총 두피 방사선치료 시 치료계획 방법에 따른 선량적 유용성 비교 평가

박별님,정동민,권용재,조용완,김세영,박광순,박령황,백종걸,Park byeal nim,Jung dong min,Kwon yong jae,Cho yong wan,Kim se young,Park kwang soon,Park ryeong hwang,Baek jong geol 대한방사선치료학회 2022 대한방사선치료학회지 Vol.34 No.-

Objective: The purpose of this study is to choose a treatment plan and equipment to maximize tangential irradiation to protect the normal brain tissues as much as possible during total scalp irradiation. Subjects and Methods: After zoning the total scalp of a phantom and selecting a target area for treatment, the study made a Helical TomoTherapy(HT) plan, a Helical TomoTherapy with a Complete Block(HTCB) plan, and a Volumetric Modulated Arc Therapy(VMAT) plan. All of these plans made sure that the volume of a treatment plan with 95% of a prescription dose(40 Gy) would not exceed 95% of the entire volume and that Dmax would not be more than 110% of the prescription dose. The therapy plans compared doses among organs at risk of damage including the brain. Doses in the brain tissues were assessed based on the volumetric criteria for normal tissues in Emami et al. Results: HT, HTCB, and VMAT had a dose of 21.68 Gy, 13.75 Gy, and 20.89 Gy, respectively, in brain tissues at D_33%, a dose of 7.06 Gy, 3.21 Gy, and 7.84 Gy, respectively, at D_67%, and a dose of 3.14 Gy, 1.75 Gy, and 3.84 Gy, respectively, at D_100%. They recorded a Dmean of 16.64 Gy, 11.78 Gy, and 16.64 Gy, respectively. These results show that the overall dose was low in the HTCB plan. When the volume of a low dose was calculated based on 5 Gy, they recorded 87%, 49%, and 96%, respectively, in V_5Gy. In addition, the maximum dose in the remaining organ(brain stem, hippocampus, and both lenses) except for the optic pathway was the lowest in HTCB Conclusion: The findings demonstrate that TomoTherapy with a complete block minimized a dose in organs at risk of damage including the brain and hippocampus on both sides and accordingly reduced the probability of side effects such as radiation-induced brain injuries and a resulting decrease in neurocognitive functions. In addition to total scalp irradiation, if additional studies on ring targets treated in various areas are conducted to establish the benefits of tangential irradiation, it is believed that TomoTherapy using Complete Block can be used to maximize tangential irradiation in treatment planning.

대청호 지류에서 이동식 녹조제거장치의 조류제거 효과 평가

박별님,박민정,조영철 대한환경공학회 2017 대한환경공학회 학술발표논문집 Vol.2017 No.11

인공습지를 이용한 호소 유입 비점오염물질 제거 효율 평가: 대청호 안내천 습지 사례 분석

박별님,조영철 한국환경영향평가학회 2023 환경영향평가 Vol.32 No.5

Harmful algal blooms (HABs) have become an increasing concern in terms of human health risks as well as aesthetic impairment due to their toxicity. The reduction of water pollutants, especially nutrients from non-point sources in a reservoir watershed, is fundamental for HABs prevention. We investigated the pollutant removal efficiencies of a constructed wetland to evaluate its feasibility as a method for controlling non-point sources located in the Annaecheon stream within the Daecheong Reservoir watershed. The overall removal efficiencies of pollutants were as follows: BOD 14.3%, COD 17.9%, SS 50.0%, T-N 19.0%, and T-P 35.4%. These results indicate that constructed wetlands are effective in controlling pollutants from non-point sources. The seasonal variation in removal efficiency depended on the specific pollutants. The removal efficiencies of BOD, COD, and T-N were stable throughout the year, except during winter, which might have been influenced by lower microorganism activity. In contrast, T-P showed a consistent removal efficiency even during the winter season, suggesting that the wetland can reduce external phosphorus loading to the reservoir.Regarding the effects of pollutant loadings on removal efficiency, the effluent concentrations of all pollutants were significantly decreased compared to those in the influent in case of middle and high loadings. This demonstrates that constructed wetlands can handle high pollutant loads, including the initial runoff during rainfall, to prevent reservoir eutrophication. Despite the various strengths of wetland water purification, there are limitations as passive treatment. Therefore, more case studies should be conducted to suggest optimum operational conditions for constructed wetlands, taking into consideration reservoir-specific characteristics.

물리적 녹조 제거 장치의 제거 효율 평가 방안

박별님,김경미,조영철 한국환경영향평가학회 2023 환경영향평가 Vol.32 No.6

국내 상수원에서 주기적으로 발생하는 녹조에 대응하기 위하여 다양한 종류의 녹조제거기술이 개발되어 적용 중이다. 이러한 기술들은 녹조제거 원리가 다르기 때문에 이들의 제거 효율을 비교ㆍ평가하기는 어렵다. 본 연구에서는 대청호 서화천 수역에서 이동식 녹조제거장치를 사용하여 제거 작업을 시행한 결과를 활용하여, 녹조제거 효율을 평가할 수 있는 표준화된 방법을 제안하였다. 녹조 제거 작업시 수거된 슬러지의 양, 함수율, 클로로필-a의 농도로부터 작업 구간 중 클로로필-a의 농도 감소량(ΔChl-a)을 계산하였다. 또한 작업 대상 수역의 면적, 일일 최대 작업 면적과 ΔChl-a로부터 대상 수역에서 1 mg/m3의 클로로필-a 농도를 저감하는데 필요한 작업일수(WD)를 계산하였다. 작업 전후 수체에서 클로로필-a의 농도 저감율, 제거 기술의 처리 용량, 작업 대상 수역의 수체 용량으로부터 녹조제거능을 계산하는 방법을 제안하였다. 본 연구에서 사용된 이동식 녹조제거장치의 녹조제거능은 6.64%/day(대청호 서화천 수역 대상, 약 500,000 m2)이었으며, 이는 다른 물리ㆍ화학적 녹조제거 기술의 녹조제거능(0.02~4.72%/day)에 비해 높은 것으로 나타났다. 본 연구에서 제시한 조류제거효율 평가 방법을 활용하여 국내에서 적용되고 있는 녹조제거 기술의 비교 평가가 가능할 것이며, 국립환경과학원이 운영하고 있는 「조류제거시설 설치ᆞ운영 및 살포용 조류제거물질 사용지침」에서 물리적 또는 물리ㆍ화학적 복합 조류제거기법의 조류제거 성능 및 제거 효율 평가를 판정하는 방법으로 활용이 가능할 것으로 판단된다. In response to the periodic occurrence of cyanobacterial blooms in Korean freshwaters, various types of cyanobacteria removal technologies are being developed and implemented. Due to the differing principles behind these technologies, it is difficult to compare and evaluate their removal efficiencies. In this study, a standardized method for evaluating cyanobacteria removal efficiency was proposed by utilizing the results of removal operations using a mobile cyanobacteria removal device in the Seohwacheon area of Daechung Reservoir. During removal operations, the decrease in chlorophyll-a(chl-a) concentration (ΔChl-a) in the working area was calculated based on the amount of collected sludge, the efficiency rate, and the concentration of chl-a. Additionally, the required working days (WD) to reduce the chl-a concentration to 1 mg/m3 in the target area was calculated based on the area of the target zone, the maximum daily working area, and the efficiency rate. A method for calculating the cyanobacteria removal capacity was proposed based on the reduction rate of chl-a concentration in the water before and after the operation, the treatment capacity of the removal technology, and the water volume of the target area. The cyanobacteria removal capacity of the mobile cyanobacteria removal device used in this study was 6.64%/day (targeting the Seohwacheon area of Daechung Reservoir, approximately 500,000 m2), which was higher compared to other physical or physicochemical cyanobacteria removal technologies(0.02~4.72%/day). Utilizing the evaluation method of cyanobacteria removal efficiency presented in this study, it will be possible to compare and evaluate the cyanobacteria removal technologies currently being applied in Korea. This method could also be used to assess the performance and efficiency of physical or physicochemical combined cyanobacteria removal techniques in the "Guidelines for the Installation and Operation of Algae Removal Facilities and the Use of Algae Removal Agents" operated by the National Institute of Environmental Research.

대청호 유역 비점오염원 제어를 위한 생태습지의 오염물질 제거효율 평가

박별님,조영철 한국하천호수학회 2023 생태와 환경 Vol.56 No.2

Daechung Reservoir has been suffering from severe cyanobacterial blooming periodically due to the water pollutants from the watershed, especially nutrients from nonpoint sources. As a countermeasure, an artificial wetland was constructed to mitigate the pollutant load from the watershed by utilizing the vegetation. We investigated the water quality of the influent and outflow of the wetland during years 2014~2020 to evaluate the performance of pollutant removal through the wetland. Major pollutants (e.g. BOD, COD, SS, T-N, and T-P) were largely reduced during the retention in the wetland while nutrients removal was more efficient than that of organic matters. Pollutant removal efficiency for different inflow concentrations was also investigated to estimate the wetland’s capability as a way of managing nonpoint sources. The efficiency of water treatment was significantly higher when inflow concentrations were above 75th percentile for all pollutant, implying the wetland can be applied to the pre-treatment of high pollution load including initial rainfall runoff. Furthermore, the yearly variation of removal efficiency for seven years was analyzed to better understand long-term trends in water treatment of the wetland. The annual treatment efficiency of T-P was very high in the early stages of vegetation growth with high concentration of inflow water. However, it was confirmed that the concentration of inflow water decreased, vegetation stabilized, and the treatment efficiency gradually decreased as the soil was saturated. The findings of the study suggest that artificial wetlands can be an effective method for controlling harmful algal blooms by alleviating pollutant load from the tributaries of Daechung Reservoir.

용적조절호형방사선치료(VMAT)의 다중치료중심(Multi- Isocenter)을 이용한 치료 시, 접합부(Junction)의 선량 변화에 대한 고찰

정동민,박광순,안혁진,최윤원,박별님,권용재,문성공,이종운,정태식,박령황,김세영,김미정,백종걸,조정희,Jung, Dong Min,Park, Kwang Soon,Ahn, Hyuk Jin,Choi, Yoon Won,Park, Byul Nim,Kwon, Yong Jae,Moon, Sung Gong,Lee, Jong Oon,Jeong, Tae Sik,Park, Ry 대한방사선치료학회 2021 대한방사선치료학회지 Vol.33 No.-

용적조절호형방사선치료(Volumetric Modulated Arc Therapy)의 다중치료중심(Multi-Isocenter)을 이용하여 치료 시, 접합부(Junction)의 재현 오차에 따른 선량변화에 대해 고찰하였다. Arccheck Phantom에 임의의 치료부위를 설정하고, 다중치료중심에 대해 치료계획을 수립하였다. 그리고 X(왼쪽), Y(위쪽), Z(안쪽, 바깥쪽) 방향에 대해서 접합부의 오차를 0 ~ 4 mm로 설정 후 선형가속기를 이용하여 방사선을 조사하였고, 이 후 phantom을 통해 얻어진 점 선량(point dose)과 감마인덱스(gamma Index)를 통해 분석하였다. X방향과 Y방향에 대한 오차가 2, 4 mm 발생 했을 때, 감마패스율(점 선량)은 각각 99.3% (2.085), 98% (2.079 Gy) 와 98.5% (2.088), 95.5% (2.093 Gy)로 나타났다. 그리고 Z방향에 대해서 안쪽과 바깥쪽에 대한 오차가 1, 2, 4 mm 발생 했을 때, 감마패스율(점 선량)은 각각 94.8% (2.131), 82.6% (2.164), 72.8% (2.22 Gy) 와 93.4% (2.069), 90.6% (2.047), 79.7% (1.962 Gy) 로 보여졌다. X, Y방향에 대해서 4 mm 까지의 오차 결과는 허용오차 안에 있었으나, Z방향에 대해서는 1 mm 를 초과하는 오차 값에 대해서 허용오차 밖의 결과 값이 도출되었다. 이는 높은 선량 영역(high dose area)과 낮은 선량 영역(low dose area)에 대해 치료부위의 진행방향과 같은 방향의 오차가 선량 분포(dose distribution)가 더 민감하다는 것을 시사한다. 향후 지속적인 연구를 통해 기관차원의 셋 업(set up) 오차에 대한 가이드라인이 정립된다면, 접합부를 이용한 치료에서 양질의 치료를 제공할 수 있을 것이라 사료된다. This study examined dose change depending on the reposition error of the junction at the time of treatment with multi-isocenter volumetric modulated arc therapy. This study selected a random treatment region in the Arccheck Phantom and established the treatment plan for multi-isocenter volumetric modulated arc therapy. Then, after setting the error of the junction at 0 ~ 4 mm in the X (left), Y (upper), and Z (inner and outer) directions, the area was irradiated using a linear accelerator; the point doses and gamma indexes obtained through the Phantom were subsequently analyzed. It was found that when errors of 2 and 4 mm took place in the X and Y directions, the gamma pass rates (point doses) were 99.3% (2.085) and 98% (2.079 Gy) in the former direction and 98.5% (2.088) and 95.5% (2.093 Gy) in the latter direction, respectively. In addition, when errors of 1, 2, and 4 mm occurred in the inner and outer parts of the Z direction, the gamma pass rates (point doses) were found to be 94.8% (2.131), 82.6% (2.164), and 72.8% (2.22 Gy) in the former part and 93.4% (2.069), 90.6% (2.047), and 79.7% (1.962 Gy) in the latter part, respectively. In the X and Y directions, errors up to 4 mm were tolerable; however, in the Z direction, error values exceeding 1 mm were beyond the tolerance level. This suggests that for high and low dose areas, errors in the direction same as the progress direction in the treatment region have a more sensitive dose distribution. If the guidelines for set-up errors are established at the institutional level through continuous research in the future, it will be possible to provide good quality treatment using junctions.

좌측 유방암 방사선치료에서 CPAP(Continuous Positive Airway Pressure)의 유용성 평가

정일훈,하진숙,장원석,전미진,김세준,정진욱,박별님,신동봉,이익재,Jung, Il Hun,Ha, Jin Sook,Chang, Won Suk,Jeon, Mi Jin,Kim, Sei Joon,Jung, Jin Wook,Park, Byul Nim,Shin, Dong Bong,Lee, Ik Jae 대한방사선치료학회 2019 대한방사선치료학회지 Vol.31 No.2

목 적: 본 연구는 좌측 유방암 방사선치료에서 환자 호흡방법에 따른 영향에 대하여 치료계획을 통해 비교 분석하고, 깊은 들숨 호흡 정지법(deep inspiration breath hold, DIBH)에서 지속적 기도 양압(continuous positive airway, CPAP)의 유용성을 평가하고자 하였다. 대상 및 방법: 좌측 유방암 환자 총 10명을 대상으로 하였다. 모의치료에서 총 세 가지 호흡법을 적용하여 영상을 획득하였다: 자유호흡법(free breathing, FB); 깊은 들숨 호흡 정지법(DIBH); 들숨 호흡 정지법(inspiration breath hold, IBH); 여기서 DIBH에서는 자가호흡확인 기구인 abches(APEX, Japan)와 IBH에서는 CPAP가 적용되었다. 치료계획은 Ray Station(5.0.2.35, Sweden)을 이용하였고, 용적 강도변조 회전방사선치료법(volumetric modulated arc therapy, VMAT) one partial Arc을 환자당 동일 각도로 적용하였다. 치료계획용적(planning target volume, PTV)의 총 처방선량은 50Gy(2Gy/fx)로 설정하였다. 치료계획분석은 PTV의 95% dose(D95), 처방선량지수(conformity index, CI)와 선량균질지수(homogeneity index, HI)를 비교 분석하였다. 손상위험장기(Organ At Risk, OAR)인 폐, 심장, 왼내림 앞가지동맥(left anterior descending artery, LAD)을 분석하였다. 결 과: 동축의 폐(ipsilateral lung)의 평균용적 FB, DIBH(Abches), IBH(CPAP)에서 각각 1245.58±301.31㎤, 1790.09±362.43㎤, 1775.44±476.71㎤였다. PTV의 평균 D95는 각각 46.67±1.89Gy, 46.85±1.72Gy, 46.97±2.34Gy였다. 평균 CI(HI)는 각각 0.95±0.02(0.91±0.01), 0.96±0.02(0.90±0.01), 0.95±0.02(0.92±0.02)였다. 폐 전체의 V20(동측 폐)은 각각 10.74±4.50%(20.45±8.65%), 8.29±3.14%(17.18±7.04%), 9.12±3.29%(18.85±7.85%)였다. 심장의 평균 선량(Dmean)은 각각 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy였다. LAD의 최대선량(Dmax)은 각각 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy였다. LAD에서 흉벽(Chest wall)까지 평균거리는 각각 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm였다. 결 론: DIBH와 CPAP에서 FB보다 폐 용적이 커짐으로써, 방사선치료영역인 흉벽과 심장의 거리가 멀어지는 효과 때문에 LAD의 선량을 감소시킬 수 있다. 좌측 유방암 방사선치료 시 DIBH방법의 대체방안으로 CPAP은 임상적 활용도가 높을 것으로 사료된다. Purpose: This study examined changes in the position of the heat and lungs depending on the patient's breathing method during left breast cancer radiotherapy and used treatment plans to compare the resulting radiation dose. Materials and methods: The participants consisted of 10 patients with left breast cancer. A CT simulator(SIMENS SOMATOM AS, Germany) was used to obtain images when using three different breathing methods: free breathing(FB), deep inspiration breath hold(DIBH with Abches, DIBH), inspiration breath hold(IBH with CPAP, CPAP). A Ray Station(5.0.2.35, Sweden) was used for treatment planning, the treatment method was volumetric modulated arc therapy (VMAT) with one partial arc of the same angle, and the prescribed dose to the planning target volume (PTV) was a total dose of 50Gy(2Gy/day). In treatment plan analysis, the 95% dose (D95) to the PTV, the conformity index(CI), and the homogeneity index (HI) were compared. The lungs, heart, and left anterior descending artery (LAD) were selected as the organs at risk(OARs). Results: The mean volume of the ipsilateral lung for FB, DIBH, and CPAP was 1245.58±301.31㎤, 1790.09±362.43 ㎤, 1775.44±476.71 ㎤. The mean D95 for the PTV was 46.67±1.89Gy, 46.85±1.72Gy, 46.97±23.4Gy, and the mean CI and HI were 0.95±0.02, 0.96±0.02, 0.95±0.02 and 0.91±0.01, 0.90±0.01, 0.92±0.02. The V20 of Whole Lung was 10.74±4.50%, 8.29±3.14%, 9.12±3.29% and The V20 of the ipsilateral lung was 20.45±8.65%, 17.18±7.04%, 18.85±7.85%, the Dmean of the heart was 7.82±1.27Gy, 6.10±1.27Gy, 5.67±1.56Gy, and the Dmax of the LAD was 20.41±7.56Gy, 14.88±3.57Gy, 14.96±2.81Gy. The distance from the thoracic wall to the LAD was measured to be 11.33±4.70mm, 22.40±6.01mm, 20.14±6.23mm. Conclusion: During left breast cancer radiotherapy, the lung volume was 46.24% larger for DIBH than for FB, and 43.11% larger for CPAP than FB. The larger lung volume increases the distance between the thoracic wall and the heart. In this way, the LAD, which is one of the nearby OARs, can be more effectively protected while still satisfying the treatment plan. The lung volume was largest for DIBH, and the distance between the LAD and thoracic wall was also the greatest. However, when performing treatment with DIBH, the intra-fraction error cannot be ignored. Moreover, communication between the patient and the radiotherapist is also an important factor in DIBH treatment. When communication is problematic, or if the patient has difficulty holding their breath, we believe that CPAP could be used as an alternative to DIBH. In order to verify the clinical efficacy of CPAP, it will be necessary to perform long-term follow-up of a greater number of patients.