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

• Progress in Medical Physics
• /
• v.22 no.1
• /
• pp.42-51
• /
• 2011

Nuclear medicine images (SPECT, PET) were widely used tool for assessment of myocardial viability and perfusion. However it had difficult to define accurate myocardial infarct region. The purpose of this study was to investigate methodological approach for automatic measurement of rat myocardial infarct size using polar map with adaptive threshold. Rat myocardial infarction model was induced by ligation of the left circumflex artery. PET images were obtained after intravenous injection of 37 MBq $^{18}F$-FDG. After 60 min uptake, each animal was scanned for 20 min with ECG gating. PET data were reconstructed using ordered subset expectation maximization (OSEM) 2D. To automatically make the myocardial contour and generate polar map, we used QGS software (Cedars-Sinai Medical Center). The reference infarct size was defined by infarction area percentage of the total left myocardium using TTC staining. We used three threshold methods (predefined threshold, Otsu and Multi Gaussian mixture model; MGMM). Predefined threshold method was commonly used in other studies. We applied threshold value form 10% to 90% in step of 10%. Otsu algorithm calculated threshold with the maximum between class variance. MGMM method estimated the distribution of image intensity using multiple Gaussian mixture models (MGMM2, ${\cdots}$ MGMM5) and calculated adaptive threshold. The infarct size in polar map was calculated as the percentage of lower threshold area in polar map from the total polar map area. The measured infarct size using different threshold methods was evaluated by comparison with reference infarct size. The mean difference between with polar map defect size by predefined thresholds (20%, 30%, and 40%) and reference infarct size were $7.04{\pm}3.44%$, $3.87{\pm}2.09%$ and $2.15{\pm}2.07%$, respectively. Otsu verse reference infarct size was $3.56{\pm}4.16%$. MGMM methods verse reference infarct size was $2.29{\pm}1.94%$. The predefined threshold (30%) showed the smallest mean difference with reference infarct size. However, MGMM was more accurate than predefined threshold in under 10% reference infarct size case (MGMM: 0.006%, predefined threshold: 0.59%). In this study, we was to evaluate myocardial infarct size in polar map using multiple Gaussian mixture model. MGMM method was provide adaptive threshold in each subject and will be a useful for automatic measurement of infarct size.

• The Korean Journal of Nuclear Medicine
• /
• v.31 no.1
• /
• pp.19-29
• /
• 1997

Recently, [I-123]IPT SPECT has been used for early diagnosis of Parkinson's patients(PP) by imaging dopamine transporters. The dynamic time activity curves in basal ganglia(BG) and occipital cortex(OCC) without blood samples were obtained for 2 hours. These data were then used to measure dopamine transporters by operationally defined ratio methods of (BG-OCC)/OCC at 2 hrs, binding potential $R_v=k_3/k_4$ using graphic method or $R_A$= (ABBG-ABOCC)/ABOCC for 2 hrs, where ABBG represents accumulated binding activity in basal ganglia(${\int}^{120min}_0$ BG(t)dt) and ABOCC represents accumulated binding activity in occipital cortex(${\int}^{120min}_0$ OCC(t)dt). The purpose of this study was to examine the IPT pharmacokinetics and investigate the usefulness of simplified methods of (BG-OCC)/OCC, $R_A$, and $R_v$ which are often assumed that these values reflect the true values of $k_3/k_4$. The rate constants $K_1,\;k_2\;k_3$ and $k_4$ to be used for simulations were derived using [I-123]IPT SPECT and aterialized blood data with a standard three compartmental model. The sensitivities and time activity curves in BG and OCC were computed by changing $K_l$ and $k_3$(only BG) for every 5min over 2 hours. The values (BG-OCC)/OCC, $R_A$, and $R_v$ were then computed from the time activity curves and the linear regression analysis was used to measure the accuracies of these methods. The late constants $K_l,\;k_2\;k_3\;k_4$ at BG and OCC were $1.26{\pm}5.41%,\;0.044{\pm}19.58%,\;0.031{\pm}24.36%,\;0.008{\pm}22.78%$ and $1.36{\pm}4.76%,\;0.170{\pm}6.89%,\;0.007{\pm}23.89%,\;0.007{\pm}45.09%$, respectively. The Sensitivities for ((${\Delta}S/S$)/(${\Delta}k_3/k_3$)) and ((${\Delta}S/S$)/(${\Delta}K_l/K_l$)) at 30min and 120min were measured as (0.19, 0.50) and (0.61, 0,23), respectively. The correlation coefficients and slopes of ((BG-OCC)/OCC, $R_A$, and $R_v$) with $k_3/k_4$ were (0.98, 1.00, 0.99) and (1.76, 0.47, 1.25), respectively. These simulation results indicate that a late [I-123]IPT SPECT image may represent the distribution of the dopamine transporters. Good correlations were shown between (3G-OCC)/OCC, $R_A$ or $R_v$ and true $k_3/k_4$, although the slopes between them were not unity. Pharmacokinetic computer simulations may be a very useful technique in studying dopamine transporter systems.

• Progress in Medical Physics
• /
• v.22 no.4
• /
• pp.190-197
• /
• 2011

Currently, the dose distribution calculation used by commercial treatment planning systems (TPSs) for high-dose rate (HDR) brachytherapy is derived from point and line source approximation method recommended by AAPM Task Group 43 (TG-43). However, the study of Monte Carlo (MC) simulation is required in order to assess the accuracy of dose calculation around three-dimensional Ir-192 source. In this study, geometry factor was calculated using segmented sources integration method by dividing microSelectron HDR Ir-192 source into smaller parts. The Monte Carlo code (MCNPX 2.5.0) was used to calculate the dose rate $\dot{D}(r,\theta)$ at a point ($r,\theta$) away from a HDR Ir-192 source in spherical water phantom with 30 cm diameter. Finally, anisotropy function and radial dose function were calculated from obtained results. The obtained geometry factor was compared with that calculated from line source approximation. Similarly, obtained anisotropy function and radial dose function were compared with those derived from MCPT results by Williamson. The geometry factor calculated from segmented sources integration method and line source approximation was within 0.2% for $r{\geq}0.5$ cm and 1.33% for r=0.1 cm, respectively. The relative-root mean square error (R-RMSE) of anisotropy function obtained by this study and Williamson was 2.33% for r=0.25 cm and within 1% for r>0.5 cm, respectively. The R-RMSE of radial dose function was 0.46% at radial distance from 0.1 to 14.0 cm. The geometry factor acquired from segmented sources integration method and line source approximation was in good agreement for $r{\geq}0.1$ cm. However, application of segmented sources integration method seems to be valid, since this method using three-dimensional Ir-192 source provides more realistic geometry factor. The anisotropy function and radial dose function estimated from MCNPX in this study and MCPT by Williamson are in good agreement within uncertainty of Monte Carlo codes except at radial distance of r=0.25 cm. It is expected that Monte Carlo code used in this study could be applied to other sources utilized for brachytherapy.

• Progress in Medical Physics
• /
• v.22 no.4
• /
• pp.216-223
• /
• 2011

Recently PTW developed a MicroLion liquid ionization chamber which is water_equivalent and has a small sensitive volume of $0.002cm^3$. The aim of this work is to investigate such dosimetric characteristics as dose linearity, dose rate dependency, spatial resolution, and output factors of the chamber for the external radiotherapy photon beam. The results were compared to those of Semiflex chamber, Pinpoint chamber and Diode chamber with the sensitive volumes of $0.125cm^3$, $0.03cm^3$ and $0.0025cm^3$, respectively and evaluated to be suitable for small fields. This study was performed in the 6MV photon energy from a Varian 2300 C/D linac accelerator and the MP3 water phantom (PTW, Freiburg) was used. Penumbras in the varios field sizes ranged from $0.5{\times}0.5cm^2$ to $10{\times}10cm^2$ were used to evaluate the spatial resolution. Output factors were measured in the field sizes of $0.5{\times}0.5$ to $40{\times}40cm^2$. Readings of the chamber was linearly proportional to dose. Dose rate dependency was measured from 100 MU/min to 600 MU/min, showed a maximum difference of 5.0%, and outputs decreased with dose rates. The spatial resolutions determined with comparing profiles for the field sizes of $0.5{\times}0.5cm^2$ to $10{\times}10cm^2$ agreed between every detector except the Semiflex chamber to within 2%. Outputs of detectors were compared to that of Semiflex chamber and showed good agreements within 2% for every chamber. This study shows that MicroLion chamber characterized by a high signal-to-noise ratio and water equivalence could be suitable for the small field dosimetry.

• Progress in Medical Physics
• /
• v.22 no.4
• /
• pp.206-215
• /
• 2011

The purpose of this was to investigate the measurement of fluence dose map for the specific patient quality assurance. The measurement of fluence map was performed using 2D matrixx detector. The absorbed dose was measured by a glass detector, Gafchromic film and ion chamber in Hybrid Optimized VMAT Phantom (HOVP). For 2D Matrixx, the results of comparison were average passing rate $85.22%{\pm}1.7$ (RT_Target), $89.96%{\pm}2.15$ (LT_Target) and $95.14%{\pm}1.18$ (G4). The dose difference was $11.72%{\pm}0.531$, $-11.47%{\pm}0.991$, $7.81%{\pm}0.857$, $-4.14%{\pm}0.761$ at the G1, G2, G3, G4. In HOVP, the results of comparison for film were average passing rate (3%, 3 mm) $93.64%{\pm}3.87$, $90.82%{\pm}0.99$. We were measured an absolute dose in steep gradient area G1, G2, G3, G4 using the glass detector. The difference between the measurement and calculation are 8.3% (G1), -5.4% (G2), 6.1% (G3), 7.2% (G4). The using an Ion-chamber were an average relative dose error $-1.02%{\pm}0.222$ (Rt_target), $0.96%{\pm}0.294$ (Lt_target). Though we need a more study using a transmission detector. However, a measurement of real-time fluence map will be predicting a dose for real-time specific patient quality assurance in volume modulated arc therapy.

• Progress in Medical Physics
• /
• v.20 no.4
• /
• pp.216-224
• /
• 2009

$^{131}I$ is a radiological isotope being used widely for treatment of cancer as emitting gamma-ray and it is also applied to estimate the function of thyroid for its accumulation in thyroid. However, $^{131}I$ is more difficult to quantitate comapred to $^{99m}Tc$, because $^{131}I$ has multiple energy gamma-ray emissions compared to $^{99m}Tc$ which is a mono energetic gamma-ray source. Especially, scattered ray and septal penetration resulted by high energy gamma ray have a bad influence upon nuclear medicine image. The purpose of this study was to estimate scatter components depending on the different source locations within a phantom using Monte Carlo simulation (GATE). The simulation results were validated by comparing with the results of real experiments. Dual-head gamma camera (ECAM, Chicago, Illinois Siemens) with high energy, general-purpose, and parallel hole collimators (hole radius: 0.17 cm, septal thickness: 0.2 cm, length: 5.08 cm) was used in this experiment. The NaI crystal is $44.5{\times}59.1\;cm$ in height and width and 0.95 cm in thickness. The diameter and height of PMMA phantom were 16 cm and 15 cm, respectively. The images were acquired at 5 different locations of $^{131}I$ point source within the phantom and the images of $^{99m}Tc$ were also acquired for comparison purpose with low energy source. The simulation results indicated that the scattering was influenced by the location of source within a phantom. The scattering effects showed the same tendency in both simulation and actual experiment, and the results showed that the simulation was very adequate for further studies. The results supported that the simulation techniques may be used to generalize the scattering effects as a function of a point source location within a phantom.

• Progress in Medical Physics
• /
• v.9 no.3
• /
• pp.163-173
• /
• 1998

Nuclear medicine emission computed tomography(ECT) can be very useful to diagnose early stage of neuronal diseases and to measure theraputic results objectively, if we can quantitate energy metabolism, blood flow, biochemical processes, or dopamine receptor and transporter using ECT. However, physical factors including attenuation, scatter, partial volume effect, noise, and reconstruction algorithm make it very difficult to quantitate independent of type of SPECT. In this study, we quantitated the effects of attenuation and scatter using brain SPECT and three-dimensional brain phantom with and without applying their correction methods. Dual energy window method was applied for scatter correction. The photopeak energy window and scatter energy window were set to 140ke${\pm}$10% and 119ke${\pm}$6% and 100% of scatter window data were subtracted from the photopeak window prior to reconstruction. The projection data were reconstructed using Butterworth filter with cutoff frequency of 0.95cycles/cm and order of 10. Attenuation correction was done by Chang's method with attenuation coefficients of 0.12/cm and 0.15/cm for the reconstruction data without scatter correction and with scatter correction, respectively. For quantitation, regions of interest (ROIs) were drawn on the three slices selected at the level of the basal ganglia. Without scatter correction, the ratios of ROI average values between basal ganglia and background with attenuation correction and without attenuation correction were 2.2 and 2.1, respectively. However, the ratios between basal ganglia and background were very similar for with and without attenuation correction. With scatter correction, the ratios of ROI average values between basal ganglia and background with attenuation correction and without attenuation correction were 2.69 and 2.64, respectively. These results indicate that the attenuation correction is necessary for the quantitation. When true ratios between basal ganglia and background were 6.58, 4.68, 1.86, the measured ratios with scatter and attenuation correction were 76%, 80%, 82% of their true ratios, respectively. The approximate 20% underestimation could be partially due to the effect of partial volume and reconstruction algorithm which we have not investigated in this study, and partially due to imperfect scatter and attenuation correction methods that we have applied in consideration of clinical applications.

• Progress in Medical Physics
• /
• v.21 no.1
• /
• pp.35-41
• /
• 2010

The purpose of this study is to quantitate regional neurochemical profile of regional normal adult mice brain and assess regional metabolic differences by using ex vivo $^1H$ high-resolution magic angle spinning nuclear magnetic resonance spectroscopy ($^1H$ HR-MAS NMRS). The animals were matched in sex and age. The collected brain tissue included frontal cortex, temporal cortex, thalamus, and hippocampus. Quantitative 1D spectra were acquired on 40 samples with the CPMG pulse sequence (8 kHz spectral window, TR/TE = 5500/2.2 ms, NEX = 128, scan time: 17 min 20 sec). The mass of brain tissue and $D_2O$+TSP solvent were 8~14 mg and 7~13 mg. A total of 16 metabolites were quantified as follow: Acet, NAA, NAAG, tCr, Cr, tCho, Cho, GPC + PC, mIns, Lac, GABA, Glu, Gln, Tau and Ala. As a results, Acet, Cho, NAA, NAAG and mIns were showed significantly different aspects on frontal cortex, hippocampus, temporal cortex and thalamus respectively. The present study demonstrated that absolute metabolite concentrations were significantly different among four brain regions of adult mice. Our finding might be helpful to investigate brain metabolism of neuro-disease in animal model.

• Progress in Medical Physics
• /
• v.23 no.1
• /
• pp.8-14
• /
• 2012

In order to develop a Patient respiratory management system includinga biofeedback function for4-dimentional radiation therapy, this study investigated anoptimal tracking algorithmfor moving target using IR (Infra-red) camera as well as commercial camera. A tracking system was developed by LabVIEW 2010. Motion phantom images were acquired using a camera (IR or commercial). After image process were conducted to convert acquired image to binary image by applying a threshold values, several edge enhance methods such as Sobel, Prewitt, Differentiation, Sigma, Gradient, Roberts, were applied. The targetpattern was defined in the images, and acquired image from a moving targetwas tracked by matching pre-defined tracking pattern. During the matching of imagee, thecoordinateof tracking point was recorded. In order to assess the performance of tracking algorithm, the value of score which represents theaccuracy of pattern matching was defined. To compare the algorithm objectively, we repeat experiments 3 times for 5 minuts for each algorithm. Average valueand standard deviations (SD) of score were automatically calculatedsaved as ASCII format. Score of threshold only was 706, and standard deviation was 84. The value of average and SD for other algorithms which combined edge detection method and thresholdwere 794, 64 in Sobel, 770, 101 in Differentiation, 754, 85 in Gradient, 763, 75 in Prewitt, 777, 93 in Roberts, and 822, 62 in Sigma, respectively. According to score analysis, the most efficient tracking algorithm is the Sigma method. Therefore, 4-dimentional radiation threapy is expected tobemore efficient if threshold and Sigma edge detection method are used together in target tracking.