• 대한방사선기술학회지:방사선기술과학
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• 제45권6호
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• pp.491-502
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• 2022

The purpose of this study was to retrospectively investigate the upper and lower control limits of treatment planning parameters using EBT film based delivery quality assurance (DQA) results and to analyze the results of statistical process control (SPC) in helical tomotherapy (HT). A total of 152 patients who passed or failed DQA results were retrospectively included in this study. Prostate (n = 66), rectal (n = 51), and large-field cancer patients, including lymph nodes (n = 35), were randomly selected. The absolute point dose difference (DD) and global gamma passing rate (GPR) were analyzed for all patients. Control charts were used to evaluate the upper and lower control limits (UCL and LCL) for all the assessed treatment planning parameters. Treatment planning parameters such as gantry period, leaf open time (LOT), pitch, field width, actual and planning modulation factor, treatment time, couch speed, and couch travel were analyzed to provide the optimal range using the DQA results. The classification and regression tree (CART) was used to predict the relative importance of variables in the DQA results from various treatment planning parameters. We confirmed that the proportion of patients with an LOT below 100 ms in the failure group was relatively higher than that in the passing group. SPC can detect QA failure prior to over dosimetric QA tolerance levels. The acceptable tolerance range of each planning parameter may assist in the prediction of DQA failures using the SPC tool in the future.

• The Journal of Advanced Prosthodontics
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• 제2권2호
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• pp.58-60
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• 2010

Presurgical prosthetic treatment planning is critical for the success of the implant prosthesis. Inadequate treatment plan, due to insufficient discussion between prosthodontist, and surgeon, may result in poor prognosis. A 26-year-old male patient was referred for prosthodontic treatment after implant was placed in the area of teeth #17,16, 22, 25 and 27, without adequate discussion nor the treatment planning between oral surgeon and prosthodontist. It was found that the patient had two hopeless teeth, and a severely resorbed alveolar ridge. Additional tooth extraction was needed and the type of definitive prosthesis was shifted from fixed type to removable one. Proper pre-surgical treatment planning is essential for the good prognosis. Implant-supported removable prosthesis on milled bars may be a useful treatment option in patients with incorrect angled placement on severely resorbed alveolar ridge.

• 대한방사선기술학회지:방사선기술과학
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• 제45권5호
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• pp.439-448
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• 2022

The purpose of this study was to analyze the results from statistical process control (SPC) to recommend upper and lower control limits for planning parameters based on delivery quality assurance (DQA) results and establish our institutional guidelines regarding planning parameters for helical tomotherapy (HT). A total of 53 brain, 41 head and neck (H & N), and 51 pelvis cases who had passing or failing DQA measurements were selected. The absolute point dose difference (DD) and the global gamma passing rate (GPR) for all patients were analyzed. Control charts were used to evaluate upper and lower control limits (UCL and LCL) for all assessed treatment planning parameters. Treatment planning parameters were analyzed to provide its range for DQA pass cases. We confirmed that the probability of DQA failure was higher when the proportion of leaf open time (LOT) below 100 ms was greater than 30%. LOT and gantry period (GP) were significant predictor for DQA failure using the SPC method. We investigated the availability of the SPC statistic method to establish the local planning guideline based on DQA results for HT system. The guideline of each planning parameter in HT may assist in the prediction of DQA failure using the SPC statistic method in the future.

• 한국의학물리학회지:의학물리
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• 제33권3호
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• pp.25-35
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• 2022

Purpose: Planning for radiotherapy relies on implicit estimation of the probability of tumor control and the probability of complications in adjacent normal tissues for a given dose distribution. Methods: The aim of this pilot study was to reconstruct dose-volume histograms (DVHs) from text files generated by the Eclipse treatment planning system developed by Varian Medical Systems and to verify the integrity and accuracy of the dose statistics. Results: We further compared dose statistics for intensity-modulated radiotherapy of the head and neck between the Eclipse software and software developed in-house. The dose statistics data obtained from the Python software were consistent, with deviations from the Eclipse treatment planning system found to be within acceptable limits. Conclusions: The in-house software was able to provide indices of hotness and coldness for treatment planning and store statistical data generated by the software in Oracle databases. We believe the findings of this pilot study may lead to more accurate evaluations in planning for radiotherapy.

• 대한방사선치료학회지
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• 제24권2호
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• pp.137-147
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• 2012

목 적: 알고리즘에 따른 치료계획의 영향을 분석하고 실제 치료계획을 수립할 때 고려사항을 적용하고, 나아가 최선의 치료계획을 수립하는 프로토콜을 제시하고자 한다. 대상 및 방법: 치료계획 시스템은 이클립스 10.0 (Eclipse 10.0, Varian, USA)이다. 선량계산의 알고리즘은 PBC (Pencil Beam Convolution)와 AAA (Anisotropic Analytical Algorithm)을 각각 적용하였고, 세기 조절 방사선 치료(IMRT)를 위한 최적화(Optimization) 알고리즘은 DVO (Dose Volume Optimizer 10.0.28), VMAT을 위한 최적화 알고리즘은 PRO II (Progressive Resolution Optimizer V 8.9.17)와 PRO III (Progressive Resolution Optimizer V 10.0.28)을 사용하였다. 실험을 위한 팬텀은 치료계획시스템에서 가상으로 만들었으며, $30{\times}30{\times}30$ cm의 규격에 밀도가 균일한 것(HU: 0)과 중간에 공기(HU: -1,000)로 가정되는 물질이 삽입한 된 비균질 팬텀으로 설정하였다. 실험은 먼저 팬텀(Phantom) 계획을 실시하여 일반적인 치료계획의 특징을 분석하고 그 내용을 토대로 실제 임상적용 할 치료계획을 수립하였다. 결 과: 균일한 밀도 팬텀에서 6 MV, 10 cm PDD (Percentage Depth Dose)는 PBC와 AAA는 모두 65.2%로 유사한 값을 나타냈지만, 비균질 팬텀에서 PDD는 저밀도 물질을 만나기 전까진 유사한 PDD 값을 보이다가 공기 영역에서 다른 선량곡선을 보여주고, 투과한 후에는 PDD 10 cm은 각각 75%, 73%이었다. 동일한 MU의 3차원 치료계획에서 보면, AAA 치료계획이 폐가 포함된 영역에서 저 선량으로 나타났다. 기관지와 폐의 영역이 포함된 경추 치료 환자의 2차원 대향 2문조사 치료계획을 15 MV을 이용하여 설계하였을 때, Conformity Index (ICRU 62)는 PBC 계산에서 0.95, AAA에서 0.93이었다. IMRT 치료계획은 DVO에서 보여지는 DVH가 선량계산 DVH와 동일하게 나타났다. 하지만 AAA으로 선량계산을 하였을 때는 DVO에서 조건을 만족하는 결과가 선량계산에서는 선량부족으로 나타났다. PRO II을 이용한 VMAT 치료계획은 최적화 할 때는 만족스런 결과를 얻었지만, 선량계산을 실시하였을 때는 저밀도 영역이 선량 부족으로 나타났다. 하지만 PRO III에서 같은 조건을 1회 더 최적화함으로써 최적화 결과와 선량계산 결과가 유사하였다. 결 론: 본 연구에서는 선량계산 알고리즘의 옳고 그름을 판단하지 않는다. 알고리즘이 나타내는 선량 분포의 특성을 분석하고, 특히 최적화가 필요한 IMRT나 VMAT 치료계획에서 최적화 알고리즘의 요인도 치료계획을 수립할 때 고려함으로써 최적의 치료계획을 위한 방법을 제시하고자 한다.

• KIEAE Journal
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• 제13권1호
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• pp.125-131
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• 2013

This is a study on space planning of dental clinic by case analysis of 30 dental clinics that were cons tructed or designed in metropolitan area in recent years, It is analyzed as the following, required basic or additional rooms according to size divisions of gross floor area, relationship of treatment chair number and floor area, ratio of gross floor area and waiting zone, medical treatment zone, supporting zone, management zone, and zoning planning, space types of medical treatment zone, etc. This study can be used as basic data for planning of dental clinic and related future researches.

• Radiation Oncology Journal
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• 제36권1호
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• pp.1-10
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• 2018

Intensity-modulated radiation therapy (IMRT) has been considered the most successful development in radiation oncology since the introduction of computed tomography into treatment planning that enabled three-dimensional conformal radiotherapy in 1980s. More than three decades have passed since the concept of inverse planning was first introduced in 1982, and IMRT has become the most important and common modality in radiation therapy. This review will present developments in inverse IMRT treatment planning and IMRT delivery using multileaf collimators, along with the associated key concepts. Other relevant issues and future perspectives are also presented.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2003년도 제27회 추계학술대회
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• pp.56-56
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• 2003

For the treatment of superficial tumors like squamous cell carcinoma of the head and neck, 6 MV photon beam is not appropriate and a spoiler is widely used to increase dose in the buildup region, while preserving the skin sparing effect. However, commercially available treatment planning systems assume a normal unspoiled beam, thereby cannot predict the buildup dose with spoiler accurately. We aimed to implement a Monte Carlo (MC) based planning system to apply it to the radiation treatment of head and neck. Lucite with thickness of 10-mm was used for the beam spoiler with Siemens Primus 6 MV photon beam. BEAM/DOSXYZ MC system was employed to model the linac and the spoiler. To verify the calculation accuracy of MC simulations, the percent depth doses (PDDs) and profiles with and without spoiler were measured using a parallel-plate chamber. For the MC based planning, we adopted a hybrid interface system between Pinnacle (Philips, USA) and BEAM/DOSXYZ to support treatment parameters of Siemens linac and the spoiler. The measurements of PDDs and profiles agreed with the corresponding MC simulations within 2% (lSD), which demonstrate the reliability of our MC simulations. The spoiler generated electrons make a contribution to the absorbed dose up to depth of 2cm, which shows that the dominant source of increased dose from spoiler system is the contaminating electrons created by the spoiler. The whole procedures necessary for MC based treatment planning were performed seamlessly between Pinnacle and BEAM/DOSXYZ system. This ability helps to increase the clinical efficiency of the spoiler technique. In conclusion, we implemented a MC based treatment planning system for a 6 MV photon beam with a spoiler. We demonstrate sophisticated MC technique makes it possible to predict dose distributions around buildup region accurately.

• Radiation Oncology Journal
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• 제12권3호
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• pp.387-392
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• 1994

Purpose : This study was done to confirm the reference point variation according to variation in applicator configuration in each fractioation of HDR ICR. Materials and Methods : We analyzed the treatment planning of HDRICR for 33 uterine cervical cancer patients treated in department of therapeutic radiology from January 1992 to February 1992. Analysis was done with respect to three view points-Interfractionation A point variation, interfractionation bladder and rectum dose ratio variation, interfractionation treatment volume variation. Interfractionation A point variation was defined as difference between maximum and minimum distance from fixed rectal point to A point in each patient. Interfractionation bladder and rectum dose ratio variation was defined as difference between maximum and minimum dose ratio of bladder or rectum to A point dose in each patient, Interfractionation treatment volume variation was defined as difference between miximum and minimum treatment volume which absorbed over the described dose-that is, 350 cGy or 400 cGy-in each patient. Results The mean of distance from rectum to A point was 4.44cm, and the mean of interfractionation distance variation was 1.14 cm in right side,1.09 cm in left side. The mean of bladder and rectum dose ratio was $63.8\%$ and $63.1\%$ and the mean of interfractionation variation was $14.9\%$ and $15.8\%$ respectively. With fixed planning administration of same planning to all fractionations as in first fractionation planning-mean of bladder and rectum dose ratio was $64.9\%$ and $72.3\%$.and the mean of interfraction variation was $28.1\%$ and $48.1\%$ reapectively. The mean of treatment volume was $84.15cm^3$ and the interfractionation variation was $21.47cm^2$. Conclusion : From these data, it was confirmed that there should be adapted planning for every fractionation ,and that confirmation device installed in ICR room would reduce the interfractionation variation due to more stable applicator configuration.

• The Journal of Advanced Prosthodontics
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• 제12권1호
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• pp.15-21
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• 2020

PURPOSE. The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS. A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS. An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION. Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.