• Title/Summary/Keyword: Optimal dose

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The Effect of MLC Leaf Motion Constraints on Plan Quality and Delivery Accuracy in VMAT (체적조절호형방사선치료 시 갠트리 회전과 다엽콜리메이터의 이동 속도에 따른 선량분포 평가)

  • Kim, Yon-Lae;Chung, Jin-Beom;Lee, Jeong-woo;Shin, Young-Joo;Kang, Dong-Jin;Jung, Jae-Yong
    • Journal of radiological science and technology
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    • v.42 no.3
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    • pp.217-222
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    • 2019
  • The purpose of this study is to evaluate the dose distribution by gantry rotation and MLC moving speed on treatment planning system(TPS) and linear accelerator. The dose analyzer phantom(Delta 4) was scanned by CT simulator for treatment planning. The planning target volumes(PTVs) of prostate and pancreas was prescribed 6,500 cGy, 5,000 cGy on VMAT(Volumetric Modulated Arc Therapy) by TPS while MLC speed changed. The analyzer phantom was irradiated linear accelerator using by planned parameters. Dose distribution of PTVs were evaluated by the homogeneity index, conformity index, dose volume histogram of organ at risk(rectum, bladder, spinal cord, kidney). And irradiated dose analysis were evaluated dose distribution and conformity by gamma index. The PTV dose of pancreas was 4,993 cGy during 0.1 cm/deg leaf and gantry that was the most closest prescribed dose(5,000 cGy). The dose of spinal cord, left kidney, and right kidney were accessed the lowest during 0.1 cm/deg, 1.5 cm/deg, 0.3 cm/deg. The PTV dose of prostate was 6,466 cGy during 0.1 cm/deg leaf and gantry that was the most closest prescribed dose(6,500 cGy). The dose of bladder and rectum were accessed the lowest during 0.3 cm/deg, 2.0 cm/deg. For gamma index, pancreas and prostate were analyzed the lowest error 100% at 0.8, 1.0 cm/deg and 99.6% at 0.3, 0.5 cm/deg. We should used the optimal leaf speed according to the gantry rotation if the treatment cases are performed VMAT.

Increasing injection frequency enhances the survival of injected bone marrow derived mesenchymal stem cells in a critical limb ischemia animal model

  • Kang, Woong Chol;Oh, Pyung Chun;Lee, Kyounghoon;Ahn, Taehoon;Byun, Kyunghee
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.6
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    • pp.657-667
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    • 2016
  • Critical limb ischemia (CLI) is one of the most severe forms of peripheral artery diseases, but current treatment strategies do not guarantee complete recovery of vascular blood flow or reduce the risk of mortality. Recently, human bone marrow derived mesenchymal stem cells (MSCs) have been reported to have a paracrine influence on angiogenesis in several ischemic diseases. However, little evidence is available regarding optimal cell doses and injection frequencies. Thus, the authors undertook this study to investigate the effects of cell dose and injection frequency on cell survival and paracrine effects. MSCs were injected at $10^6$ or $10^5$ per injection (high and low doses) either once (single injection) or once in two consecutive weeks (double injection) into ischemic legs. Mice were sacrificed 4 weeks after first injection. Angiogenic effects were confirmed in vitro and in vivo, and M2 macrophage infiltration into ischemic tissues and rates of limb salvage were documented. MSCs were found to induce angiogenesis through a paracrine effect in vitro, and were found to survive in ischemic muscle for up to 4 weeks dependent on cell dose and injection frequency. In addition, double high dose and low dose of MSC injections increased vessel formation, and decreased fibrosis volumes and apoptotic cell numbers, whereas a single high dose did not. Our results showed MSCs protect against ischemic injury in a paracrine manner, and suggest that increasing injection frequency is more important than MSC dosage for the treatment CLI.

Calculation of Effective Dose on Domestic Chest PA X-ray Examinations (국내 흉부 X-선 검사에 따른 유효선량 계산)

  • Choi, Seokyoon
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.827-832
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    • 2018
  • Research on effective dose analysis of actual conditions of use based on large data is scarce. In this study, the exposure conditions of Chest X-Ray examinations used by 324 medical institutions in Korea were calculated and evaluated using computer simulations. As a result of the experiment, the effective dose in the low energy parameter bands was 0.024 mSv, followed by spleen, adrenal glands, and lung. The effective dose in the high-energy exposure parameter band was 0.123 mSv, followed by height, spleen and adrenal glands. The effective dose was 0.017 mSv when the optimal conditions considered the quality and exposure proposed in Park's study were used. The results of the study will be a reference for chest X-rays and will help reduce patient exposure.

A Study on Establishment of the Optimal Target Exposure Index for Skull Radiography Based on Diagnostic Reference Level (진단참고수준 기반 두부 방사선검사의 최적 목표노출지수 설정에 관한 연구)

  • Park, Hye-Min;Yoon, Yong-Su;Kim, Eun-Hye;Jeong, Hoi-Woun;Kim, Jung-Su
    • Journal of radiological science and technology
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    • v.44 no.6
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    • pp.599-605
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    • 2021
  • The International Electrotechnical Commission (IEC) 62494-1 has defined the exposure index (EI) that have a proportional relationship with the dose incident on the image receptor, and target exposure index (EIT), deviation index (DI). In this study, an appropriate EIT for skull radiography was established through the diagnostic reference level (DRL) and changes in DI were confirmed. Entrance surface dose (ESD) and EI were obtained using the computed radiography system displayed the EI as per IEC on console and skull phantom by experiment based on the national average exposure conditions announced in 2012 and 2019. And appropriate EIT was established by applying the DRL in 2012 and 2019. As a results, the EIT is changed according to the change in the DRL, and the exposure condition that becomes the ideal DI according to the change in the EIT also has a difference of about 1.41 times. DRL is recommended to optimize the patient dose, however it is difficult to measure in real time at medical institutions whereas EI and DI are displayed on the console at the same time as exposure. When the EIT is set based on the DRL and the DI is closed to an ideal value, it is useful as a patient dose management tool. Therefore, when the EIT is periodically managed along with the revision of the DRLs, the patient dose can be optimized through the EI, EIT and DI.

Feasibility Test of Flat-Type Faraday Cup for Ultrahigh-Dose-Rate Transmission Proton Beam Therapy

  • Sang-il Pak;Sungkoo Cho;Seohyeon An;Seonghoon Jeong;Dongho Shin;Youngkyung Lim;Jong Hwi Jeong;Haksoo Kim;Se Byeong Lee
    • Progress in Medical Physics
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    • v.33 no.4
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    • pp.108-113
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    • 2022
  • Purpose: Proton therapy has been used for optimal cancer treatment by adapting its Bragg-peak characteristics. Recently, a tissue-sparing effect was introduced in ultrahigh-dose-rate (FLASH) radiation; the high-energy transmission proton beam is considered in proton FLASH therapy. In measuring high-energy/ultrahigh-dose-rate proton beam, Faraday Cup is considered as a dose-rate-independent measurement device, which has been widely studied. In this paper, the feasibility of the simply designed Faraday Cup (Poor Man's Faraday Cup, PMFC) for transmission proton FLASH therapy is investigated. Methods: In general, Faraday cups were used in the measurement of charged particles. The simply designed Faraday Cup and Advanced Markus ion chamber were used for high-energy proton beam measurement in this study. Results: The PMFC shows an acceptable performance, including accuracy in general dosimetric tests. The PMFC has a linear response to the dose and dose rate. The proton fluence was decreased with the increase of depth until the depth was near the proton beam range. Regarding secondary particles backscatter from PMFC, the effect was negligible. Conclusions: In this study, we performed an experiment to investigate the feasibility of PMFC for measuring high-energy proton beams. The PMFC can be used as a beam stopper and secondary monitoring system for transmission proton beam FLASH therapy.

In Vitro Culture of the Isolated Mouse Preantral Follicles: Effect of Different Types of FSH and Vitrification (생쥐 Preantral 난포의 체외배양: FSH의 종류와 농도 및 초자화 냉동보존의 영향)

  • Lee, Sook-Hyun;Shin, Chang-Sook;Chung, Hyung-Min;Ko, Jung-Jae;Cha, Kwang-Yul;Lee, Kyung-Ah
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.4
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    • pp.387-392
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    • 2000
  • Objectives: 1) To compare the efficacy of urofollitropin (Follimon) to that of recombinant human FSH (rhFSH) on the growth and maturation of mouse early preantral follicles in vitro, and 2) effect of vitrification on the growth and maturation of preantral follicles and oocytes . Methods: Isolated early preantra1 follicles (100-130 ${\mu}m$ diameter) were cultured for 12 days in 20 ${\mu}l$ ${\alpha}$-MEM media drop under the mineral oil. Follimon or rhFSH was added to the culture medium at various concentrations (0, 10, 100, and 1000 mIU/ml). Results: With Follimon, the dose of 10 mIU/ml showed the best follicle survival, growth, and MIl rate of oocyte than the other concentrations. Whereas the optimal dose of rhFSH was 100 mIU/ml. Despite the different optimal doses, the efficacy of two different FSHs on the follicle growth and maturation was similar. Isolated mouse preantral follicles were cryopreserved by vitrification and cultured in vitro for 12 days with 100 mIU/ml rhFSH. Despite the decreased follicular survival rate after thawing, the follicular growth and maturation rate of its oocyte were comparable to those of the fresh follicle. Conclusion: Results from the present study revealed that 1) the optimal doses of Follimon and rhFSH for in-vitro culture of mouse follicles are different, and 2) the frozen-thawed follicles develop normally after vitrification.

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Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion

  • Lee, Seul;Lee, Heock;Lee, Dong Hyun;Kang, Bo Hyoung;Roh, Mee Sook;Son, Choohee;Kim, Sung Hyun;Lee, Hyun-Kyung;Um, Soo-Jung
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.134-139
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    • 2021
  • Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Methods: We retrospectively enrolled 92 patients with CPPE or empyema who underwent intrapleural urokinase treatment at two tertiary hospitals. Patients received antibiotics, chest tube drainage, and other treatments as part of routine care. The primary outcome was the treatment success rate in the half dose urokinase group (50,000 IU daily for maximal 6 days) and the conventional dose urokinase group (100,000 IU daily). Treatment success was defined as clinical and radiological improvements without surgical treatment or re-admission within one month. Results: Forty-four patients received half dose urokinase, whereas 48 patients were treated with conventional dose urokinase. Both groups were relatively well matched at baseline, excluding higher serum white blood cell count and higher empyema prevalence in the half dose urokinase group. The treatment success rate was not different between the two groups (p=0.048). There were no differences in the rate of in-hospital death and surgical treatment, hospitalization duration, and indwelling catheter duration. In the multivariate analysis, urokinase dose was not a predictor of treatment success. Conclusion: Half dose intrapleural urokinase is equally effective conventional dose urokinase in treating patients with CPPE or empyema.

Image Evaluation according to Tube Current of X-ray Device for Intraoral Imaging (구내 촬영용 엑스선 장치의 관전류에 따른 영상 평가)

  • A Yeon Kim;Byungdu Jo;Seung-Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.515-521
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    • 2023
  • The radiation dose received by the patient varies according to the tube current and time used during dental intraoral imaging. A large amount of tube current is required for image quality, but the radiation dose to the patient increases accordingly. Therefore, in this study, the optimal amount of tube current that can reduce the radiation dose received by the patient while securing the image quality was calculated through the evaluation of the image quality according to the tube current used during intraoral imaging through simulation. The average tube current, time, and tube voltage presented in the Guidelines for Diagnostic Reference Level for intraoral radiography were used as basic imaging conditions, and images were obtained when only the tube current was changed, and then the optimal tube current was compared and analyzed with the basic image quantity was calculated. Images were obtained by changing the tube current to 0.1, 0.5, 1, 2, 3, 4 and 5 mA under the basic conditions of 63 kV, 6 mA, and 0.29 s. The obtained image was evaluated for structural similarity index with the image taken under the condition of 6 mA using the ICY program. As a result, even under the condition of 0.5 mA tube current, the index of structural similarity with the image of 6 mA was evaluated to be high. Based on these results, it is considered that the radiation dose given to the patient can be greatly reduced if imaging is performed at 0.5 mA instead of 6 mA during dental intraoral imaging.

Analysis of the major factors of influence on the conditions of the Intensity Modulated Radiation Therapy planning optimization in Head and Neck (두경부 세기견조방사선치료계획 최적화 조건에서 주요 인자들의 영향 분석)

  • Kim, Dae Sup;Lee, Woo Seok;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.11-19
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    • 2014
  • Purpose : To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. Materials and Methods : The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. Results : When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was $1.299{\pm}0.006$ and HI was $1.095{\pm}0.004$ while D5%/D95% was $1.090{\pm}1.011$. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute values of the volume dose-priority increased by 40,60,70,90. When the dose smooth strength from each treatment plan was increased, PCI value increased to $1.338{\pm}0.006$. Conclusion : The optimization algorithm was more influenced by the ratio of each condition than the absolute value of volume dose-priority. If the same ratio was maintained, similar treatment plan was established even if the absolute values were different. Volume dose-priority of the treatment volume should be more than 50% of the normal organ volume dose-priority in order to achieve a successful treatment plan. Dose fluence smooth value should increase or decrease proportional to the volume dose-priority. Volume dose-priority is not enough to satisfy the conditions when the absolute value are applied solely.

Analysis on the Calculated Dose in the Lung Radiation Surgery Planning Using TomoTherpay (토모테라피를 이용한 폐종양 방사선수술 계획 시 선량 분석)

  • Song, Ju-Young;Jung, Jae-Uk;Yoon, Mee-Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nah, Byung-Sik;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.22 no.4
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    • pp.178-183
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    • 2011
  • The applicability and feasibility of TomoTherapy in the lung radiation surgery was analyzed by comparison of the calculated dose distribution in TomoTherapy planning with the results of conventional IMRS (intensity modulated radiation surgery) using LINAC (linear accelerator). The acquired CT (computed tomograph) images of total 10 patients whose tumors' motion were less than 5 mm were used in the radiation surgery planning and the same prescribed dose and the same dose constraints were used between TomoTherapy and LINAC. The results of TomoTherapy planning fulfilled the dose requirement in GTV (gross tumor volume) and OAR (organ at risk) in the same with the conventional IMRS using LINAC. TomoTherapy was superior in the view point of low dose in the normal lung tissue and conventional LINAC was superior in the dose homogeneity in GTV. The calculated time for treatment beam delivery was long more than two times in TomoTherapy compared with the conventional LINAC. Based on the results in this study, TomoTherapy can be evaluated as an effective way of lung radiation surgery for the patients whose tumor motion is little when the optimal planning is produced considering patient's condition and suitability of dose distribution.