6MV 광자선에서 측정조건의 변화와 측정법의 차이에 의한 절대 선량값의 비교

김회남,Kim, Hoi-Nam 대한방사선치료학회 1998 大韓放射線治療技術學會誌 Vol.10 No.1

The absolute absorbed dose can be determined according to the measurement conditions ; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of $10{\times}10cm$ field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations on phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG2l and IAEA protocol. The differences between two protocols are within $1\%\;while\;the\;average\;value\;of\;IAEA\;protocol\;was\;0.5\%$ smaller than TG2l protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within $1\%,\;but\;individual\;discrepancies\;are\;in\;the\;range\;of\;-2.5\%\;to\;1.2\%$ depending upon the choice of measurement combination. The largest discrepancy of $-25\%$ was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coefficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, It shows that absorbed dose could be affected by phantom material other than water.

토모테라피와 선형가속기를 이용한 동일 부위의 치료 시 종양 및 정상조직의 흡수선량 평가

천금성,김창욱,김회남,허경훈,송진호,홍주영,정재용,Cheon, Geum-Seong,Kim, Chang-Uk,Kim, Hoi-Nam,Heo, Gyeong-Hun,Song, Jin-Ho,Hong, Joo-Yeong,Jeong, Jae-Yong 대한방사선치료학회 2010 대한방사선치료학회지 Vol.22 No.2

Purpose: Treating same region with different modalities there is a limit to evaluate the total absorbed dose of normal tissues. The reason is that it does not support to communication each modalities yet. In this article, it evaluates absorbed dose of the patients who had been treated same region by a tomotherapy and a linear accelerator. Materials and Methods: After reconstructing anatomic structure with a anthropomorphic phantom, administrate 45 Gy to a tumor in linac plan system as well as prescribe 15 Gy in tomotherapy plan system for make an ideal treatment plan. After the plan which made by tomoplan system transfers to the oncentra plan system for reproduce plan under the same condition and realize total treatment plan with summation 45 Gy linac treatment plan. To evaluate the absorbed dose of two different modalities, do a comparative study both a simple summation dose values and integration dose values. Then compare and analyze absorbed dose of normal tissues and a tumor with the patients who had been exposured radiation by above two differents modalities. Results: The result of compared data, in case of minimum dose, there are big different dose values in spleen (12.4%). On the other hand, in case of the maximum dose, it reports big different in a small bowel (10.2%) and a cord (5.8%) in head & neck cancer patients, there presents that oral (20.3%), right lens (7.7%) in minimum dose value. About maximum dose, it represents that spinal (22.5), brain stem (12%), optic chiasm (8.9%), Rt lens (11.5%), mandible (8.1%), pituitary gland (6.2%). In case of Rt abdominal cancer patients, there represents big different minimum dose as Lt kidney (20.3%), stomach (8.1%) about pelvic cancer patients, it reports there are big different in minimum dose as a bladder (15.2%) as well as big different value in maximum dose as a small bowel (5.6%), a bladder (5.5%) in addition, making treatment plan it is able us to get. Conclusion: In case of comparing both simple summation absorbed dose and integration absorbed dose, the minimum dose are represented higher as well as the maximum dose come out lower and the average dose are revealed similar with our expected values data. It is able to evaluate tumor & normal tissue absorbed dose which could had been not realized by treatment plan system. The DVH of interesting region are prescribed lower dose than expected. From now on, it needs to develop the new modality which are able to realize exact dose distribution as well as integration absorbed dose evaluation in same treatment region with different modalities.

영상기반 방사선 치료기기를 위한 QA 팬텀 시작품 개발

장지나,오승종,정원균,장홍석,김회남,강대규,이두현,서태석,Chang, Jin-A,Oh, Seoung-Jong,Jung, Won-Kyun,Jang, Hong-Suk,Kim, Hoi-Nam,Kang, Dae-Gyu,Lee, Doo-Hyun,Suh, Tae-Suk 한국의학물리학회 2008 의학물리 Vol.19 No.2

In this study, we developed the protopype of QA phantom for image QA including an additional component for image based radiation treatment system. The new phantom considered two main parts: Image quality and fusion accuracy. Image quality part included for daily CT number linearity and spatial resolution, and fusion accuracy part designed to simulate a simple translation-rotation setting. The CT scans of the phantom obtained from conventional CT, MVCT of Tomotherapy unit, and both image sets were satisfied the recommendation of spatial resolution. This phantom was simple and efficient for daily imaging QA, and it is important to provide a new concept of verification of image registration. 본 연구에서는 영상 기반 방사선 치료기기의 영상 QA를 위한 필요한 추가적인 요소를 포함시킨 QA 팬텀 시제품을 개발하였다. 개발된 팬텀은 크게 영상 질 평가 부분과 정합 정확도 평가 부분의 두 가지로 이루어져 있다. 영상 질 평가를 위해 CT number 선형성과 공간 해상도 평가가 가능하게 설계되었고, 정합 정확도 평가를 위하여 간단한 이동 및 회전조절이 가능하게 설계되었다. 제작된 팬텀의 영상은 일반 CT와 Tomotherapy의 MVCT에서 획득되었고, 두 영상 모두 해상도 평가 기준을 충족하였다. 이 팬텀은 일간 영상 QA를 위한 간단하고, 효율적이며, 그리고 영상 정합 평가의 새로운 개념을 제시했다는 데에 큰 의의가 있다.

두경부 암환자 치료 시 CT On-rail System을 이용한 이하선의 위치 보정 및 선량 평가

장형준,임충근,천금성,정일선,김회남,Jang, Hyeong-Jun,Im, Chung-Geun,Chun, Geum-Sung,Jeong, Il-Seon,Kim, Hoi-Nam 대한방사선치료학회 2008 대한방사선치료학회지 Vol.20 No.2

Purpose: The checking method of target and normal structure are used by MVCBCT, KVCBCT, CT On-rail System, Ultrasound in H&N cancer patient. In case of MVCT, the utilization of bone structure is valuable to check around tissue. But the utilization of soft tissue is not enough. The point of this paper is dose variation in movable parotid and changeable volume of H&N cancer patient of CT On-rail System. Materials and Methods: The object of H&N cancer patient is 5 in this hospital. The selected patient are scanned ARTISTE CT Vision (CT On-ral System) a triweekly. After CT scanning, tranfered coordinates are obtained by movable of parotid gland comparison with planning image. Checking for the changeable volume of parotid gland. A Obtained CT image are tranfered to the RTP System. So dose variation are checked by following changed volume. Results: The changes of target coordinate by the parotid gland movement are X: -0.4~0.4 cm, Y: -0.4~0.3 cm, Z: -0.3~0.3 cm. the volume of GTV is decreased to about 7.11%/week and then both parotid gland volume are shrinked about 4.81%/week (Lt), 2.91%/week (Rt). At the same time, each parotid gland are diminished in radiation dose as 3.66%/week (Lt), 2.01%/week. Conclusion: Images from CT on the rail System which are able to aquire the better quality images of soft tissue in Target area than MVCBCT. After replanning and dose redistribution by required images, It could gain not only the correction of the patient set-tup errors but exact dose distribution. Accordingly, the delivery of compensated dose, It makes that we could do Adaptive Targeting Radiotherapy and need Real Time Adaptive Targeting Radiotherapy by reduce beam delivary time.

좌측 유방 방사선치료 시 4D-CT를 이용한 심장의 체적 및 선량변화에 대한 연구

박선미,천금성,허경훈,신성필,김광석,김창욱,김회남,Park, Seon Mi,Cheon, Geum Seong,Heo, Gyeong Hun,Shin, Sung Pil,Kim, Kwang Seok,Kim, Chang Uk,Kim, Hoi Nam 대한방사선치료학회 2013 대한방사선치료학회지 Vol.25 No.2

목 적: 좌측 유방암 환자 치료 시 4D-CT를 이용하여 기존에 호흡이 고려되지 않았던 치료와 비교하여 심장의 체적 변화와 호흡에 따른 심장의 선량 차이를 알아보고자 한다. 대상 및 방법: 2012년 3월부터 5월까지 본원에 내원한 2문 접선조사로 치료받은 좌측 유방암 환자 10명을 대상으로 하였다. 좌측 유방이 충분히 포함될 수 있도록 FOV (Field-of-view)를 설정하고 자유 호흡 상태의 일반 CT (Free-Breathing CT)와 4D-CT를 통해 영상을 획득하였다. 선량은 50.4 Gy (1.8 Gy/28 fraction)로 필요에 따라 추가적으로 계획용표적체적(PTV: Planning target volume)에 전자선 1문 조사 9 Gy (1.8 Gy/5 Fraction)를 처방하였고 선량체적히스토그람(Dose Volume Histogram)를 이용하여 심장에 받는 선량과 체적을 비교 분석하였다. 결 과: Free-Breathing CT 영상과 4D-CT 영상의 심장에 받는 선량과 체적을 비교 분석한 결과 4D-CT 영상에서 심장의 체적이 최대 40.5% 크게 나타났으며 또한 심장의 총 흡수선량도 최대, 최소, 평균선량이 최대 8.8%, 27.9%, 37.4% 높게 나타났다. 결 론: 4D-CT를 촬영하여 호흡을 고려한 치료계획이 Free-Breathing CT 영상으로 치료 계획한 것 보다 환자의 심장선량이 높게 조사된 것으로 나타났다. 따라서 심장과 근접한 좌측 유방 방사선치료 시 심장박동에 의한 심장의 체적변화를 고려한 치료계획을 세워야 할 것으로 사료된다. Purpose: We investigate the results of changed heart volume and heart dose in the left breast cancer patients while considering the movements of respiration. Materials and Methods: During the months of March and May in 2012, we designated the 10 patients who had tangential irradiation with left breast cancer in the department of radiation Oncology. With acquired images of free breathing pattern through 3D and 4D CT, we had planed enough treatment filed for covered up the whole left breast. It compares the results of the exposed dose and the volume of heart by DVH (Dose Volume histogram). Although total dose was 50.4 Gy (1.8 Gy/28 fraction), reirradiated 9 Gy (1.8 Gy/5 Fraction) with PTV (Planning Target Volume) if necessary. Results: It compares the results of heart volume and heart dose with the free breathing in 3D CT and 4D CT. It represents the maximum difference volume of heart is 40.5%. In addition, it indicated the difference volume of maximum and minimum, average are 8.8% and 27.9%, 37.4% in total absorbed dose of heart. Conclusion: In case of tangential irradiation (opposite beam) in left breast cancer patients, it is necessary to consider the changed heart volume by the respiration of patient and the heartbeat of patient.

영상 기반 치료 장비용 팬톰을 이용한 토모테라피 피부 선량 검증

박지연,장지나,오승종,강대규,정원균,이정우,장홍석,김회남,박혜진,김성환,서태석,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 한국의학물리학회 2009 의학물리 Vol.20 No.2

최근 토모테라피의 빗면 조사 빔(tangential beam)을 이용하여 전자 빔과 광자 빔의 인접 조사 없이도 치료에 필요한 선량을 균일하게 전달할 수 있다는 결과가 보고되면서, 토모테라피를 이용한 피부암 치료가 증가하고 있다. 그러나 토모테라피 치료 빔은 선형가속기 빔과는 다른 물리적인 특성을 갖고 있으며, 여러 가지 동적 요소들이 결합되어 빔을 조사하므로 기존에 사용하고 있는 팬톰 이외의 독립적인 도구를 사용하여 피부 선량을 검증할 필요가 있다. 피부 선량 검증을 위하여 영상 기반 치료용 팬톰에 선량 측정 기능을 추가한 새로운 팬톰을 개발하였으며, 열형광선량계(LiF, TLD-100)와 GafChromic EBT필름을 팬톰에 삽입하여 전달된 피부 선량을 측정하였다. 팬톰의 반지름 방향으로 피부 영역을 포함하여 깊이 35 mm 영역까지 균일한 선량을 전달했을 때, 필름으로 측정한 특정 점에서의 선량은 계산 선량에 대하여 평균 약 2% 정도 낮게 나타났으며 처방 선량보다 최대 ${\pm}14%$까지 더 높거나 낮은 선량이 전달된 영역이 나타나는 것을 확인 할 수 있었다. 치료 계획 시스템의 계산 결과와 비교하였을 때, 조사 영역에서 측정한 선량 분포의 균일성이 감소하였으며 팬톰 내에 삽입한 테플론에 의한 선량 변화는 거의 나타나지 않았다. 토모테라피의 치료 빔을 이용하여 피부암과 같이 굴곡이 있는 낮은 깊이에 위치한 표적에 선량을 전달하는 경우, 연속적으로 회전하며 조사되는 빗면 조사 빔의 특성과 치료 계획 시스템의 선량 계산 방식에 따라서 피부 선량의 오차가 허용 범위보다 더 크게 나타날 수 있으므로 치료전 측정을 통한 피부 선량 검증이 필요하다. 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.

호흡동조방사선치료 시 Real Time Monitor와 Ventilator의 유용성 평가

조중훈,김병진,노시원,이현찬,장형준,김회남,송재훈,김영재,Jo, Jung Hun,Kim, Byeong Jin,Roh, Shi Won,Lee, Hyeon Chan,Jang, Hyeong Jun,Kim, Hoi Nam,Song, Jae Hun,Kim, Young Jae 대한방사선치료학회 2013 대한방사선치료학회지 Vol.25 No.1

목 적: 호흡동조방사선치료 시 호흡에 따른 종양의 위치를 정확하게 파악하여 치료하기 위해서는 안정되고 일정한 호흡유지가 중요하다. 이에 본 연구에서 Real time monitor와 Ventilator를 이용하여 측정한 호흡유지방법을 소개하고 그 유용성을 평가하고자 한다. 대상 및 방법: 7명의 실험자를 대상으로 하여 Gate on time (Beam on time) 600초를 기준으로 실험자를 총 5개의 그룹 -자연 호흡, Monitor를 이용하여 유도한 호흡, Ventilator를 이용하여 유도한 호흡, Monitor와 Ventilator를 동시에 이용하여 유도한 호흡, 실험자 스스로 Real time monitor를 이용하여 주기적 Breath-hold 상태를 유지하는 호흡- 으로 분류 하였다. 분류 후 ANZAI 4D system을 이용하여 각각의 호흡신호를 획득 하였다. 호흡신호별 총 소요 시간을 비교하고 호흡주기 상의 Gate on/off time 평균값, 표준편차, 분산, 평균 호흡 주기의 횟수와 변화 등을 각각 분석하여 호흡의 안정성을 평가 하였다. 동시에 실험자들을 대상으로 설문조사를 실시하여 각 장치들의 의존성을 정성적으로 조사하였다. 결 과: 5개 그룹의 호흡신호 편차변화를 비교하여 실험자의 각 호흡신호 안정성을 평가하였다. 그 결과 모든 실험자는 Gate on time 600초 동안 소요되는 시간이 Monitor와 Ventilator를 동시에 사용 했을 경우에 실험시간이 가장 짧게 걸렸고, 가장 안정된 호흡을 유지한 것으로 나타났다. 결 론: 본 연구에서 Real time monitor와 Ventilator를 사용하여 호흡유도를 진행해본 결과 실험대상자들의 안정적인 호흡유지에 유용성이 있는 것으로 나타났다. 2개의 장비를 독립적으로 사용하였을 경우 보다 동시에 사용할 경우 호흡유지 안정도가 더 우수한 것으로 나타났다. Real time monitor와 Ventilator를 이용하여 환자의 호흡조건을 설정하여 환자에게 적용시킨다면 호흡조절방사선치료 시 치료의 정확도를 높일 수 있으리라 예상되며 동시에 치료시간도 단축될 것으로 사료된다. 특히 규칙적인 호흡조절이 가능한 환자의 경우 Real time monitor를 활용한 Breath-hold 방법의 활용은 치료시간 단축의 효과를 현저히 높일 수 있을 것이라 사료된다. Purpose: The purpose of this study was to evaluate the possibility to optimize the gated treatment delivery time and maintenance of stable respiratory by the introduction of breath with the assistance of auditory-visual-tactile sense. Materials and Methods: The experimenter's respiration were measured by ANZAI 4D system. We obtained natural breathing signal, monitor-induced breathing signal, monitor & ventilator-induced breathing signal, and breath-hold signal using real time monitor during 10 minutes beam-on-time. In order to check the stability of respiratory signals distributed in each group were compared with means, standard deviation, variation value, beam_time of the respiratory signal. Results: The stability of each respiratory was measured in consideration of deviation change studied in each respiratory time lapse. As a result of an analysis of respiratory signal, all experimenters has showed that breathing signal used both Real time monitor and Ventilator was the most stable and shortest time. Conclusion: In this study, it was evaluated that respiratory gated radiation therapy with auditory-visual-tactual sense and without auditory-visual-tactual sense feedback. The study showed that respiratory gated radiation therapy delivery time could significantly be improved by the application of video feedback when this is combined with audio-tactual sense assistance. This delivery technique did prove its feasibility to limit the tumor motion during treatment delivery for all patients to a defined value while maintaining the accuracy and proved the applicability of the technique in a conventional clinical schedule.

IoT 플랫폼에서 뉴로모픽 아키텍처 기반 지능형 응용 개발 지원을 위한 프레임워크 설계

정재혁(Jaehyeok Jeong),박지수(Jisu Park),김서연(Seoyeon Kim),김회남(Hoi nam Kim),김재희(Jaehee Kim),김봉재(Bongjae Kim),윤영선(Young-Sun Yun),정진만(Jinman Jung) 한국정보과학회 2019 한국정보과학회 학술발표논문집 Vol.2019 No.12