• Title/Summary/Keyword: treatment planning

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Ecological Niche of Quercus acutissima and Quercus variabilis (상수리나무와 굴참나무의 생태적 지위에 관한 연구)

  • Kim, Hae-Ran;Jeong, Heon-Mo;Kim, Hyea-Ju;You, Young-Han
    • Korean Journal of Environmental Biology
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    • v.26 no.4
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    • pp.385-391
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    • 2008
  • In Korea, Quercus acutissima distributed in good condition with high nutrients and moisture content, but Quercus variabilis in dry soil or rock habitate. In order to understand this ecological distribution of Q. acutissima and Q. variabilis, we cultivated the seedlings of two oak species treated with light, soil moisture and nutrient gradients each four level, from May to October in glass house. Then we measured the ecological niche breadth and niche overlap of the two species, and analyzed the relationship of competition using cluster analysis and PCA ordination. Ecological niche breadths of Q. acutissima under moisture and nutrient treatments were slightly wider than those under light one. Among 14 characters measured, 6 characters related with length items were wider in all the environmental treatments, but 8 characters connected with weight terms narrower in light treatment. Ecological niche breadths of Q. variabilis under moisture and nutrient treatment were wider than those of light one. Ecological niche of Q. acutissima was wider than those of Q. variabilis in all the environmental treatments. Ecological overlap between two species was higher with a range of 0.87$\sim$0.92, especially higher in soil moisture factor. These results means that Q. acutissima is more competitive than Q. variabilis, especially in soil moisture condition. Two species were ordinated with distinct group based on 9 characters. From these results, it can be explained that what Q. variabilis distributed in bad soil condition is due to the escape strategy, because of its low competitive ability to Q. acutissima in natural communities.

Evaluation of Dose Change by Using the Deformable Image Registration (DIR) on the Intensity Modulated Radiation Therapy (IMRT) with Glottis Cancer (성문암 세기조절 방사선치료에서 변형영상정합을 이용한 선량변화 평가)

  • Kim, Woo Chul;Min, Chul Kee;Lee, Suk;Choi, Sang Hyoun;Cho, Kwang Hwan;Jung, Jae Hong;Kim, Eun Seog;Yeo, Seung-Gu;Kwon, Soo-Il;Lee, Kil-Dong
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.167-175
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    • 2014
  • The purpose of this study is to evaluate the variation of the dose which is delivered to the patients with glottis cancer under IMRT (intensity modulated radiation therapy) by using the 3D registration with CBCT (cone beam CT) images and the DIR (deformable image registration) techniques. The CBCT images which were obtained at a one-week interval were reconstructed by using B-spline algorithm in DIR system, and doses were recalculated based on the newly obtained CBCT images. The dose distributions to the tumor and the critical organs were compared with reference. For the change of volume depending on weight at 3 to 5 weeks, there was increased of 1.38~2.04 kg on average. For the body surface depending on weight, there was decreased of 2.1 mm. The dose with transmitted to the carotid since three weeks was increased compared be more than 8.76% planned, and the thyroid gland was decreased to 26.4%. For the physical evaluation factors of the tumor, PITV, TCI, rDHI, mDHI, and CN were decreased to 4.32%, 5.78%, 44.54%, 12.32%, and 7.11%, respectively. Moreover, $D_{max}$, $D_{mean}$, $V_{67.50}$, and $D_{95}$ for PTV were increased or decreased to 2.99%, 1.52%, 5.78%, and 11.94%, respectively. Although there was no change of volume depending on weight, the change of body types occurred, and IMRT with the narrow composure margin sensitively responded to such a changing. For the glottis IMRT, the patient's weight changes should be observed and recorded to evaluate the actual dose distribution by using the DIR techniques, and more the adaptive treatment planning during the treatment course is needed to deliver the accurate dose to the patients.

The Perception and Emotional Experiences of Rare and Intractable Diseases in Caregivers and Pediatric Patients with Mitochondrial diseases (미토콘드리아 질환 소아 환자 보호자에서의 질환 인식 및 정서변화)

  • Eom, Soyong;Lee, Joo Young;Hyun, Jiah;Lee, Young-Mock
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.1
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    • pp.1-10
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    • 2017
  • Purpose: This study aimed to investigate the perception and emotional experiences in rare and intractable diseases for caregivers of pediatric patients with mitochondrial diseases in order to provide therapeutic interventions for patients, caregivers, and families. Methods: A total of 83 caregivers of pediatric patients with mitochondrial diseases were recruited from the pediatric mitochondrial disease clinics of the Gangnam Severance Hospital in South Korea. Participants completed the survey about their perception of mitochondrial disease and emotional experiences after the diagnosis, and these clinical data were analyzed accordingly. Results: Surveys from a total of 83 caregivers of patients were analyzed, and the patients' age ranged from 6 to 12 years (33%), followed by ages 1 to 6 years (30%). Children with mitochondrial diseases were between 0 and 0.5 years of age at the time of first symptom onset (43%), and the duration of illness lasted more than 10 years in most cases (42%). Prior to diagnosis of mitochondrial diseases, the amount of awareness the caregivers had was 'Not at all' for both rare and intractable diseases and mitochondrial diseases in 44 cases and 68 cases, respectively. For the caregivers' emotional experiences, the most common initial responses were 'Discouraged/despair', 'Helpless/lethargic', and 'Disconcerted'. 'Anxious', 'Committed to treatment', and 'Responsibility as family members' were the most common emotional responses from the caregivers, followed by 'Disconcerted' and 'Helpless/lethargic'. Conclusion: It is important to consider the level of perception and emotional experiences of caregivers and patients with rare and intractable mitochondrial diseases for planning treatment programs.

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A study on the preorthodontic prediction values versus the actual postorthodontic values in Class III surgery patients (골격성 III급 부정교합 환자에서 술전 교정전 예측치와 교정 후 실측치의 차이에 관한 연구)

  • Hwang, Chung-Ju;Kwon, Hee-Jeong
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.1-9
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    • 2003
  • The purpose of this study was to find out and evaluate discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to it in 45 patients(17 male, 28 female) who were diagnosed as skeletal Class III ma)occlusion and received presurgical orthodontic treatment and orthognathic surgery at Yonsei university dental hospital. Lateral cephalograms were analysed at pretreatment(T1), orthodontic Prediction(T2), immediately before surgery(T3) and designated the landmark as coordinates or X and Y axes. The samples were divided according to ALD, upper and lower incisor inclination(Ul to SN, IMPA), COS, extraction, the position of extracted teeth and the statistical significance was tested to find out the factors contributing to the prediction. The results were as follows: 1. Differences between preorthodontic prediction values and actual postorthodontic values(T2-T3) were statistically significant(p<0.05) in the x coordinates of U6mbc, L1x and in y coordinates of U1i, U1x, U6me, U6mbc, L6mbc 2. The accuracy of prediction is relatively higher in horizontal changes compared to vortical changes. 3. The statistical significance(p<0.05) between prediction and actual values is observed more in the landmarks of the maxilla than the mandible. 4. Differences between prediction and actual values of incisor and first molar were statistically significant(p<0.05) according to extraction vs non-extraction, extraction type, ALD in the maxilla and according to ALD, IMPA in the mandible. Discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to the prediction must be considered in treatment planning of Cl III surgical patients to increase the accuracy of prediction. Furthermore future investigations are needed on the prediction of vortical changes.

A Longitudinal Study on the Skeletal Maturity of the Hand and Wrist among Various Malocclusion Groups(I) (부정교합자의 수완부 골성숙도에 관한 누년적 연구(I))

  • Kim, Kyung-Ho
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.183-195
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    • 1999
  • Growth and development evaluation of patients with growth potential is of great importance for orthodontic treatment planning. Timing of orthodontic intervention greatly depends on one's developmental status, thus if there is a difference in skeletal maturation among malocclusion types different treatment timing should be applied. The objective of this study was to evaluate and compare skeletal maturation among different malocclusion types. The samples used in this study was 38 Class I, 36 Class II and 33 ClassIII females aging from 8 to 10 years. Handwrist X-rays were taken with 6 month interval till 12-13 years of age. The results were as follows. 1. There was no skeletal maturity difference among different malocclusion types. 2. The hamular process of hamate was observed at $9.16{\pm}0.72$ years, pisiform bone at $9.13{\pm}0.71$ years and the ulnar sesamoid at $10.34{\pm}0.84$ years. 3. The timing of epiphyseal capping on the third finger was $10.96{\pm}0.80$ years for distal phalanx and $11.27{\pm}0.87$ years for middle phalanx, $11.12{\pm}0.85$ years for proximal phalanx of the first finger, $11.21{\pm}0.82$ years for radius and $11.62{\pm}0.85$ years for middle phalanx of the fifth finger. 4. The appearance of pisiform bone showed high correlation with appearance of hamular process of hamate(r=0.91) and ulnar sesamoid bone appearance showed high correlation with advanced ossification of hamular process(r=0.86). Timing of epiphyseal capping among different parts showed high correlation(r=0.80-0.90). 5. The shape of middle phalanx of the fifth finger showed the highest variability ($20.6\%$).

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A Comparison of Peripheral Doses Scattered from a Physical Wedge and an Enhanced Dynamic Wedge (금속쐐기와 기능강화동적쐐기의 조사야 주변부 선량 비교)

  • Park, Jong-Min;Kim, Hee-Jung;Min, Je-Soon;Lee, Je-Hee;Park, Charn-Il;Ye, Sung-Joon
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.107-117
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    • 2007
  • In order to evaluate the radio-protective advantage of an enhanced dynamic wedge (EDW) over a physical wedge (PW), we measured peripheral doses scattered from both types of wedges using a 2D array of ion-chambers. A 2D array of ion-chambers was used for this purpose. In order to confirm the accuracy of the device we first compared measured profiles of open fields with the profiles calculated by our commissioned treatment planning system. Then, we measured peripheral doses for the wedge angles of $15^{\circ},\;30^{\circ},\;45^{\circ},\;and\;60^{\circ}$ at source to surface distances (SSD) of 80 cm and 90 cm. The measured points were located at 0.5 cm depth from 1 cm to 5 cm outside of the field edge. In addition, the measurements were repeated by using thermoluminescence dosimeters (TLD). The peripheral doses of EDW were (1.4% to 11.9%) lower than those of PW (2.5% to 12.4%). At 15 MV energy, the average peripheral doses of both wedges were 2.9% higher than those at 6MV energy. At a small SSD (80 cm vs. 90 cm), peripheral dose differences were more recognizable. The average peripheral doses to the heel direction were 0.9% lower than those to the toe direction. The results from the TLD measurements confirmed these findings with similar tendency. Dynamic wedges can reduce unnecessary scattered doses to normal tissues outside of the field edge in many clinical situations. Such an advantage is more profound in the treatment of steeper wedge angles, and shorter SSD.

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The Patient Specific QA of IMRT and VMAT Through the AAPM Task Group Report 119 (AAPM TG-119 보고서를 통한 세기조절방사선치료(IMRT)와 부피적세기조절회전치료(VMAT)의 치료 전 환자별 정도관리)

  • Kang, Dong-Jin;Jung, Jae-Yong;Kim, Jong-Ha;Park, Seung;Lee, Keun-Sub;Sohn, Seung-Chang;Shin, Young-Joo;Kim, Yon-Lae
    • Journal of radiological science and technology
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    • v.35 no.3
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    • pp.255-263
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    • 2012
  • The aim of this study was to evaluate the patient specific quality assurance (QA) results of intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) through the AAPM Task Group Report 119. Using the treatment planning system, both IMRT and VMAT treatment plans were established. The absolute dose and relative dose for the target and OAR were measured by using an ion chamber and the bi-planar diode array, respectively. The plan evaluation was used by the Dose volume histogram (DVH) and the dose verification was implemented by compare the measured value with the calculated value. For the evaluation of plan, in case of prostate, both IMRT and VMAT were closed the goal of target and OARs. In case of H&N and Multi-target, IMRT was not reached the goal of target, but VMAT was reached the goal of target and OARs. In case of C-shape(easy), both were reached the goal of target and OARs. In case of C-shape(hard), both were reached the goal of target but not reached the goal of OARs. For the evaluation of absolute dose, in case of IMRT, the mean of relative error (%) between measured and calculated value was $1.24{\pm}2.06%$ and $1.4{\pm}2.9%$ for target and OAR, respectively. The confidence limits were 3.65% and 4.39% for target and OAR, respectively. In case of VMAT the mean of relative error was $2.06{\pm}0.64%$ and $2.21{\pm}0.74%$ for target and OAR, respectively. The confidence limits were 4.09% and 3.04% for target and OAR, respectively. For the evaluation of relative dose, in case of IMRT, the average percentage of passing gamma criteria (3mm/3%) were $98.3{\pm}1.5%$ and the confidence limits were 3.78%. In case of VMAT, the average percentage were $98.2{\pm}1.1%$ and the confidence limits were 3.95%. We performed IMRT and VMAT patient specific QA using TG-119 based procedure, all analyzed results were satisfied with acceptance criteria based on TG-119. So, the IMRT and VMAT of our institution was confirmed the accuracy.

Improved Breast Irradiation Techniques Using Multistatic Fields or Three Dimensional Universal Compensators (Multistatic Field또는 3차원 공용보상체를 사용한 유방의 방사선 조사법의 평가)

  • Han Youngyih;Cho Jae Ho;Park Hee Chul;Chu Sung Sil;Suh Chang-Ok
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.24-33
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    • 2002
  • Purpose : In order to improve dose homogeneity and to reduce acute toxicity in tangential whole breast radiotherapy, we evaluated two treatment techniques using multiple static fields or universal compensators. Materials and Methods : 1) Multistatic field technique : Using a three dimensional radiation treatment planning system, Adac Pinnacle 4.0, we accomplished a conventional wedged tangential plan. Examining the isodose distributions, a third field which blocked overdose regions was designed and an opposing field was created by using an automatic function of RTPS. Weighting of the beams was tuned until an ideal dose distribution was obtained. Another pair of beams were added when the dose homogeneity was not satisfactory. 2) Universal compensator technique : The breast shapes and sizes were obtained from the CT images of 20 patients who received whole breast radiation therapy at our institution. The data obtained were averaged and a pair of universal physical compensators were designed for the averaged data. DII (Dose Inhomogeneity Index : percentage volume of PTV outside $95\~105\%$ of the prescribed dose) $D_{max}$ (the maximum point dose in the PTV) and isodose distributions for each technique were compared. Results : The multistatic field technique was found to be superior to the conventional technique, reducing the mean value of DII by $14.6\%$ (p value<0.000) and the $D_{max}$ by $4.7\%$ (p value<0.000). The universal compensator was not significantly superior to the conventional technique since it decreased $D_{max}$ by $0.3\%$ (p value=0.867) and reduced DII by $3.7\%$ (p value=0.260). However, it decreased the value of DII by maximum $18\%$ when patients' breast shapes fitted in with the compensator geometry. Conclusion : The multistatic field technique is effective for improving dose homogeneity for whole breast radiation therapy and is applicable to all patients, whereas the use of universal compensators is effective only in patients whose breast shapes fit inwith the universal compensator geometry, and thus has limited applicability.

Superficial Dosimetry for Helical Tomotherapy (토모테라피를 이용한 표면 치료 계획과 선량 분석)

  • Kim, Song-Yih;You, Sei-Hwan;Song, Tae-Soo;Kim, Yong-Nam;Keum, Ki-Chang;Cho, Jae-Ho;Lee, Chang-Geol;Seong, Jin-Sil
    • Radiation Oncology Journal
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    • v.27 no.2
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    • pp.103-110
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    • 2009
  • Purpose: To investigate the feasibility of helical tomotherapy on a wide curved area of the skin, and its accuracy in calculating the absorbed dose in the superficial region. Materials and Methods: Two types of treatment plans were made with the cylinder-shaped 'cheese phantom'. In the first trial, 2 Gy was prescribed to a 1-cm depth from the surface. For the other trial, 2 Gy was prescribed to a 1-cm depth from the external side of the surface by 5 mm. The inner part of the phantom was completely blocked. To measure the surface dose and the depth dose profile, an EDR2 film was inserted into the phantom, while 6 TLD chips were attached to the surface. Results: The film indicated that the surface dose of the former case was 118.7 cGy and the latter case was 130.9 cGy. The TLD chips indicated that the surface dose was higher than these, but it was due to the finite thickness of the TLD chips. In the former case, 95% of the prescribed dose was obtained at a 2.1 mm depth, while the prescribed does was at 2.2 mm in the latter case. The maximum dose was about 110% of the prescribed dose. As the depth became deeper, the dose decreased rapidly. Accordingly, at a 2-cm depth, the dose was 20 % of the prescribed dose. Conclusion: Helical tomotherapy could be a useful application in the treatment of a wide area of the skin with curvature. However, for depths up to 2 mm, the planning system overestimated the superficial dose. For shallower targets, the use of a compensator such as a bolus is required.

A Theoretical Model for the Analysis of Residual Motion Artifacts in 4D CT Scans (이론적 모델을 이용한 4DCT에서의 Motion Artifact 분석)

  • Kim, Tae-Ho;Yoon, Jai-Woong;Kang, Seong-Hee;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.3
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    • pp.145-153
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    • 2012
  • In this study, we quantify the residual motion artifact in 4D-CT scan using the dynamic lung phantom which could simulate respiratory target motion and suggest a simple one-dimension theoretical model to explain and characterize the source of motion artifacts in 4DCT scanning. We set-up regular 1D sine motion and adjusted three level of amplitude (10, 20, 30 mm) with fixed period (4s). The 4DCT scans are acquired in helical mode and phase information provided by the belt type respiratory monitoring system. The images were sorted into ten phase bins ranging from 0% to 90%. The reconstructed images were subsequently imported into the Treatment Planning System (CorePLAN, SC&J) for target delineation using a fixed contour window and dimensions of the three targets are measured along the direction of motion. Target dimension of each phase image have same changing trend. The error is minimum at 50% phase in all case (10, 20, 30 mm) and we found that ${\Delta}S$ (target dimension change) of 10, 20 and 30 mm amplitude were 0 (0%), 0.1 (5%), 0.1 (5%) cm respectively compare to the static image of target diameter (2 cm). while the error is maximum at 30% and 80% phase ${\Delta}S$ of 10, 20 and 30 mm amplitude were 0.2 (10%), 0.7 (35%), 0.9 (45%) cm respectively. Based on these result, we try to analysis the residual motion artifact in 4D-CT scan using a simple one-dimension theoretical model and also we developed a simulation program. Our results explain the effect of residual motion on each phase target displacement and also shown that residual motion artifact was affected that the target velocity at each phase. In this study, we focus on provides a more intuitive understanding about the residual motion artifact and try to explain the relationship motion parameters of the scanner, treatment couch and tumor. In conclusion, our results could help to decide the appropriate reconstruction phase and CT parameters which reduce the residual motion artifact in 4DCT.