• Journal of Radiation Protection and Research
• /
• 제43권2호
• /
• pp.59-65
• /
• 2018

Background: We analyzed changes in the doses, structure volumes, and dose-volume histograms (DVHs) when data were transferred from one commercial treatment planning system (TPS) to another commercial TPS. Materials and Methods: A total of 22 volumetric modulated arc therapy (VMAT) plans for nasopharyngeal cancer were generated with the Eclipse system using 6-MV photon beams. The computed tomography (CT) images, dose distributions, and structure information, including the planning target volume (PTV) and organs at risk (OARs), were transferred from the Eclipse to the MRIdian system in digital imaging and communications in medicine (DICOM) format. Thereafter, DVHs of the OARs and PTVs were generated in the MRIdian system. The structure volumes, dose distributions, and DVHs were compared between the MRIdian and Eclipse systems. Results and Discussion: The dose differences between the two systems were negligible (average matching ratio for every voxel with a 0.1% dose difference criterion = $100.0{\pm}0.0%$). However, the structure volumes significantly differed between the MRIdian and Eclipse systems (volume differences of $743.21{\pm}461.91%$ for the optic chiasm and $8.98{\pm}1.98%$ for the PTV). Compared to the Eclipse system, the MRIdian system generally overestimated the structure volumes (all, p < 0.001). The DVHs that were plotted using the relative structure volumes exhibited small differences between the MRIdian and Eclipse systems. In contrast, the DVHs that were plotted using the absolute structure volumes showed large differences between the two TPSs. Conclusion: DVH interpretation between two TPSs should be performed using DVHs plotted with the absolute dose and absolute volume, rather than the relative values.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제23권4호
• /
• pp.27-36
• /
• 2017

Purpose: The characteristics of spatial allocation planning in dentistry through examining the dental hospitals in Korea and comparison between them are necessary for the development of planning of the dental healthcare system. This study has been started to provide basic informations such as zoning, allocation distribution, and space configuration for the planning of dental hospital architecture. Methods: Literature review of dental care departments and investigation on current status of dental hospital in Korea have been conducted. The spatial allocation and space configuration of eleven dental hospitals have been analyzed. Results: The result of this study can be summarized in three points. The first one is that dental hospitals in Korea are consisted with eight to eleven dental care departments and they are divided with the horizontal allocation type with three to four departments in a floor for the spatial communication or the vertical allocation type with a department in each floor for the independent space. The second one is that oral medicine and oral maxillofacial radiology are located near the main entrance, orthodontics and pedodontic dentistry in lower level, prosthodontics in upper level, and conservative dentistry and periodontics have no specific spatial consideration. The third one is that the factors to consider the allocation planning are zoning for examination & diagnosis, basic practice, adolescence, surgery, circulations for patient, dentist, staff, different access for department like as easy access for reception and pedodontic dentistry, enclosure space for prosthodontics and surgery, frequency of visit and treatment care time, and change of treatment concept from treatment department to disease control corporative practice. Implications: This study is the starting point for the research of spatial configuration in dentistry and it is necessary to analyze the architectural planning to develop the dental healthcare system.

• 대한치과보철학회지
• /
• 제38권3호
• /
• pp.321-327
• /
• 2000

Statement of Problem. As a standard means of diagnostics, an orthopantomogram(OPT) permits to measure the vertical and mesiodistal dimension of available bone at the desired implant site with the help of suitable radioopaque references. Based on the clinical investigation of the dentition and the edentulous sites, information upon the width of the implant site can be obtained and documented in the dental scheme. Both findings permit together systematic primary planning for endosteal implants. Purpose of Study. Contents of the present article are the representation of a semiquantitative classification of available bone with the aim to simplify the primary phase of a systematic implant planning. Results. Thus the ASCIi- system permits a clear protocol of bone findings for the implant case with all information available during the primary appointment for treatment planning as a basis of further diagnostic and therapeutic measures. Conclusion. With the ASCIi system, important parameters such as alveolar height and sub-crestal alveolar width can be documented systematically, easily and time saving in the dental scheme as a basis for exact treatment planning.

• 한국의학물리학회:학술대회논문집
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.11-12
• /
• 2002

Accidental overexposures by radiotherapy have gathered attention recently in Japan. The widely publicized accidents have occurred at the government official benefit society hospital and at the hospital affiliated to a medical school. The accident at the government official benefit society hospital occurred when one of two existing accelerators was renewed. A radiotherapy planning system was also introduced at that time. Then treatment planning for the old and the new linear accelerator was performed using the system. There were variations in wedge factors for the 30 degrees wedge filter between the old and the new linear accelerator. That is, the difference in the structure of the wedge filter (30 degrees) resulted in variations of the wedge factors between both accelerators. In order to keep strength, a lead board was backed to the lead wedge filter for the new linear accelerator, whereas the wedge filter for the old one was made of the iron. The X-ray attenuation of the iron wedge filter is smaller than that of the lead wedge filter. The basic beam data of the old linear accelerator, however, wasn't delivered properly between the user and the maker. Then, the accident took place because the same wedge factor was used for the old and the new linear accelerator. On the other hand, the accident which occurred at the university hospital was brought about by the input mistake in initialization of the computer system when a linear accelerator was introduced. The input mistake was found when the software of the system was updated. If the dose had been measured and confirmed adequately, the accidents could have been prevented in both cases.

• 한국의학물리학회지:의학물리
• /
• 제28권3호
• /
• pp.122-128
• /
• 2017

Eclipse Scripting Application Programming Interface (ESAPI) was devised to enhance the efficiency in such treatment related workflows as contouring, treatment planning, plan quality measure, and data-mining by communicating with the treatment planning system (TPS). It is provided in the form of C# programming based toolbox, which could be modified to fit into the clinical applications. The Scripting program, however, does not offer all potential functionalities that the users intend to develop. The shortcomings can be overcome by combining the Scripting programming with user-executable program on Windows or Linux. The executed program has greater freedom in implementation, which could strengthen the ability and availability of the Scripting on the clinical applications. This work shows the use of the Scripting programming throughout the simple modification of the given toolbox. Besides, it presents the implementation of combining both Scripting and user-executed programming based on MATLAB, applied to automated dynamic MLC wedge and FIF treatment planning procedure for promoting the planning efficiency.

• Journal of Hospice and Palliative Care
• /
• 제25권1호
• /
• pp.42-49
• /
• 2022

As population aging increases the burden of cancer, the quality of death of patients with cancer is emerging as an important issue alongside their quality of life. To improve the quality of death, it is necessary to prepare for death, allowing patients to die comfortably and with dignity at the end. Considering these issues, I aim to discuss the practical aspects of notifying the patient of the terminal phase of cancer and planning for end-of-life care (i.e., advance care planning). When cancer treatment that can extend the patent's lifespan becomes difficult, the patient enters a treatment transition period. Treatment is shifted from life-prolonging care to life-enhancing care, and end-of-life care must be well planned. Medical providers often worry too much about whether the patient will be disappointed or psychologically traumatized when notified of the terminal phase of their cancer, thus delaying plans for end-of-life care. In fact, patients can accept their condition and prepare for end-of-life care better than we expect. During the treatment transition period, notification of terminal status should be given, and a well-prepared advance care plan should be established early when the patient has decision-making ability. In addition to conveying information, it is always necessary to be sensitive to whether the patient and caregiver understand the information and respond to their emotions.

• Radiation Oncology Journal
• /
• 제4권2호
• /
• pp.183-186
• /
• 1986

고선량율을 이용한 자궁강내 치료시 정확하고 신속한 계산을 위하여 저자들은 개인용 컴퓨터를 이용하여 기준점의 선량분포 및 방사선조사 시간을 간편하게 계산할 수 있는 software를 개발하였다. 치료 계획용 software를 이용하여 짧은 시간내에 선량 분포 및 조사시간을 용이하고 정확하게 계산할 수 있으며, 고선량을 자궁경부암 임상적응에 효과적으로 이용할 수 있어서 보고한다.

• 한국의학물리학회지:의학물리
• /
• 제17권3호
• /
• pp.144-152
• /
• 2006

네트워크기술을 이용한 서버-클라이언트 원격의료기술은 특히 의료시설이 낙후된 지방도시의 의료기관에 질 높은 의료서비스를 제공할 수 있는 기술이다. 이러한 기술은 중앙 집중 방식으로 진단과 검사용으로 사용되는 대형 컴퓨터 하드웨어와 소프트웨어를 매우 효율적이고 경제적으로 관리할 수 있게 하게 때문에 궁극적으로는 의료수가를 감소시키는데도 기여할 것이다. 각 환자에 대해 환자 맞춤형 방사선 치료계획은 매우 효율적인 암 치료를 가능하게 하기 때문에 환자와 의사 모두에게 매우 유익한 방법이다. 치료계획전문가들은 환자에게 너무 적은 선량을 주면 암이 계속 재발할 확률이 높고 너무 많은 선량을 주면 환자를 다치게 할 수도 있다는 것을 잘 이해한다. 최고의 해법은 가장 정확한 선량을 주는 것인데 이것은 각 환자의 CT 자료를 기반으로 정확한 선량계획 시뮬레이션 시스템을 사용하는 것이다. 우리는 네트워크 기반과 웹 기반을 이용한 환자 맞춤형 치료계획 시뮬레이션 시스템개발을 위해 관련된 4가지 컴퓨터 프로그램을 개발하고 있다. 환자의 CT자료를 이용하여 각 환자의 표적 자료를 만드는 프로그램, 이 표적자료를 바탕으로 방사선 선량 시뮬레이션을 하는 병렬 몬테카를로 프로그램, 선량주사변수들을 최적화시키는 프로그램, 그리고 계산결과를 시각화하는 프로그램들이다. 모든 소프트웨어는 약 100-200개의 개인컴퓨터로 구성된 클러스터에서 병렬모드로 운영이 된다. 이와 같이 방대한 하드웨어와 소프트웨어의 효과적인 관리를 각 병원에 맡기는 것은 효율적이지 못하기 때문에 이를 중앙에서 관리하면서 각 병원에서는 네트워크나 웹을 통하여 마치 모든 것이 자기 병원에 있는 것과 같이 편리하게 쓸 수 있게 하는 시스템으로 의사와의 계속적인 의사소통은 클라이언트-서버 시스템의 메신저 기능을 이용한다.

• Nuclear Engineering and Technology
• /
• 제41권4호
• /
• pp.531-544
• /
• 2009

This paper is intended to provide key issues and current research outcomes on accelerator-based Boron Neutron Capture Therapy (BNCT). Accelerator-based neutron sources are efficient to provide epithermal neutron beams for BNCT; hence, much research, worldwide, has focused on the development of components crucial for its realization: neutron-producing targets and cooling equipment, beam-shaping assemblies, and treatment planning systems. Proton beams of 2.5 MeV incident on lithium target results in high yield of neutrons at relatively low energies. Cooling equipment based on submerged jet impingement and micro-channels provide for viable heat removal options. Insofar as beam-shaping assemblies are concerned, moderators containing fluorine or magnesium have the best performance in terms of neutron accumulation in the epithermal energy range during the slowing-down from the high energies. NCT_Plan and SERA systems, which are popular dose distribution analysis tools for BNCT, contain all the required features (i.e., image reconstruction, dose calculations, etc.). However, detailed studies of these systems remain to be done for accurate dose evaluation. Advanced research centered on accelerator-based BNCT is active in Korea as evidenced by the latest research at Hanyang University. There, a new target system and a beam-shaping assembly have been constructed. The performance of these components has been evaluated through comparisons of experimental measurements with simulations. In addition, a new patient-specific treatment planning system, BTPS, has been developed to calculate the deposited dose and radiation flux in human tissue. It is based on MCNPX, and it facilitates BNCT efficient planning based via a user-friendly Graphical User Interface (GUI).

• 대한방사선치료학회지
• /
• 제26권2호
• /
• pp.207-216
• /
• 2014

목 적 : 모나코 치료계획 시스템은 몬테카를로 알고리즘을 기반으로 선량을 구현하는 대표적인 시스템이다. 모나코 치료계획 시스템에서 치료계획 완성 후, 같은 조건으로 최적화를 재 실시하여 처음과는 다른 치료계획이 만들어질 때 본 연구는 이러한 차이를 줄이는 방법을 제시하고자 한다. 대상 및 방법 : 모나코 치료계획 시스템은 세기변조방사선치료나 용적변조방사선치료를 위한 역 선량계산을 실시할 때, 두 단계를 거쳐 최적화를 실시한다. 본 연구는 우선 최적화 두 단계를 모두 실시하여 선량으로 완성된 치료계획을, 최적화 조건을 바꾸지 않고 일반적인 1단계부터 2단계까지 순차적 최적화를 실시하였다. 이때 2단계에선 펜슬 빔과 몬테카를로 알고리즘을 각각 적용하여 실험을 실시하였다. 두 가지 알고리즘의 치료계획 모두 처음 완성된 치료계획과 최적화를 재 실시한 치료계획을 비교하고 선량 측정기를 이용하여 치료선량을 평가하였다. 두 번째는 초기 완성된 치료계획에 대하여 최적화를 재 실시할 때 단계적으로 실시하여 치료계획을 완성하고 선량을 측정하였다. 결 과 : 초기 완성된 치료계획에서 동일한 조건으로 일반적인 최적화를 다시 실시한 결과는 동일하지 않았다. 치료계획시스템의 비교에서 보면 유사한 선량-용적 히스토그람은 유사한 경향을 나타내지만 최고선량, 선량 균질도 및 제한 선량 등은 최적화 조건을 만족 시키지 못하는 다른 값을 보였다. 또한 선량측정비교에서도 20%이상 다르게 나타냈다. 또한 선량 알고리즘이 달라져도 다른 측정 값이 나왔다. 반면, 단계적 최적화를 실시 할 경우에는, 초기 치료계획과 비교하였을 때 종양 및 정상 장기의 선량 분포가 5% 이하의 차이를 보였다. 결 론 : 치료계획의 최적화 과정은 수 많은 시행 착오를 수행하며 궁극적인 해를 찾아가는 과정이다. 이때 초기 치료계획의 완성만을 신뢰하며 최적화를 실시하면 또 다른 치료계획이 만들어 질 수 있다. 유사한 경향을 보이긴 하지만, 반드시 최적화 조건을 만족한다고 볼 수 없기 때문에, 최적화 과정을 재 실시할 경우에는 반드시 단계적인 최적화 과정을 통하여 선량분포를 확인하면서 순차적으로 최적화 조건을 적용해야 할 것이다.