• Title/Summary/Keyword: radiosurgery

Search Result 343, Processing Time 0.027 seconds

Analysis of Dose Distribution on Critical Organs for Radiosurgery with CyberKnife Real-Time Tumor Tracking System (사이버나이프 실시간 종양추적 시스템을 이용한 방사선수술 시 주요 장기의 선량분포 분석)

  • Huh, Hyun-Do;Choi, Sang-Hyoun;Kim, Woo-Chul;Kim, Hun-Jeong;Kim, Seong-Hoon;Ji, Young-Hoon;Kim, Kum-Bae;Lee, Sang-Hoon;Choi, Jin-Ho;Lee, Re-Na;Shin, Dong-Oh
    • Progress in Medical Physics
    • /
    • v.20 no.1
    • /
    • pp.14-20
    • /
    • 2009
  • We measured the dose distribution for spinal cord and tumor using Gafchromic film, applying 3D and 4D-Treatment Planning for lung tumor within the phantom. A measured dose distribution was compared with a calculated dose distribution generated from 3D radiation treatment planning and 4D radiation treatment planning system. The agreement of the dose distribution in tumor for 3D and 4D treatment planning was 90.6%, 97.64% using gamma index computed for a distance to agreement of 1 mm and a dose difference of 3%. However, a gamma agreement index of 3% dose difference tolerence of and 2 mm distance to agreement, the accordance of the dose distribution around cord for 3D and 4D radiation treatment planning was 57.13%, 90.4%. There are significant differences between a calculated dose and a measured dose for 3D radiation treatment planning, no significant differences for 4D treatment planning. The results provide the effectiveness of the 4D treatment planning as compared to 3D. We suggest that the 4-dimensional treatment planning should be considered in the case where such equipments as Cyberknife with the real time tracking system are used to treat the tumors in the moving organ.

  • PDF

Study on Dosimetric Properties of Radiophotoluminescent Glass Rod Detector (유리선량계의 선량 특성에 관한 연구)

  • Rah, Jeong-Eun;Shin, Dong-Oh;Hong, Ju-Young;Kim, Hee-Sun;Lim, Chun-Il;Jeong, Hee-Gyo;Suh, Tea-Suk
    • Journal of Radiation Protection and Research
    • /
    • v.31 no.4
    • /
    • pp.181-186
    • /
    • 2006
  • A radiophotoluminescent glass rod detector (GRD) system has recently become commercially available. We investigate the dosimetric properties of the GRD regarding the reproducibility of signal, dose linearity and energy dependence. The reproducibility of five measurements for 50 GRDs is presented by an average of one standard deviation of each GRD and it is ${\pm}1.2%$. It is found to be linear in response to doses of $^{60}Co$ beam in the range 0.5 to 50 Gy with a coefficient of linearity of 0.9998. The energy dependence of the GRD is determined by comparing the dose obtained using cylindrical chamber to that by using the GRD. The GRD response for each beam is normalized to the response for a $^{60}Co$ beam. The responses for 6 and 15 MV x-ray beams are within ${\pm}1.5%$ (1SD). The energy response of GRD for high-energy photon is almost the same as the energy dependence of LiF:Mg:Ti (TLD-100)and shows little energy dependence unlike p-type silicon diode detector. The GRDs have advantages over other detectors such diode detector, and TLD: linearity, reproducibility and energy dependency. It has been verified to be an effective device for small field dosimetry for stereotactic radiosurgery.

Evaluation of Dosimetric Characteristics of a Double-focused Dynamic Micro-Multileaf Collimator (DMLC) (이중으로 집중된 동적 미세 다엽콜리메이터의 선량학적 특성 평가)

  • Kim, Ae Ran;Seo, Jae-Hyuk;Shin, Hun-Joo;Park, Hyeong Wook;Lee, Ki Woong;Lee, Jae Choon;Kim, Shin-Wook;Kim, Ji Na;Park, Hyeli;Lee, Heui-Kwan;Kang, Young-Nam
    • Progress in Medical Physics
    • /
    • v.26 no.4
    • /
    • pp.223-228
    • /
    • 2015
  • Double-focused micro-Multileaf Collimator (${\mu}MLC$) is able to create radiation fields having sharper dose gradients at the field edges than common MLC. Therefore, ${\mu}MLC$ has been used for the stereotactic radiosurgery (SRS) and Stereotactic Radiotherapy (SRT). We evaluated the dosimetric characteristics of a doublefocused Dynamic-${\mu}MLC$ (DMLC) attached to the Elekta Synergy linear accelerator. For this study, the dosimetric parameters including, Percent Depth Dose (PDD), Leaf leakage and penumbra, have been measured by using of the radiochromic films (GafChromic EBT2), EDGE diode detector and three-dimensional water phantom. All datas were measured on 6 MV x-ray. As a result, The DMLC shows transmission below to 1% and because of double-focused construction of the DMLC, the penumbras of fields with DMLC are independent from the field sizes. In this paper, the resulting dosimetric evaluations proved the applicability of the DMLC attached to the Elekta Synergy linear accelerator.

The Use of Polymer Gel for the Visualization of 3-D Dose Distribution in Brachytherapy Using Magnetic Resonance Imaging (방사선 근접치료에 있어서 핵자기공명영상을 이용한 3차원 방사선 선량분포도의 가시화를 위한 polymer 젤의 이용)

  • 강해진;조삼주;정은기;강승희;오영택;전미선;권수일
    • Progress in Medical Physics
    • /
    • v.9 no.4
    • /
    • pp.207-215
    • /
    • 1998
  • There have been many radiation measurement methods so far among which film dosimetry, TLD, and ion chamber are the most frequently used methods. But this study describes a new radiation measurement method which uses polymer gel and magnetic resonance imaging(MRI). The objective of this study is to fabricate a polymer gel sensitive to radiation and to generate a dose to MRI contrast relationship, and to apply this results to the radiation measurement for the brachytherapy. To do this, 12 cm diameter cylindrical gel phantom was made, and the phantom was irradiated using the 30 mm diameter circular collimator which was used for radiosurgery. And this irradiated phantom was scanned with MRI. To find out the relationship between the radiation dose and the transversal relaxation time, an image processing software(IDL) was used. From this study it is found out that the radiation dose showed linear relationship to the transversal relaxation time of the gel up to 17 Gy($R^2$=0.993) and they had a different relationship above 17 Gy. The dose distributions were calculated using these results for the Ir-192 sources, one for the HDR afterloading system and the other for a 2 mCi seed source. And these calculated dose distributions were compared to the ones from the treatment planning computers. From this study the dose to the irradiated gel's transversal relaxation time relationship was examined, and this result was tried for the measurement of the brachytherapy.

  • PDF

Treatment Outcomes of Brain metastasis from Papillary Thyroid Cancer (갑상선 유두암 뇌전이의 치료 효과)

  • Bae, Hyeonwoo;Kim, Seok-Mo;Kim, Soo Young;Chang, Ho Jin;Kim, Bup-Woo;Lee, Yong Sang;Chang, Hang-Seok;Park, Cheong Soo
    • Korean Journal of Head & Neck Oncology
    • /
    • v.34 no.1
    • /
    • pp.9-13
    • /
    • 2018
  • Background/Objectives: Brain metastasis (BM) is a rare form of distant metastasis with papillary thyroid cancer (PTC). Patients with BM of PTC carry a poor prognosis. The aim of this study was to contribute to the understanding of this disease by analyzing patients with BM of PTC. Materials & Methods: Between March 2003 and December 2013, the patient database was conducted to identify thyroid cancer patients treated. Among the 22,758 thyroid cancer patients, 14 (0.06 %) were identified to have metastasis to the brain during follow-up. The medical records of 14 patients with BM were retrospectively reviewed, focusing on the following: patient characteristics, synchronous or previous distant metastasis, treatments including whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) and surgery, and characteristics on radiologic findings, time interval between first diagnosis of primary thyroid cancer and BM and survival after BM. Results: The mean age at initial diagnosis and BM were $50.9{\pm}15.8years$ and $61.3{\pm}12.7years$. The mean duration between initial diagnosis and BM was $10.4{\pm}7.9years$. Patients were treated with varied combinations of surgery, SRS and WBRT except 4 patients who had refused treatment. The median overall survival (OS) time after BM diagnosis was 10 months (range 1 - 19). Patients receiving treatment (WBRT and/or surgery, SRS) had a significant longer median OS of 16.5 months in comparison to 3.5 months for those treated without treatment. (p = 0.005) Conclusion: Patients who received aggressive treatment had a longer OS than those with only supportive care. Treatment such as surgery, SRS and WBRT should be considered in patients with BM.

Percutaneous Vertebroplasty versus Conservative Treatment Using a Transdermal Fentanyl Patch for Osteoporotic Vertebral Compression Fractures

  • Oh, Younggyu;Lee, Byungjou;Lee, Subum;Kim, Junghwan;Park, Jinhoon
    • Journal of Korean Neurosurgical Society
    • /
    • v.62 no.5
    • /
    • pp.594-602
    • /
    • 2019
  • Objective : Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs. Methods : Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures. Results : Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months. Conclusion : We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.

Is the Spinal Instability Neoplastic Score Accurate and Reliable in Predicting Vertebral Compression Fractures for Spinal Metastasis? A Systematic Review and Qualitative Analysis

  • Lee, Chang-Hyun;Hong, Jae Taek;Lee, Sun-Ho;Yi, Seong;Sohn, Moon-Jun;Kim, Sung Hwan;Chung, Chun Kee;Korean Spine Oncology Research Society
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.1
    • /
    • pp.4-12
    • /
    • 2021
  • Spinal metastases can present with varying degrees of mechanical instability. The Spinal Instability Neoplastic Score (SINS) was developed as a tool to assess spinal neoplastic-related instability while helping to guide referrals among oncology specialists. Some previous papers suggested that the SINS was accurate and reliable, while others disagreed with this opinion. We performed a systematic review regarding the SINS to evaluate its accuracy and precision in predicting vertebral compression fractures (VCFs). The 21 included studies investigated a total of 2118 patients. Thirteen studies dealt with the accuracy of SINS to predict post-radiotherapy VCFs, and eight dealt with the precision. Among 13 studies, 11 agreed that the SINS categories showed statistically significant accuracy in predicting VCF. Among eight studies, body collapse was effective for predicting VCFs in six studies, and alignment and bone lesion in two studies. Location has no statistical significance in predicting VCFs in any of the eight studies. The precision of SINS categories was substantial to excellent in six of eight studies. Among the six components of the SINS, the majority of the included studies reported that location showed near perfect agreement; body collapse, alignment, and posterolateral involvement showed moderate agreement; and bone lesion showed fair agreement. Bone lesion showed significant accuracy in predicting VCFs in half of eight studies, but displayed fair reliability in five of seven studies. Although location was indicated as having near perfect reliability, the component showed no accuracy for predicting VCFs in any of the studies and deleting or modifying the item needs to be considered. The SINS system may be accurate and reliable in predicting the occurrence of post-radiotherapy VCFs for spinal metastasis. Some components seem to be substantially weak and need to be revised.

An accuracy analysis of Cyberknife tumor tracking radiotherapy according to unpredictable change of respiration (예측 불가능한 호흡 변화에 따른 사이버나이프 종양 추적 방사선 치료의 정확도 분석)

  • Seo, jung min;Lee, chang yeol;Huh, hyun do;Kim, wan sun
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.27 no.2
    • /
    • pp.157-166
    • /
    • 2015
  • Purpose : Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. Results : If the target error is a sine curve breathing form, the size of the target of the movement is in response to the 5 mm, 10 mm, 20 mm, respectively, of the average $1.14{\pm}0.13mm$, $1.05{\pm}0.20mm$, with $2.37{\pm}0.17mm$, suddenly for it is variations in breathing, respective average $1.87{\pm}0.19mm$, $2.15{\pm}0.21mm$, and analyzed with $2.44{\pm}0.26mm$. If the correlation error can be defined by the length of the displacement vector in the target track is a sinusoidal breathing mode, the size of the target of the movement in response to 5 mm, 10 mm, 20 mm, respective average $0.84{\pm}0.01mm$, $0.70{\pm}0.13mm$, with $1.63{\pm}0.10mm$, if it is a variant of sudden breathing respective average $0.97{\pm}0.06mm$, $1.44{\pm}0.11mm$, and analyzed with $1.98{\pm}0.10mm$. The larger the correlation error values in both the both the respiratory form, the target error value is large. If the motion size of the target of the sine curve breathing form is greater than or equal to 20 mm, was measured at 1.5 mm or more is a recommendation value of both cyber knife manufacturer of both error value. Conclusion : There is a tendency that the correlation error value between about target error value magnitude of the target motion is large is increased, the error value becomes large in variation of rapid respiration than breathing the form of a sine curve. The more the shape of the breathing large movements regular shape of sine curves target accuracy of the tumor tracking system can be judged to be reduced. Using the algorithm of Cyber-Knife tumor tracking system, when there is a change in the sudden unpredictable respiratory due patient coughing during treatment enforcement is to stop the treatment, it is assumed to carry out the internal target validation process again, it is necessary to readjust the form of respiration. Patients under treatment is determined to be able to improve the treatment of accuracy to induce the observed form of regular breathing and put like to see the goggles monitor capable of the respiratory form of the person.

  • PDF

Evaluation on Usefulness of Stereotactic Radio Surgery using $Fraxion^{(R)}$ System ($Fraxion^{(R)}$ System을 이용한 뇌 정위적 방사선 수술 유용성 평가)

  • Kim, Tae Won;Park, Kwang Woo;Ha, Jin Sook;Jeon, Mi Jin;Cho, Yoon Jin;Kim, Sei Joon;Kim, Jong Dae;Shin, Dong Bong
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.26 no.2
    • /
    • pp.345-354
    • /
    • 2014
  • Purpose : We evaluated the usefulness of $Fraxion^{(R)}$ system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. Materials and Methods : 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while $Fraxion^{(R)}$ system was used for the other 3 patients (group2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. Results : The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when $Fraxion^{(R)}$ system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using $Fraxion^{(R)}$ system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when s-thermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using $Fraxion^{(R)}$ system showed only 1.9%. All percentage were calculated with respect to average value. Conclusion : Using $Fraxion^{(R)}$ system including mouthpiece, Fraxion frame, frontpiece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.

Optimization of Total Arc Degree for Stereotactic Radiotherapy by Using Integral Biologically Effective Dose and Irradiated Volume (정위방사선치료 시 적분 생물학적 유효선량 및 방사선조사용적을 이용한 Total Arc Degree의 최적화)

  • Lim Do Hoon;Lee Myung Za;Chun Ha Chung;Kim Dae Yong
    • Radiation Oncology Journal
    • /
    • v.19 no.2
    • /
    • pp.199-204
    • /
    • 2001
  • Purpoe : To find the optimal values of total arc degree to protect the normal brain tissue from high dose radiation in stereotactic radiotherapy planning. Methods and Materials : With Xknife-3 planning system & 4 MV linear accelerator, the authors planned under various values of parameters. One isocenter, 12, 20, 30, 40, 50, and 60 mm of collimator diameters, $100^{\circ},\;200^{\circ},\;300^{\circ},\;400^{\circ}C,\;500^{\circ},\;600^{\circ}$ or total arc degrees, and $30^{\circ}\;or\;45^{\circ}$ or arc intervals were used. After the completion of planning, the plans were compared each other using $V_{50}$ (the volume of normal brain that is delivered high dose radiation) and integral biologically effective dose. Results : At $30^{\circ}$ of arc interval, the values of $V_{50}$ had the decreased pattern with the increase of total arc degree in any collimator diameter. At 45 arc interval, up to $400^{\circ}$ of total arc degree, the values of $ V_{50}$ decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. At $30^{\circ}$ of arc interval, integral biologically effective dose showed the decreased pattern with the increase of total arc degree in any collimator diameter. At $45^{\circ}$ arc interval with less than 40 mm collimator diameter, the integral biologically effective dose decreased with the increase of total arc degree, but with n and n mm or collimator diameters, up to $400^{\circ}$ or total arc degree, integral biologically effective dose decreased with the increase of total arc degree, but at $500^{\circ}\;and\;600^{\circ}$ of total arc degrees, the values increased. Conclusion : In the stereotactic radiotherapy planning for brain lesions, planning with $400^{\circ}$ of total arc degree is optimal. Especially, when the larger collimator more than 50 mm diameter should be used, the uses of $500^{\circ}\;and\;600^{\circ}$ of total arc degrees make the increase of$V_{50}$ and integral biologically effective dose. Therefore stereotactic radiotherapy planning using $400^{\circ}$ of total arc degree can increase the therapeutic ratio and produce the effective outcome in the management of personal and mechanical sources in radiotherapy department.

  • PDF