Proceedings of the Korean Society of Medical Physics Conference
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2002.09a
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pp.150-153
/
2002
High dose rate (HDR) brachytherapy in the treatment of cervix carcinoma has become popular, because it eliminated many of the problems with conventional brachytherapy. In order to improve clinical effectiveness with HDR brachytherapy, dose calculation algorithm, optimization procedures, and image registrations should be verified by comparing the dose distributions from a planning computer and those from a humanoid phantom irradiated. Therefore, the humanoid phantom should be designed such that the dose distributions could be quantitatively evaluated by utilizing the dosimeters with high spatial resolution. Therefore, the small size of thermoluminescent dosimeter (TLD) chips with the dimension of 1/8" and film dosimetry with spatial resolution of <1mm used to measure the radiation dosages in the phantom. The humanoid phantom called a pelvic phantom is made of water and tissue-equivalent acrylic plates. In order to firmly hold the HDR applicators in the water phantom, the applicators are inserted into the grooves of the applicator supporters. The dose distributions around the applicators, such as Point A and B, can be measured by placing a series of TLD chips (TLD-to- TLD distance: 5mm) in three TLD holders, and placing three verification films in orthogonal planes.
We analyzed the differential effects of histopathology, apoptosis and expression of radiation response genes after chronic low dose rate (LDR) and acute high dose rate (HDR) radiation exposure in spleen, lung and liver of rats. Female 6-week-old Sprague-Dawley rats were used. For chronic low-dose whole body irradiation, rats were maintained for 14 days in a $^{60}Co$ gamma ray irradiated room and received a cumulative dose of 2 Gy or 5 Gy. Rats in the acute whole body exposure group were exposed to an equal dose of radiation delivered as a single pulse ($^{137}Cs$-gamma). At 24 hours after exposure, spleen, lung and liver tissues were extracted for histopathologic examination, western blotting and RT-PCR analysis. 1. The spleen showed the most dramatic differential response to acute and chronic exposure, with the induction of substantial tissue damage by HDR but not by LDR radiation. Effects of LDR radiation on the lung were only apparent at the higher dose (5 Gy), but not at lower dose (2 Gy). In the liver, HDR and LDR exposure induced a similar damage response at both doses. RT-PCR analysis identified cyclin G1 as a LDR-responsive gene in the spleen of rats exposed to 2 Gy and 5 Gy gamma radiation and in the lung of animals irradiated with 5 Gy. 2. The effects of LDR radiation differed among lung, liver, and spleen tissues. The spleen showed the greatest differential effect between HDR and LDR. The response to LDR radiation may involve expression of cyclin G1.
As the breast cancer rate is increasing fast in Korean women, people pay more attention to mammography and number of mammography have been increasing dramatically over the last few years. Mammography is the only means to diagnose breast cancer early, but harms caused by radiation exposure shouldn't be overlooked. Therefore, it is important to calculate the radiation dose being absorbed into the breast tissue during the process of mammography for a protective measure against radiation exposure. Because it is impossible to directly measure the radiation dose being absorbed into the human body, statistical calculation methods are commonly used, and most of them are supposed to simulate the interaction between radiation and matter by describing the human body internal structure with anthropomorphic phantoms. However, a simulation using Geant4 Code of Monte Carlo Method, which is well-known as most accurate in calculating the absorbed dose inside the human body, helps calculate exact dose by recreating the anatomical human body structure as it is through the DICOM file of CT. To calculate the absorbed dose in the breast tissue, therefore, this study carried out a simulation using Geant4 Code, and by using the DICOM converted file provided by Geant4, this study changed the human body structure expressed on the CT image data into geometry needed for this simulation. Besides, this study attempted to verify if the dose calculation of Geant4 interlocking with the DICOM file is useful, by comparing the calculated dose provided by this simulation and the measured dose provided by the PTW ion chamber. As a result, under the condition of 28kVp/190mAs, the Difference(%) between the measured dose and the calculated dose was found to be 0.08 %~0.33 %, and at 28 kVp/70 mAs, the Difference(%) of dose was 0.01 %~0.16 %, both of which showed results within 2%, the effective difference range. Therefore, this study found out that calculation of the absorbed dose using Geant4 Simulation is useful in measuring the absorbed dose in the breast tissue for mammography.
Low-dose rate brachytherapy(LDR) has been effective modality for treatment of oral cancer. But the disadvantage of LDR is radioexposure of medical staff. To overcome this problem, high dose rate(HDR) brachytherapy has been developed. Our study evaluates the outcomes of patients with tongue cancer as treated by HDR brachytherapy. Between 2002 and 2005, eight patients with carcinoma of the tongue were treated with HDR brachytherapy. Five patients had AJCC stage I or II disease and the remaining three patients had AJCC stage III or IV. The male-to-female ratio was 2:6 and the mean age was 60.1 years (range: 21-80 years).The median follow-up time was 23.8 months (range: 7-55 months). There was no local failure until now. Three patients showed some complications. Two patients showed soft tissue necrosis. There was no bone sequela in all cases. Our experience in treating tongue cancer with HDR brachytherapy is encouraging, because it gave a satisfactory local control. Prospective studies are necessary to delineate the optimum indication for this treatment modality and long-term outcome.
The purpose of this study was to evaluate the cancer incidence rate and provide basic data by measuring the photoneutron dose generated during intensity-modulated radiation therapy and volumetric modulated arc therapy used in radiation therapy for prostate cancer. The optically stimulated luminescence albedo neutron dosimeter for neutron measurement was placed on the Rando phantom in the abdomen and thyroid and photoneutron dose generated was measured. As a result of the study, intensity-modulated radiation therapy (7 portal) was measured to be higher than volumetric rotational radiation therapy in both abdominal and thyroid locations. When the cancer incidence rate was evaluated using the nominal risk coefficient of ICRP 103, the cancer incidence rate due to exposure to the colon and thyroid during intensity-modulated radiation therapy was 9.9 per 1,000 people, and volumetric rotational radiation therapy for 1,000 people. It was 3.5 per person. Based on the principle of ALARA (As low as reasonably archievable), it is considered to be a guideline for minimizing the exposure dose to normal organs in the establishment of a radiation treatment plan.
When X-rays were projected into a patient, there occured the phenomena such as penetration, absorption and scattering etc. The penetrating rays were recorded on films as X-ray image used for diagnosis but scattered rays caused the radiation hazard both to the patient, specialist and technicians. The soft tissue includes many organs which are sensitive to the radiation and in may occupy $40{\sim}50%$ of body weight. Therefore X-rays should be carefully projected to the patient and it is strongly recommended to analyse the distribution of X-rays, when ever the patient is exposed to X-rays. In this study, the distribution of X-ray according to the thickness, the radiation field and the tube voltages (kVp) in soft tissue, the following results were obtained: 1. Total transmitted rays which kept the step with X-ray tube voltage (kVp) increased in proportion to the increasing of X-ray tube voltage. 2. The scattered ray rate in the total transmitted ray was not significantly found with X-ray tube voltage. 3. The affecting factors of the scattered ray rate in total transmitted ray were shown through the radiation field and the thickness. 4. The dose of scattered ray by the angle was observed more in direction of primary ray ($0^{\circ}$) and back scattering ($160^{\circ}$) than in direction of $90^{\circ}$. 5. The more the distance from phantom to the patient should be less distribution of scattered ray.
Lee Sam-Sun;Kang Beom-Hyun;Choi Hang-Moon;Jeon In-Seong;Heo Min-Suk;Choi Soon-Chul
Imaging Science in Dentistry
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v.30
no.4
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pp.275-279
/
2000
Purpose: Radiation damage is produced and viable cell number is reduced. We need to know the type of cell death by the ionizing radiation and the amount and duration of cell cycle arrest. In this study, we want to identified the main cause of the cellular damage in the oral cancer cells and normal keratinocytes with clinically useful radiation dosage. Materials and Methods: Human gingival tissue specimens obtained from healthy volunteers were used for primary culture of the normal human oral keratinocytes (NHOK). Primary NHOK were prepared from separated epithelial tissue and maintained in keratinocyte growth medium containing 0.15 mM calcium and a supplementary growth factor bullet kit. Fadu and Hep-2 cell lines were obtained from KCLB. Cells were irradiated in a /sup 137/Cs γ-irradiator at the dose of 10 Gy. The dose rate was 5.38 Gy/min. The necrotic cell death was examined with Lactate Dehydrogenase (LDH) activity in the culture medium. Every 4 day after irradiation, LDH activities were read and compared control group. Cell cycle phase distribution and preG1-incidence after radiation were analyzed by flow cytometry using Propidium Iodine staining. Cell cycle analysis were carried out with a FAC Star plus flowcytometry (FACS, Becton Dickinson, USA) and DNA histograms were processed with CELLFIT software (Becton Dickinson, USA). Results: LDH activity increased in all of the experimental cells by the times. This pattern could be seen in the non-irradiated cells, and there was no difference between the non-irradiated cells and irradiated cells. We detected an induction of apoptosis after irradiation with a single dose of 10 Gy. The maximal rate of apoptosis ranged from 4.0% to 8.0% 4 days after irradiation. In all experimental cells, we detected G2/M arrest after irradiation with a single dose of 10 Gy. Yet there were differences in the number of G2/M arrested cells. The maximal rate of the G2/M ranges from 60.0% to 80.0% 24h after irradiation. There is no significant changes on the rate of the G0/G1 phase. Conclusion: Radiation sensitivity was not related with necrosis but cell cycle arrest and apoptosis. These data suggested that more arrested cell is correlated with more apoptosis.
Park, Seung-Jin;Chung, Woong-Ki;Ahn, Sung-Ja;Nam, Taek-Keun;Nah, Byung-Sik
Radiation Oncology Journal
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v.12
no.2
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pp.233-241
/
1994
Purpose : This study was performed to verify dose distribution with the tissue compensator which is used for uniform dose distribution in total body irradiation(TBI). Materials and methods : The compensators were made of lead(0.8mm thickness) and aluminum(1mm or 5mm thickness) plates. The humanoid phantom of adult size was made of paraffin as a real treatment position for bilateral total body technique. The humanoid phantom was set at 360cm of source-axis distance(SAD) and irradiated with geographical field size(FS) $144{\times}144cm^2(40{\times}40cm^2$ at SAD 100cm) which covered the entire phantom. Irradiation was done with 10MV X-ray(CLINAC 1800, Varian Co., USA) of linear accelerator set at Department of Therapeutic Radiology, Chonnam University Hospital. The midline absorbed dose was checked at the various regions such as head, mouth, mid-neck, sternal notch, mid-mediastinum, xiphoid, umbilicus, pelvis, knee and ankle with or without compensator, respectively. We used exposure/exposure rate meter(model 192, Capintec Inc., USA) with ionization chamber(PR 05) for dosimetry, For the dosimetry of thorax region TLD rods of $1x1x6mm^3$ in volume(LiF, Harshaw Co., Netherland) was used at the commercially available humanoid phantom. Results : The absorbed dose of each point without tissue compensator revealed significant difference(from $-11.8\%\;to\;21.1\%$) compared with the umbilicus dose which is a dose prescription point in TBI. The absorbed dose without compensator at sternal notch including shoulder was $11.8\%$ less than the dose of umbilicus. With lead compensator the absorbed doses ranged from $+1.3\%\;to\;-5.3\%$ except mid-neck which revealed over-compensation($-7.9\%$). In case of aluminum compensator the absorbed doses were measured with less difference(from $-2.6{\%}\;to\;5.3\%$) compared with umbilicus dose. Conclusion : Both of lead and aluminum compensators applied to the skull or lower leg revealed a good compensation effect. It was recognized that boost irradiation or choosing reference point of dose prescription at sternal notch according to the lateral thickness of patient in TBI should be considered.
Background: Magnetic resonance (MR) image guided radiation therapy system, enables real time MR guided radiotherapy (RT) without additional radiation exposure to patients during treatment. However, MR image lacks electron density information required for dose calculation. Image fusion algorithm with deformable registration between MR and computed tomography (CT) was developed to solve this issue. However, delivered dose may be different due to volumetric changes during image registration process. In this respect, synthetic CT generated from the MR image would provide more accurate information required for the real time RT. Materials and Methods: We analyzed 1,209 MR images from 16 patients who underwent MR guided RT. Structures were divided into five tissue types, air, lung, fat, soft tissue and bone, according to the Hounsfield unit of deformed CT. Using the deep learning model (U-NET model), synthetic CT images were generated from the MR images acquired during RT. This synthetic CT images were compared to deformed CT generated using the deformable registration. Pixel-to-pixel match was conducted to compare the synthetic and deformed CT images. Results and Discussion: In two test image sets, average pixel match rate per section was more than 70% (67.9 to 80.3% and 60.1 to 79%; synthetic CT pixel/deformed planning CT pixel) and the average pixel match rate in the entire patient image set was 69.8%. Conclusion: The synthetic CT generated from the MR images were comparable to deformed CT, suggesting possible use for real time RT. Deep learning model may further improve match rate of synthetic CT with larger MR imaging data.
In dose modeling, the shape of actual source and sealed capsule are important parameter to determine the physical dose computation. The author investigated the effect of filter of source self-absorption and sealed capsule to designed the high dose rate Ir-192 source for Ralstron(Japan) unit. The size of source designed to 1.5 mm $\Phi$ x 1.5mm length of actual source sealed with stainless steel which is 3.0mm $\Phi$ x 12.0mm length connected to driving cable. The dose attenuation was derived 66.3 % from 2655 segmented source at reference point of 10mm lateral distance of source. The output dose rate factor in tissue for designed source showed 0.0013511 cGy/mCi-sec in reference point at 1cm lateral distance of source center. The dose distribution at inferior of source showed the 52% of that of source tip region, however, the filtering effect was small as 4% at 45degrees of source axis. The dose attenuation within 20 degrees of source axis at near source-cable connector showed large filtering effect as 40% over, but the small effect was revealed isotropic dose distribution at large angle.
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