• 한국의학물리학회지:의학물리
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• 제26권4호
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• pp.241-249
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• 2015

방사선치료는 수술, 항암치료와 함께 암의 3대 치료방법으로써 많은 암환자들이 방사선치료를 받게 된다. 최대한 많은 방사선을 암에 집중시키고 최대한 적은 방사선을 주변 정상 조직에 가해주기 위해 치료 전 치료계획을 철저히 세우고 품질 관리를 시행하지만 방사선치료가 잘못 시행되어 의도치 않은 방사선이 환자에게 전달되는 의료사고가 발생하기도 한다. 이를 해결하기 위해 환자 내부의 선량을 검증하기 위한 방법을 투과선량 측정을 통한 환자 내부선량의 역추정 방법이 제시되고 있다. 본 연구에서 제시한 투과선량을 이용한 환자선량 계산 방법을 거리역자승법칙, 심부선량백분율, scatter factor를 이용한 방법으로써 실제 환자 선량 평가 가능성에 대해 균질한 물등가 팬텀을 이용한 연구이다. 투과선량에 대한 이온함과 유리선량계의 교정 결과 유리선량계의 신호값이 이온함으로 측정한 선량값에 비해 6 MV에서 0.824, 10 MV에서 0.736배인 것으로 나타났고 scatter factor는 평균적으로 1.4정도인 것으로 확인되었다. 심부선량백분율 데이터를 사용하기 위해 Mayneord F factor를 적용하였으며 위의 정보들을 이용하여 균질한 팬텀에서 알고리즘을 검증한 결과 최대 오차 약 1.65%로 계산이 정확하게 실시됨을 확인하였다.

• Radiation Oncology Journal
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• 제35권4호
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• pp.380-384
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• 2017

Massive chylous leakage is a rare postoperative complication that can prolong hospital stay and cause secondary morbidities. Conservative management strategies are the treatment of choice; however, radiation therapy (RT) can be used as an alternative for cases that are refractory to conservative treatment. Herein, we report a 69-year-old female patient who suffered from massive chylous leakage after subtotal gastrectomy. Due to persistent massive chylous leakage, she was scheduled to undergo low-dose RT. Radiation was delivered with a daily dose of 1 Gy, using an anterior-posterior and posterior-anterior beam arrangement. The clinical target volume encompassed the entire lymph node area of the D2 dissection. RT was completed at the total dose of 8 Gy because the amount of chylous leakage declined rapidly. Percutaneous drainage tube was removed after 3 days of RT. The patient did not complain of any symptoms related to massive chylous leakage 2 years after the completion of RT.

• 한국의학물리학회지:의학물리
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• 제28권3호
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• pp.111-121
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• 2017

Verification of dose distribution is an essential part of ensuring the treatment planning system's (TPS) calculated dose will achieve the desired outcome in radiation therapy. Each measurement have uncertainty associated with it. It is desirable to reduce the measurement uncertainty. A best approach is to reduce the uncertainty associated with each step of the process to keep the total uncertainty under acceptable limits. Point dose patient specific quality assurance (QA) is recommended by American Association of Medical Physicists (AAPM) and European Society for Radiotherapy and Oncology (ESTRO) for all the complex radiation therapy treatment techniques. Relative and absolute point dose measurement methods are used to verify the TPS computed dose. Relative and absolute point dose measurement techniques have a number of steps to measure the point dose which includes chamber cross calibration, electrometer reading, chamber calibration coefficient, beam quality correction factor, reference conditions, influences quantities, machine stability, nominal calibration factor (for relative method) and absolute dose calibration of machine. Keeping these parameters in mind, the estimated relative percentage uncertainty associated with the absolute point dose measurement is 2.1% (k=1). On the other hand, the relative percentage uncertainty associated with the relative point dose verification method is estimated to 1.0% (k=1). To compare both point dose measurement methods, 13 head and neck (H&N) IMRT patients were selected. A point dose for each patient was measured with both methods. The average percentage difference between TPS computed dose and measured absolute relative point dose was 1.4% and 1% respectively. The results of this comparative study show that while choosing the relative or absolute point dose measurement technique, both techniques can produce similar results for H&N IMRT treatment plans. There is no statistically significant difference between both point dose verification methods based upon the t-test for comparing two means.

• Journal of Radiation Protection and Research
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• 제30권3호
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• pp.113-119
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• 2005

전산화단층촬영(Computed Tomography, CT)은 높은 품질의 인체 단층 영상을 제공하지만 기존의 진단 X선 촬영에 비해 상당히 높은 선량을 환자에게 부여한다. 더욱이 CT 촬영의 수요는 계속적인 증가추세를 보이고 있어 CT 촬영 환자의 선량에 대한 관심이 높아지고 있다. 이에 본 연구에서는 물리적 실측 팬텀과 열형광 선량계를 이용하여 CT 촬영으로 인한 환자의 피폭 선량을 측정을 통해 평가해 보았다. 촬영방식을 기존의 축방향 스캔과 현재 주류를 이루고 있는 나선형 스캔으로 구분하여 선량 측정을 수행하였으며 그 결과 환자의 유효선량이 각각 17.78mSv, 10.01mSv으로 평가되었다. 또한 나선형 스캔 시 환자 선량의 감축 정도는 pitch에 의존한다는 기존의 연구결과를 재확인할 수 있었다. 본 연구에서 사용한 실측 기법은 CT 기술 발전에 기인한 촬영 프로토콜의 변화가 있는 경우 환자 선량 재평가에 응용할 수 있다.

• 대한방사선기술학회지:방사선기술과학
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• 제42권1호
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• pp.61-66
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• 2019

The purpose of this study was to improve the unstable treatment posture by placing the Carbon fabric blanket on the couch which was used for the patient fixation for the unstable posture from the severe pain caused by the neuromuscular pressure of the spinal metastatic cancer patient and to analyze the dose difference caused by the energy loss of high energy radiation. Using a linear accelerator, a FC-65G was installed at a depth of 5 cm at a solid phantom at 6 MV and 10 MV energies. The SAD was 100 cm, Gantry angle was $0^{\circ}$, a Cotton and Carbon blanket with a thickness of 1 cm on the couch, The blankets were placed on the couch and the dose was measured according to field size. For the dose measurement, and the dose was measured at 100 MU each time, and the mean value was calculated by repeating the measurement three times in order to reduce the error. The results showed that the difference rate in dose between Carbon blanket and Cotton blanket was respectively -0.54% and -0.75% based on the absence of the blanket(Non). Therefore, it is considered that the use of Carbon fabric blanket, which reduces the patient's pain and does not affect the depth dose, may be useful during radiation therapy of the spine metastasis cancer.

• Journal of Microbiology and Biotechnology
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• 제11권3호
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• pp.524-528
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• 2001

The measurement of radiation response using simple and informative techniques would be of great value in studying the genetic risk following occupational, therapeutic, or accidental exposure to radiation. When patients receive radiation therapy, many suffer from side effects. Since each patient receives a different dose due to different physical conditions, it is important to measure the exact dose of radiation received by each patient to lessen the side effects. Even though several biological dosimetric systems have already been developed, there is no ideal system that can satisfy all the criteria for an idean dosimetric system, especially for low-dose radiation as used in radiation therapy. In this study, an SOS Chromotest of E. coli PQ37 was evaluated as a novel dosimeter for low-dose gamma-rays. E. coli PQ37 was originally developed to screen chemical mutagens using the SOS Chromotest-a colorimtric assay, based on the induction of ${\beta}$-galactosidase ue to DNA damage. The survival fraction of E. coli PQ37 decreased dose-dependently with an increasing dose of cobalt-60 gamma-rays. Also, a good linear correlation was found between the biological damage revealed by the ${\beta}$-galactosidase expression and the doses of gamma-rays. The expression of ${\beta}$-galactosidase activity that responded to low-dose radiation under 1 Gy was $Y=0.404+(0.089{\pm}0.3)D+(-0.018{\pm}0.16)D^2$ (Y, absorbance at 420 nm; D, Dose of irradiation) as calculated using Graph Pad In Plot and Excel. When a rabbit was fed with capsules containing an agar block embdded with E. coli PQ37 showed a linear response to the radiation doses. Accordingly, the results confirm that E. coli PQ37 can be used as a sensitive biological dosimeter fro cobalt-60 gamma-rays. To the best of our knowledge, this is the first time that a bacterium has been used as a biological dosimeter, especially for low-dose radiation.

• 한국방사선학회논문지
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• 제13권3호
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• pp.433-438
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• 2019

의료기관에서는 환자의 진단 및 치료를 위해 방사선발생장치 및 방사성동위원소를 사용하고 있다. 환자이송원은 환자이송을 위해 불가피하게 방사선 관리구역에 출입하거나, 동위원소가 투여된 환자를 근거리에서 이송하는 등 일반인과 비교했을 때, 방사선에 노출될 확률이 높은 환경에서 업무를 수행한다. 따라서 환자이송원의 피폭 정도를 알아보고자 연구를 진행했다. 인천 A 종합병원에서 근무하고 있는 12명의 환자이송원을 대상으로 2019년 4월 1일부터 4월 30일까지 한 달 동안 선량계를 가슴에 패용하고, 누적된 선량을 측정했다. 사용된 선량계는 광자극발광선량계(OSLD), 선량판독은 OSLD Microstar Reading System을 사용했다. 한 달 동안 누적선량 측정 결과 심부선량은 평균 0.13 mSv, 표층선량은 평균 0.13 mSv로 측정되었고, 한 달 동안 누적된 선량에 12를 곱해 일 년 동안 업무를 수행할 시 받게 될 누적선량 예상치를 추정한 결과 심부선량은 평균 1.52 mSv, 표층선량은 평균 1.51 mSv로 나타났다. 환자이송원의 수시출입자 분류를 통해 피폭선량을 측정, 관리 하고, 교육훈련을 통해 방사선에 대한 방호지식을 높이며 건강진단을 통해 방사선장해 발생을 방지하기 위한 노력이 필요하다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 춘계학술대회
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• pp.489-492
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• 2014

본 논문에서는 컴퓨터 단층활영(CT)을 통해 발생되는 방사선 노출량의 관리를 위한 시스템의 소프트웨어 설계를 제안한다. 방사선 피폭량은 환자의 각 신체 부위별로 민감성의 차이에 따라 다르기 때문에 방사선의 노출량을 관리할 수 있게 되면 결과적으로 환자의 방사선 피폭량을 추정할 수 있다. 최근 일본 원전의 방사선 누출 사건이 국제적으로 뉴스가 되었고 원전 뿐 만아니라 의료용 방사선 피폭까지 폭넓게 관심이 커지고 있다. 현재 방사선 안전관리는 방사선 관계 종사자에 대해서만 관리되고 있지만, 이제는 환자에 대한 피폭 관리까지 요구되고 있다. 우리나라에서 방사선을 이용한 검사와 시술이 증가하여 이에 따른 의료 피폭이 증가하였으나 의료 기관에서는 환자에게 가해지는 방사선 피폭 수치를 알지 못하는 실정이다. 따라서 의료 기관에서 환자의 방사선 피폭을 관리할 수 있는 시스템이 필요하다. 본 논문에서는 의료 기관에서 방사선을 이용하는 대표적인 촬영 도구인 CT의 방사선 노출량을 관리할 수 있는 소프트웨어 설계를 제시한다. 방사선의 노출량을 확인하고 선량의 한도를 설정함으로써 환자의 의료 피폭량을 최적화 하는데 도움이 되고자 한다.

• 한국의학물리학회지:의학물리
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• 제30권4호
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• pp.120-127
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• 2019

Purpose: This study was designed to evaluate the dosimetric performance of Mobius3D by comparison with an aSi-based electronic portal imaging device (EPID) and Octavius 4D, which are conventionally used for patient-specific prescription dose verification. Methods: The study was conducted using nine patients who were treated by volumetric modulated arc therapy. To evaluate the feasibility of Mobius3D for prescription dose verification, we compared the QA results of Mobius3D to an aSi-based EPID and the Octavius 4D dose verification methods. The first was the comparison of the Mobius3D verification phantom dose, and the second was to gamma index analysis. Results: The percentage differences between the calculated point dose and measurements from a PTW31010 ion chamber were 1.6%±1.3%, 2.0%±0.8%, and 1.2%±1.2%, using collapsed cone convolution, an analytical anisotropic algorithm, and the AcurosXB algorithm respectively. The average difference was found to be 1.6%±0.3%. Additionally, in the case of using the PTW31014 ion chamber, the corresponding results were 2.0%±1.4%, 2.4%±2.1%, and 1.6%±2.5%, showing an average agreement within 2.0%±0.3%. Considering all the criteria, the Mobius3D result showed that the percentage dose difference from the EPID was within 0.46%±0.34% on average, and the percentage dose difference from Octavius 4D was within 3.14%±2.85% on average. Conclusions: We conclude that Mobius3D can be used interchangeably with phantom-based dosimetry systems, which are commonly used as patient-specific prescription dose verification tools, especially under the conditions of 3%/3 mm and 95% pass rate.

• 한국의학물리학회지:의학물리
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• 제30권4호
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• pp.75-88
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• 2019

Diagnostic reference level (DRL) is employed to optimize the radiation doses of patients. The objective of this study is to review the DRLs for interventional procedures in Korea and abroad. Literature review was performed to investigate radiation dose index and measurement methodology commonly used in DRL determination. Dose area product (DAP) and fluoroscopy time within each major procedure category were systematically abstracted and analyzed. A wide variation was found in the radiation dose. The DAP values and fluoroscopy times ranged 0.01-3,081 Gy·㎠ and 2-16,878 seconds for all the interventional procedures, 8.5-1,679 Gy·㎠ and 32-5,775 seconds for the transcatheter arterial chemoembolization (TACE), and 0.1-686 Gy·㎠ and 16-6,636 seconds for the transfemoral cerebral angiography (TFCA), respectively. The DRL values of the DAP and fluoroscopy time were 238 Gy·㎠ and 1,224 seconds for the TACE and 189 Gy·㎠ and 686 seconds for the TFCA, respectively. Generally, the DRLs of Korea were lower than those of other developed countries, except for the percutaneous transluminal angioplasty with stent in arteries of the lower extremity (LE PTA and stent), aneurysm coil embolization, and Hickman insertion procedures. The wide variation in the radiation doses of the different procedures suggests that more attention must be paid to reduce unnecessary radiation exposure from medical imaging. Furthermore, periodic nationwide survey of medical radiation exposures is necessary to optimize the patient dose for radiation protection, which will ultimately contribute to patient dose reduction and radiological safety.