• Title/Summary/Keyword: treatment planning

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Prognostic Indicators of Extremity Liposarcoma (사지에 발생하는 지방육종의 예후 인자에 대한 분석)

  • Park, Kee Young;Kim, Jeung Il;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.331-337
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    • 2020
  • Purpose: The aim of this retrospective study was to define the prognostic factors for liposarcoma to aid in the selection of effective treatments. Materials and Methods: This study analyzed 41 cases out of 45 cases diagnosed with and treated for liposarcoma 2002 to 2015; 4 cases of well-differentiated liposarcoma were excluded. The effects of sex, age, site, stage, and histological classification on survival were analyzed retrospectively. For 28 cases diagnosed with myxoid liposarcoma, additional analysis was performed after the inclusion of round cell components. Results: The mean age at diagnosis was 52.05 years (range 25-82 years) and the average follow-up period was 63.7 months. The disease-free survival rate was 43.2%. Most factors, including sex and age, were not significantly associated with the survival rate. On the other hand, the stage (Musculoskeletal Tumor Society stage) was significantly associated with the survival rate. The survival rate of patients with myxoid liposarcoma was 69% and the local recurrence and metastasis results varied according to the presence of round cells. Conclusion: The stage of liposarcoma and the sex of the patient were found to be effective factors for prognosis. When planning the treatment for liposarcoma, the treatment outcome for liposarcoma differs according to several prognostic factors.

Developed Vacuum Film Packaging Method Maintains Quality of Enoki Mushrooms (Flammulina velutipes) during Simulated Vessel Export to Vietnam (팽이버섯의 베트남 모의수출 중 진공포장방법 개선을 통한 품질 유지 효과)

  • Choi, Ji Weon;Lim, Sooyeon;Lee, Ji Hyun;Eum, Hyang Lan;Lee, Jung-Soo;Park, Hye Sung;Im, Ji-Hoon;Do, Kyung Ran
    • KOREAN JOURNAL OF PACKAGING SCIENCE & TECHNOLOGY
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    • v.28 no.2
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    • pp.133-142
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    • 2022
  • Korean enoki mushrooms are exported to Southeast Asia and the United States, where there are complaints due to quality deterioration during the distribution process. In this study, we evaluated the efficacy of vacuum film packaging on quality maintenance in Korean enoki mushrooms during simulated vessel export to Vietnam using selected film, which was developed with vacuum packaging machine and oxygen absorber. We selected two MA film, one was 2-layerd 30 ㎛ CPP film (control) and the other was 3-layered 30 ㎛ CPP film (treatment) which is optimized film of higher gas and moisture permeability. The Korean enoki mushrooms were packaged with these two films using PAC-2000 or PAC-3000 vacuum packaging machine which was improved vacuuming of higher speed. Packed mushrooms were stored at 1℃ for 2 weeks and distributed at 20℃ for 2 days or 8℃ for 6 days. The efficiency of the film packaging was analyzed by vacuum maintaining index, and overall the quality characteristics such as off odor, color, cap cleavage, stem elongations and sensory evaluation were evaluated during storage and distribution. Results suggest that postharvest loss of fresh enoki mushroom could be reduced by packaging mushroom with 3-layered 30 ㎛ CPP films packaged using PAC-3000 machine during simulated vessel export to Vietnam due to vacuum maintaining. Oxygen absorber promoted off-odor at 20℃ distribution temperature, and did not affect storability at 1℃ storage compared to treated group without oxygen absorber treatment.

Evaluation of Metal Volume and Proton Dose Distribution Using MVCT for Head and Neck Proton Treatment Plan (두경부 양성자 치료계획 시 MVCT를 이용한 Metal Volume 평가 및 양성자 선량분포 평가)

  • Seo, Sung Gook;Kwon, Dong Yeol;Park, Se Joon;Park, Yong Chul;Choi, Byung Ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.25-32
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    • 2019
  • Purpose: The size, shape, and volume of prosthetic appliance depend on the metal artifacts resulting from dental implant during head and neck treatment with radiation. This reduced the accuracy of contouring targets and surrounding normal tissues in radiation treatment plan. Therefore, the purpose of this study is to obtain the images of metal representing the size of tooth through MVCT, SMART-MAR CT and KVCT, evaluate the volumes, apply them into the proton therapy plan, and analyze the difference of dose distribution. Materials and Methods : Metal A ($0.5{\times}0.5{\times}0.5cm$), Metal B ($1{\times}1{\times}1cm$), and Metal C ($1{\times}2{\times}1cm$) similar in size to inlay, crown, and bridge taking the treatments used at the dentist's into account were made with Cerrobend ($9.64g/cm^3$). Metal was placed into the In House Head & Neck Phantom and by using CT Simulator (Discovery CT 590RT, GE, USA) the images of KVCT and SMART-MAR were obtained with slice thickness 1.25 mm. The images of MVCT were obtained in the same way with $RADIXACT^{(R)}$ Series (Accuracy $Precision^{(R)}$, USA). The images of metal obtained through MVCT, SMART-MAR CT, and KVCT were compared in both size of axis X, Y, and Z and volume based on the Autocontour Thresholds Raw Values from the computerized treatment planning equipment Pinnacle (Ver 9.10, Philips, Palo Alto, USA). The proton treatment plan (Ray station 5.1, RaySearch, USA) was set by fusing the contour of metal B ($1{\times}1{\times}1cm$) obtained from the above experiment by each CT into KVCT in order to compare the difference of dose distribution. Result: Referencing the actual sizes, it was appeared: Metal A (MVCT: 1.0 times, SMART-MAR CT: 1.84 times, and KVCT: 1.92 times), Metal B (MVCT: 1.02 times, SMART-MAR CT: 1.47 times, and KVCT: 1.82 times), and Metal C (MVCT: 1.0 times, SMART-MAR CT: 1.46 times, and KVCT: 1.66 times). MVCT was measured most similarly to the actual metal volume. As a result of measurement by applying the volume of metal B into proton treatment plan, the dose of $D_{99%}$ volume was measured as: MVCT: 3094 CcGE, SMART-MAR CT: 2902 CcGE, and KVCT: 2880 CcGE, against the reference 3082 CcGE Conclusion: Overall volume and axes X and Z were most identical to the actual sizes in MVCT and axis Y, which is in the superior-Inferior direction, was regular in length without differences in CT. The best dose distribution was shown in MVCT having similar size, shape, and volume of metal when treating head and neck protons. Thus it is thought that it would be very useful if the contour of prosthetic appliance using MVCT is applied into KVCT for proton treatment plan.

The first private-hospital based proton therapy center in Korea; status of the Proton Therapy Center at Samsung Medical Center

  • Chung, Kwangzoo;Han, Youngyih;Kim, Jinsung;Ahn, Sung Hwan;Ju, Sang Gyu;Jung, Sang Hoon;Chung, Yoonsun;Cho, Sungkoo;Jo, Kwanghyun;Shin, Eun Hyuk;Hong, Chae-Seon;Shin, Jung Suk;Park, Seyjoon;Kim, Dae-Hyun;Kim, Hye Young;Lee, Boram;Shibagaki, Gantaro;Nonaka, Hideki;Sasai, Kenzo;Koyabu, Yukio;Choi, Changhoon;Huh, Seung Jae;Ahn, Yong Chan;Pyo, Hong Ryull;Lim, Do Hoon;Park, Hee Chul;Park, Won;Oh, Dong Ryul;Noh, Jae Myung;Yu, Jeong Il;Song, Sanghyuk;Lee, Ji Eun;Lee, Bomi;Choi, Doo Ho
    • Radiation Oncology Journal
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    • v.33 no.4
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    • pp.337-343
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    • 2015
  • Purpose: The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. Materials and Methods: The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. Results: The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. Conclusion: The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

Effect of Protein and Energy Levels on Performance and Carcass Rate in Cross Bred Chicks (단백질 및 대사 에너지 수준이 유색 육용계의 생산성 및 도체율에 미치는 영향)

  • Na, J.C.;Park, S.B.;Bang, H.T.;Kang, H.K.;Kim, M.J.;Choi, H.C.;Seo, O.S.;Ryu, K.S.;Jang, H.K.;Choi, J.T.
    • Korean Journal of Poultry Science
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    • v.36 no.1
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    • pp.23-28
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    • 2009
  • The experiment were protein and metabolizable energy level in performance and carcass rate in cross bred chicks. One day old, 720 male and female cross bred chick were used for the experiments, and 20 chicks were placed at each pen. The energy level of feed was maintained about 2,950, 3,000, 3,050 kcal/kg, and protein content was adjusted about 19, 20, 21% from 0 to 5 weeks and energy level was maintained about 3,100, 3,150, 3,200 kcal/kg, and protein content was adjusted about 17, 18, 19% from the 6 to 10 weeks old of the experiment. At the whole time, ME 3,100 (2,950), 3,150 (3,000) and 3,200 (3,050) kcal/kg treatment groups was not significant difference in weight gain, feed intake, but 3,150 (3,000), 3,200 (3,050) kcal/kg treated groups revealed to show improved feed conversion rate than the group treated with ME 3,100 (2,950) kcal (P<0.05). And CP 17 (19), 18 (20), 19 (21)% treatment groups did not significant difference weight gain and feed intake but CP 19 (21)% treated group wan significant difference feed conversion rate than the CP 17 (19)% treated group (P<0.05). ME level of 3,100 (2,950), 3,150 (3,000), 3,200 (3,050) kcal/kg treatment groups in carcass rate and abdominal fat rate was not signficant difference and protein of 17 (19), 18 (20), 19 (21)% treatment groups after end of experiment. Between ME and CP of dietary was significant appeared to interact at 6~10 weeks (P<0.05).

Evaluating the Dosimetric Characteristics of Radiation Therapies according to Head Elevation Angle for Head and Neck Tumors (두 경부 종양 치료 시 거상각도에 따른 치료기법 별 선량특성 평가)

  • Cheon, Geum-Seong;Kang, Seong-Hee;Kim, Dong-Su;Kim, Tae-Ho;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.27 no.1
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    • pp.14-24
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    • 2016
  • Since the head and neck region is densely located with organs at risk (OAR), OAR-sparing is an important issue in the treatment of head and neck cancers. This study-in which different treatment plans were performed varying the head tilt angle on brain tumor patients-investigates the optimal head elevation angle for sparing normal organs (e.g. the hippocampus) and further compares the dosimetric characteristics of different types of radiation equipment. we performed 3D conformal radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and tomotherapy on 10 patients with brain tumors in the frontal lobe while varying the head tilt angle of patients to analyze the dosimetric characteristics of different therapy methods. In each treatment plan, 95% of the tumor volume was irradiated with a dose of 40 Gy in 10 fractions. The step and shoot technique with nine beams was used for IMRT, and the same prescription dose was delivered to the tumor volume for the 3D-CRT and tomotherapy plans. The homogeneity index, conformity index, and normal tissue complication probability (NTCP) were calculated. At a head elevation angle of $30^{\circ}$, conformity of the isodose curve to the target increased on average by 53%, 8%, and 5.4%. In 3D-CRT, the maximum dose received by the brain stem decreased at $15^{\circ}$, $30^{\circ}$, and $40^{\circ}$, compared to that observed at $0^{\circ}$. The NTCP value of the hippocampus observed in each modality was the highest at a head and neck angle of $0^{\circ}$ and the lowest at $30^{\circ}$. This study demonstrates that the elevation of the patients' head tilt angle in radiation therapy improves the target region's homogeneity of dose distribution by increasing the tumor control rate and conformity of the isodose curve to the target. Moreover, the study shows that the elevation of the head tilt angle lowers the NTCP by separating the tumor volume from the normal tissues, which helps spare OARs and reduce the delivered dose to the hippocampus.

Comparison of the Efficacy of 2D Dosimetry Systems in the Pre-treatment Verification of IMRT (세기조절방사선치료의 환자별 정도관리를 위한 2차원적 선량계의 유용성 평가)

  • Hong, Chae-Seon;Lim, Jong-Soo;Ju, Sang-Gyu;Shin, Eun-Hyuk;Han, Young-Yih;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.91-102
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    • 2009
  • Purpose: To compare the accuracy and efficacy of EDR2 film, a 2D ionization chamber array (MatriXX) and an amorphous silicon electronic portal imaging device (EPID) in the pre-treatment QA of IMRT. Materials and Methods: Fluence patterns, shaped as a wedge with 10 steps (segments) by a multi-leaf collimator (MLC), of reference and test IMRT fields were measured using EDR2 film, the MatriXX, and EPID. Test fields were designed to simulate leaf positioning errors. The absolute dose at a point in each step of the reference fields was measured in a water phantom with an ionization chamber and was compared to the dose obtained with the use of EDR2 film, the MatriXX and EPID. For qualitative analysis, all measured fluence patterns of both reference and test fields were compared with calculated dose maps from a radiation treatment planning system (Pinnacle, Philips, USA) using profiles and $\gamma$ evaluation with 3%/3 mm and 2%/2 mm criteria. By measurement of the time to perform QA, we compared the workload of EDR2 film, the MatriXX and EPID. Results: The percent absolute dose difference between the measured and ionization chamber dose was within 1% for the EPID, 2% for the MatriXX and 3% for EDR2 film. The percentage of pixels with $\gamma$%>1 for the 3%/3 mm and 2%/2 mm criteria was within 2% for use of both EDR2 film and the EPID. However, differences for the use of the MatriXX were seen with a maximum difference as great as 5.94% with the 2%/2 mm criteria. For the test fields, EDR2 film and EPID could detect leaf-positioning errors on the order of -3 mm and -2 mm, respectively. However it was difficult to differentiate leaf-positioning errors with the MatriXX due to its poor resolution. The approximate time to perform QA was 110 minutes for the use of EDR2 film, 80 minutes for the use of the MatriXX and approximately 55 minutes for the use of the EPID. Conclusion: This study has evaluated the accuracy and efficacy of EDR2 film, the MatriXX and EPID in the pre-treatment verification of IMRT. EDR2 film and the EPID showed better performance for accuracy, while the use of the MatriXX significantly reduced measurement and analysis times. We propose practical and useful methods to establish an effective QA system in a clinical environment.

A study on the status of the Dental Health of Adults (일 지역 성인의 구강건강실태에 관한 조사연구)

  • 정영숙
    • Korean Journal of Health Education and Promotion
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    • v.17 no.1
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    • pp.95-113
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    • 2000
  • The purpose of this study is to investigate the state of the dental health of adults, used self-reporting qestionnaire as objects of 923 residents living in nine districts at random among the sites of eleven town located in a County. The level of knowledge on dental health of adults in a County was 65.6 points out of 100 points, comparatively low. Accodingly, it is necessary for entire adults to have a dental health-related education and get high standard of knowledge. Especially, educational approach should be performed for groups of 40-49 years old, 50-59 years old, above 60 years old, male, no educational background, having only elementary and middle school education, not having any jobs, engaging in agriculture, doing business on their own and so on. When planning the contents of health education, one actually has to include the habit of amalgam, the factor in influencing on dental health as well as show an example such as how to brush teeth, checking point of proper brushing, how to grip toothbrush. The attitude score related to dental heath was 71.2 points out of 100 points, relatively low. Consequently, the change of attitude related the dental health among entire adults is necessary, particularily, the strategical approach is essential to change dental health connected to attitude positively for groups of male, having high school education background, office workers and the civil service. Besides, among dental health related symtoms, more that 30-40% of objects showed negative attitude toward as the following cases; in case that plaque or food debris are attached to the teeth (40.8%), upper and lower teeth do not fit together(40.3%), you cannot sleep well because of toothache(31.0%), more than one tooth fall out(31.0%), you have loosing teeth(30.6%), the approach should be conducted to form attitude that dental care is necessry. The state of dental health through dental health related symtoms was 33.3 points out of 100 points, which was fairly satisfactory. However, dental treatment for the state of dental health should be executed in case of comparison of the dental health state according to general characteristics, the group who are above 60 years old, have elementary school education background, engage in aggriculture who are not good in dental health state as opposed to other groups. Furthermore, there should be dental care needs according to dental health related symtoms, particularly, more than 60-70% of objects have experienced symtoms that plaque or food debris attached to the teeth, tartar is on the teeth so dental treatment should be peformed for a large number of adults. In addition, for the people who have indications that there was a cavity, more than one tooth loss, chilled teeth, toothache when chewing, loose teeth, upper and lower teeth do not fit together, you cannnt sleep well due to the toothach, etc, there should be care through dental treatment. The actual conditions of the hygine of the mouth was relatively good and the difference of the actual state of dental health care in terms of general characteristics showed in only gender; female was more careful in dental health. Comparing the state of oral health synthetically, when they have symtoms, only 34.8% of objects go to a dentist, 60.7% are using passive or negative care such as gargling, tolerating or ignoring. There was many symtoms to care through dental therapy such as plaque or food debris get in between the teeth, tartar on the teeth, teeth are very cold, more than one tooth fallout, loose teeth, there is wrong amalgam, and so on, among symtoms to care passively or negatively. Therefore the education for proper treatment program should be performed. As a result of dental health-related knowlege, attitude, health state, verification of correlation between the actual condition of care, the higher the dental heath-related knowldege becomes, the more positive the dental health-related attitude is, and the state of dental health, that is, the standard of the symtom of dental health diminishes. the care for dental health executed through more active method and the more positive dental health-related attitude is, the more active means they performed. Consequently, the high level of dental health-related knowledge should be necessary, the more positive the dental health-related attitude was, the more active method they adopted, therefore, the program is needed to form attitude related to the dental health positively. As the knowledge on dental health is increasing, the attitude is also positive, after all, the plan to increase the standard of knowledge on dental health should be contrived through education program related to dental health.

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Clinical Application Analysis of 3D-CRT Methods Using Tomotherapy (토모테라피를 이용한 3차원 입체 조형 치료의 임상적 적용 분석)

  • Cho, Kang-Chul;Kim, Joo-Ho;Kim, Hun-Kyum;Ahn, Seung-Kwon;Lee, Sang-Kyoo;Yoon, Jong-Won;Cho, Jeong-Hee;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.36 no.4
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    • pp.327-335
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    • 2013
  • This study investigates the case of clinical application for TomoDirect 3D-CRT(TD-3D) and TomoHelical 3D-CRT(TH-3D) with evaluating dose distribution for clinical application in each case. Treatment plans were created for 8 patients who had 3 dimensional conformal radiation therapy using TD-3D and TH-3D mode. Each patients were treated for sarcoma, CSI(craniospinal irradiaion), breast, brain, pancreas, spine metastasis, SVC syndrome and esophagus. DVH(dose volume histogram) and isodose curve were used for comparison of each treatment modality. TD-3D shows better dose distribution over the irradiation field without junction effect because TD-3D was not influenced by target length for sarcoma and CSI case. In breast case, dosimetric results of CTV, the average value of D 99%, D 95% were $49.2{\pm}0.4$ Gy, $49.9{\pm}0.4$ Gy and V 105%, V 110% were 0%, respectively. TH-3D with the dosimetric block decreased dose of normal organ in brain, pancreas, spine metastasis case. SCV syndrome also effectively decreased dose of normal organ by using dose block to the critical organs(spinal cord <38 Gy). TH-3D combined with other treatment modalities was possible to boost irradiation and was total dose was reduced to spinal cord in esophagus case(spinal cord <45 Gy, lung V 20 <20%). 3D-CRT using Tomotherapy could overcomes some dosimetric limitations, when we faced Conventional Linac based CRT and shows clinically proper dose distribution. In conclusion, 3D-CRT using Tomotherapy will be one of the effective 3D-CRT techniques.

Verification of Skin Dose in Tomotherapy Using the Developed Phantom for Image Based Radiation Treatment System (영상 기반 치료 장비용 팬톰을 이용한 토모테라피 피부 선량 검증)

  • Park, Ji-Yeon;Chang, Ji-Na;Oh, Seung-Jong;Kang, Dae-Gyu;Jung, Won-Gyun;Lee, Jeong-Woo;Jang, Hong-Suk;Kim, Hoi-Nam;Park, Hae-Jin;Kim, Sung-Hwan;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.20 no.2
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    • pp.88-96
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    • 2009
  • Radiation treatment for skin cancer has recently increased in tomotherapy. It was reported that required dose could be delivered with homogeneous dose distribution to the target without field matching using electron and photon beam. Therapeutic beam of tomotherapy, however, has several different physical characteristic and irradiation of helical beam is involved in the mechanically dynamic factors. Thus verification of skin dose is requisite using independent tools with additional verification method. Modified phantom for dose measurement was developed and skin dose verification was performed using inserted thermoluminescent dosimeters (TLDs) and GafChromic EBT films. As the homogeneous dose was delivered to the region including surface and 6 mm depth, measured dose using films showed about average 2% lower dose than calculated one in treatment planning system. Region indicating about 14% higher and lower absorbed dose was verified on measured dose distribution. Uniformity of dose distribution on films decreased as compared with that of calculated results. Dose variation affected by inhomogeneous material, Teflon, little showed. In regard to the measured dose and its distribution in tomotherapy, verification of skin dose through measurement is required before the radiation treatment for the target located at the curved surface or superficial depth.

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