• Title/Summary/Keyword: Oncology patients

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Evaluation of DQA for Tomotherapy using 3D Volumetric Phantom (3차원 체적팬텀을 이용한 토모치료의 Delivery Quality Assurance 평가)

  • Lee, Sang-Uk;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.39 no.4
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    • pp.607-614
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    • 2016
  • The study investigates the necessity of 3 dimensional dose distribution evaluation instead of point dose and 2 dimensional dose distribution evaluation. Treatment plans were generated on the RANDO phantom to measure the precise dose distribution of the treatment site 0.5, 1, 1.5, 2, 2.5, 3 cm with the prescribed dose; 1,200 cGy, 5 fractions. Gamma analysis (3%/3 mm, 2%/2 mm) of dose distribution was evaluated with gafchromic EBT2 film and ArcCHECK phantom. The average error of absolute dose was measured at $0.76{\pm}0.59%$ and $1.37{\pm}0.76%$ in cheese phantom and ArcCHECK phantom respectively. The average passing ratio for 3%/3 mm were $97.72{\pm}0.02%$ and $99.26{\pm}0.01%$ in gafchromic EBT2 film and ArcCHECK phantom respectively. The average passing ratio for 2%/2 mm were $94.21{\pm}0.02%$ and $93.02{\pm}0.01%$ in gafchromic EBT2 film and ArcCHECK phantom respectively. There was a more accurate dose distribution of 3D volume phantom than cheese phantom in patients DQA using tomotherapy. Therefor it should be evaluated simultaneously 3 dimensional dose evaluation on target and peripheral area in rotational radiotherapy such as tomotherapy.

Quantitative Analysis of 3D-CRT Radiotherapy Planning Factors with or without IR in Patients with High Density Artifacts (고밀도 인공물 환자에서 반복적 재구성 사용 유무에 따른 3차원 입체조형 방사선 치료 계획 인자의 정량분석)

  • Lee, Gyu-Wook;Choi, U-Hyeong;Jung, Yae-Hyun;Lee, Joo-Hee;Yun, In-Ha;Heo, Yeong-Cheol
    • Journal of the Korean Society of Radiology
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    • v.14 no.1
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    • pp.7-14
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    • 2020
  • The purpose of this study is to assess the usefulness of IR to compensate for uncertainties in inserting high density artificial objects in radiation treatment planning in the 3D-CRT treatment technique. CT images of the subjects with phantom and titanium inserted were obtained from images without IR and images with IR, and the dose evaluation factors HI, MU and volume evaluation factors Volume and PCI were compared. The results of the stainless steel and titanium phantom experiments showed that the volume of high density artificial material was reduced by 4.850% and 11.456% respectively when applying IR. MU decreased 0.924% and 1.181%. HI was down 0.106% and 0.272%. PCI decreased 0.358% and 0.867%. When IR was applied to CT images of subjects with vertebroplasty, Femur alignment pin and wrist alignment pin, the volume of artifacts decreased by 47.76%, 23.841%, and 49.339%. MU also decreased 0.924%, 0.294% and 1.675%, while HI decreased 1.232%, 0.412% and 1.695%. PCI decreases 4.022%, 0.512%, and 13.472%. In conclusion, When IR was applied to 3D-CRT treatment plan, both dose and volume in phantom and subject case with high density artificial insert were reduced.

An Analysis of the Awareness and Performance of Radiation Workers' Radiation/Radioactivity Protection in Medical Institutions: Focused on Busan Regional Medical Institutions (의료기관 방사선작업종사자들의 방사선/능 방어에 대한 인식도 및 수행도 분석: 부산지역 의료기관을 중심으로)

  • Park, Cheol Koo;Hwang, Chul Hwan;Kim, Dong Hyun
    • Journal of radiological science and technology
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    • v.40 no.1
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    • pp.101-108
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    • 2017
  • The purpose of this study was to investigate safety management awareness and behavioral investigation of radiation/radioactivity performance defenses of radiation workers' in medical institutions. Data collection consisted of 267 radiation workers working in medical institutions using structured questionnaires. As a result, it was analyzed that radiation safety management awareness and performance were high in 40s, 50s group and higher education group. The analysis according to the radiation safety management knowledge was analyzed that the "Know very well" group had higher scores on awareness and performance scores. The analysis according to the degree of safety management effort showed the high awareness scale and the performance scale in the group "Receiving various education or studying the safety management contents through book". The correlations between the sub-factors showed the highest positive correlation between perceived practician and personal perspective and perceived by patient and patient's caretaker perspective. Therefore, radiation safety management for workers, patients, and patient's caretaker should be conducted through continuous education of radiation safety management through various routes of radiation workers working at medical institutions.

LncRNA CRNDE Promotes the Progression of B-cell Precursor Acute Lymphoblastic Leukemia by Targeting the miR-345-5p/CREB Axis

  • Wang, Weimin;Wu, Feifei;Ma, Ping;Gan, Silin;Li, Xue;Chen, Li;Sun, Ling;Sun, Hui;Jiang, Zhongxing;Guo, Feng
    • Molecules and Cells
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    • v.43 no.8
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    • pp.718-727
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    • 2020
  • The imbalance between the proliferation and apoptosis of B-cell precursors is an important contributor to the pathogenesis of B-cell precursor acute lymphoblastic leukemia (BCP-ALL), while its specific regulatory mechanism remains perplexing. This study aimed to expound the underlying mechanism of the proliferation and apoptosis of BCP-ALL cells from the perspective of non-coding RNA. In this study, long non-coding RNA colorectal neoplasia differentially expressed (LncRNA CRNDE) was upregulated in the bone marrow of BCP-ALL patients and BCP-ALL cell lines (NALM-6 and RS4;11). Functionally, LncRNA CRNDE knockdown restrained cell proliferation and boosted cell apoptosis in NALM-6 and RS4;11 cells. The subsequent investigation confirmed that LncRNA CRNDE bound to miR-345-5p and negatively regulated miR-345-5p expression. The overexpression of miR-345-5p suppressed cell proliferation and boosted cell apoptosis in NALM-6 and RS4;11 cells. Further experiments revealed that miR-345-5p downregulated cyclic AMP response element-binding protein (CREB) expression by targeting its mRNA directly. CREB overexpression reversed the effect of miR-345-5p mimic on cell proliferation and apoptosis in NALM-6 and RS4;11 cells. Finally, in vivo experiments showed that LncRNA CRNDE knockdown prolonged the survival of mice xenotransplanted with NALM-6 cells. In conclusion, LncRNA CRNDE upregulated CREB expression by suppressing miR-345-5p, thus promoting cell proliferation and reducing cell apoptosis in BCP-ALL.

Application of Volumetric Analysis to Glioblastomas: a Correlation Study on the Status of the Isocitrate Dehydrogenase Mutation

  • Bae, Seon Yong;Park, Chul-Kee;Kim, Tae Min;Park, Sung-Hye;Kim, Il Han;Choi, Seung Hong
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.4
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    • pp.218-223
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    • 2015
  • Purpose: To investigate whether volumetric analysis based on T2WI and contrast-enhanced (CE) T1WI can distinguish between isocitrate dehydrogenase-1 mutation-positive ($IDH1^P$) and -negative ($IDH1^N$) glioblastomas (GBMs). Materials and Methods: We retrospectively enrolled 109 patients with histopathologically proven GBMs after surgery or stereotactic biopsy and preoperative MR imaging. We measured the whole-tumor volume in each patient using a semiautomatic segmentation method based on both T2WI and CE T1WI. We compared the tumor volumes between $IDH1^P$ (n = 12) and $IDH1^N$ (n = 97) GBMs using an unpaired t-test. In addition, we performed receiver operating characteristic (ROC) analysis for the differentiation of $IDH1^P$ and $IDH1^N$ GBMs using the tumor volumes based on T2WI and CE T1WI. Results: The mean tumor volume based on T2WI was larger for $IDH1^P$ GBMs than $IDH1^N$ GBMs ($108.8{\pm}68.1$ and $59.3{\pm}37.3mm^3$, respectively, P = 0.0002). In addition, $IDH1^P$ GBMs had a larger tumor volume on CE T1WI than did $IDH1^N$ tumors ($49.00{\pm}40.14$ and $22.53{\pm}17.51mm^3$, respectively, P < 0.0001). ROC analysis revealed that the tumor volume based on T2WI could distinguish $IDH1^P$ from $IDH1^N$ with a cutoff value of 90.25 (P < 0.05): 7 of 12 $IDH1^P$ (58.3%) and 79 of 97 $IDH1^N$ (81.4%). Conclusion: Volumetric analysis of T2WI and CE T1WI could enable $IDH1^P$ GBMs to be distinguished from $IDH1^N$ GBMs. We assumed that secondary GBMs with $IDH1^P$ underwent stepwise progression and were more infiltrative than those with $IDH1^N$, which might have resulted in the differences in tumor volume.

Chest-wall Surface Dose During Post-mastectomy Radiation Therapy, with and without Nonmagnetic Bolus: A Phantom Study

  • Choi, Cheon Woong;Hong, Joo Wan;Park, Cheol Soo;Ahn, Jae Ouk
    • Journal of Magnetics
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    • v.21 no.2
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    • pp.293-297
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    • 2016
  • For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

A Study on the Dose Changes Depending on the Shielding Block Type of Irradiation During Electron Beam Theraphy (전자선치료 시 조사부위 차폐물 형태에 따른 선량변화 연구)

  • Lee, Sun-Yeb;Park, Cheol-Soo;Lee, Jae-Seung;Goo, Eun-Hoe;Cho, Jae-Hwan;Kim, Eng-Chan;Moon, Soo-Ho;Kim, Jin-Soo;Park, Cheol-Woo;Dong, Kyung-Rae;Kweon, Dae-Cheol
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.253-260
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    • 2010
  • The primary focus of this study was to explore the variation in dose distributions of electron beams between different types of construction structure of cut-out blocks embodied in electron cones, given that the structure is considered one of the causes of multiple scattered radiation from electrons which may affect dose distributions. For evaluation, two types of cut-out blocks, divergency and straight, manufactured for this study, were compared in terms of area of interval in distribution of dose, and flatness and symmetric state of surface being radiated. The results showed that divergency cut-out blocks reduced the lateral scattering effects on the thickness of cut-out blocks more substantially than straight ones, leading to more uniform dose distribution at baseline depth. Notably in divergency cut-out blocks, the high dose area decreased more significantly, and more uniform dose distribution was observed at the edge of the irradiated field. This points to a need to consider the characteristics of dose distribution of electron beams when setting up radiotherapy planing at the venues. Therefore, this study is significant as an exploratory work for ensuring high accuracy in dose delivery for patients.

Evaluation of quantitative on T-spine exhalation technique and T-spine breathing technique of natural breathing (T-spine exhalation technique과 자연스런 호흡 상태에서 촬영하는 T-spine breathing technique의 정량적 평가)

  • Son, Soon-Yong;Choi, Kwan-Woo;Min, Jung-Whan;Son, Jin-Hyun;Kim, Ki-Won;Jung, Jae-Hong;Jeong, Hoi-Woun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4429-4436
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    • 2013
  • Measurements of CNR(Contrast to Noise Ratio) and SNR(Signal to Noise Ratio) of T-spine breathing technique (TBT) using spontaneous breathing and T-spine exhalation technique (TET) with full exhalation were carried out, and with which the more appropriate method was suggested. Both TBT and TET were examined in a sample of fifty-three patients who visit to our hospital for spinal disease from June 2012 to November 2012. All images were evaluated with CNR measured from the differences between the mean pixels and contrast density as setting ROI of spinous process, pedicle, vertebral body, intervertebral foramen, and intervertebral disk using Image J. SNR was measured with the mean pixels and the standard deviation as setting ROI of vertebral body using Image J. In CNR comparison and SNR comparison of TET and TBT, TBT was indicated as excellent in ROI of pedicle, vertebral body, intervertebral foramen and intervertebral disk, and statistical analysis were significant(p<.01). As TBT indicated excellent images compared to the existing T-spine lateral radiography, T-spine lateral radiography would be reestablished and significant as applying to various medical institutions.

The Effect of Patients Positioning System on the Prescription Dose in Radiation Therapy (방사선치료 시 자세확인시스템이 처방선량에 미치는 영향)

  • Kim, Jeong-Ho;Bae, Seok-Hwan
    • Journal of radiological science and technology
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    • v.40 no.4
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    • pp.613-620
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    • 2017
  • Planning dose must be delivered accurately for radiation therapy. Also, It must be needed accurately setup. However, patient positioning images were need for accuracy setup. Then patient positioning images is followed by additional exposure to radiation. For 45 points in the phantom, we measured the doses for 6 MV and 10 MV photon beams, OBI(On Board Imager) and CBCT(Conebeam Computed Tomography) using OSLD(Optically Stimulated Luminescent Dosimeter). We compared the differences in the cases where posture confirmation imaging at each point was added to the treatment dose. Also, we tried to propose a photography cycle that satisfies the 5% recommended by AAPM(The American Association of Physicists in Medicine). As a result, a maximum of 98.6 cGy was obtained at a minimum of 45.27 cGy at the 6 MV, a maximum of 99.66 cGy at a minimum of 53.34 cGy at the 10 MV, a maximum of 2.64 cGy at the minimum of 0.19 cGy for the OBI and a maximum of 17.18 cGy at the minimum of 0.54 cGy for the CBCT.The ratio of the radiation dose to the treatment dose is 3.49% in the case of 2D imaging and the maximum is 22.65% in the case of 3D imaging. Therefore, tolerance of 2D image is 1 exposure per day, and 3D image is 1 exposure per week. And it is need to calculation of separate in the parallelism at additional study.

Ethical Attitudes according to Education and Clinical Experience of Do-Not-Resuscitate (DNR) (심폐소생술금지 교육 및 임상 경험에 따른 윤리적 태도)

  • Kae, Young Ae;Lee, Mi Yeon;Park, Jin Sook;Kim, Hyo Joo;Jung, Tae Youn;Jang, Bo Young;Kim, Yoon Jeong;Koo, Dong-Hoe
    • Journal of Hospice and Palliative Care
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    • v.18 no.3
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    • pp.208-218
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    • 2015
  • Purpose: Although a Do-Not-Resuscitate (DNR) order is widely in use, it is one of the challenging issues in end-of-life care. This study was conducted to investigate attitudes toward DNR according to education and clinical experience. Methods: Data were collected using a structured questionnaire comprising 30 items in a tertiary hospital in Seoul, Korea. Results: Participants were 238 nurses and 72 physicians. Most participants (99%) agreed to the necessity of DNR for reasons such as dignified death (52%), irreversible medical condition (23%) and patients' autonomy in decision making (19%). Among all, 33% participants had received education about DNR and 87% had DNR experience. According to participants' clinical DNR experience, their attitudes toward DNR significantly differed in terms of the necessity of DNR, timing of the DNR consent and post-DNR treatments including antibiotics. However, when participants were grouped by the level of DNR education, no significant difference was observed except in the timing of the DNR consent. Conclusion: This study suggests that the attitudes toward DNR were more affected by clinical experience of DNR rather than education. Therefore, DNR education programs should involve clinical settings.