• Title/Summary/Keyword: Maximum Dose

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Comparison of CT based-CTV plan and CT based-ICRU38 plan in brachytherapy planning of uterine cervix cancer (자궁경부암 강내조사 시 CT를 이용한 CTV에 근거한 치료계획과 ICRU 38에 근거할 치료계획의 비교)

  • Shim JinSup;Jo JungKun;Si ChangKeun;Lee KiHo;Lee DuHyun;Choi KyeSuk
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.9-17
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    • 2004
  • Purpose : Although Improve of CT, MRI Radio-diagnosis and Radiation Therapy Planing, but we still use ICRU38 Planning system(2D film-based) broadly. 3-Dimensional ICR plan(CT image based) is not only offer tumor and normal tissue dose but also support DVH information. On this study, we plan irradiation-goal dose on CTV(CTV plan) and irradiation-goal dose on ICRU 38 point(ICRU38 plan) by use CT image. And compare with tumor-dose, rectal-dose, bladder-dose on both planning, and analysis DVH Method and Material : Sample 11 patients who treated by Ir-192 HDR. After 40Gy external radiation therapy, ICR plan established. All the patients carry out CT-image scanned by CT-simulator. And we use PLATO(Nucletron) v.14.2 planing system. We draw CTV, rectum, bladder on the CT image. And establish plan irradiation-$100\%$ dose on CTV(CTV plan) and irradiation-$100\%$ dose on A-point(ICRU38 plan) Result : CTV volume($average{\pm}SD$) is $21.8{\pm}26.6cm^3$, rectum volume($average{\pm}SD$) is $60.9{\pm}25.0cm^3$, bladder volume($average{\pm}SD$) is $116.1{\pm}40.1cm^3$ sampled 11 patients. The volume including $100\%$ dose is $126.7{\pm}18.9cm^3$ on ICRU plan and $98.2{\pm}74.5cm^3$ on CTV plan. On ICRU planning, the other one's $22.0cm^3$ CTV volume who residual tumor size excess 4cm is not including $100\%$ isodose. 8 patient's $12.9{\pm}5.9cm^3$ tumor volume who residual tumor size belows 4cm irradiated $100\%$ dose. Bladder dose(recommended by ICRU 38) is $90.1{\pm}21.3\%$ on ICRU plan, $68.7{\pm}26.6\%$ on CTV plan, and rectal dose is $86.4{\pm}18.3\%,\;76.9{\pm}15.6\%$. Bladder and Rectum maximum dose is $137.2{\pm}50.1\%,\;101.1{\pm}41.8\%$ on ICRU plan, $107.6{\pm}47.9\%,\;86.9{\pm}30.8\%$ on CTV plan. Therefore CTV plan more less normal issue-irradiated dose than ICRU plan. But one patient case who residual tumor size excess 4cm, Normal tissue dose more higher than critical dose remarkably on CTV plan. $80\%$over-Irradiated rectal dose(V80rec) is $1.8{\pm}2.4cm^3$ on ICRU plan, $0.7{\pm}1.0cm^3$ on CTV plan. $80\%$over-Irradiated bladder dose(V80bla) is $12.2{\pm}8.9cm^3$ on ICRU plan, $3.5{\pm}4.1cm^3$ on CTV plan. Likewise, CTV plan more less irradiated normal tissue than ICRU38 plan. Conclusion : Although, prove effect and stability about previous ICRU plan, if we use CTV plan by CT image, we will reduce normal tissue dose and irradiated goal-dose at residual tumor on small residual tumor case. But bigger residual tumor case, we need more research about effective 3D-planning.

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Performance Evaluation of Stealth Chamber as a Novel Reference Chamber for Measuring Percentage Depth Dose and Profile of VitalBeam Linear Accelerator (VitalBeam 선형가속기의 심부선량백분율과 측방선량분포 측정을 위한 새로운 기준 전리함으로서 스텔스 전리함의 성능 평가)

  • Kim, Yon-Lae;Chung, Jin-Beom;Kang, Seong-Hee;Kang, Sang-Won;Kim, Kyeong-Hyeon;Jung, Jae-Yong;Shin, Young-Joo;Suh, Tae-Suk;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.41 no.3
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    • pp.201-207
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    • 2018
  • The purpose of this study is to evaluate the performance of a "stealth chamber" as a novel reference chamber for measuring percentage depth dose (PDD) and profile of 6, 8 and 10 MV photon energies. The PDD curves and dose profiles with fields ranging from $3{\times}3$ to $25{\times}25cm^2$ were acquired from measurements by using the stealth chamber and CC 13 chamber as reference chamber. All measurements were performed with Varian VitalBeam linear accelerator. In order to assess the performance of stealth chamber, PDD curves and profiles measured with stealth chamber were compared with measurement data using CC13 chamber. For PPDs measured with both chambers, the dosimetric parameters such as $d_{max}$ (depth of maximum dose), $D_{50}$ (PDD at 50 mm depth), and $D_{100}$ (PDD at 100 mm depth) were analyzed. Moreover, root mean square error (RMSE) values for profiles at $d_{max}$ and 100 mm depth were evaluated. The measured PDDs and profiles between the stealth chamber and CC13 chamber as reference detector had almost comparable. For PDDs, the evaluated dosimetric parameters were observed small difference (<1%) for all energies and field sizes, except for $d_{max}$ less than 2 mm. In addition, the difference of RMSEs for profiles at $d_{max}$ and 100 mm depth was similar for both chambers. This study confirmed that the use of stealth chamber for measuring commission beam data is a feasible as reference chamber for fields ranging from $3{\times}3$ to $20{\times}20cm^2$. Furthermore, it has an advantage with respect to measurement of the small fields (less than $3{\times}3cm^2$ field) although not performed in this study.

Planning and Dosimetric Study of Volumetric Modulated Arc Based Hypofractionated Stereotactic Radiotherapy for Acoustic Schwannoma - 6MV Flattening Filter Free Photon Beam

  • Swamy, Shanmugam Thirumalai;Radha, Chandrasekaran Anu;Arun, Gandhi;Kathirvel, Murugesan;Subramanian, Sai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.5019-5024
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    • 2015
  • Background: The purpose of this study was to assess the dosimetric and clinical feasibility of volumetric modulated arc based hypofractionated stereotactic radiotherapy (RapidArc) treatment for large acoustic schwannoma (AS >10cc). Materials and Methods: Ten AS patients were immobilized using BrainLab mask. They were subject to multimodality imaging (magnetic resonance and computed tomography) to contour target and organs at risk (brainstem and cochlea). Volumetric modulated arc therapy (VMAT) based stereotactic plans were optimized in Eclipse (V11) treatment planning system (TPS) using progressive resolution optimizer-III and final dose calculations were performed using analytical anisotropic algorithm with 1.5 mm grid resolution. All AS presented in this study were treated with VMAT based HSRT to a total dose of 25Gy in 5 fractions (5fractions/week). VMAT plan contains 2-4 non-coplanar arcs. Treatment planning was performed to achieve at least 99% of PTV volume (D99) receives 100% of prescription dose (25Gy), while dose to OAR's were kept below the tolerance limits. Dose-volume histograms (DVH) were analyzed to assess plan quality. Treatments were delivered using upgraded 6 MV un-flattened photon beam (FFF) from Clinac-iX machine. Extensive pretreatment quality assurance measurements were carried out to report on quality of delivery. Point dosimetry was performed using three different detectors, which includes CC13 ion-chamber, Exradin A14 ion-chamber and Exradin W1 plastic scintillator detector (PSD) which have measuring volume of $0.13cm^3$, $0.009cm^3$ and $0.002cm^3$ respectively. Results: Average PTV volume of AS was 11.3cc (${\pm}4.8$), and located in eloquent areas. VMAT plans provided complete PTV coverage with average conformity index of 1.06 (${\pm}0.05$). OAR's dose were kept below tolerance limit recommend by American Association of Physicist in Medicine task group-101(brainstem $V_{0.5cc}$ < 23Gy, cochlea maximum < 25Gy and Optic pathway <25Gy). PSD resulted in superior dosimetric accuracy compared with other two detectors (p=0.021 for PSD.

STUDY ON MONITORING UNIT EFFICIENCY OF FLATTENING-FILTER FREE PHOTON BEAM IN ASSOCIATION WITH TUMOR SIZE AND LOCATION

  • Kim, Dae Il;Kim, Jung-In;Yoo, Sook Hyun;Park, Jong Min
    • Journal of Radiation Protection and Research
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    • v.38 no.4
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    • pp.194-201
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    • 2013
  • To investigate monitoring unit (MU) efficiency and plan quality of volumetric modulated arc therapy (VMAT) using flattening-filter free (FFF) photon beam in association with target size and location. A virtual patient was generated in Eclipse$^{TM}$ (ver. A10, Varian Medical Systems, Palo Alto, USA) treatment planning system. The length of major and minor axis in axial view was 50 cm and 30 cm, respectively. Cylindrical-shaped targets were generated inside that patient at the center (symmetric target) and in the periphery (asymmetric target, 7.5 cm away from the center of the patient to the right direction) of the virtual patient. The longitudinal length was 10 cm and the diameters were 2, 5, 10 and 15 cm. Total 8 targets were generated. RapidArc$^{TM}$ plans using TrueBeam STx$^{TM}$ were generated for each target. Two full arcs were used and the axis of rotation of the gantry was set to be at the center of the virtual patient. Total MU, homogeneity index (HI), target mean dose, the value of gradient measure and body mean dose were calculated. In the case of symmetric targets, averaged total MU of FFF plan was 23% and 19% higher than that of flattening filter (FF) plan when using 6 MV and 10 MV photons, respectively. The difference of HI, target mean dose, gradient measure and body mean dose between FF and FFF was less than 0.04, 2.6%, 0.1 cm and 2.2%, respectively. For the asymmetric targets, total MU of FFF plan was 21% and 32% was higher than that of FF when using 6 MV and 10 MV photons, respectively. The homogeneity of the target was always worse when using FFF than using FF. The maximum difference of HI was 0.22. The target mean dose of FFF was 3.2% and 4.1% higher than that of FF for the 6 MV and 10 MV, respectively. The difference of gradient measure was less than 0.1 cm. The body mean dose was higher when using FFF than FF about 4.2% and 2.8% for the 6 MV and 10 MV, respectively. No significant differences between VMAT plans of FFF beam and FF beam were observed in terms of quality of treatment plan. The HI was higher when using FFF 10 MV photons for the asymmetric targets. The MU was increased noticeably when using FFF photon beams.

The Kinetics of Secondary Response of Antigen-Specific $CD4^+$ T Cells Primed in vitro with Antigen (실험적으로 항원에 의하여 일차 자극된 $CD4^+$ T 세포의 이차 면역 반응의 분석)

  • Park, Seong-Ok;Han, Young-Woo;Aleyas, Abi George;George, June Abi;Yoon, Hyun-A;Eo, Seong-Kug
    • IMMUNE NETWORK
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    • v.6 no.2
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    • pp.93-101
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    • 2006
  • Background: Memory T lymphocytes of the immune system provide long-term protection in response to bacterial or viral infections/immunization. Ag concentration has also been postulated to be important in determining whether T cell differentiation favors effector versus memory cell development. In the present study we hypothesized that naive Ag-specific $CD4^+$ T cells briefly stimulated with different Ag doses at the primary exposure could affect establishment of memory cell pool after secondary immunization. Methods: To assess this hypothesis, the response kinetics of DO11.10 TCR $CD4^+$ T cells primed with different Ag doses in vitro was measured after adoptive transfer to naive BALB/c mice. Results: Maximum expansion was shown in cells primarily stimulated with high doses of ovalbumin peptide $(OVA_{323-339})$, whereas cells in vitro stimulated with low dose were expanded slightly after in vivo secondary exposure. However, the cells primed with low $OVA_{323-339}$ peptide dose showed least contraction and established higher number of memory cells than other treated groups. When the cell division was analyzed after adoptive transfer, the high dose Ag-stimulated donor cells have undergone seven rounds of cell division at 3 days post-adoptive transfer. However, there was very few division in naive and low dose of peptide-treated group. Conclusion: These results suggest that primary stimulation with a low dose of Ag leads to better memory $CD4^+$ T cell generation after secondary immunization. Therefore, these facts imply that optimally primed $CD4^+$ T cells is necessary to support effective memory pool following administration of booster dose in prime-boost vaccination.

The Development of a Multi-Purpose Irradiator and the Characteristic of Dose Distribution (다목적 방사선 조사장치 개발 및 선량분포특성)

  • Lee, Dong-Hoon;Ji, Young-Hoon;Lee, Dong-Han;Kim, Yoon-Jong;Hong, Seung-Hong
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.39 no.6
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    • pp.42-48
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    • 2002
  • The design, construction and performance test of a convenient multi-purpose irradiator is described. A multi-purpose irradiator using Cesium-137 has been developed for studies of low dose radiation effects in biology and for calibration of Thermo Luminescent dosimeter(TLD). During the operation, three rods of radioactive material which are 10cm in length revolve 180 degrees and irradiate biological samples, or TLD, and return to their shielded position, after the programmed time. A programmable Logic Controller(PLC) controls the sequence of operation, interlock, motor rotation and safety system. The rotation speed of biological samples can vary up to 20 RPM. A real time monitoring system was also incorporated to check and control the operation status of the irradiator. The capacity of the irradiation chamber was 4.5 liters. The isodose distribution at arbitrary vertical planes was measured by using film dosimetry. The dose-rate was 0.13 cGy/min in air and 0.11 cGy/min in water equivalent material in the case of Cesium-137. Range of activity was 2 Ci. The homogeneity of dose distribution in the chamber was ${\pm}$7%. The actual radiation level on the surface was within permissible levels. The irradiator had a maximum 0.35 mR/min radiation leakage on its surface.

A Harmonized Method for Dose-response Risk Assessment Based on the Hazard & Risk Evaluation of Chemicals (HREC) According to the Industrial Safety and Health Act (ISHA) (산업안전보건법 상 유해성.위험성 평가제도 적용을 위한 양-반응 평가의 통일화 방안 연구)

  • Lim, Cheol-Hong;Yang, Jeong-Sun;Park, Sang-Yong
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.22 no.3
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    • pp.175-183
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    • 2012
  • Objectives: This study developed a harmonized method for risk assessment based on the Hazard & Risk Evaluation of Chemicals (HREC) according to the Industrial Safety and Health Act (ISHA). Methods: Three preliminary studies, performed during 2010 and 2011 by the Occupational Safety and Health Research Institute and three academic research groups, were compared. The differences in risk assessment, especially in the dose-response assessment method, were analyzed. A new harmonized method for dose-response assessment was suggested and its applicability for the HREC was examined. Results: Considering the various steps of each dose-response assessment, the equivalent steps in quantitative correction, uncertainty factor 2 (UF2) for intra-species uncertainty, and UF3 for the experimental period in the uncertainty correction were relatively high. Using our new method, the total correction values (quantitative correction plus uncertainty correction) ranged from 72~15,789 to 30~60, and the ratio of the threshold limit value (TLV) to the reference concentration decreased from 12.8~1900 to 5.4~11.8. Furthermore, when we performed risk characterization by our new method, hazard quotient (HQ) values for chloroethylene, epichlorohydrin, and barium sulfate became 3.0, 14.1, and 1.13 respectively, whereas three previous studies reported HQ values of 7.1, 4580, and 87.3 considering reasonable maximum exposure (RME) conditions. HQs of the three chemicals were calculated to be 0.6, 2.4, and 0.1 respectively, when compared to their TLVs. Conclusions: Our new method could be applicable for the HREC because the total correction values and the ratio of TLVs were within reasonable ranges. It is also recommended that additional risk management measures be applied for epichlorohydrin, for which the HQ values were greater than 1 when compared with both reference values and the TLV. Our proposed method could be used to harmonize dose-response assessment methods for the implementation of risk assessment based on the HREC according to ISHA.

Geant4 Code Based Simulation of 6 MV Photon Beam for Analysis of Dose Distribution (Geant4 코드를 이용한 선형가속기 6 MV 광자선의 선량분포에 관한 연구)

  • Lee, Jun-Seong;Kim, Yang-Soo;Lee, Sun-Young
    • Journal of radiological science and technology
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    • v.45 no.5
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    • pp.449-455
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    • 2022
  • This study is to present a Geant4 code for the simulation of the absorbed dose distribution given by a medical linac for 6 MV photon beam. The dose distribution was verified by comparison with calculated beam data and beam data measured in water phantom. They were performed for percentage depth dose(PDD) and beam profile of cross-plane for two field sizes of 10 × 10 and 15 × 15 cm2. Deviations of a percentage and distance were obtained. In energy spectrum, the mean energy was 1.69 MeV. Results were in agreement with PDD and beam profile of the phantom with a tolerance limit. The differences in the central beam axis data 𝜹1 for PDD had been less than 2% and in the build up region, these differences increased up to 4.40% for 10 cm square field. The maximum differences of 𝜹2 for beam profile were calculated with a result of 4.35% and 5.32% for 10 cm, 15 cm square fields, respectively. It can be observed that the difference was below 4% in 𝜹3 and 𝜹4. For two field sizes of 𝜹50-90 and RW50, the results agreed to within 2 mm. The results of the t-test showed that no statistically significant differences were found between the data for PDD of 𝜹1, p>0.05. A significant difference on PDD was observed for field sizes of 10 × 10 cm2, p=0.041. No significant differences were found in the beam profile of 𝜹3, 𝜹4, RW50, and 𝜹50-90. Significant differences on beam profile of 𝜹2 were observed for field sizes of 10 × 10 cm2, p=0.025 and for 15 × 15 cm2, p=0.037. This work described the development and reproducibility of Geant4 code for verification of dose distribution.

Diagnostic Reference Levels for Patient Radiation Doses in Pelvis and Lumbar spine Radiography in Korea (우리나라의 골반 및 요추 엑스선검사에서의 환자선량 권고량)

  • Lee, Kwang-Yong;Lee, Byung-Young;Lee, Jung-Eun;Lee, Hyun-Koo;Jung, Seung-Hwan;Kim, Byung-Woo;Kim, Hyeog-Ju;Kim, Dong-Sup
    • Journal of radiological science and technology
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    • v.32 no.4
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    • pp.401-410
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    • 2009
  • Purpose : Pelvis and lumbar spine radiography, among various types of diagnostic radiography, include gonads of the human body and give patients high radiation dose. Nevertheless, diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography has not yet been established in Korea. Therefore, the radiation dose that patients receive from pelvis and lumbar radiography is measured and the diagnostic reference level on patient radiation dose for the optimization of radiation protection of patients in pelvis and lumbar spine radiography was established. Methods : The conditions and diagnostic imaging information acquired during the time of the postero-anterior view of the pelvis and the postero-anterior and lateral view of the lumbar spine at 125 medical institutions throughout Korea are collected for analysis and the entrance surface dose received by patients is measured using a glass dosimeter. The diagnostic reference levels for patient radiation dose in pelvis and lumbar spine radiography to be recommended to the medical institutes is arranged by establishing the dose from the patient radiation dose that corresponds to the 3rd quartile values as the appropriate diagnostic reference level for patient radiation dose. Results : According to the results of the assessment of diagnostic imaging information acquired from pelvis and lumbar spine radiography and the measurement of patient entrance surface dose taken at the 125 medical institutes throughout Korea, the tube voltage ranged between 60~97 kVp, with the average use being 75 kVp, and the tube current ranged between 8~123 mAs, with the average use being 30 mAs. In the posteroanterior and lateral views of lumbar spine radiography, the tube voltage of each view ranged between 65~100 kVp (average use: 78 kVp) and 70~109 kVp (average use: 87 kVp), respectively, and the tube current of each view ranged between 10~100 mAs(average use: 35 mAs) and between 8.9~300 mAs(average use: 64 mAs), respectively. The measurements of entrance surface dose that patients receive during the pelvis and lumbar spine radiography show the following results: in the posteroanterior view of pelvis radiography, the minimum value is 0.59 mGy, the maximum value is 12.69 mGy and the average value is 2.88 mGy with the 1st quartile value being 1.91 mGy, the median being 0.59 mGy, and the 3rd quartile value being 3.43 mGy. Also, in the posteroanterior view of lumbar spine radiography, the minimum value is 0.64 mGy, the maximum value is 23.84 mGy, and the average value is 3.68 mGy with the 1st quartile value being 2.41 mGy, the median being 3.40 mGy, and the 3rd quartile value being 4.08 mGy. In the lateral view of lumbar spine radiography, the minimum value is 1.90 mGy, the maximum value is 45.42 mGy, and the average value is 10.08 mGy with the 1st quartile value being 6.03 mGy, the median being 9.09 mGy and the 3rd quartile value being 12.65 mGy. Conclusions : The diagnostic reference levels for patient radiation dose to be recommended to the medical institutes in Korea is 3.42 mGy for the posteroanterior view of pelvis radiography, 4.08 mGy for the posteroanterior view of lumbar spine radiography, and 12.65 mGy for the lateral view of lumbar spine radiography. Such values are all lower than the values recommended by 6 international organizations including World Health Organization, where the recommended values are 10 mGy for the posteroanterior view of pelvis radiography, 10 mGy for the posteroanterior view of lumbar spine radiography and 30 mGy for the lateral view of lumbar spine radiography.

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Study on Dosimetry Used TLD Dosimeter and Body Mass Index at Total Body Irradiation (전신조사방사선치료에서 열형광선량계를 이용한 선량 측정과 체질량지수에 관한 고찰)

  • Seo, Dong-Rin;Kim, Yeon-Soo;Kim, Dae-Sup;Yoon, Hwa-Ryong;Back, Geum-Mun;Kwak, Jung-Won
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.2
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    • pp.91-96
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    • 2011
  • Purpose: The aim of study is to expose a more uniform dose depending on the relationship between a body mass index in patients who underwent radiation therapy and an acquired dosimetric information by using a thermoluminescent dosimeter. Materials and Methods: Since 2006 to August 2011 we investigated 28 people who underwent radiation therapy were enrolled in AMC. Each patient was measured on the head, neck, chest, abdomen, pelvis, thigh, knee joint, and ankle joint using the thermoluminescent dosimeter. The measurement value of each points compared with the prescribed center point, abdominal point, and dose measurements of points on which to base the abdomen and the patient's body mass index (BMI) were compared with reference point, abdomen dose. Results: 28 patients on prescribed dose in the abdomen by which the center point, an average dose was $100.6{\pm}5.5%$, and the other seven measuring points with the average maximum difference among the head, neck, chest, pelvic, thigh, knee, and ankle were $92.8{\pm}4.2%$, $97.6{\pm}6.2%$, $96.4{\pm}5.5%$, $102.6{\pm}5.3%$, $103.4{\pm}7.9%$, $95.8{\pm}5.9%$, $96.1{\pm}5.5%$. The relationship of abdominal point dose and the patient's body mass index (BMI) was analyzed a scatter plot, and the result of linear relationship analysis by regression method, the regression of the dose (y) was -1.009 BMI (x) plus 123.3 and coefficient of determination ($R^2$) was represented 0.697. Conclusion: The total body irradiation treatment process was evaluated the dose deviation and then the prescribed dose by which the average abdominal dose was satisfied with $100.6{\pm}5.5%$. Results of the relationship analysis between BMI and dose, if we apply the correction value for each patients, it can be achieved more uniform dose delivery.

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