Purpose: To assess the usefulness of implanted fiducial markers in the setup of hypofractionated radiotherapy for prostate cancer patients by comparing a fiducial marker matched setup with a pelvic bone match. Materials and Methods: Four prostate cancer patients treated with definitive hypofractionated radiotherapy between September 2009 and August 2010 were enrolled in this study. Three gold fiducial markers were implanted into the prostate and through the rectum under ultrasound guidance around a week before radiotherapy. Glycerin enemas were given prior to each radiotherapy planning CT and every radiotherapy session. Hypofractionated radiotherapy was planned for a total dose of 59.5 Gy in daily 3.5 Gy with using the Novalis system. Orthogonal kV X-rays were taken before radiotherapy. Treatment positions were adjusted according to the results from the fusion of the fiducial markers on digitally reconstructed radiographs of a radiotherapy plan with those on orthogonal kV X-rays. When the difference in the coordinates from the fiducial marker fusion was less than 1 mm, the patient position was approved for radiotherapy. A virtual bone matching was carried out at the fiducial marker matched position, and then a setup difference between the fiducial marker matching and bone matching was evaluated. Results: Three patients received a planned 17-fractionated radiotherapy and the rest underwent 16 fractionations. The setup error of the fiducial marker matching was $0.94{\pm}0.62$ mm (range, 0.09 to 3.01 mm; median, 0.81 mm), and the means of the lateral, craniocaudal, and anteroposterior errors were $0.39{\pm}0.34$ mm, $0.46{\pm}0.34$ mm, and $0.57{\pm}0.59$ mm, respectively. The setup error of the pelvic bony matching was $3.15{\pm}2.03$ mm (range, 0.25 to 8.23 mm; median, 2.95 mm), and the error of craniocaudal direction ($2.29{\pm}1.95$ mm) was significantly larger than those of anteroposterior ($1.73{\pm}1.31$ mm) and lateral directions ($0.45{\pm}0.37$ mm), respectively (p<0.05). Incidences of over 3 mm and 5 mm in setup difference among the fractionations were 1.5% and 0% in the fiducial marker matching, respectively, and 49.3% and 17.9% in the pelvic bone matching, respectively. Conclusion: The more precise setup of hypofractionated radiotherapy for prostate cancer patients is feasible with the implanted fiducial marker matching compared with the pelvic bony matching. Therefore, a less marginal expansion of planning target volume produces less radiation exposure to adjacent normal tissues, which could ultimately make hypofractionated radiotherapy safer.
Cho Byung Chul;Park Suk Won;Oh Do Hoon;Bae Hoonsik
Radiation Oncology Journal
/
v.19
no.3
/
pp.275-286
/
2001
Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.
Corrections of attenuation, scatter and resolution are important in order to improve the accuracy of single photon emission computed tomography (SPECT) image reconstruction. Especially, the heart movement by respiration and beating cause the errors in the corrections. Myocardial phantom is used to verify the correction methods, but there are many different parts in the current phantoms in actual human body. Therefore the results using a phantom are often considered apart from the clinical data. We developed a new phantom that implements the human body structure around the thorax more faithfully. The new phantom has the small mediastinum which can simulate the structure in which the lung adjoins anterior, lateral and apex of myocardium. The container was made of acrylic and water-equivalent material was used for mediastinum. In addition, solidified polyurethane foam in epoxy resin was used for lung. Five different sizes of myocardium were developed for the quantitative gated SPECT (QGS). The septa of all different cardiac phantoms were designed so that they can be located at the same position. The proposed phantom was attached with liver and gallbladder, the adjustment was respectively possible for the height of them. The volumes of five cardiac ventricles were 150.0, 137.3, 83.1, 42.7 and 38.6ml respectively. The SPECT were performed for the new phantom, and the differences between the images were examined after the correction methods were applied. The three-dimensional tomography of myocardium was well reconstructed, and the subjective evaluations were done to show the difference among the various corrections. We developed the new cardiac and torso phantom, and the difference of various corrections was shown on SPECT images and QGS results.
This study focuses on the correction of topographic effects caused by a combination of solar elevation and azimuth, and topographic relief in single optical remote sensing imagery, and by a combination of changes in position of the sun and topographic relief in comparative analysis of multi-temporal imageries. For the Jeju Island, Republic of Korea, where Mt. Halla and various cinder cones are located, a Landsat 7 ETM+ imagery and ASTER GDEM data were used to normalize the topographic effects on the imagery, using two topographic normalization methods: cosine correction assuming a Lambertian condition and assuming a non-Lambertian c-correction, with kernel sizes of $3{\times}3$, $5{\times}5$, $7{\times}7$, and $9{\times}9$ pixels. The effects of each correction method and kernel size were then evaluated. The c-correction with a kernel size of $7{\times}7$ produced the best result in the case of a land area with various land-cover types. For a land-cover type of forest extracted from an unsupervised classification result using the ISODATA method, the c-correction with a kernel size of $9{\times}9$ produced the best result, and this topographic normalization for a single land cover type yielded better compensation for topographic effects than in the case of an area with various land-cover types. In applying the relative radiometric normalization to topographically normalized three multi-temporal imageries, more invariant spectral reflectance was obtained for infrared bands and the spectral reflectance patterns were preserved in visible bands, compared with un-normalized imageries. The results show that c-correction considering the remaining reflectance energy from adjacent topography or imperfect atmospheric correction yielded superior normalization results than cosine correction. The normalization results were also improved by increasing the kernel size to compensate for vertical and horizontal errors, and for displacement between satellite imagery and ASTER GDEM.
The respiratory gating radiation therapy which Irradiates only in the stable respiratory period with analyzing the periodic motion of a reflective marker on the patient's abdomen has been applied to the precise radiation treatment in order to minimize the effect of organ motion induced by the respiration. This respiratory gating system establishes irradiation region using the amplitude-based or phase-based method. Although phase-based method Is preferred because of the stability in the real treatment conditions, it has some limits to explain the exact correlation between the marker motion and organ motion. Even when the variation of amplitude which can introduce target motion considered as an error is produced, the phase-based method has the possibility to irradiate including the error positions. In this study, the error analysis program was developed for the verification of the tumor position's variation correlated with the variation of marker's amplitude which can be occurred during a phase-based respiratory sating treatment. The analysis program was tested with a virtual treatment record file and with a record file using moving phantom which were modified considering the irregular amplitude's variation simulating the real clinical situations. In both cases, accurate discrimination of error points and error calculation were produced. When the treatment record files of a real patient were analyzed with the program, the accurate recognition and calculation of the error points were also verified. The analysis program developed in this study will be applied as a useful tool for the analysis of errors due to the irregular variation of patients' respiration during the phase-base respiratory gating radiation treatment.
An orbit propagation software for the Mars orbiting spacecraft has been developed and verified in preparations for the future Korean Mars missions. Dynamic model for Mars orbiting spacecraft has been studied, and Mars centered coordinate systems are utilized to express spacecraft state vectors. Coordinate corrections to the Mars centered coordinate system have been made to adjust the effects caused by Mars precession and nutation. After spacecraft enters Sphere of Influence (SOI) of the Mars, the spacecraft experiences various perturbation effects as it approaches to Mars. Every possible perturbation effect is considered during integrations of spacecraft state vectors. The Mars50c gravity field model and the Mars-GRAM 2001 model are used to compute perturbation effects due to Mars gravity field and Mars atmospheric drag, respectively. To compute exact locations of other planets, JPL's DE405 ephemerides are used. Phobos and Deimos's ephemeris are computed using analytical method because their informations are not released with DE405. Mars Global Surveyor's mapping orbital data are used to verify the developed propagator performances. After one Martian day propagation (12 orbital periods), the results show about maximum ${\pm}5$ meter errors, in every position state components(radial, cross-track and along-track), when compared to these from the Astrogator propagation in the Satellite Tool Kit. This result shows high reliability of the developed software which can be used to design near Mars missions for Korea, in future.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.4
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pp.63-68
/
2018
The establishment of Ground Control Points (GCPs) in UAV-Photogrammetry is a working process that requires the most time and expenditure. Recently, the rapid developments of navigation sensors and communication technologies have enabled Unmanned Aerial Vehicles (UAVs) to conduct photogrammetric mapping without using GCP because of the availability of new methods such as RTK (Real Time Kinematic) and PPK (Post Processed Kinematic) technology. In this study, an experiment was conducted to evaluate the potential of RTK-UAV mapping with no GCPs compared to that of non RTK-UAV mapping. The positioning accuracy results produced by images obtained simultaneously from the two different types of UAVs were compared and analyzed. One was a RTK-UAV without GCPs and the other was a non RTK-UAV with different numbers of GCPs. The images were taken with a Canon IXUS 127 camera (focal length 4.3mm, pixel size $1.3{\mu}m$) at a flying height of approximately 160m, corresponding to a nominal GSD of approximately 4.7cm. As a result, the RMSE (planimetric/vertical) of positional accuracy according to the number of GCPs by the non-RTK method was 4.8cm/8.2cm with 5 GCPs, 5.4cm/10.3cm with 4 GCPs, and 6.2cm/12.0cm with 3 GCPs. In the case of non RTK-UAV photogrammetry with no GCP, the positioning accuracy was decreased greatly to approximately 112.9 cm and 204.6 cm in the horizontal and vertical coordinates, respectively. On the other hand, in the case of the RTK method with no ground control point, the errors in the planimetric and vertical position coordinates were reduced remarkably to 13.1cm and 15.7cm, respectively, compared to the non-RTK method. Overall, UAV photogrammetry supported by RTK-GPS technology, enabling precise positioning without a control point, is expected to be useful in the field of spatial information in the future.
Purpose: To develop a whole body frame for the purpose of reducing patient motion and minimizing setup error for extra-cranial stereotactic radiotherapy, and to evaluate the repositioning setup error of a patient in the frame. Materials and Methods: The developed whole body frame is composed of a base plate, immobilizer, vacuum cushion, ruler and belts. The dimension of the base plate is 130 cm in length, 50 cm in width and 1 cm in thickness. The material used in the base plate of the frame was bakelite and the immobilizer was made of acetal. In addition, Radiopaque angio-catheter wires were engraved on the base plate for a coordinate system to determine the target localization. The measurement for radiation transmission and target localization is peformed in order to test the utilization of the frame. Also, a Matlab program analyzed the patients setup error by using the patient's setup images obtained from a CCTV camera and digital record recorder (DVR). Results: A frame that is useful for CT simulation and radiation treatment was fabricated. The frame structure was designed to minimize collisions from the changes in the rotation angle of the gantry and to maximize the transmission rate of the Incident radiation at the lateral or posterior oblique direction. The lightening belts may be used for the further reduction of the patient motion, and the belts can be adjusted so that they are not in the way of beam direction. The radiation transmission rates of this frame were measured as 95% and 96% at 10 and 21 MV, respectively. The position of a test target on the skin of a volunteer is accurately determined by CT simulation using the coordinate system in the frame. The estimated setup errors by Matlab program are shown 3.69$\pm$1.60, 2.14$\pm$0.78 mm at the lateral and central chest, and 7.11 $\pm$2.10, 6.54$\pm$2.22 mm at lateral and central abdomen, respectively. The setup error due to the lateral motion of breast is shown as 6.33$\pm$ 1.55 mm. Conclusion: The development and test of a whole body frame has proven very useful and practical in the radiosurgery for extra-cranial cancers. It may be used in determining target localization, and it can be used as a patient immobilization tool. More experimental data should be obtained in order to improve and confirm the results of the patient setup error.
Purpose: In the PET/CT images, various artifacts cause degradation of the quantitative assessment. Most hotspot generated by radiopharmaceutical injection errors cause an artifact and degrade the quality of the images as well as the accuracy of the quantitative evaluation. The purpose of this study is to assess effectiveness of the elimination of the hotspot at the injection sites using shifting the center of DFOV (Display Field of View, DFOV) method and evaluate the quantitative evaluation of result. Materials and Methods: GE Discovery STE 16 (GE Healthcare, Milwaukee, USA) and 1994 NEMA phantom were used for imaging acquisition. Phantom was filled with 0.005 MBq/mL of $^{18}F-FDG$. A hotspot was artificially placed on the outside of the phantom. The ratio of hotspot area activity to background area activity was regulated as 200:1. After image acquisition with routine protocol, all of the images were reconstructed using the shifting the center of DFOV method that wasn't overlapped with hotspot. Those images obtained before and after applying the shifting reconstruction method were compared. ROIs (Region Of Interests) were set in the hotspot areas, meanSUVs and standard deviations were calculated. Percentage differences were calculated with those meanSUVs and standard deviations. The evaluation on the effects of the shifting reconstruction method was done by comparison of the meanSUVs and the standard deviations, which were calculated for background areas unaffected by hotspot. Results: In the areas of unaffected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.67{\pm}0.06g/mL$ and $0.65{\pm}0.06g/mL$, respectively. In the artifact areas affected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.32{\pm}0.08g/mL$ and $0.56{\pm}0.12g/mL$, respectively. The percentage differences of the area adjacent to the hotspot and the area distant from the hotspot were 65.3% and 97.4%, respectively. Conclusion: In the PET/CT images, meanSUV was improved by 32.1% when the effect of artifact was removed with application of the shifting the center of DFOV methode. In other areas unaffected by artifacts, meanSUVs were not significantly different after applying DFOV center shift method. As shown in the result, adverse effects of hotspot made by swelling in the injection site can be reduced by applying DFOV center shift method. Therefore, DFOV center shift method can be applied for the more precise quantitative evaluation, and contribute to the increase of the diagnostic value of the images.
The Journal of Korean Society for Radiation Therapy
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v.20
no.2
/
pp.83-89
/
2008
Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.
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