• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.289-293
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• 2001

Objectives : The optimal treatment of craniopharyngioma is controversial. Despite recent advances in microsurgical management, complete surgical removal of craniopharyngioma remains very difficult. Radiation added to surgery is effective, but radiation therapy resulted in untoward side effect in young patient. Gamma knife radiosurgery offers the theoretical advantage of a reduced radiation dose to surrounding structures during the treatment of residual or recurrent craniopharyngioma compared with fractionated radiotheraphy. We described retrospective analysis of tumor size and clinical symptoms of patients after gamma knife radiosurgery in residual or recurrent craniopharyngioma were performed. Material and Methods : From September 1990 to January 2000, 18 patients of craniopharyngioma were treated by gamma knife radiosurgery. All patient had undergone surgery, but residual or recurrent tumor was found and all of them treated postoperative gamma knife radiosurgery. The mean age was 19(from 6 to 66) and male to female ratio was 10 to 8 and 8 patients were below 15 years old. In young age group(below age 15), the average volume of the tumor was $2904.8mm^3$ and mean maximal gamma knife dose was 34.9Gy. In old age group(older than 15), the average volume of the tumor was $2590.4mm^3$ and mean maximal gamma knife dose was 45.2Gy. The size of the tumor was average $2730.1mm^3$($88-12000mm^3$), mean average radiation dose was 40.7Gy and the mean prescription dose was 17.6 Gy(4-35Gy) delivered to a median prescription 50.7% isodose. Results : The follow up was from 1 year to 9 years(mean 59.1 months) after gamma knife radiosurgery. The tumor was controlled in 13(72.2%) patients. The tumor decreased in 9 patients and not changed in 4 patients. The tumor size increased in 4(22.2%) patients during follow up period. In two cases the tumor size increased because of its cystic portion was increased, but their solid portion of the tumor was not changed. In another two patients, the solid portion of the tumor was increased. So, one patient underwent reoperation and the other patient underwent operation and repeated gamma knife radiosurgery. The tumor recurred in one case(5.6%) that is a outside of irradiated site. The presenting symptoms were improved in 4 patients(improved visual acuity in 1, controlled increased intracranial presure sign in 3 patients). In one case, visual acuity decreased after gamma knife radiosurgery. The endocrine symptoms were not influenced by gamma knife radiosurgery. Conclusion : Craniopharyngioma can be treated successfully by gamma knife radiosurgery. Causes of the tumor regrowth are inadequate dose planning because of postoperatively poor margination of the tumor, close approximation of optic nerve and residual tumors outside the target lesion. Recurrence can develop 4 years after gamma knife radiosurgery. Volume is important, but the accurate targeting is more important to prevent tumor recurrence. If the tumor definition is not clear during planning gamma knife surgery, long-term image follow up is required.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.75-81
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• 2019

Purpose: Tomo therapy and Proton therapy treatment plans for the treatment of prostate cancer patients were established, and the characteristics of dose distribution according to beam delivery method using Tomo therapy IMRT method and Proton therapy PBS method to compare and analyze the treatment effect were sought. Materials and Methods: Tomo IMRT treatment plan and Proton PBS treatment plan were established using the Hi.art planning station 5.1.1.6 of Tomo therapy and Eclipse 13.7 of VARIAN for three prostate cancer patients who were treated with radiotherapy only for radical purposes without surgery. For the evaluation of two treatment plans, the average dose (Dmean) and maximum dose (Dmax) of PGTV were calculated from dose volume histogram (DVH) to confirm the coverage and calculate CI and HI. In OAR evaluation, the dose received from the rectal volume 25% and the dose received from the bladder were evaluated to compare the normal long-term protection effect. Results: The mean maximum doses of the three patients were 71.4Gy, 75.3Gy and the mean doses were 70.4Gy and 72.8Gy in the DVH of the Tomo IMRT and Proton PBS. The CI was 1.16 and 1.31, and the HI was 0.04 and 0.12 respectively, and the Tomo IMRT was superior to the Proton PBS in dose suitability. Conclusion: The mean dose of PGTV in prostate cancer patients was 3.4% higher in Proton PBS than in Tomo IMRT. This is because the Dose suitability of Tomo IMRT was better, but it is considered to be a small difference to be seen as a significant result. However, the results of the two methods were 51.2% in D 25% and 55.7% less in the average dose of bladder, which could reduce the side effects of patients in proton PBS.

• Progress in Medical Physics
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• v.29 no.4
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• pp.137-142
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• 2018

This study aimed to evaluate and verify a process for correcting the extended source-to-imager distance (SID) in portal dosimetry (PD). In this study, eight treatment plans (four volumetric modulated arc therapy and four intensity-modulated radiation therapy plans) at different treatment sites and beam energies were selected for measurement. A Varian PD system with portal dose image prediction (PDIP) was used for the measurement and verification. To verify the integrity of the plan, independent measurements were performed with the MapCHECK device. The predicted and measured fluence were evaluated using the gamma passing rate. The output ratio was defined as the ratio of the absolute dose of the reference SID (100 cm) to that of each SID (120 cm or 140 cm). The measured fluence for each SID was absolutely and relatively compared. The average SID output ratios were 0.687 and 0.518 for 120 SID and 140 SID, respectively; the ratio showed less than 1% agreement with the calculation obtained by using the inverse square law. The resolution of the acquired EPIDs were 0.336, 0.280, and 0.240 for 100, 120, and 140 SID, respectively. The gamma passing rates with PD and MapCHECK exceeded 98% for all treatment plans and SIDs. When autoalignment was performed in PD, the X-offset showed no change, and the Y-offset decreased with increasing SID. The PD-generated PDIP can be used for extended SID without additional correction.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.11-20
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• 2024

As the importance of intervention has recently increased, interest in the health of medical staff performing the procedure is increasing. Existing radiation shielding devices have limited the operator's movement and have not been properly used due to the risk of infection, and adequate radiation shielding of the operator's gonads and furthermore, the entire area of the procedure room has not been achieved. An auxiliary shielding device was manufactured by attaching a Bismuth to the elbow support used in the procedure, and the radiation shielding effect was measured. As a result of the measurement, the average spatial dose rate decreased by about 64.8%, and the independent sample t-test analysis showed statistically significant below the significance probability (p<0.05). The use of an auxiliary shielding device is considered to be an effective shielding method that can shield the operator's gonads and reduce the radiation spatial dose rate of the entire area of the procedure room.

• Journal of the Korean Society of Radiology
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• v.6 no.6
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• pp.455-464
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• 2012

This study suggested evaluation of approximately exposure to low-dose ionization radiation from medical images using a computed radiography (CR) system in standard X-ray examination and experimental model can compare diagnostic reference level (DRL) will suggest on optimization condition of guard about medical radiation of low dose space. Entrance surface dose (ESD) cross-measuring by standard dosimeter and optically stimulated luminescence dosimeters (OSLDs) in experiment condition about tube voltage and current of X-ray generator. Also, Hounsfield unit (HU) scale measured about each experiment condition in CR system and after character relationship table and graph tabulate about ESD and HU scale, approximately radiation dose about head, neck, thoracic, abdomen, and pelvis draw a measurement. In result measuring head, neck, thoracic, abdomen, and pelvis, average of ESD is 2.10, 2.01, 1.13, 2.97, and 1.95 mGy, respectively. HU scale is $3,276{\pm}3.72$, $3,217{\pm}2.93$, $2,768{\pm}3.13$, $3,782{\pm}5.19$, and $2,318{\pm}4.64$, respectively, in CR image. At this moment, using characteristic relationship table and graph, ESD measured approximately 2.16, 2.06, 1.19, 3.05, and 2.07 mGy, respectively. Average error of measuring value and ESD measured approximately smaller than 3%, this have credibility cover all the bases radiology area of measurement 5%. In its final analysis, this study suggest new experimental model approximately can assess radiation dose of patient in standard X-ray examination and can apply to CR examination, digital radiography and even film-cassette system.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.86-89
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• 2002

The purpose is to develop a system to reduce the organ movement from the respiration during the 3DCRT or IMRT. This research reports the experience of utilizing personally developed system for mobile tumors. The patients clinical database was structured for 10 mobile tumors and patient setup error measurement and immobilization device effects were investigated. The RMRD system is composed of the respiratory motion reduction device utilized in prone position and abdominal strip device(ASD) utilized in the supine position, and the analysis program, which enables the analysis on patients setup reproducibility. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the normal tissue volume, field margins and dose volume histogram(DVH) using fluoroscopy and CT images. And, reproducibility of patients setup verify by utilization of digital images. When patients breathed freely, average movement of diaphragm was 1.2 cm in prone position in contrast to 1.6 cm in supine position. In prone position, difference in diaphragm movement with and without RMRDs was 0.5 cm and 1.2 cm, respectively, showing that PTV margins could be reduced to as much as 0.7 cm. With RMRDs, volume of the irradiated normal tissue (lung, liver) reduced up to 20 % in DVH analysis. Also by obtaining the digital image, reproducibility of patients setup verify by visualization using the real-time image acquisition, leading to practical utilization of our software. Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.

• Journal of the Korean Society of Radiology
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• v.17 no.3
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• pp.449-457
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• 2023

Shielding for reducing exposure dose can make the diagnosis limited. The purpose of this study is to increase the efficiency of radiation protection and minimize the loss of image information by producing the shielding made of the water and the contrast medium which has different proportion and finding out the ideal proportion of them. Each shielding materials were made of water and water-soluble iodine contrast medium with the different proportion. The attenuation rate of absorbed dose was evaluated by the shielding materials in the plastic contents for measuring the efficiency of the radiation protection. As a result, the higher ratio of the contrast medium, the more efficient it is for radiation attenuation. The anatomical structure was observed most properly in case of the solution with 20 ml of the contrast medium and most difficultly in case of more than 60 ml of the contrast medium. In case of the signal intensity between skeleton and gas, the difference of average value had a significant as p < 0.001. Shielding with contrast medium attenuates less than the conventional shielding but in the examination for the sensitive part to radiation, it can be used to minimize the loss of the image information and reduce the exposure dose.

• Journal of radiological science and technology
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• v.43 no.2
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• pp.105-114
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• 2020

This study aimed to assess of beam-matching accuracy for an 8 MV beam between the same model linear accelerators(Linac) commissioned over two years. Two models were got the customer acceptance procedure(CAP) criteria. For commissioning data for beam-matched linacs, the percentage depth doses(PDDs), beam profiles, output factors, multi-leaf collimator(MLC) leaf transmission factors, and the dosimetric leaf gap(DLG) were compared. In addition, the accuracy of beam matching was verified at phantom and patient levels. At phantom level, the point doses specified in TG-53 and TG-119 were compared to evaluate the accuracy of beam modelling. At patient level, the dose volume histogram(DVH) parameters and the delivery accuracy are evaluated on volumetric modulated arc therapy(VMAT) plan for 40 patients that included 20 lung and 20 brain cases. Ionization depth curve and dose profiles obtained in CAP showed a good level for beam matching between both Linacs. The variations in commissioning beam data, such as PDDs, beam profiles, output factors, TF, and DLG were all less than 1%. For the treatment plans of brain tumor and lung cancer, the average and maximum differences in evaluated DVH parameters for the planning target volume(PTV) and the organs at risk(OARs) were within 0.30% and 1.30%. Furthermore, all gamma passing rates for both beam-matched Linacs were higher than 98% for the 2%/2 mm criteria and 99% for the 2%/3 mm criteria. The overall variations in the beam data, as well as tests at phantom and patient levels remains all within the tolerance (1% difference) of clinical acceptability between beam-matched Linacs. Thus, we found an excellent dosimetric agreement to 8 MV beam characteristics for the same model Linacs.

• Journal of Radiation Protection and Research
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• v.42 no.1
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• pp.42-47
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• 2017

Background: One of the most urgent issues following the accident at the Fukushima Daiichi nuclear power plant (FDNPP) was the remediation of the land, in particular, for residential area contaminated by the radioactive materials discharged. In this study, the effect of decontamination on reduction of ambient dose equivalent outdoors and indoors was evaluated. The latter is essential for residents as most individuals spend a large portion of their time indoors. Materials and Methods: From December 2012 to November 2014, thirty-seven Japanese single-family detached wooden houses were investigated before and after decontamination in evacuation zones. Outdoor and indoor dose measurements (n = 84 and 114, respectively) were collected based on in situ measurements using the NaI (Tl) scintillation surveymeter. Results and Discussion: The outdoor ambient dose equivalents [$H^*(10)_{out}$] ranged from 0.61 to $3.71{\mu}Sv\;h^{-1}$ and from 0.23 to $1.32{\mu}Sv\;h^{-1}$ before and after decontamination, respectively. The indoor ambient dose equivalents [$H^*(10)_{in}$] ranged from 0.29 to $2.53{\mu}Sv\;h^{-1}$ and from 0.16 to $1.22{\mu}Sv\;h^{-1}$ before and after decontamination, respectively. The values of reduction efficiency (RE), defined as the ratio by which the radiation dose has been reduced via decontamination, were evaluated as $0.47{\pm}0.13$, $0.51{\pm}0.13$, and $0.58{\pm}0.08$ ($average{\pm}{\sigma}$) when $H^*(10)_{out}$ < $1.0{\mu}Sv\;h^{-1}$, $1.0{\mu}Sv\;h^{-1}$ < $H^*(10)_{out}$ < $2.0{\mu}Sv\;h^{-1}$, and $2.0{\mu}Sv\;h^{-1}$ < $H^*(10)_{out}$, respectively, indicating the values of RE increased as $H^*(10)_{out}$ increased. It was found that the values of RE were $0.53{\pm}0.12$ outdoors and $0.41{\pm}0.09$ indoors, respectively, indicating RE was larger outdoors than indoors. Conclusion: Indoor dose is essential as most individuals spend a large portion of their time indoors. The difference between outdoors and indoors should be considered carefully in order to estimate residents' exposure dose before their returning home.

• Journal of IKEEE
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• v.18 no.4
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• pp.544-551
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• 2014

This paper suggests an algorithm to measure low-level radiation by radiation measuring devices, and the other algorithm to improve reaction speed of the device to better respond to dramatic changes in radiation amount. The former algorithm to improve the accuracy of measuring low-level radiation takes advantage of a dual window radiation measurement method which is based on accumulated average of pulses gathered by a radiation measuring sensor. The latter algorithm is to enhance reaction speed of a measuring device to more sensitively react to dramatic changes in radiation amount by adopting a dual window radiation measurement method which analyzes data patterns newly put into for six seconds. To verify the suggested algorithms, a hardware-which consists of sensor and high-voltage generator, controller, charger and power supply circuit, wireless communication part, and display part-was used. Tests conducted on the dual window radiation measurement method as used in the suggested algorithm have proved that accuracy improves to measure low-level radiation of 5uSv/h, and linearity also gets better. Other tests were conducted to see whether the suggested algorithm enhances the reaction speed of a radiation measuring device so that the device responds better to dramatically changing radiation amount. The experimental results have shown meaningful changes in numbers after six seconds. Therefore, the conclusions are made that the algorithm enhances the reaction speed of the device.