• Progress in Medical Physics
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• v.29 no.4
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• pp.123-136
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• 2018

The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.56-60
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• 2009

Purpose: The various studies and efforts to develop program are in progress in the field of nuclear medicine for the purpose of reducing scan time. The Oncoflash is one of the programs used in whole body bone scan which allows to maintain the image quality while to reduce scan time. When Those applications are used in clinical setting, both the image quality and reduction of scan time should be considered, therefore, the purpose of this study was to determine the criteria for proper scan speed. Materials and Methods: The subjects of this study were the patients who underwent whole body bone scan at the departments of nuclear medicine in the Asan Medical Center located in Seoul from 1st to 10th, July, 2008. The whole body bone images obtained in the scan speed of 30cm/min were classified by the total counts into under 800 K, and over 800 K, 900 K, 1,000 K, 1,500 K, and 2,000 K. The image quality were assessed qualitatively and the percentages of those of 1,000K and under of total counts were calculated. The FWHM before and after applying the Oncoflash were analyzed using images obtained in $^{99m}Tc$ Flood and 4-Quadrant bar phantom in order to compare the resolution according to the amount of total counts by the application of the Oncoflash. Considering the counts of the whole body bone scan, the dosed 2~5 mCi were used. 152 patients underwent the measurement in which the counts of Patient Postioning Monitor (PPM) were measured with including head and the parts of chest which the starting point of whole body bone scan from 7th to 26th, August, 2008. The correlations with total counts obtained in the scan speed of 30cm/min among them were analyzed (The exclusion criteria were after over six hours of applying isotopes or low amount of doses). Results: The percentage of the whole body bone image which has the geometric average of total counts of under 1,000K among them obtained in the scan speed of 30cm/min were 17.6%(n=58) of 329 patients. The qualitative analysis of the image groups according to the whole body counts showed that the images of under 1,000K were assessed to have coarse particles and increased noises. The analysis on the FWHM of the images before and after applying the Oncoflash showed that, in the case of PPM counts of under 3.6 K, FWHM values after applying the Oncoflash were higher than that before applying the Oncoflash, whereas, in the case of that of over 3.6 K, the FWHM after applying the Oncoflash were not higher than that before applying the Oncoflash. The average of total counts at 2.5~3.0 K, 3.1~3.5 K, 3.6~4.0 k, 4.1~4.5 K, 4.6~5.0 K, 5.1~6.0 K, 6.1~7.0 K, and 7.1 K over (in PPM) were $965{\pm}173\;K$, $1084{\pm}154\;K$, $1242{\pm}186\;K$, $1359{\pm}170\;K$, $1405{\pm}184\;K$, $1640{\pm}376\;K$, $1,771{\pm}324\;K$, and $1,972{\pm}385\;K$, respectively and the correlations between the counts in PPM and the total counts of image obtained in the scan speed of 30 cm/min demonstrated strong correlation (r=.775, p<.01). Conclusions: In the case of PPM coefficient over 3.6 K, the image quality obtained in the scan speed of 30cm/min and after applying the Oncoflash was similar to that obtained in the scan speed of 15 cm/min. In the case of total counts over 1,000 K, it is expected to reduce scan time without any damage on the image quality. In the case of total counts under 1,000 K, however, the image quality were decreased even though the Oncoflash is applied, so it is recommended to perform the re-image in the scan speed of 15 cm/min.

• Progress in Medical Physics
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• v.17 no.4
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• pp.246-251
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• 2006

The purpose of this study was to evaluate SUV (standard uptake value) using different reconstruction methods in whole body PET/CT Imaging. PET/CT studies were peformed with and without correction for effect of contrast media. The patients data were acquired using GE DSTe commercial PET/CT system. The liver disease (hepatocellular carcinoma, HCC) and renal disease (renal ceil carcinoma, RCC) patients were selected for this study, The PET/CT data were reconstructed using post CT scan with and without correction for effect of contrast media. We selected ROIs (region of Interest) at the same location and same area for the same patient to compare SUVs in these two methods. For HCC and RCC, the average differences of SUVs were measured as $1.5{\pm}1.2%\;and\;1.0{\pm}0.9%$, respectively. For HCC and RCC, the maximum differences of SUVs were measured as 4.3% and 1.9%, respectively. We observed that SUVs without correction for effect of contrast media were higher than SUVs with correction for effect of contrast media. However the differences of SUVs were very minimal. These results may be limited to HCC and RCC and further studies will be Heeded for other organs or diseases to see any changes in SUV with and without correction for effect of contrast media.

• Progress in Medical Physics
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• v.9 no.1
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• pp.47-53
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• 1998

Nuclear Medicine Images have comparatively poor spatial resolution, making it difficult to relate the functional information which they contain to precise anatomical structures. Anatomical structures useful in the interpretation of SPECT /PET Images were radiolabelled. PET/SPECT Images Provide functional information, whereas MRI mainly demonstrate morphology and anatomical. Fusion or Image Registration improves the information obtained by correlating images from various modalities. Brain Scan were studied on one or more occations using MRI and SPECT. The data were aligned using a point pair methods and surface matching. SPECT and MR Images was tested using a three dimensional water fillable Hoffman Brain Phantom with small marker and PET and MR Image was tested using a patient data. Registration of SPECT and MR Images is feasible and allows more accurate anatomic assessment of sites of abnormal uptake in radiolabeled studies. Point based registration was accurate and easily implemented three dimensional registration of multimodality data set for fusion of clinical anatomic and functional imaging modalities. Accuracy of a surface matching algorithm and homologous feature pair matching for three dimensional image registration of Single Photon Emission Computed Tomography Emission Computed Tomography (SPECT), Positron Emission Tomography (PET) and Magnetic Resonance Images(MRD was tested using a three dimensional water fill able brain phantom and Patients data. Transformation parameter for translation and scaling were determined by homologous feature point pair to match each SPECT and PET scan with MR images.

• Progress in Medical Physics
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• v.13 no.1
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• pp.37-43
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• 2002

Effect of scatter media materials and thickness, located between radioactivity and small gamma camera, on imaging characteristics was evaluated. The small gamma camera developed for breast imaging was consisted of collimator, NaI(T1) crystal(60$\times$60$\times$6 ㎣), PSPMT(position sensitive photomultimplier tube), NIMs and personal computer. Monte Carlo simulation was performed to evaluate the system sensitivity with different scatter media thickness(0~8 cm) and materials(air and acrylic) with parallel hole collimator and diverging collimator. The sensitivity and spatial resolution was measured using the small gamma camera with the same condition applied to the simulation. Counts was decreased by 10%(air) and 54%(acryl) with the parallel hole collimator and by 35%(air) and 63%(acryl) with the diverging collimator. Spatial resolution was decreased as increasing the thickness of scatter media. This study substantiate the importance of a gamma camera positioning and the minimization of the distance between detector and target lesion in the clinical application of a gamma camera.

• Progress in Medical Physics
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• v.14 no.2
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• pp.74-80
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• 2003

The purpose of this study was to evaluate the performance of the teflon encapsulated TLD rod, which may be used in nuclear medicine for the direct in vivo measurements of radiation dose. We analyzed the influence of teflon encapsulation for measuring absorbed dose. An experiment was carried out to evaluate and observe the response of a LiF TLD-100 rod in a thin-wall teflon capsule at different depths in a solid phantom. An adult anthropomorphic phantom was used to measure the absorbed dose using thin teflon encapsulated TLD. The measurements of PDD-, and TMR in solid phantom and athe bsorbed dose in humanoid phantom performed with normal TLD were compared with values obtained by teflon encapsulated TLD. It was demonstrated that the difference of TL response of LiF in phantom with and without teflon thin-wall capsule was less than 3％ under the same conditions beyond the build-up region. However, significant differences were observed near the phantom surface because of the build-up effect caused by the thin-wall thickness of the teflon capsule. Thus, our study showed that the contribution of teflon thin-wall capsule to TLD response for the megavoltage photon beams was negligible and that it did not significantly effect dose measurement. The teflon encapsulated TLD described in this work has been proven to be appropriate for in vivo dosimetry in therapeutic environments.

• Progress in Medical Physics
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• v.24 no.3
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• pp.154-161
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• 2013

This study assessed compared photon and proton treatment techniques, such as intensity modulated radiation therapy (IMRT), uniform scanning proton therapy (USPT), and intensity modulated proton therapy (IMPT), for a total of 10 prostate cancers. All treatment plans delivered 70 Gy to 95% of the planned target volume in 28 fractions. IMRT plans had 7 fields for the step and shoot technique, while USPT and IMPT plans employed two equally weighted, parallel-opposed lateral fields to deliver the prescribed dose to the planned target. Inverse planning was then incorporated to optimize IMPT. The homogeneity index (HI) and conformity index (CI) for the target and the normal tissue complication probability (NTCP) for organ at risk (OAR) were calculated. Although the mean HI and CI for target were not significantly different for each treatment techniques, the NTCP of the rectum was 2.233, 3.326, and 1.707 for IMRT, USPT, and IMPT, respectively. The NTCP of the bladder was 0.008, 0.003, and 0.002 respectively. The NTCP values at the rectum and bladder were significantly lower using IMPT. Our study shows that using proton therapy, particularly IMPT, to treat prostate cancer could be beneficial compared to 7-field IMRT with similar target coverage. Given these results, radiotherapy using protons, particularly optimized IMPT, is a worthwhile treatment option for prostate cancer.

• BMB Reports
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• v.57 no.2
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• pp.71-78
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• 2024

Melanoma is one of the most aggressive skin tumors, and conventional treatment modalities are not effective in treating advanced melanoma. Although immunotherapy is an effective treatment for melanoma, it has disadvantages, such as a poor response rate and serious systemic immune-related toxic side effects. The main solution to this problem is the use of biological materials such as hydrogels to reduce these side effects and amplify the immune killing effect against tumor cells. Hydrogels have great advantages as local slow-release drug carriers, including the ability to deliver antitumor drugs directly to the tumor site, enhance the local drug concentration in tumor tissue, reduce systemic drug distribution and exhibit good degradability. Despite these advantages, there has been limited research on the application of hydrogels in melanoma treatment. Therefore, this article provides a comprehensive review of the potential application of hydrogels in melanoma immunotherapy. Hydrogels can serve as carriers for sustained drug delivery, enabling the targeted and localized delivery of drugs with minimal systemic side effects. This approach has the potential to improve the efficacy of immunotherapy for melanoma. Thus, the use of hydrogels as drug delivery vehicles for melanoma immunotherapy has great potential and warrants further exploration.

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.307-312
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• 2016

Alzheimer's disease is the most common degenerative brain diseases that causes dementia. ${\beta}$-amyloid neuritic plaque density that accumulates in the brain is difficult to perform daily living, such as memory loss, language ability deterioration. It is used to estimate ${\beta}$-amyloid neuritic plaque density in adult patients with cognitive impairment who are being evaluated for Alzheimer's disease and other causes of cognitive impairment. Using the $^{18}F$-Florbetaben with high sensitivity and specificity for the ${\beta}$-amyloid neuritic plaque density to evaluate the usefulness for the early diagnosis of Alzheimer's disease. In $^{18}F$-FDG Brain imaging shows no specific findings. And it appeared on the MR-Brain imaging without atrophy of the hippocampus. However, the intake of ${\beta}$-amyloid neuritic plaque density in $^{18}F$-Florbetaben informs that it is the progress of Alzheimer's disease. Therefore, $^{18}F$-Florobetaben is very useful for early diagnosis of Alzheimer's disease.

• Progress in Medical Physics
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• v.19 no.1
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• pp.1-8
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• 2008

Technisium $(^{99m}Tc)$ is one of the most widely used radioactive isotopes for diagnosis in nuclear medicine. In general, technisium is produced inside the so called $^{99m}Tc$ generator which is usually made out of lead to shield relatively high energy radiation from $^{99}Mo$ and its daughter nuclide $^{99m}Tc$. In this paper, a GEANT4 simulation is carried out to test the safety of the $^{99m}Tc$ generator, taking the Daiichi product with radioactivity of 500 mCi as an example. According to the domestic regulation on radiation safety, the dose at 10 cm and 100 cm away from the surface of shielding container should not exceed 2.0 mSv/h and 0.02 mSv/h, respectively. The simulated dose turned out to be less than the limit, satisfying the domestic regulation.