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Radiation Therapy Using M3 Wax Bolus in Patients with Malignant Scalp Tumors (악성 두피 종양(Scalp) 환자의 M3 Wax Bolus를 이용한 방사선치료)

  • Kwon, Da Eun;Hwang, Ji Hye;Park, In Seo;Yang, Jun Cheol;Kim, Su Jin;You, Ah Young;Won, Young Jinn;Kwon, Kyung Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.75-81
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    • 2019
  • Purpose: Helmet type bolus for 3D printer is being manufactured because of the disadvantages of Bolus materials when photon beam is used for the treatment of scalp malignancy. However, PLA, which is a used material, has a higher density than a tissue equivalent material and inconveniences occur when the patient wears PLA. In this study, we try to treat malignant scalp tumors by using M3 wax helmet with 3D printer. Methods and materials: For the modeling of the helmet type M3 wax, the head phantom was photographed by CT, which was acquired with a DICOM file. The part for helmet on the scalp was made with Helmet contour. The M3 Wax helmet was made by dissolving paraffin wax, mixing magnesium oxide and calcium carbonate, solidifying it in a PLA 3D helmet, and then eliminated PLA 3D Helmet of the surface. The treatment plan was based on Intensity-Modulated Radiation Therapy (IMRT) of 10 Portals, and the therapeutic dose was 200 cGy, using Analytical Anisotropic Algorithm (AAA) of Eclipse. Then, the dose was verified by using EBT3 film and Mosfet (Metal Oxide Semiconductor Field Effect Transistor: USA), and the IMRT plan was measured 3 times in 3 parts by reproducing the phantom of the head human model under the same condition with the CT simulation room. Results: The Hounsfield unit (HU) of the bolus measured by CT was $52{\pm}37.1$. The dose of TPS was 186.6 cGy, 193.2 cGy and 190.6 cGy at the M3 Wax bolus measurement points of A, B and C, and the dose measured three times at Mostet was $179.66{\pm}2.62cGy$, $184.33{\pm}1.24cGy$ and $195.33{\pm}1.69cGy$. And the error rates were -3.71 %, -4.59 %, and 2.48 %. The dose measured with EBT3 film was $182.00{\pm}1.63cGy$, $193.66{\pm}2.05cGy$ and $196{\pm}2.16cGy$. The error rates were -2.46 %, 0.23 % and 2.83 %. Conclusions: The thickness of the M3 wax bolus was 2 cm, which could help the treatment plan to be established by easily lowering the dose of the brain part. The maximum error rate of the scalp surface dose was measured within 5 % and generally within 3 %, even in the A, B, C measurements of dosimeters of EBT3 film and Mosfet in the treatment dose verification. The making period of M3 wax bolus is shorter, cheaper than that of 3D printer, can be reused and is very useful for the treatment of scalp malignancies as human tissue equivalent material. Therefore, we think that the use of casting type M3 wax bolus, which will complement the making period and cost of high capacity Bolus and Compensator in 3D printer, will increase later.

An Essay on the Change of Jinju Sword Dance after being designated as an Important Intangible Cultural Asset (<진주검무> 중요무형문화재 지정 이후의 변화에 관한 소고)

  • Lee, Jong Sook
    • Korean Journal of Heritage: History & Science
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    • v.49 no.1
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    • pp.4-21
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    • 2016
  • The purpose of this study is to investigate changes of Jinju Sword Dance, characteristics of the changes, and the current condition of its preservation and succession after the designation as the important intangible cultural property no. 12 in January 16th, 1967. In other words, this study understands the situation which has established the present state of after changes over generations. As of now. the year of 2015, the 3 generation holders have been approved since 1967. In 1967, 8 members of $1^{st}$ generation holders were selected from gisaengs of Gwonbeon. However, the succession training was incomplete due to conflicts among the holders, the deaths of some holders, and economic activities of the individuals. As the need of a pivot for succession training and activities was rising, Seong, Gye-Ok was additionally approved as the $2^{nd}$ generation holder on June $21^{st}$, 1978. Seong, Gye-Ok who had never been a gisaeng had dramatically changed with a lot of new attempts. After the death of Seong, Gye-Ok in 2009, Kim, Tae-Yeon and Yu, Yeong-Hee were approved as the $3^{rd}$ generation holders in February, 2010. Based on the resources including the "Cultural Research Reports of Important Intangible Cultural Properties" in 1966 and videos up to 2014, the changes of the dance and surroundings are as follow. 1. The formation of musical accompaniment has been changed during the 3 generations. In the video of the $1^{st}$ generation(in 1970), the performance lasted about 15 minutes, whereas the performance lasted 25 minutes in the video of the $2^{nd}$ generation. Yumbuldoduri rhythm was considered as Ginyumbul(Sangryeongsan) and played more slowly. The original dance requiring only 15 rhythms was extended to 39 rhythms to provide longer performance time. In the $3^{rd}$ generation, the dance recovered 15 rhythms using the term Ginyumbul. The facts that Yumbul was played for 3 minutes in the $1^{st}$ generation but for 5 minutes in the 3rd generation shows that there was tendency pursuing the slowness from the $2^{nd}$ generation. 2. For the composition of the Dance, the performance included additional 20 rhythms of Ginyumbul and Ah(亞)-shaped formation from the $2^{nd}$ generation. From the $3^{rd}$ generation, the performance excluded the formation which had no traditional base. For the movement of the Dance, the bridge poses of Ggakjittegi and Bangsukdoli have been visibly inflexible. Also, the extention of time value in 1 beat led the Dance less vibrant. 3. At the designation as an important intangible cultural property (in 1967), the swords with rotatable necks were used, whereas the dancers had been using the swords with non-rotatable necks since late 1970s when the $2^{nd}$ generation holder began to used them. The swords in the "Research Reports" (in 1966) was pointy and semilunar, whereas the straight swords are being used currently. The use of the straight swords can be confirmed from the videos after 1970. 4. There is no change in wearing Jeonlib, Jeonbok, and Hansam, whereas the arrangement of Saekdong of Hansam was different from the arrangement shown in the "Research Reports". Also, dancers were considered to begin wearing the navy skirts when the swords with non-rotatable necks began to be used. Those results showed that has been actively changed for 50 years after the designation. The $2^{nd}$ generation holder, Seong, Gye-Ok, was the pivot of the changes. However, , which was already designated as an important intangible cultural property, is considered to be only a victim of the change experiment from the project to restore Gyobang culture in Jinju, and it is a priority to conduct studies with historical legitimacy. First of all, the slowing beat should be emphasized as the main fact to reduce both the liveliness and dynamic beauty of the Dance.

A Study on the Spatial Structure of Eupchi(邑治) and Landscape Architecture of Provincial Government Office(地方官衙) in the Late Joseon Dynasty through 'Sukchunjeahdo(宿踐諸衙圖)' - Focused on the Youngyuhyun Pyeongan Province and Sincheongun Hwanghae Province - (『숙천제아도(宿踐諸衙圖)』를 통해 본 조선시대 읍치(邑治)의 공간구조와 관아(官衙) 조경 - 평안도 영유현과 황해도 신천군을 중심으로 -)

  • Shin, Sang sup;Lee, Seung yoen
    • Korean Journal of Heritage: History & Science
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    • v.49 no.2
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    • pp.86-103
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    • 2016
  • 'Sukchunjeahdo' illustration-book, which was left by Han, Pil-gyo(韓弼敎 : 1807~1878)in the late Joseon Dynasty, includes pictorial record paintings containing government offices, Eupchi, and Feng Shui condition drawn by Gyehwa(界畵) method Sabangjeondomyobeop(四方顚倒描法) and is the rare historical material that help to understand spatial structure and landscape characteristics. Youngyuhyun(永柔縣) and Sincheongun(信川郡) town, the case sites of this study, show Feng Shui foundation structure and placement rules of government offices in the Joseon Period are applied such as 3Dan 1Myo(三壇一廟 : Sajikdan, Yeodan, Seonghwangdan, Hyanggyo), 3Mun 3Jo(三門三朝 : Oeah, Dongheon, Naeah) and Jeonjohuchim(前朝後寢) etc. by setting the upper and lower hierarchy of the north south central axis. The circulation system is the pattern that roads are segmented around the marketplace of the entrance of the town and the structure is that heading to the north along the internal way leads to the government office and going out to the main street leads to the major city. Baesanimsu(背山臨水 : Mountain in backward and water in front) foundation, back hill pine forest, intentionally created low mountains and town forest etc. showed landscape aesthetics well suited for the environmental comfort condition such as microclimate control, natural disaster prevention, psychological stability reflecting color constancy principle etc. and tower pavilions were built throughout the scenic spot, reflecting life philosophy and thoughts of contemporaries such as physical and mental discipline, satisfied at the reality of poverty, returning to nature etc. For government office landscape, shielding and buffer planting, landscape planting etc. were considered around Gaeksa(客舍), Dongheon(東軒), Naeah(內衙) backyard and deciduous tree s and flowering trees were cultivated as main species and in case of Gaeksa, tiled pavilions and pavilions topped with poke weed in tetragonal pond were introduced to Dongheon and Naeah and separate pavilions were built for the purpose of physical and mental discipline and military training such as archery. Back hill pine tree forest formed back landscape and zelkova, pear trees, willow trees, old pine trees, lotus, flowering trees etc. were cultivated as gardening trees and Feng-Shui forest with willow trees as its main species was created for landscape and practical purposes. On the other hand, various cultural landscape elements etc. were introduced such as pavilions, pond serving as fire protection water(square and circle), stone pagoda and stone Buddha, fountains and wells, monument houses, flagpoles etc. In case of Sincheongun town forest(邑藪), Manhagwan(挽河觀), Moonmujeong(文武井), Sangjangdae(上場岱) and Hajangdae(下場岱) Market place, Josanshup<(造山藪 : Dongseojanglim(東西長林)>, Namcheon(南川) etc. were combined and community cultural park with the nature of modern urban park was operated. In this context, government office landscape shows the garden management aspect where square pond and pavilions, flowering trees are harmonized around side pavilion and backyard. Also, environmental design technique not biased to aesthetics and ideological moral philosophy and comprehensively considering functionality (shielding and fire prevention, microclimate control, etc.) and environmental soundness etc. is working.

An Examination into the Illegal Trade of Cultural Properties (문화재(文化財)의 국제적 불법 거래(不法 去來)에 관한 고찰)

  • Cho, Boo-Keun
    • Korean Journal of Heritage: History & Science
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    • v.37
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    • pp.371-405
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    • 2004
  • International circulation of cultural assets involves numerous countries thereby making an approach based on international law essential to resolving this problem. Since the end of the $2^{nd}$ World War, as the value of cultural assets evolved from material value to moral and ethical values, with emphasis on establishing national identities, newly independent nations and former colonial states took issue with ownership of cultural assets which led to the need for international cooperation and statutory provisions for the return of cultural assets. UNESCO's 1954 "Convention for the Protection of Cultural Property in the Event of Armed Conflict" as preparatory measures for the protection of cultural assets, the 1970 "Convention on the Means of Prohibiting and Preventing the Illicit Import and Transfer of Ownership of Cultural Property" to regulate transfer of cultural assets, and the 1995 "Unidroit Convention on Stolen or Illegally Exported Cultural Objects" which required the return of illegally acquired cultural property are examples of international agreements established on illegal transfers of cultural assets. In addition, the UN agency UNESCO established the Division of Cultural Heritage to oversee cultural assets related matters, and the UN since its 1973 resolution 3187, has continued to demonstrate interest in protection of cultural assets. The resolution 3187 affirms the return of cultural assets to the country of origin, advises on preventing illegal transfers of works of art and cultural assets, advises cataloguing cultural assets within the respective countries and, conclusively, recommends becoming a member of UNESCO, composing a forum for international cooperation. Differences in defining cultural assets pose a limitation on international agreements. While the 1954 Convention states that cultural assets are not limited to movable property and includes immovable property, the 1970 Convention's objective of 'Prohibiting and preventing the illicit import, export and transfer of ownership of cultural property' effectively limits the subject to tangible movable cultural property. The 1995 Convention also has tangible movable cultural property as its subject. On this point, the two conventions demonstrate distinction from the 1954 Convention and the 1972 Convention that focuses on immovable cultural property and natural property. The disparity in defining cultural property is due to the object and purpose of the convention and does not reflect an inherent divergence. In the case of Korea, beginning with the 1866 French invasion, 36 years of Japanese colonial rule, military rule and period of economic development caused outflow of numerous cultural assets to foreign countries. Of course, it is neither possible nor necessary to have all of these cultural properties returned, but among those that have significant value in establishing cultural and historical identity or those that have been taken symbolically as a demonstration of occupational rule can cause issues in their return. In these cases, the 1954 Convention and the ratification of the first legislation must be actively considered. In the return of cultural property, if the illicit acquisition is the core issue, it is a simple matter of following the international accords, while if it rises to the level of diplomatic discussions, it will become a political issue. In that case, the country requesting the return must convince the counterpart country. Realizing a response to the earnest need for preventing illicit trading of cultural assets will require extensive national and civic societal efforts in the East Asian area to overcome its current deficiencies. The most effective way to prevent illicit trading of cultural property is rapid circulation of information between Interpol member countries, which will require development of an internet based communication system as well as more effective deployment of legislation to prevent trading of illicitly acquired cultural property, subscription to international conventions and cataloguing collections.

Analysis of Metadata Standards of Record Management for Metadata Interoperability From the viewpoint of the Task model and 5W1H (메타데이터 상호운용성을 위한 기록관리 메타데이터 표준 분석 5W1H와 태스크 모델의 관점에서)

  • Baek, Jae-Eun;Sugimoto, Shigeo
    • The Korean Journal of Archival Studies
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    • no.32
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    • pp.127-176
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    • 2012
  • Metadata is well recognized as one of the foundational factors in archiving and long-term preservation of digital resources. There are several metadata standards for records management, archives and preservation, e.g. ISAD(G), EAD, AGRkMs, PREMIS, and OAIS. Consideration is important in selecting appropriate metadata standards in order to design metadata schema that meet the requirements of a particular archival system. Interoperability of metadata with other systems should be considered in schema design. In our previous research, we have presented a feature analysis of metadata standards by identifying the primary resource lifecycle stages where each standard is applied. We have clarified that any single metadata standard cannot cover the whole records lifecycle for archiving and preservation. Through this feature analysis, we analyzed the features of metadata in the whole records lifecycle, and we clarified the relationships between the metadata standards and the stages of the lifecycle. In the previous study, more detailed analysis was left for future study. This paper proposes to analyze the metadata schemas from the viewpoint of tasks performed in the lifecycle. Metadata schemas are primarily defined to describe properties of a resource in accordance with the purposes of description, e.g. finding aids, records management, preservation and so forth. In other words, the metadata standards are resource- and purpose-centric, and the resource lifecycle is not explicitly reflected in the standards. There are no systematic methods for mapping between different metadata standards in accordance with the lifecycle. This paper proposes a method for mapping between metadata standards based on the tasks contained in the resource lifecycle. We first propose a Task Model to clarify tasks applied to resources in each stage of the lifecycle. This model is created as a task-centric model to identify features of metadata standards and to create mappings among elements of those standards. It is important to categorize the elements in order to limit the semantic scope of mapping among elements and decrease the number of combinations of elements for mapping. This paper proposes to use 5W1H (Who, What, Why, When, Where, How) model to categorize the elements. 5W1H categories are generally used for describing events, e.g. news articles. As performing a task on a resource causes an event and metadata elements are used in the event, we consider that the 5W1H categories are adequate to categorize the elements. By using these categories, we determine the features of every element of metadata standards which are AGLS, AGRkMS, PREMIS, EAD, OAIS and an attribute set extracted from DPC decision flow. Then, we perform the element mapping between the standards, and find the relationships between the standards. In this study, we defined a set of terms for each of 5W1H categories, which typically appear in the definition of an element, and used those terms to categorize the elements. For example, if the definition of an element includes the terms such as person and organization that mean a subject which contribute to create, modify a resource the element is categorized into the Who category. A single element can be categorized into one or more 5W1H categories. Thus, we categorized every element of the metadata standards using the 5W1H model, and then, we carried out mapping among the elements in each category. We conclude that the Task Model provides a new viewpoint for metadata schemas and is useful to help us understand the features of metadata standards for records management and archives. The 5W1H model, which is defined based on the Task Model, provides us a core set of categories to semantically classify metadata elements from the viewpoint of an event caused by a task.

Importance and Satisfaction Analysis for Vitalization of River Estuary - Focused on the Nakdong Estuary - (강 하구역 활성화를 위한 자원의 중요도·만족도 분석 - 낙동강 하구역의 사례를 중심으로 -)

  • An, Byung-Chul;Kwon, Jin-Wook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.6
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    • pp.49-59
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    • 2018
  • The purpose of this study was to analyze the importance and satisfaction of resources in the mouth of Nakdong River. A Pearson's chi-square test was performed in SPSS 24.0 for statistical analysis and the result of the study was summarized by three points. First, the results of importance analysis on resources in Nakdong estuary found that the importance of ecology resources was the highest with 27.1%, followed by landscape resources (18.5%), waterside leisure resources (6.5%), complex cultural resources (5.4%), and historic and cultural resources (3.3%). The probability values (p-value) of each group had shown significant differences depending on gender, age, and the location of the survey. For instance, women respondents reported a higher preference to ecology resources and complex cultural resources such as museums than men respondents as much as two times and three times, respectively. Meanwhile, men respondents showed a higher preference to waterside leisure resources in three times as much as women respondents. As for the analysis by age, the respondents in their 20s and 30s recorded a higher value than those in other age groups, and people in their 30s reported a higher preference to waterside leisure resources than those in different age groups by three times. Lastly, no significant differences were found in the preference analysis by occupation (p>.05). With regard to the results of satisfaction analysis, the average level of satisfaction on landscape resources was 6.01, and that of ecology resources and complex cultural resource were 5.65 and 5.15, respectively. Also, significant differences were found between landscape and ecology resources in the satisfaction analysis by age, landscape resources by age, ecology resources by region, and between landscape resources and ecology resources by occupation. The p-value of complex cultural resources was p=0.012, although the satisfaction level of landscape resources and ecology resources were reported to have no significant differences by age. As for the level of satisfaction in landscape resources, respondents in their 40s and 50s showed a high level of satisfaction. However, those in their 20s showed a relatively low level of satisfaction in the same category. The survey respondents living in Busan and South Gyeongsang Province and those living outside the regions revealed no significant differences in terms of satisfaction in landscape resources and complex cultural resources. However, the two same groups were found to show significant differences in the satisfaction analysis on ecology resources. In the satisfaction analysis of landscape resources and ecology resources by occupation, significant differences were found among college students, government employees, ordinary citizens, and expert groups. However, they showed no significant differences in the level of satisfaction to complex cultural resources. Third, the results of importance-satisfaction analysis on Nakdong estuary found that the average levels of satisfaction to landscape resources for each group of respondents who considered landscape, ecology, and cultural resources as important was 6.19, 6.08, and 5.67, respectively. Their levels of satisfaction on ecology resources were 5.95, 5.57, and 5.41 for each. Its correlation to the importance was insignificant. However, it was confirmed that the correlation to the level of satisfaction on complex cultural resources had a significant difference (p=0.025). In addition, the results of the analysis on 15 detailed items that was carried out with the aim to improving values and vitalizing resources in the mouth of Nakdong River found that respondents considered that the vitalization of eco-tourism (49.5%) and restoration of reed marsh (47.5%) were important. The results of detailed analysis revealed respondents' high awareness on the need of enhancing values on ecology resources. Also, improving infrastructure nearby the mouth, creating cycling routes, walkways, waterside leisure facilities, and others were considered as the requirements for the vitalization of Nakdong estuary.

The relationship of nutrition of rice and positive evaluation of the rice-based meal on the physical and emotional self-diagnosis and learning efficiency of the middle and highschool students in the jeonju area (전주 지역 청소년 대상 쌀의 영양과 쌀을 기반으로 한 식사에 대한 긍정적 평가에 따른 신체·정서적 자각증상 및 학습 효능감과의 관련성)

  • Lee, Hyeon Kyeong;Lee, Young Seung;Jung, Soo Jin;Kang, Min Sook;Hwang, Yu Jin;Yoo, Sun Mi;Cha, Yeon Soo;Cho, Soo Muk
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.90-103
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    • 2019
  • Purpose: This study examined the relationship of the nutrition of rice and the positive evaluation of the rice-based meal with the food consumption habits, physical and emotional health status, and learning efficacy of 601 middle and high school students in Jeonju area. Methods: The participants were divided into two groups using cluster analysis in that the participants belonging to the upper groups had a center score of 46.86 (n = 348), while the people belonging to the lower group had a center score of 36.89 (n = 253). Statistical differences were tested for all the relationships between the physical and emotional health symptoms and learning efficacy between the groups at the ${\alpha}=0.05$ level. Results: Significant differences in the physical self-evaluated symptoms were observed in all five items in each cluster (p < 0.05). In the case of the emotional health status, nine out of 10 items showed significant differences between the groups. Similarly, significant differences in all five items in learning efficacy questionnaire were noted (p < 0.05). Positive attitudes of the parents toward having breakfast also showed significant differences among the groups. Conclusion: The nutrition of rice and a positive evaluation of the rice-based meals significantly affect the physical and emotional health status and learning efficacy of juveniles. These findings can be used as baseline information for promoting nutrition education, particularly rice-based breakfast.

A Study on the Types and Changes of the King's Amusement Activities through 『Annals of The Joseon Dynasty(朝鮮王朝實錄)』 (『조선왕조실록(朝鮮王朝實錄)』을 통해 본 왕의 위락활동 유형과 변천)

  • Kang, Hyun-Min;Shin, Sang-Sup;Kim, Hyun-Wuk;Ma, Yi-Chu;Han, Rui-Ting
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.4
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    • pp.39-49
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    • 2018
  • "Annals of The Joseon Dynasty" is a book recording the Joseon Dynasty's historical facts in an annalistic format. The King's amusement activities through "Annals of The Joseon Dynasty" which were established by the Ye-ak(禮樂) system were analyzed. The results are as follows. The king's amusement activities that were performed during the Joseon Dynasty period could be classified as state banquets, military banquets, and banquets for play. The analysis of the king's amusement activity was divided into five stages. The characteristic of [1 period : King Taejo~Sejo(Yejong)] was dominated the military banquets of the Goryeo Dynasty. Neo-Confucianism is the establishment of political and social turning of the ballast, considerations of military culture, culture, and Hoeryeyeon Jinpungjeong, a cloud of dust and elders banquets such as Giroyeon and Yangnoyeon on the nature of the party. A lasting ordinance was institutionalized[2 period : King Seongjong~Jungjong]. In the chopper and jeongyujaeran, Hong Kyung Rae led a royal amusement activities are stagnant, often produce isolated storage compute in the gloomy situation[3 period : King Injong~Hyeonjong]. Revival period is pride of the amusement activity through the culture of Joseon Dynasty royal culture [4 period : King Sukjong~Jeongjo]. The throne, crashed due to political power is an ebb of royal amusement activities, while also rapidly waning[5 period : King Seonjo~Seonjong]. During the early Joseon Dynasty, hunting took place around the forest area northeast of Hanyang and during King Seongjong's period, it took place closer to the capital city, while in Lord Yeonsan's period, it was expanded to a 39 kilometer radius area from the palace, and banquets such as various forms of entertainment of Cheoyongmu, and Flower-viewing. The Joseon kings who enjoyed hunting were King Sejong, Sejo, Seongjong, Yeonsan, and Jungjong. Most of hunting objects were tigers, bears, deer and roe deer, leopards, boars, their animals and falconry took, and the purpose of the hunting was to perform ancestral rites to the royal ancestry or the royal tombs. Lord Yeonsan's hunting activities had negative effects after King Jungjong the king's hunting activity decreased sharply. However, there were also positive aspects of Lord Yeonsan's Prohibition of cutting woods ect. In conclusion, the expansion of the King's garden(庭:courtyard${\rightarrow}$園:privacy garden${\rightarrow}$苑:king's garden${\rightarrow}$苑?:national hunting park) is evident which starts from formal and informal activities that took place in Oejo, Chijo, and Yeonjo, which went further to the separate and secret gardens, and then even further, thus setting the amusement activity area as a 39 kilometer radius range from Hanyang.

The Evaluation of Non-Coplanar Volumetric Modulated Arc Therapy for Brain stereotactic radiosurgery (뇌 정위적 방사선수술 시 Non-Coplanar Volumetric Modulated Arc Therapy의 유용성 평가)

  • Lee, Doo Sang;Kang, Hyo Seok;Choi, Byoung Joon;Park, Sang Jun;Jung, Da Ee;Lee, Geon Ho;Ahn, Min Woo;Jeon, Myeong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.9-16
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    • 2018
  • Purpose : Brain Stereotactic Radiosurgery can treat non-invasive diseases with high rates of complications due to surgical operations. However, brain stereotactic radiosurgery may be accompanied by radiation induced side effects such as fractionation radiation therapy because it uses radiation. The effects of Coplanar Volumetric Modulated Arc Therapy(C-VMAT) and Non-Coplanar Volumetric Modulated Arc Therapy(NC-VMAT) on surrounding normal tissues were analyzed in order to reduce the side effects caused fractionation radiation therapy such as head and neck. But, brain stereotactic radiosurgery these contents were not analyzed. In this study, we evaluated the usefulness of NC-VMAT by comparing and analyzing C-VMAT and NC-VMAT in patients who underwent brain stereotactic radiosurgery. Methods and materials : With C-VMAT and NC-VMAT, 13 treatment plans for brain stereotactic radiosurgery were established. The Planning Target Volume ranged from a minimum of 0.78 cc to a maximum of 12.26 cc, Prescription doses were prescribed between 15 and 24 Gy. Treatment machine was TrueBeam STx (Varian Medical Systems, USA). The energy used in the treatment plan was 6 MV Flattening Filter Free (6FFF) X-ray. The C-VMAT treatment plan used a half 2 arc or full 2 arc treatment plan, and the NC-VMAT treatment plan used 3 to 7 Arc 40 to 190 degrees. The angle of the couch was planned to be 3-7 angles. Results : The mean value of the maximum dose was $105.1{\pm}1.37%$ in C-VMAT and $105.8{\pm}1.71%$ in NC-VMAT. Conformity index of C-VMAT was $1.08{\pm}0.08$ and homogeneity index was $1.03{\pm}0.01$. Conformity index of NC-VMAT was $1.17{\pm}0.1$ and homogeneity index was $1.04{\pm}0.01$. $V_2$, $V_8$, $V_{12}$, $V_{18}$, $V_{24}$ of the brain were $176{\pm}149.36cc$, $31.50{\pm}25.03cc$, $16.53{\pm}12.63cc$, $8.60{\pm}6.87cc$ and $4.03{\pm}3.43cc$ in the C-VMAT and $135.55{\pm}115.93cc$, $24.34{\pm}17.68cc$, $14.74{\pm}10.97cc$, $8.55{\pm}6.79cc$, $4.23{\pm}3.48cc$. Conclusions : The maximum dose, conformity index, and homogeneity index showed no significant difference between C-VMAT and NC-VMAT. $V_2$ to $V_{18}$ of the brain showed a difference of at least 0.5 % to 48 %. $V_{19}$ to $V_{24}$ of the brain showed a difference of at least 0.4 % to 4.8 %. When we compare the mean value of $V_{12}$ that Radione-crosis begins to generate, NC-VMAT has about 12.2 % less amount than C-VMAT. These results suggest that if NC-VMAT is used, the volume of $V_2$ to $V_{18}$ can be reduced, which can reduce Radionecrosis.

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Dosimetric Comparison of One Arc & Two Arc VMAT Plan for Prostate cancer patients (Prostate Cancer 환자에 대한 One Arc와 Two Arc VMAT Plan의 선량 측정 비교 분석)

  • Kim, Byoung Chan;Kim, Jong Deok;Kim, Hyo Jung;Park, Ho Chun;Baek, Jeong Ok
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.107-116
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    • 2018
  • Purpose : Intensity-modulated radiation therapy(IMRT) has been widely used for radiation therapy of Prostate Cancer because it can reduce radiation adverse effects on normal tissues and deliver more dose to the Prostate than 3D radiation therapy. Volumetric modulated arc therapy(VMAT) has been widely used due to recent advances in equipment and treatment techniques. VMAT can reduce treatment time by up to 55 % compared to IMRT, minimizing motion error during treatment. Materials and Methods : In this study, compared the MU and DVH values of 10 patients with prostate cancer by classifying them into 4 groups with 5 LN-Prostate groups and 5 Only-Prostate. And DQA measurements were performed using ArcCHECK and MapCHECK. Results : The results of Target and OAR dose distribution of Prostate patients are as follows. $D_{max}$ was in the range of 100~110 % in 4 groups, and more than 110 % of hot spot was not seen. Only-Prostate ($P_1$, $P_2$) without LN had a satisfactory dose distribution for the target dose, but slightly better for 2 arc plan($P_2$) than 1 arc plan($P_1$). The target dose $D_{98%}$ distribution in the LN-Prostate ($P_{L1}$, $P_{L2}$) group showed better 2 arc plan($P_{L2}$) than 1 arc plan($P_{L1}$), But in the case of 1 arc plan($P_{L1}$), the target dose $D_{98%}$ value was not enough. In OAR, the dose distribution of 1 Arc($P_1$) Plan and 2 Arc($P_2$) Plan in the Only-Prostate ($P_1$, $P_2$) Group satisfied the prescribed dose value. But, The dose distribution of 1 arc($P_1$) was slightly higher. In LN-Prostate OAR, 1 Arc($P_{L1}$) Plan showed higher dose than the prescribed dose. The Gamma evaluation pass rate of ArcCHECK and MapCHECK calculated from the DQA measurements was slightly higher than 99 % and the mean error range of the point dose measurements using the CC04 ion chamber was less than 1 %. Conclusion : In this study, Only-Prostate ($P_1$, $P_2$) group, the dose of 2 Arc plan was better. However, considering the treatment time and MU value, 1 Arc treatment method was more suitable. In the LN-Prostate ($P_{L1}$, $P_{L2}$) group, 2 Arc($P_{L2}$) treatment method showed better results and satisfied with Target $D_{98%}$ and OAR prescription dose.

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