This study examined the dosimetric influence of implanted gold markers in proton therapy and the effects of their positions in the spread-out Bragg peak (SOBP) proton beam. The implanted cylindrical gold markers were 3 mm long and 1.2 mm in diameter. The dosimetric influence of the gold markers was determined with markers at various locations in a proton-beam field. Spatial dose distributions were measured using a three-dimensional moving water phantom and a stereotactic diode detector with an effective diameter of 0.5 mm. Also, a film dosimetry was performed using Gafchromic External Beam Treatment (EBT) film. The GEANT4 simulation toolkit was used for Monte-Carlo simulations to confirm the measurements and to construct the dose-volume histogram with implanting markers. Motion data were obtained from the portal images of 10 patients to investigate the effect of organ motions on the dosimetric influence of markers in the presence of a rectal balloon. The underdosed volume due to a single gold marker, in which the dose was less than 95% of a prescribed amount, was 0.15 cc. The underdosed volume due to the presence of a gold marker is much smaller than the target volume. However, the underdosed volume is inside the gross tumor volume and is not smeared out due to translational prostate motions. The positions of gold markers and the conditions of the proton-beam field give different impacts on the dose distribution of a target with implanted gold markers, and should be considered in all clinical proton-based therapies.
The purpose of this study was to determine the dose distribution and image quality according to slice thickness and BC(beam collimation) in the gantry aperture. CT scans were performed with a 64-slice MDCT(Brilliance 64, Philips, Cleveland, USA) scanner. To determine the dose distribution according to BC, a ionization chamber was placed at isocenter and 5, 10, 15, 20, 25 and 30 cm positions from the isocenter in the 12, 3, 6 and 9 o'clock directions. The dose distribution for phantom scan was also measured using CT head and body dose phantom with five holes at the center of the phantom and the positions of the 12, 3, 6 and 9 o'clock directions. The image noise measurement for different BCs was performed using an AAPM CT phantom. Water-filled block of the phantom was moved by 5 cm or 10 cm to the 12 o'clock direction, and the image noise was measured at the center of the phantom, and the points of 12, 3, 6 and 9 o'clock direction respectively. Some points were placed beyond the scan field of view (SFOV), so that measurement was not possible at that points. The results are as follows: The CTDIw showed a larger decrease as the source goes farther from the iso-center or the BC became wider. The CTDIw depends on the BC width more than the number of the channel of a detector array. The value of CTDIW decreased with increasing BC, but the value decreased 16.6~31.9% in the head phantom scan in air scan and 51.0~64.5% in the body phantom scan. The value of the noise was 3.9~5.9 in the head and 5.3~7.4 in the body except for BC of $2{\times}0.5\;mm$, regardless of the degree of deviation from the iso-center. When a subject was located within the SFOV, the position did not significantly affect image quality even if the subject was out of the center.
Purpose : This is a retrospective analysis for pattern of failure, survival rate and prognostic factors of 114 patients with histologically proven invasive cancer of the uterine cervix treated with definitive irradiation. Materials and Methods : One hundred fourteen patients with invasive carcinoma of the cervix were treated with a combination of intracavitary irradiation using Fletcher-Suit applicator and external beam irradiation by 6MV X-ray at the Ewha Womans University Hospital between March 1982 and Mar 1990. The median age was 53 years(range:30-77 years). FIGO stage distribution was 19 for IB, 23 for IIA, 42 for IIB, 12 for IIIA and 18 for IIIB. Summation dose of external beam and intracavitary irradiation to point A was 80-90 Gy(median:8580 cGy) in early stage(IB-IIA) and 85-100 Gy(median:8850 cGy) in advanced stage(IIB-IIIB). Kaplan-Meier method was used to estimate the survival rate and multivariate analysis for progrostic factors was performed using the Log likelihood for Weibull Results : The pelvic failure rates by stage were $10.5{\%}$ for IB. $8.7{\%}$ for IIA, $23.8{\%}$ for IIB, $50.0{\%}$ for IIIA and $38.9{\%}$ for IIIB. The rate of distant metastasis by stage were $0{\%}$ for IB, $8.7{\%}$ for IIA, $4.8{\%}$ for IIB. $0{\%}$ for IIIA and $11.1{\%}$ for IIIB. The time of failure was from 3 to 50 months and with median of 15 months after completion of radiation therapy. There was no significant coorelation between dose to point A($\leq$90 Gy vs >90 Gy) and pelvic tumor control(P>0.05). Incidence rates of grade 2 rectal and bladder complications were $3.5{\%}$(4/114) and $7{\%}$(8/114), respectively and 1 patient had sigmoid colon obstruction and 1 patient had severe cystitis. Overall 5-year survival rate was $70.5{\%}$ and disease-free survival rate was $53.6{\%}$. Overall 5-year survival rate by stage was $100{\%}$ for IB, $76.9{\%}$ for IIA, $77.6{\%}$ for IIB $87.5{\%}$ for IIIA and $69.1{\%}$ for IIIB. Five-rear disease-free survival rate by stage was $81.3{\%}$ for IB, $67.9{\%}$ for IIA, $46.8{\%}$ for IIB, $45.4{\%}$ for IIIA and $34.4{\%}$ for IIIB. The prognostic factors for disease-free survival rate by multivariate analysis was performance status(p= 0.0063) and response rate after completion of radiation therapy(p= 0.0026) but stage, age and radiation dose to point A were not siginificant. Conclusion : The result of radiation therapy for early stage of the uterine cervix cancer was relatively good but local control rate and survival rate in advanced stage were poor inspite of high dose irradiation to point A above 90 Gy. Prospective randomized studies are recommended to establish optimal tumor doses for various stages and volume of carcinoma of uterine cervix, And ajuvant chemotherapy or radiation-sensitizing agents must be considered to increase the pelvic control and survival rate in advanced cancer of uterine cervix.
Purpose : To evaluate our clinical experience with the combination of teletherapy and intraluminal brachytherapy in patients with unresectable or inoperable esophageal cancers. Materials and Methods : From Nov 1989 to Mar 1993, twenty patients with esophageal cancer were treated with radical radiotherapy and intraluminal brachytherapy at Yonsei Cancer Center. All patients had squamous histolgy and stage distribution was as follows: stage II, 4($20{\%}$)patients; III, 15 ($75{\%}$)patients; IV, 1($5{\%}$)patients. A dose of S-12Gy/1-3weeks with intraluminal brachytherapy (3-5Gy/fraction) to 5mm from the outside of the esophageal tube using high dose rate Iridium-192 remotely afterloading brachytherapy machine was given 2 weeks after a total dose of 59-64Gy with external radiotherapy. Induction chemotherapy using cisplatin and 5-FU was performed in 13 patients with median 3 cycles(1-6 cycles), Response rate, local control rate, survival and complications were analysed retrospectively. Results : Two-year overall survival rate and median survival were $15.8{\%}$ and 13.5 months. Response rates were as follows complete remission(CR) 5($25{\%}$): partial remission a(PRa) 7($35{\%}$): partial remission b(PRb) 7($35{\%}$), no response(NR) 1($5{\%}$). Patterns of failure were as follows; local failure 13($65{\%}$), local and distant failure 3($15{\%}$), distant failure 0($0{\%}$). Ultimate local control rate was $20{\%}$. Treatment related complications included esophageal ulcer in two patients and esophageal stricture in one. Conclusion : Though poor local conrol rate, median survival was improved as compared with previous results of radiation therapy alone(8months) and chemoradiation combined treatment(11 months) in Yonsei Cancer Center High-dose-rate intraluminal brachytherapy following external irradiation is an effective treatment modality with acceptable toxicity in esophageal cancer.
Suh Tae-suk;Yoon Sei Chul;Shinn Kyung Sub;Park Yong Whee
Radiation Oncology Journal
/
v.9
no.1
/
pp.143-152
/
1991
The work suggested in this paper addresses a method for collecting beam data for small circular fields. Beam data were obtained from philips 6 and 8 MV LINAC at Dept. Radiation Therapy at Gainesville Incorporated and Shands Teaching Hospital. Specific quantities measured include tissue maximum ratio (TMR), off-axis ratio (OAR) and relative output factor (ROF) In small field irradiation, special collimators were used to produce circular fields of 1 cm to 3 cm diameter in 2 mm steps, measured at SAO (soura axis distance) of 100 cm. Diode detector was chosen for primary beam measurement and compared with measurements made with photographic film and TLD dosimeters. The measured TMRs and OARs were formulated from limited measurements to generate basic beam data for reference set-up. The empirical formula were later, extended and generalized for any possible set-up using the trends of fitting parameters. The measured TMRs and OARs were well represented by the fitting formula developed.
We intend to use topic modeling to identify radiation-themed papers published from 1989 to 2022 and analyze the relevance and weight between topics. This study analyzed topics derived from national subjects for 717 papers published until recently in 2022 to contribute to the revitalization of research in the field of radiation. Through text mining, overall research trends on the subject distribution of the study were analyzed, and five topics were derived through topic modeling. First, among the papers to be analyzed, a total of 1,675 words were frequency-analyzed through the preprocessing process of key words in a total of 717 papers centered on keywords. Second, as a result of analyzing topics based on the association of constituent words for five topics, it was found that studies focused on minimizing dose in the range that does not degrade image quality in the fields of radiation, image, CT clinical. In addition, it was found that various studies were mainly conducted in the MRI, and the study of ultrasound in various areas of disease analysis was actively attempted.
The Journal of Korean Institute of Electromagnetic Engineering and Science
/
v.24
no.12
/
pp.1158-1166
/
2013
SAR calculation method following the Mobi-Kids study protocol is analyzed and evaluation method of cumulative RF dose from mobile phones which have been used by a subject of case and control groups is proposed. An SAR database is built by calculating SAR distributions in 4 head models at different ages for representative phone models with the same conducted power. To obtain SAR distribution in a subject's head for a specific commercial phone which had/have been used by him/her, an SAR correction factor using SAR compliance test results is determined. Cumulative dose is calculated by considering mobile phone characteristics and use pattern such as call time and laterality(right and left).
The purpose of this study was to measure the dose distribution from the moving phantom for the respiratory motion. The phantom for TLD measurement was designed and built for this study based on the multiple plates for placing TLD and film. The TLDs may be inserted at 3 mm intervals in each TLD plate. For the measurements, TLD plate was inserted into the phantom at 1.5 cm ($d_{max}$) depth, and phantom was allowed to move in SI directions in the range of 1 to 2 cm with 0.5 cm interval for 6 MV X-ray beams. Penumbra and FWHM were measured at both moving state and compared stationary. It was found that penumbra increased 0.71 cm at stationary and 2.10 cm at moving state in 2 cm movement, and that FWHM are 7.52 cm for stationary state and 7.02 cm for moving state (2 cm movement). In this study, film was used to compared with TLD results of measurements and simitar results were observed. Therefore, it is expected that TLD moving phantom may be useful for the treatment of tumors that move due to the respiratory motion.
Lee, Soon Sung;Choi, Sang Hyoun;Min, Chul Kee;Kim, Woo Chul;Ji, Young Hoon;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Kim, Kum Bae
Progress in Medical Physics
/
v.26
no.3
/
pp.168-177
/
2015
For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.
The Monte Carlo calculation is the most accurate means of predicting radiation dose, but its accuracy is accompanied by an increase in the amount of time required to produce a statistically meaningful dose distribution. In this study, the effects on calculation time by introducing variance reduction techniques and increasing computing power, respectively, in the Monte Carlo dose calculation for a 6 MV photon beam from the Varian 600 C/D were estimated when maintaining accuracy of the Monte Carlo calculation results. The EGSnrcbased BEAMnrc code was used to simulate the beam and the EGSnrcbased DOSXYZnrc code to calculate dose distributions. Variance reduction techniques in the codes were used to describe reducedphysics, and a computer cluster consisting of ten PCs was built to execute parallel computing. As a result, time was more reduced by the use of variance reduction techniques than that by the increase of computing power. Because the use of the Monte Carlo dose calculation in clinical practice is yet limited by reducing the computational time only through improvements in computing power, introduction of reducedphysics into the Monte Carlo calculation is inevitable at this point. Therefore, a more active investigation of existing or new reducedphysics approaches is required.
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