Seungryong;Kim, Jin Sung;Han, Youngyih;Ju, Sang Gyu;Ahn, Sung Hwan;Shin, Eunhyuk;Shin, Jung Suk;Park, Won;Pyo, Hongryul;Choi, Doo Ho
    • Progress in Medical Physics
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    • v.24 no.3
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    • pp.154-161
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    • 2013
  • This study assessed compared photon and proton treatment techniques, such as intensity modulated radiation therapy (IMRT), uniform scanning proton therapy (USPT), and intensity modulated proton therapy (IMPT), for a total of 10 prostate cancers. All treatment plans delivered 70 Gy to 95% of the planned target volume in 28 fractions. IMRT plans had 7 fields for the step and shoot technique, while USPT and IMPT plans employed two equally weighted, parallel-opposed lateral fields to deliver the prescribed dose to the planned target. Inverse planning was then incorporated to optimize IMPT. The homogeneity index (HI) and conformity index (CI) for the target and the normal tissue complication probability (NTCP) for organ at risk (OAR) were calculated. Although the mean HI and CI for target were not significantly different for each treatment techniques, the NTCP of the rectum was 2.233, 3.326, and 1.707 for IMRT, USPT, and IMPT, respectively. The NTCP of the bladder was 0.008, 0.003, and 0.002 respectively. The NTCP values at the rectum and bladder were significantly lower using IMPT. Our study shows that using proton therapy, particularly IMPT, to treat prostate cancer could be beneficial compared to 7-field IMRT with similar target coverage. Given these results, radiotherapy using protons, particularly optimized IMPT, is a worthwhile treatment option for prostate cancer.

Evaluation of the Usefulness of MapPHAN for the Verification of Volumetric Modulated Arc Therapy Planning (용적세기조절회전치료 치료계획 확인에 사용되는 MapPHAN의 유용성 평가)

  • Woo, Heon;Park, Jang Pil;Min, Jae Soon;Lee, Jae Hee;Yoo, Suk Hyun
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.115-121
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    • 2013
  • Purpose: Latest linear accelerator and the introduction of new measurement equipment to the agency that the introduction of this equipment in the future, by analyzing the process of confirming the usefulness of the preparation process for applying it in the clinical causes some problems, should be helpful. Materials and Methods: All measurements TrueBEAM STX (Varian, USA) was used, and a file specific to each energy, irradiation conditions, the dose distribution was calculated using a computerized treatment planning equipment (Eclipse ver 10.0.39, Varian, USA). Measuring performance and cause errors in MapCHECK 2 were analyzed and measured against. In order to verify the performance of the MapCHECK 2, 6X, 6X-FFF, 10X, 10X-FFF, 15X field size $10{\times}10$ cm, gantry $0^{\circ}$, $180^{\circ}$ direction was measured by the energy. IGRT couch of the CT values affect the measurements in order to confirm, CT number values : -800 (Carbon) & -950 (COUCH in the air), -100 & 6X-950 in the state for FFF, 15X of the energy field sizes $10{\times}10$, gantry $180^{\circ}$, $135^{\circ}$, $275^{\circ}$ directionwas measured at, MapPHAN allocated to confirm the value of HU were compared, using the treatment planning computer for, Measurement error problem by the sharp edges MapPHAN Learn gantry direction MapPHAN of dependence was measured in three ways. GANTRY $90^{\circ}$, $270^{\circ}$ in the direction of the vertically erected settings 6X-FFF, 15X respectively, and Setting the state established as a horizontal field sizes $10{\times}10$, $90^{\circ}$, $45^{\circ}$, $315^{\circ}$, $270^{\circ}$ of in the direction of the energy-6X-FFF, 15X, respectively, were measured. Without intensity modulated beam of the third open arc were investigated. Results: Of basic performance MapCHECK confirm the attenuation measured by Couch, measured from the measured HU values that are assigned to the MAP-PHAN, check for calculation accuracy for the angled edge of the MapPHAN all come in a range of valid measurement errors do not affect the could see. three ways for the Gantry direction dependence, the first of the meter built into the value of the Gantry $270^{\circ}$ (relative $0^{\circ}$), $90^{\circ}$ (relative $180^{\circ}$), 6X-FFF, 15X from each -1.51, 0.83% and -0.63, -0.22% was not affected by the AP/PA direction represented. Setting the meter horizontally Gantry $90^{\circ}$, $270^{\circ}$ from the couch, Energy 6X-FFF 4.37, 2.84%, 15X, -9.63, -13.32% the difference. By-side direction measurements MapPHAN in value is not within the valid range can not, because that could be confirmed as gamma pass rate 3% of the value is greater than the value shown. You can check the Open Arc 6X-FFF, 15X energy, field size $10{\times}10$ cm $360^{\circ}$ rotation of the dose distribution in the state to look at nearly 90% pass rate to emerge. Conclusion: Based on the above results, the MapPHAN gantry direction dependence by side in the direction of the beam relative dose distribution suitable for measuring the gamma value, but accurate measurement of the absolute dose can not be considered is. this paper, a more accurate treatment plan in order to confirm, Reduce the tolerance for VMAT, such as lateral rotation investigation in order to measure accurate absolute isodose using a combination of IMF (Isocentric Mounting Fixture) MapCHEK 2, will be able to minimize the impact due to the angular dependence.

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Construction of Vegetation Information Management System Using GIS (GIS를 이용한 식생정보 통합관리시스템 구축 방안)

  • Song, Ji Hye;Kang, In Joon;Hong, Soon Heon;Park, Dong Hyun
    • Journal of Korean Society for Geospatial Information Science
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    • v.22 no.4
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    • pp.99-106
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    • 2014
  • After 1960 forest and ecosystem are rapidly destroyed by industrialization and urbanization. Accordingly, studies that produce vegetation map continue for forest and ecosystem management. Since 1986 national natural environment survey is being conducted in Korea. Also, vegetation information is managed properly through forest geospatial information service(FGIS) of the Department of Environment when NGIS project was promoted since 1995. But it provide dominant species information based on text. In particular, some vegetation information dose not provide to end-user. Therefore, we suggest construction method of vegetation information management system based on GIS to solve the problem. Also, we suggest connection method of related system for an accurate analysis, planning and decision-making support.

Blood Heavy Metal Concentrations of Korean Adults by Seafood Consumption Frequency: Using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008 (국민건강영양조사 제4기 2차년도 (2008)를 이용한 어패류 섭취빈도에 따른 한국 성인의 혈중 중금속 농도 조사)

  • Kim, Young-A;Kim, Young-Nam;Cho, Kyung-Dong;Kim, Mi-Young;Kim, Eun-Jin;Baek, Ok-Hee;Lee, Bog-Hieu
    • Journal of Nutrition and Health
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    • v.44 no.6
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    • pp.518-526
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    • 2011
  • To determine blood heavy metal concentrations by seafood consumption in Korean adults, blood cadmium, mercury, and lead concentrations in a representative sample of 1,709 Koreans participated in the Fourth Korea National Health and Nutrition Examination Survey (KHANES IV-2) in 2008 were analyzed by age and seafood consumption frequency. The mean blood cadmium, mercury, and lead concentrations were $1.14{\pm}0.73{\mu}g/L$, $5.50{\pm}3.83{\mu}g/L$, and $2.56{\pm}1.22{\mu}g/dL$, respectively. The subjects aged ${\geq}$ 50 years had significantly higher blood cadmium concentrations than the subjects aged 20~39 years. Blood mercury concentrations of the 50's were significantly higher than those of the 20's and 30's (p < 0.05). Approximately, 43% of males and 22% of females had blood mercury concentrations > $5.8{\mu}g/L$ which is a blood mercury level equivalent to the current Reference Dose. Only 2 subjects had lead concentrations > $10{\mu}g/dL$, the standard lead level by the Centers for Disease Control and Prevention, USA. The subjects consuming pollack, mackerel, anchovy, corvina, shellfish, and salted seafood at least once a week had significantly higher mercury concentrations than the subjects consuming those seafoods less than once a month. However, there were no clear relationships between blood cadmium and lead concentrations and seafood consumption frequencies.

The Feasibility Study on the Direct Use of the MC-derived Physical Quantities to Determine the Model Parameters of RTPS with -Model-Based Photon Dose Calculation Algorithm (모델기반 광자선량 계산방식을 사용하는 전산화치료계획장치의 모델변수 결정에 있어 몬테카를로 모사법에 의해 유도된 방사선 물리량의 직접 적용 가능성에 대한 연구)

  • 강세권;박희철;배훈식;조병철
    • Progress in Medical Physics
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    • v.15 no.2
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    • pp.77-83
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    • 2004
  • The commissioning of a model-based treatment planning system requires many parameters to fit the measured depth doses and transverse profiles. For the commissioning of the Pinnacle$^3$ system, through the Monte Carlo (MC) simulation, the necessary parameters, including the photon spectrum, contaminant electrons, off-axis softening and fluency of photons, were observed. Through the simulation the parameters contained valuable information, but the calculated results of the Pinnacle$^3$ using the MC-derived parameters showed discrepancies with those measured for the off-axis softening and the fluency of photons. Even though the MC calculation produces reasonable values for the commissioning, the thorough physical basis of the Pinnacle$^3$'s commissioning process is needed in order to directly use the MC derived parameters.

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Erythromycin Withdrawal Time in Olive Flounder (Paralichthys olivaceus) after Oral Administration (양식 넙치(Paralichthys olivaceus)에 대한 Erythromycin 휴약기간 설정)

  • Lee, Tae-Seek;Park, Mi-Jung;Choi, Hye-Sung;Shim, Kil-Bo;Park, Mi-Seon;Shin, Il-Shik
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.42 no.3
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    • pp.204-208
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    • 2009
  • The withdrawal time of erythromycin in cultured olive flounder was investigated to ensure the food safety of the fish treated with erythromycin. The oral administration of erythromycin was carried out using the experimental diet containing erythromycin (200 mg/kg) daily dose of 40 mg/kg body weight. The 45 day experimental period was broken into 7 days of habituation, 8 days of medication and 30 days of additional feeding without antibiotics. The erythromycin concentration in the flounder muscle had been increased gradually with medication. After 5 days of medication, the concentration increased to its maximum level of 6.05 mg/kg. After discontinuing the antibiotic, the erythromycin concentration decreased drastically and day 9 was below 0.1 mg/kg. The erythromycin concentration had slowly declined from the 6th to the 20th day after medication and disappeared completely after 25 days. From these results, the time needed to reduce the erythromycin level to the 0.2 mg/kg limit adopted by the ED and Japan was suspected to be 4-6 days. Therefore, a reasonable withdrawal time following ED and Japanese regulatory guidelines for erythromycin in the cultured flounder could be estimated to be 10 days.

Gamma Knife Radiosurgery for Juxtasellar Tumors (터어키안 주변종양에 대한 감마나이프 방사선 수술)

  • Chang, Jong Hee;Chang, Jin Woo;Park, Yong Gou;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1345-1351
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    • 2000
  • Objective : Around the sellar area, there are many important structures. But, the optimal radiation dosage for minimal toxicity to surrounding neural tissue has not been firmly established. The purpose of this study is to evaluate the radiosurgical outcome of juxtasellar tumors and to investigate the relationship between radiation dosage and toxicity to neural tissue. Method : Between May 1992 and June 2000, we treated 65 juxtasellar tumors by using the Leksell Gamma Knife. Among them, 52 patients who could be followed more than 1 year were included in this study. The radiosurgical dosage to the optic pathway, cavernous sinus, Meckel's cave, hypothalamus, pituitary gland and stalk, and brain stem was analyzed and correlated with clinical outcome. The mean follow-up period was 33.5 months(range 12.2- 99.0 months). Result : The clinical response rate was 69.2%. The volume response rate was 61.0% and the radiologic control rate was 92.7%. There were 4 complications(7.7%) of 2 trigeminal neuropathy, 1 abducens nerve palsy, and 1 trigeminal and transient abducens nerve palsy. The optic apparatus appeared to tolerate doses greater than 10Gy. The risk of cranial nerve complications in cavernous sinus seemed to be related to doses of more than 16Gy. In 3 of 4 patients who received more than 16Gy to cavernous sinus, the abducens or trigeminal neuropathy occurred. Also, one patient who received more than 15Gy to the Meckel's cave, trigeminal neuropathy developed. The hypothalamus, pituitary gland and stalk, and brain stem were relatively tolerable to radiation. Conclusion : Gamma Knife radiosurgery seems to be an effective method to control the growth of juxtasellar tumors. To avoid injury to surrounding important neural tissue, careful dose planning and further study for radiation toxicity to neural tissue were needed.

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Predictive factors of symptomatic radiation pneumonitis in primary and metastatic lung tumors treated with stereotactic ablative body radiotherapy

  • Kim, Kangpyo;Lee, Jeongshim;Cho, Yeona;Chung, Seung Yeun;Lee, Jason Joon Bock;Lee, Chang Geol;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.163-171
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    • 2017
  • Purpose: Although stereotactic ablative body radiotherapy (SABR) is widely used therapeutic technique, predictive factors of radiation pneumonitis (RP) after SABR remain undefined. We aimed to investigate the predictive factors affecting RP in patients with primary or metastatic lung tumors who received SABR. Materials and Methods: From 2012 to 2015, we reviewed 59 patients with 72 primary or metastatic lung tumors treated with SABR, and performed analyses of clinical and dosimetric variables related to symptomatic RP. SABR was delivered as 45-60 Gy in 3-4 fractions, which were over 100 Gy in BED when the ${\alpha}/{\beta}$ value was assumed to be 10. Tumor volume and other various dose volume factors were analyzed using median value as a cutoff value. RP was graded per the Common Terminology Criteria for Adverse Events v4.03. Results: At the median follow-up period of 11 months, symptomatic RP was observed in 13 lesions (12 patients, 18.1%), including grade 2 RP in 11 lesions and grade 3 in 2 lesions. Patients with planning target volume (PTV) of ${\leq}14.35mL$ had significantly lower rates of symptomatic RP when compared to others (8.6% vs. 27%; p = 0.048). Rates of symptomatic RP in patients with internal gross tumor volume (iGTV) >4.21 mL were higher than with ${\leq}4.21mL$ (29.7% vs. 6.1%; p = 0.017). Conclusions: The incidence of symptomatic RP following treatment with SABR was acceptable with grade 2 RP being observed in most patients. iGTV over 4.21 mL and PTV of over 14.35 mL were significant predictive factors related to symptomatic RP.

Stereotactic body radiation therapy for liver oligo-recurrence and oligo-progression from various tumors

  • Cha, Yu Jin;Kim, Mi-Sook;Jang, Won-Il;Seo, Young Seok;Cho, Chul Koo;Yoo, Hyung Jun;Paik, Eun Kyung
    • Radiation Oncology Journal
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    • v.35 no.2
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    • pp.172-179
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    • 2017
  • Purpose: To evaluate the outcomes of stereotactic body radiation therapy (SBRT) for patients with liver oligo-recurrence and oligo-progression from various primary tumors. Materials and Methods: Between 2002 and 2013, 72 patients with liver oligo-recurrence (oligo-metastasis with a controlled primary tumor) and oligo-progression (contradictory progression of a few sites of disease despite an overall tumor burden response to therapy) underwent SBRT. Of these, 9 and 8 patients with uncontrollable distant metastases and patients immediate loss to follow-up, respectively, were excluded. The total planning target volume was used to select the SBRT dose (median, 48 Gy; range, 30 to 60 Gy, 3-4 fractions). Toxicity was evaluated using the Common Toxicity Criteria for Adverse Events v4.0. Results: We evaluated 55 patients (77 lesions) treated with SBRT for liver metastases. All patients had controlled primary lesions, and 28 patients had stable lesions at another site (oligo-progression). The most common primary site was the colon (36 patients), followed by the stomach (6 patients) and other sites (13 patients). The 2-year local control and progression-free survival rates were 68% and 22%, respectively. The 2- and 5-year overall survival rates were 56% and 20%, respectively. The most common adverse events were grade 1-2 fatigue, nausea, and vomiting; no grade ${\geq}3$ toxicities were observed. Univariate analysis revealed that oligo-progression associated with poor survival. Conclusion: SBRT for liver oligo-recurrence and oligo-progression appears safe, with similar local control rates. For liver oligo-progression, criteria are needed to select patients in whom improved overall survival can be expected through SBRT.

Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.