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Lee E, Cho B, Kwak J, Jeong C, Park MJ, Kim SW, Song SY, Goh Y. Deep learning proton beam range estimation model for quality assurance based on two-dimensional scintillated light distributions in simulations. Med Phys 2023; 50:7203-7213. [PMID: 37517077 DOI: 10.1002/mp.16646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/13/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Many studies have utilized optical camera systems with volumetric scintillators for quality assurances (QA) to estimate the proton beam range. However, previous analytically driven range estimation methods have the difficulty to derive the dose distributions from the scintillation images with quenching and optical effects. PURPOSE In this study, a deep learning method utilized to QA was used to predict the beam range and spread-out Bragg peak (SOBP) for two-dimensional (2D) map conversion from the scintillation light distribution (LD) into the dose distribution in a water phantom. METHODS The 2D residual U-net modeling for deep learning was used to predict the 2D water dose map from a 2D scintillation LD map. Monte Carlo simulations for dataset preparation were performed with varying monoenergetic proton beam energies, field sizes, and beam axis shifts. The LD was reconstructed using photons backpropagated from the aperture as a virtual lens. The SOBP samples were constructed based on monoenergetic dose distributions. The training set, including the validation set, consisted of 8659 image pairs of LD and water dose maps. After training, dose map prediction was performed using a 300 image pair test set generated under random conditions. The pairs of simulated and predicted dose maps were analyzed by Bragg peak fitting and gamma index maps to evaluate the model prediction. RESULT The estimated beam range and SOBP width resolutions were 0.02 and 0.19 mm respectively for varying beam conditions, and the beam range and SOBP width deviations from the reference simulation result were less than 0.1 and 0.8 mm respectively. The simulated and predicted distributions showed good agreement in the gamma analysis, except for rare cases with failed gamma indices in the proximal and field-marginal regions. CONCLUSION The deep learning conversion method using scintillation LDs in an optical camera system with a scintillator is feasible for estimating proton beam range and SOBP width with high accuracy.
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Affiliation(s)
- Eunho Lee
- Department of Radiation Oncology, Yonsei Cancer Center, Seoul, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Chiyoung Jeong
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Min-Jae Park
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Sung-Woo Kim
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Youngmoon Goh
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
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Jelsone-Swain L, Settepani M, McMullen K, Stafford J, Cho B. An examination of mindfulness on Mu suppression and pain empathy and its relation to trait empathy. Soc Neurosci 2023; 18:245-255. [PMID: 37519186 DOI: 10.1080/17470919.2023.2242093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/02/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023]
Abstract
There have been multiple benefits reported from the practice of mindfulness meditation. Recently social functioning, including empathy, has emerged as one such possible benefit. However, the literature is mixed and it is unknown if mindfulness has an effect on the neural mechanism involved in empathy. Therefore, we conducted a large-scale experimental study involving over 100 participants that were either enrolled in a behavioral or EEG experiment to examine pain empathy and mu suppression, respectively. We also measured state and trait mindfulness and trait empathy. Results did not show a change in pain empathy or mu suppression in response to an acute mindfulness manipulation. However, pain empathy responses were able to be predicted significantly better when the component of state mindfulness involving decentering was incorporated into a regression model compared to trait empathy alone. Also, trait empathy was related to trait mindfulness. Collectively, state decentering may be involved in increased pain empathy, while trait mindfulness appears more related to general trait empathy. Further research is warranted to better understand the potential benefit a brief mindfulness meditation may produce in the realm of brain activity and social functioning.
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Affiliation(s)
- L Jelsone-Swain
- Department of Psychology, University of South Carolina Aiken, Aiken, SC, USA
| | - M Settepani
- Department of Psychology, University of South Carolina Aiken, Aiken, SC, USA
| | - K McMullen
- Department of Psychology, University of South Carolina Aiken, Aiken, SC, USA
| | - J Stafford
- Department of Psychology, University of South Carolina Aiken, Aiken, SC, USA
| | - B Cho
- Department of Psychology, University of South Carolina Aiken, Aiken, SC, USA
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Schoettler ML, Carreras E, Cho B, Dandoy CE, Ho VT, Jodele S, Moissev I, Sanchez-Ortega I, Srivastava A, Atsuta Y, Carpenter P, Koreth J, Kroger N, Ljungman P, Page K, Popat U, Shaw BE, Sureda A, Soiffer R, Vasu S. Harmonizing Definitions for Diagnostic Criteria and Prognostic Assessment of Transplantation-Associated Thrombotic Microangiopathy: A Report on Behalf of the European Society for Blood and Marrow Transplantation, American Society for Transplantation and Cellular Therapy, Asia-Pacific Blood and Marrow Transplantation Group, and Center for International Blood and Marrow Transplant Research. Transplant Cell Ther 2023; 29:151-163. [PMID: 36442770 PMCID: PMC10119629 DOI: 10.1016/j.jtct.2022.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/27/2022]
Abstract
Transplantation-associated thrombotic microangiopathy (TA-TMA) is an increasingly recognized complication of hematopoietic cell transplantation (HCT) associated with significant morbidity and mortality. However, TA-TMA is a clinical diagnosis, and multiple criteria have been proposed without universal application. Although some patients have a self-resolving disease, others progress to multiorgan failure and/or death. Poor prognostic features also are not uniformly accepted. The lack of harmonization of diagnostic and prognostic markers has precluded multi-institutional studies to better understand incidence and outcomes. Even current interventional trials use different criteria, making it challenging to interpret the data. To address this urgent need, the American Society for Transplantation and Cellular Therapy, Center for International Bone Marrow Transplant Research, Asia-Pacific Blood and Marrow Transplantation, and European Society for Blood and Marrow Transplantation nominated representatives for an expert panel tasked with reaching consensus on diagnostic and prognostic criteria. The panel reviewed literature, generated consensus statements regarding diagnostic and prognostic features of TA-TMA using the Delphi method, and identified future directions of investigation. Consensus was reached on 4 key concepts: (1) TA-TMA can be diagnosed using clinical and laboratory criteria or tissue biopsy of kidney or gastrointestinal tissue; however, biopsy is not required; (2) consensus diagnostic criteria are proposed using the modified Jodele criteria with additional definitions of anemia and thrombocytopenia. TA-TMA is diagnosed when ≥4 of the following 7 features occur twice within 14 days: anemia, defined as failure to achieve transfusion independence despite neutrophil engraftment; hemoglobin decline by ≥1 g/dL or new-onset transfusion dependence; thrombocytopenia, defined as failure to achieve platelet engraftment, higher-than-expected transfusion needs, refractory to platelet transfusions, or ≥50% reduction in baseline platelet count after full platelet engraftment; lactate dehydrogenase (LDH) exceeding the upper limit of normal (ULN); schistocytes; hypertension; soluble C5b-9 (sC5b-9) exceeding the ULN; and proteinuria (≥1 mg/mg random urine protein-to-creatinine ratio [rUPCR]); (3) patients with any of the following features are at increased risk of nonrelapse mortality and should be stratified as high-risk TA-TMA: elevated sC5b-9, LDH ≥2 times the ULN, rUPCR ≥1 mg/mg, multiorgan dysfunction, concurrent grade II-IV acute graft-versus-host disease (GVHD), or infection (bacterial or viral); and (4) all allogeneic and pediatric autologous HCT recipients with neuroblastoma should be screened weekly for TA-TMA during the first 100 days post-HCT. Patients diagnosed with TA-TMA should be risk-stratified, and those with high-risk disease should be offered participation in a clinical trial for TA-TMA-directed therapy if available. We propose that these criteria and risk stratification features be used in data registries, prospective studies, and clinical practice across international settings. This harmonization will facilitate the investigation of TA-TMA across populations diverse in race, ethnicity, age, disease indications, and transplantation characteristics. As these criteria are widely used, we expect continued refinement as necessary. Efforts to identify more specific diagnostic and prognostic biomarkers are a top priority of the field. Finally, an investigation of the impact of TA-TMA-directed treatment, particularly in the setting of concurrent highly morbid complications, such as steroid-refractory GVHD and infection, is critically needed.
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Affiliation(s)
- M L Schoettler
- Department Blood and Marrow Transplantation, Children's Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Atlanta, Georgia
| | - E Carreras
- Spanish Bone Marrow Donor Registry, Josep Carreras Foundation and Leukemia Research Institute, Barcelona, Catalunya, Spain
| | - B Cho
- Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul, Korea
| | - C E Dandoy
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - V T Ho
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - S Jodele
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - I Moissev
- RM Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russian Federation
| | | | - A Srivastava
- Department of Haematology, Christian Medical College, Vellore, India
| | - Y Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan
| | - P Carpenter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - J Koreth
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - N Kroger
- Division of Hematology, Ohio State University, Columbus, Ohio
| | - P Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - K Page
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - U Popat
- Department of Stem Cell Transplantation & Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - B E Shaw
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - A Sureda
- Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet, Barcelona, Spain
| | - R Soiffer
- Department of Medical Oncology, Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA
| | - S Vasu
- Division of Hematology, Ohio State University, Columbus, Ohio.
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Hidayat R, Kim HL, Khumaini K, Chowdhury T, Mayangsari TR, Cho B, Park S, Lee WJ. Selective etching mechanism of silicon oxide against silicon by hydrogen fluoride: a density functional theory study. Phys Chem Chem Phys 2023; 25:3890-3899. [PMID: 36647706 DOI: 10.1039/d2cp05456f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Selective etching of silicon oxide (SiO2) against silicon (Si) using anhydrous hydrogen fluoride (HF) vapor has been used for semiconductor device fabrication. We studied the underlying mechanism of the selective etching by density functional theory (DFT) calculation. We constructed surface slab models of SiO2 or Si with different degrees of fluorination and simulated the four steps of fluorination. The calculations show relatively low activation energies of 0.72-0.79 eV for the four steps of fluorination of SiO2, which are close to ∼0.69 eV observed in the experiment. The four-membered ring structure of -Si-O-H-F- in all transition states stabilized the system, resulting in relatively low activation energies. Thus, continuous etching of SiO2 by HF is plausible at near-room temperature. In contrast, the fluorinations of Si showed relatively high activation energies ranging from 1.22 to 1.56 eV due to the less stable transition state geometries. Thus, negligible etching of silicon by HF is expected by the near-room temperature process. Our calculation results explain well the experimental observation of the selective etching of SiO2 against Si by HF vapor.
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Affiliation(s)
- Romel Hidayat
- Department of Nanotechnology and Advanced Materials Engineering, Sejong University, Seoul, 05006, Republic of Korea.
| | - Hye-Lee Kim
- Metal-organic Compounds Materials Research Center, Sejong University, Seoul, 05006, Republic of Korea
| | - Khabib Khumaini
- Department of Nanotechnology and Advanced Materials Engineering, Sejong University, Seoul, 05006, Republic of Korea. .,Department of Chemistry, Universitas Pertamina, Jakarta 12220, Indonesia
| | - Tanzia Chowdhury
- Department of Nanotechnology and Advanced Materials Engineering, Sejong University, Seoul, 05006, Republic of Korea.
| | | | | | | | - Won-Jun Lee
- Department of Nanotechnology and Advanced Materials Engineering, Sejong University, Seoul, 05006, Republic of Korea. .,Metal-organic Compounds Materials Research Center, Sejong University, Seoul, 05006, Republic of Korea
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Hwang I, Han Y, Kim M, Kim K, Cho B, W.H. mChoi, Kim Y, Yoo S, Lee S. PP069 Preferred versus actual place of care and factors associated with home discharge among Korean patients with terminal cancer. ESMO Open 2022. [DOI: 10.1016/j.esmoop.2022.100662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Kim C, Kim H, Kim SW, Goh Y, Park MJ, Kim H, Jeong C, Cho B, Choi EK, Lee SW, Yoon SM, Kim SS, Park JH, Jung J, Song SY, Kwak J. A study of quantitative indicators for slice sorting in cine-mode 4DCT. PLoS One 2022; 17:e0272639. [PMID: 36026490 PMCID: PMC9417040 DOI: 10.1371/journal.pone.0272639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/22/2022] [Indexed: 11/28/2022] Open
Abstract
The uncertainties of four-dimensional computed tomography (4DCT), also called as residual motion artefacts (RMA), induced from irregular respiratory patterns can degrade the quality of overall radiotherapy. This study aims to quantify and reduce those uncertainties. A comparative study on quantitative indicators for RMA was performed, and based on this, we proposed a new 4DCT sorting method that is applicable without disrupting the current clinical workflow. In addition to the default phase sorting strategy, both additional amplitude information from external surrogates and the quantitative metric for RMA, investigated in this study, were introduced. The comparison of quantitative indicators and the performance of the proposed sorting method were evaluated via 10 cases of breath-hold (BH) CT and 30 cases of 4DCT. It was confirmed that N-RMSD (normalised root-mean-square-deviation) was best matched to the visual standards of our institute’s regime, manual sorting method, and could accurately represent RMA. The performance of the proposed method to reduce 4DCT uncertainties was improved by about 18.8% in the averaged value of N-RMSD compared to the default phase sorting method. To the best of our knowledge, this is the first study that evaluates RMA indicators using both BHCT and 4DCT with visual-criteria-based manual sorting and proposes an improved 4DCT sorting strategy based on them.
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Affiliation(s)
- Changhwan Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hojae Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Seoul, Republic of Korea
| | - Sung-woo Kim
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Youngmoon Goh
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Min-jae Park
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Hojin Kim
- Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chiyoung Jeong
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Kyung Choi
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Min Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Su Ssan Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin-hong Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jinhong Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
- * E-mail:
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7
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Sung W, Cho B. Modeling of radiation effects to immune system: a review. J Korean Phys Soc 2022; 81:1013-1019. [PMID: 35966936 PMCID: PMC9358382 DOI: 10.1007/s40042-022-00574-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 03/17/2022] [Accepted: 05/18/2022] [Indexed: 06/15/2023]
Abstract
Cancer metastasis is the major cause of cancer mortality and accounts for about 90% of cancer death. Although radiation therapy has been considered to reduce the localized cancer burden, emerging evidence that radiation can potentially turn tumors into an in situ vaccine has raised significant interest in combining radiation with immunotherapy. However, the combination approach might be limited by the radiation-induced immunosuppression. Assessment of radiation effects on the immune system at the patient level is critical to maximize the systemic antitumor response of radiation. In this review, we summarize the developed solutions in three different categories for systemic radiation therapy: blood dose, radiation-induced lymphopenia, and tumor control. Furthermore, we address how they could be combined to optimize radiotherapy regimens and maximize their synergy with immunotherapy.
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Affiliation(s)
- Wonmo Sung
- Department of Biomedical Engineering and of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Lee J, Ha D, Cho B. Exosomes/EVs: Late Breaking Abstract: INTRAVENOUS ADMINISTRATION OF MSC-DERIVED EXTRACELLULAR VESICLES ALLEVIATE INFLAMMATORY BOWEL DISEASE. Cytotherapy 2022. [DOI: 10.1016/s1465-3249(22)00279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wainberg Z, Matos I, Delord J, Cassier P, Gil-Martin M, Kim T, LoRusso P, Bahleda R, Italiano A, Mendus D, Hoang T, Xue C, Wen X, Carvalho O, Pham T, Patil N, Meng R, Bendell J, Cervantes A, Cho B. LBA-5 Phase Ib study of the anti-TIGIT antibody tiragolumab in combination with atezolizumab in patients with metastatic esophageal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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Jeon Y, Min G, Park S, Park S, Yoon J, Lee S, Cho B, Eom K, Kim Y, Min C, Lee J, Cho S. Efficacy of ex vivo purging with CD34 positive selection during autologous stem cell transplantation in peripheral T-cell lymphomas. Cytotherapy 2021. [DOI: 10.1016/s1465324921003807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Keall PJ, Sawant A, Berbeco RI, Booth JT, Cho B, Cerviño LI, Cirino E, Dieterich S, Fast MF, Greer PB, Munck Af Rosenschöld P, Parikh PJ, Poulsen PR, Santanam L, Sherouse GW, Shi J, Stathakis S. AAPM Task Group 264: The safe clinical implementation of MLC tracking in radiotherapy. Med Phys 2021; 48:e44-e64. [PMID: 33260251 DOI: 10.1002/mp.14625] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/25/2022] Open
Abstract
The era of real-time radiotherapy is upon us. Robotic and gimbaled linac tracking are clinically established technologies with the clinical realization of couch tracking in development. Multileaf collimators (MLCs) are a standard equipment for most cancer radiotherapy systems, and therefore MLC tracking is a potentially widely available technology. MLC tracking has been the subject of theoretical and experimental research for decades and was first implemented for patient treatments in 2013. The AAPM Task Group 264 Safe Clinical Implementation of MLC Tracking in Radiotherapy Report was charged to proactively provide the broader radiation oncology community with (a) clinical implementation guidelines including hardware, software, and clinical indications for use, (b) commissioning and quality assurance recommendations based on early user experience, as well as guidelines on Failure Mode and Effects Analysis, and (c) a discussion of potential future developments. The deliverables from this report include: an explanation of MLC tracking and its historical development; terms and definitions relevant to MLC tracking; the clinical benefit of, clinical experience with and clinical implementation guidelines for MLC tracking; quality assurance guidelines, including example quality assurance worksheets; a clinical decision pathway, future outlook and overall recommendations.
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Affiliation(s)
- Paul J Keall
- ACRF Image X Institute, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, 2006, Australia
| | - Amit Sawant
- Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Ross I Berbeco
- Radiation Oncology, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Jeremy T Booth
- Radiation Oncology, Royal North Shore Hospital, St Leonards, 2065, NSW, Australia.,Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW, 2006, Australia
| | - Byungchul Cho
- Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Laura I Cerviño
- Radiation Medicine & Applied Sciences, Radiation Oncology PET/CT Center, UC San Diego, LA Jolla, CA, 92093-0865, USA.,Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065-6007, USA
| | - Eileen Cirino
- Lahey Health and Medical Center, Burlington, MA, 01805, USA
| | - Sonja Dieterich
- Department of Radiation Oncology, UC Davis Medical Center, Sacramento, CA, 95618, USA
| | - Martin F Fast
- Department of Radiotherapy, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
| | - Peter B Greer
- Calvary Mater Newcastle, Newcastle, NSW, 2310, Australia
| | - Per Munck Af Rosenschöld
- Radiation Physics, Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Parag J Parikh
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA.,Department of Radiation Oncology, Henry Ford Hospital, Detroit, MI, 48202, USA
| | - Per Rugaard Poulsen
- Department of Oncology and Danish Center for Particle Therapy, Aarhus University Hospital, 8200, Aarhus, Denmark
| | - Lakshmi Santanam
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, 63110, USA.,Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065-6007, USA
| | | | - Jie Shi
- Sun Nuclear Corp, Melbourne, FL, 32940, USA
| | - Sotirios Stathakis
- University of Texas Health San Antonio Cancer Center, San Antonio, TX, 78229, USA
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Yu J, Goh Y, Song KJ, Kwak J, Cho B, Kim SS, Lee S, Choi EK. Feasibility of automated planning for whole-brain radiation therapy using deep learning. J Appl Clin Med Phys 2021; 22:184-190. [PMID: 33340391 PMCID: PMC7856520 DOI: 10.1002/acm2.13130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/27/2020] [Accepted: 11/28/2020] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The purpose of this study was to develop automated planning for whole-brain radiation therapy (WBRT) using a U-net-based deep-learning model for predicting the multileaf collimator (MLC) shape bypassing the contouring processes. METHODS A dataset of 55 cases, including 40 training sets, five validation sets, and 10 test sets, was used to predict the static MLC shape. The digitally reconstructed radiograph (DRR) reconstructed from planning CT images as an input layer and the MLC shape as an output layer are connected one-to-one via the U-net modeling. The Dice similarity coefficient (DSC) was used as the loss function in the training and ninefold cross-validation. Dose-volume-histogram (DVH) curves were constructed for assessing the automatic MLC shaping performance. Deep-learning (DL) and manually optimized (MO) approaches were compared based on the DVH curves and dose distributions. RESULTS The ninefold cross-validation ensemble test results were consistent with DSC values of 94.6 ± 0.4 and 94.7 ± 0.9 in training and validation learnings, respectively. The dose coverages of 95% target volume were (98.0 ± 0.7)% and (98.3 ± 0.8)%, and the maximum doses for the lens as critical organ-at-risk were 2.9 Gy and 3.9 Gy for DL and MO, respectively. The DL technique shows the consistent results in terms of the DVH parameter except for MLC shaping prediction for dose saving of small organs such as lens. CONCLUSIONS Comparable with the MO plan result, the WBRT plan quality obtained using the DL approach is clinically acceptable. Moreover, the DL approach enables WBRT auto-planning without the time-consuming manual MLC shaping and target contouring.
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Affiliation(s)
- Jesang Yu
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Youngmoon Goh
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Kye Jin Song
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Jungwon Kwak
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Byungchul Cho
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Su San Kim
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Sang‐wook Lee
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
| | - Eun Kyung Choi
- Department of Radiation OncologyAsan Medical CenterSeoulRepublic of Korea
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Park S, Jung J, Cho B, Kim SY, Yun SC, Lim YS, Lee HC, Park J, Park JH, Kim JH, Yoon SM. In reply to Huo et al.: Treating small hepatocellular carcinoma: Stereotactic body radiation therapy versus radiofrequency ablation. J Gastroenterol Hepatol 2020; 35:2293. [PMID: 32909286 DOI: 10.1111/jgh.15250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/07/2020] [Indexed: 12/09/2022]
Affiliation(s)
- S Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - J Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - B Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S Y Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-C Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y-S Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H C Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J-H Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J H Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S M Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Park S, Jung J, Cho B, Kim SY, Yun SC, Lim YS, Lee HC, Park J, Park JH, Kim JH, Yoon SM. Clinical outcomes of stereotactic body radiation therapy for small hepatocellular carcinoma. J Gastroenterol Hepatol 2020; 35:1953-1959. [PMID: 32052884 DOI: 10.1111/jgh.15011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/20/2020] [Accepted: 02/08/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM The purpose of this study was to investigate the long-term oncologic outcomes after stereotactic body radiation therapy (SBRT) for small hepatocellular carcinoma (HCC). METHODS A total of 290 patients with HCC were registered between March 2007 and July 2013. A dose of 10-15 Gy per fraction was given over three to four consecutive days, resulting in a total dose of 30-60 Gy. Overall and recurrence-free survivals were estimated from the date of the start of SBRT to the date of death, the last follow-up examination, or to the date of tumor recurrence. RESULTS The median follow-up period of all patients was 38.2 months, and the median tumor size was 1.7 cm. Overall survival (OS) rate at 5 years was 44.9%. Multivariate analyses revealed that age, Child-Pugh class, tumor size, and albumin levels were significant factors for OS. The 5-year local control rate was 91.3%. In multivariate analysis, tumor size and albumin were significantly associated with local tumor control. However, there was a negative correlation between total dose and tumor size in Pearson's correlation analysis (r = -0.111, P = 0.046). CONCLUSIONS Stereotactic body radiation therapy was an excellent ablative treatment option for patients with small HCC. Tumor size was a significant factor for local tumor control after SBRT, although the total dose was negatively correlated with tumor size. Considering the low OS rates and the high local tumor control rates, the combined SBRT and systemic therapies may be beneficial for improving survival outcomes.
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Affiliation(s)
- Sunmin Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Jinhong Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Suk Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jongmoo Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin-Hong Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong Hoon Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Min Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lee S, Kim K, Cho B, Roh K, Kim S, Lee S. 307 Safety and clinical effects of systemic allogeneic UCB-MSCs therapy for patients with RDEB. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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16
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Kim SW, Kim C, Cho MS, Noh S, Lee M, Jeong C, Kwak J, Koh M, Song SY, Lee SW, Soh J, Cho S, Cho B. Clinical implementation of a wide-field electron arc technique with a scatterer for widespread Kaposi's sarcoma in the distal extremities. Sci Rep 2020; 10:9693. [PMID: 32546847 PMCID: PMC7297993 DOI: 10.1038/s41598-020-66846-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 05/27/2020] [Indexed: 11/09/2022] Open
Abstract
A novel wide-field electron arc technique with a scatterer is implemented for widespread Kaposi's sarcoma (KS) in the distal extremities. Monte Carlo beam modeling for electron arc beams was established to achieve <2% deviation from the measurements, and used for dose calculation. MC-based electron arc plan was performed using CT images of a foot and leg mimicking phantom and compared with in-vivo measurement data. We enrolled one patient with recurrent KS on the lower extremities who had been treated with photon radiation therapy. The 4- and 6-MeV electron arc plans were created, and then compared to two photon plans: two opposite photon beam and volumetric modulated arc with bolus. Compared to the two photon techniques, the electron arc plans resulted in superior dose saving to normal organs beneath the skin region, although it shows inferior coverage and homogeneity for PTV. The electron arc treatment technique with scatterer was successfully implemented for the treatment of widespread KS in the distal extremities with lower radiation exposure to the normal organs beyond the skin lesions, which could be a treatment option for recurrent skin cancer in the extremities.
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Affiliation(s)
- Sung-Woo Kim
- Department of Radiation Oncology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Changhwan Kim
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Min-Seok Cho
- Department of Radiation Oncology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.,Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Seonyeong Noh
- Department of Radiation Oncology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Minsik Lee
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Chiyoung Jeong
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Minji Koh
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeongtae Soh
- Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Seungryong Cho
- Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. .,Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Lee J, Ha D, Cho B, Yi Y. A Toxicity study of exosomes derived from mesenchymal stem cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kim H, Jung J, Kim J, Cho B, Kwak J, Jang JY, Lee SW, Lee JG, Yoon SM. Abdominal multi-organ auto-segmentation using 3D-patch-based deep convolutional neural network. Sci Rep 2020; 10:6204. [PMID: 32277135 PMCID: PMC7148331 DOI: 10.1038/s41598-020-63285-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/30/2020] [Indexed: 02/08/2023] Open
Abstract
Segmentation of normal organs is a critical and time-consuming process in radiotherapy. Auto-segmentation of abdominal organs has been made possible by the advent of the convolutional neural network. We utilized the U-Net, a 3D-patch-based convolutional neural network, and added graph-cut algorithm-based post-processing. The inputs were 3D-patch-based CT images consisting of 64 × 64 × 64 voxels designed to produce 3D multi-label semantic images representing the liver, stomach, duodenum, and right/left kidneys. The datasets for training, validating, and testing consisted of 80, 20, and 20 CT simulation scans, respectively. For accuracy assessment, the predicted structures were compared with those produced from the atlas-based method and inter-observer segmentation using the Dice similarity coefficient, Hausdorff distance, and mean surface distance. The efficiency was quantified by measuring the time elapsed for segmentation with or without automation using the U-Net. The U-Net-based auto-segmentation outperformed the atlas-based auto-segmentation in all abdominal structures, and showed comparable results to the inter-observer segmentations especially for liver and kidney. The average segmentation time without automation was 22.6 minutes, which was reduced to 7.1 minutes with automation using the U-Net. Our proposed auto-segmentation framework using the 3D-patch-based U-Net for abdominal multi-organs demonstrated potential clinical usefulness in terms of accuracy and time-efficiency.
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Affiliation(s)
- Hojin Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jinhong Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jieun Kim
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jeong Yun Jang
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - June-Goo Lee
- Department of Convergence Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
| | - Sang Min Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
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Lee H, Cheong KH, Jung JW, Cho B, Cho S, Yeo I. On-beam computed tomography reconstruction for radiotherapy verification from projection image differences caused by motion during treatment. Phys Med Biol 2020; 65:055001. [DOI: 10.1088/1361-6560/ab6eb9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kim K, Kim S, Lee J, Yoon JS, Chung N, Cho B. Sleep quality in children with bronchiolitis obliterans syndrome. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lee S, Ahn B, Park S, Kim D, Lee C, Cho J, Kim J, Kim H, Kim YH, Park S, Chun Y, Hong M, Kim H, Cho B. A phase II trial of preoperative chemoradiotherapy and pembrolizumab for locally advanced esophageal squamous cell carcinoma (ESCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz266.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Park J, Pyo K, Song Y, Lee W, Kim J, Ji H, Park S, Koh Y, Lee K, Cho B, Chun BH, Oh Y, Yang BG, Nam S, Jang M. GI101, a novel triple-targeting bispecific CD80-IgG4-IL2variant fusion protein, elicits synergistic anti-tumour effects in preclinical models. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz253.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kim H, Jung J, Jeong C, Kwak J, Choi E, Lee S, Yoon S, Cho B. Prediction of Hepatic Parenchymal Change in Gd-EOB-DTPA MR Images after Stereotactic Body Radiation Therapy by Cycle GAN Deep Neural Network. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kim H, Jung J, Kim J, Cho B, Kwak J, Jang J, Lee S, Lee J, Yoon S. Abdominal Multi-Organ Auto-Segmentation with 3D-Patch Based Deep Convolutional Neural Network. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Cho B, Kim J, Ha D, Yi Y. Exosomes derived from mesenchymal Stem cells alleviate atopic dermatitis by suppressing inflammation and improving skin barrier function. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoon S, Lee S, Kim H, Jung J, Kwak J, Cho B. PO-0789 Evaluation of Hepatic Toxicity after Repeated Stereotactic Body RT for Hepatocellular Carcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kim H, Kwak J, Jung J, Jeong C, Yoon K, Lee SW, Ahn SD, Choi EK, Kim SS, Cho B. Automated Field-In-Field (FIF) Plan Framework Combining Scripting Application Programming Interface and User-Executed Program for Breast Forward IMRT. Technol Cancer Res Treat 2019; 17:1533033818810391. [PMID: 30384804 PMCID: PMC6259058 DOI: 10.1177/1533033818810391] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Purpose: To develop an one-click option on treatment planning system that enables for the
automated breast FIF planning by combining the Eclipse Scripting application programming
interfaces and user-executed programming in Windows. Methods: Scripting application programming interfaces were designed to promote automation in
clinical workflow associated with radiation oncology. However, scripting cannot provide
all functions that users want to perform. Thus, a new framework proposes to integrate
the benefits of the scripting application and user-executed programming for the
automated field-in-field technique. We adopted the Eclipse Scripting applications, which
provide an interface between treatment planning system server and client and enable for
running the executed program to create dose clouds and adjust the planning parameters
such as multi-leaf collimator placements and monitor unit values. Importantly, all tasks
are designed to perform with one-click option on treatment planning system, including
the automated pushback of the proposed plan to the treatment planning system. Results: The plans produced from the proposed framework were validated against the manual
field-in-field plans with 40 retrospective breast patient cases in planning efficiency
and plan quality. The elapsed time for running the framework was less than 1 minute,
which significantly reduced the manual multi-leaf collimator/monitor unit adjustment
time. It decreased the total planning time by more than 50%, relative to the manual
field-in-field planning. In dosimetric aspects, the mean and maximum dose of the heart,
lung, and whole breast did not exceed 1% deviation from the manual plans in most patient
cases, while maintaining the target dose coverage and homogeneity index inside the
target volume. From numerical analysis, the automated plans were demonstrated to be
sufficiently close to the manual plans. Conclusion: The combination of scripting applications and user-executed programming for automated
breast field-in-field planning accomplished a significant enhancement in planning
efficiency without degrading the plan quality, relative to the manual field-in-field
procedure.
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Affiliation(s)
- Hojin Kim
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jungwon Kwak
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jinhong Jung
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chiyoung Jeong
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoungjun Yoon
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Wook Lee
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Do Ahn
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Kyung Choi
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Su Ssan Kim
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byungchul Cho
- 1 Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee H, Lee J, Kim H, Cho B, Cho S. Deep-Neural-Network-Based Sinogram Synthesis for Sparse-View CT Image Reconstruction. IEEE Trans Radiat Plasma Med Sci 2019. [DOI: 10.1109/trpms.2018.2867611] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Lee M, Yoon K, Cho B, Kim SS, Song SY, Choi EK, Ahn S, Lee SW, Kwak J. Comparing phase- and amplitude-gated volumetric modulated arc therapy for stereotactic body radiation therapy using 3D printed lung phantom. J Appl Clin Med Phys 2019; 20:107-113. [PMID: 30667581 PMCID: PMC6371017 DOI: 10.1002/acm2.12533] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/16/2018] [Accepted: 12/29/2018] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To compare the dosimetric impact and treatment delivery efficacy of phase-gated volumetric modulated arc therapy (VMAT) vs amplitude-gated VMAT for stereotactic body radiation therapy (SBRT) for lung cancer by using realistic three-dimensional-printed phantoms. METHODS Four patient-specific moving lung phantoms that closely simulate the heterogeneity of lung tissue and breathing patterns were fabricated with four planning computed tomography (CT) images for lung SBRT cases. The phantoms were designed to be bisected for the measurement of two-dimensional dose distributions by using EBT3 dosimetry film. The dosimetric accuracy of treatment under respiratory motion was analyzed with the gamma index (2%/1 mm) between the plan dose and film dose measured under phase- and amplitude-gated VMAT. For the validation of the direct usage of the real-time position management (RPM) data for respiratory motion, the relationship between the RPM signal and the diaphragm position was measured by four-dimensional CT. By using data recorded during the beam delivery of both phase- and amplitude-gated VMAT, the total time intervals were compared for each treatment mode. RESULTS Film dosimetry showed a 5.2 ± 4.2% difference of gamma passing rate (2%/1 mm) on average between the phase- vs amplitude-gated VMAT [77.7% (72.7%-85.9%) for the phase mode and 82.9% (81.4%-86.2%) for the amplitude mode]. For delivery efficiency, frequent interruptions were observed during the phase-gated VMAT, which stopped the beam delivery and required a certain amount of time before resuming the beam. This abnormality in phase-gated VMAT caused a prolonged treatment delivery time of 366 s compared with 183 s for amplitude-gated VMAT. CONCLUSIONS Considering the dosimetric accuracy and delivery efficacy between the gating methods, amplitude mode is superior to phase mode for gated VMAT treatment.
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Affiliation(s)
- Minsik Lee
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - KyoungJun Yoon
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Byungchul Cho
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Su Ssan Kim
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Si Yeol Song
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Kyung Choi
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - SeungDo Ahn
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Wook Lee
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - JungWon Kwak
- Departments of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kim C, Pua R, Lee CH, Choi DI, Cho B, Lee SW, Cho S, Kwak J. An additional tilted-scan-based CT metal-artifact-reduction method for radiation therapy planning. J Appl Clin Med Phys 2018; 20:237-249. [PMID: 30597725 PMCID: PMC6333137 DOI: 10.1002/acm2.12523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/13/2018] [Accepted: 11/27/2018] [Indexed: 11/26/2022] Open
Abstract
Purpose As computed tomography (CT) imaging is the most commonly used modality for treatment planning in radiation therapy, metal artifacts in the planning CT images may complicate the target delineation and reduce the dose calculation accuracy. Although current CT scanners do provide certain correction steps, it is a common understanding that there is not a universal solution yet to the metal artifact reduction (MAR) in general. Particularly noting the importance of MAR for radiation treatment planning, we propose a novel MAR method in this work that recruits an additional tilted CT scan and synthesizes nearly metal‐artifact‐free CT images. Methods The proposed method is based on the facts that the most pronounced metal artifacts in CT images show up along the x‐ray beam direction traversing multiple metallic objects and that a tilted CT scan can provide complementary information free of such metal artifacts in the earlier scan. Although the tilted CT scan would contain its own metal artifacts in the images, the artifacts may manifest in a different fashion leaving a chance to concatenate the two CT images with the metal artifacts much suppressed. We developed an image processing technique that uses the structural similarity (SSIM) for suppressing the metal artifacts. On top of the additional scan, we proposed to use an existing MAR method for each scan if necessary to further suppress the metal artifacts. Results The proposed method was validated by a simulation study using the pelvic region of an XCAT numerical phantom and also by an experimental study using the head part of the Rando phantom. The proposed method was found to effectively reduce the metal artifacts. Quantitative analyses revealed that the proposed method reduced the mean absolute percentages of the error by up to 86% and 89% in the simulation and experimental studies, respectively. Conclusions It was confirmed that the proposed method, using complementary information acquired from an additional tilted CT scan, can provide nearly metal‐artifact‐free images for the treatment planning.
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Affiliation(s)
- Changhwan Kim
- Department of Nuclear and Quantum Engineering, KAIST, Daejeon, Republic of Korea
| | - Rizza Pua
- Department of Nuclear and Quantum Engineering, KAIST, Daejeon, Republic of Korea
| | - Chung-Hwan Lee
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
| | - Da-In Choi
- Department of Nuclear and Quantum Engineering, KAIST, Daejeon, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering, KAIST, Daejeon, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, Seoul, Republic of Korea
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Yoon KJ, Cho B, Kwak JW, Lee D, Kwon DH, Ahn SD, Lee SW, Kim CJ, Roh SW, Cho YH. Cyberknife Dosimetric Planning Using a Dose-Limiting Shell Method for Brain Metastases. J Korean Neurosurg Soc 2018; 61:753-760. [PMID: 30396248 PMCID: PMC6280060 DOI: 10.3340/jkns.2018.0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/04/2018] [Indexed: 11/30/2022] Open
Abstract
Objective We investigated the effect of optimization in dose-limiting shell method on the dosimetric quality of CyberKnife (CK) plans in treating brain metastases (BMs).
Methods We selected 19 BMs previously treated using CK between 2014 and 2015. The original CK plans (CKoriginal) had been produced using 1 to 3 dose-limiting shells : one at the prescription isodose level (PIDL) for dose conformity and the others at lowisodose levels (10–30% of prescription dose) for dose spillage. In each case, a modified CK plan (CKmodified) was generated using 5 dose-limiting shells : one at the PIDL, another at intermediate isodose level (50% of prescription dose) for steeper dose fall-off, and the others at low-isodose levels, with an optimized shell-dilation size based on our experience. A Gamma Knife (GK) plan was also produced using the original contour set. Thus, three data sets of dosimetric parameters were generated and compared.
Results There were no differences in the conformity indices among the CKoriginal, CKmodified, and GK plans (mean 1.22, 1.18, and 1.24, respectively; p=0.079) and tumor coverage (mean 99.5%, 99.5%, and 99.4%, respectively; p=0.177), whereas the CKmodified plans produced significantly smaller normal tissue volumes receiving 50% of prescription dose than those produced by the CKoriginal plans (p<0.001), with no statistical differences in those volumes compared with GK plans (p=0.345).
Conclusion These results indicate that significantly steeper dose fall-off is able to be achieved in the CK system by optimizing the shell function while maintaining high conformity of dose to tumor.
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Affiliation(s)
- Kyoung Jun Yoon
- Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Won Kwak
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Doheui Lee
- Radiosurgery Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Do Hoon Kwon
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung Do Ahn
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang-Wook Lee
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chang Jin Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Woo Roh
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Hyun Cho
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yun J, Cho B, Lim S. Risk factors of primary care clinic closure in Korea using nationwide data. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - S Lim
- Graduate School of Public Health, Seoul National University, Seoul, South Korea
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Kim H, Jeong C, Cho B, Goh Y, Lim Y, Hwang U, Choi S, Song S, Lee S, Kwak J. Plan Optimization to Minimize Number of Source Dwelling Positions and Angles in a New Rotational,Intensity Modulated Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Cho I, Park JW, Cho B, Kwak J, Yoon SM, Nesseler JP, Park J, Kim JH. Dosimetric analysis of stereotactic rotational versus static intensity-modulated radiation therapy for pancreatic cancer. Cancer Radiother 2018; 22:754-762. [PMID: 30322818 DOI: 10.1016/j.canrad.2018.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/20/2018] [Accepted: 01/24/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE Stereotactic body radiation therapy is a promising treatment modality for locally advanced pancreatic cancer. To determine the optimal radiation treatment, we compared the plan characteristics of volumetric-modulated arc therapy and intensity-modulated radiation therapy when administered with stereotactic body radiation therapy to treat pancreatic cancer. PATIENTS AND METHODS Fifteen patients with locally advanced pancreatic cancer were treated by stereotactic body radiation therapy at a dose of 24-32Gy in four fractions with marker-guided gated volumetric-modulated arc therapy. Four dimensional-computed tomography scans were used to assess the target and surrounding normal organs. The same images, contours, and dose constraints were used for dual-arc volumetric-modulated arc therapy and 9-field intensity-modulated radiation therapy planning. Plans were compared using dosimetric parameters and treatment performance. RESULTS Volumetric-modulated arc therapy required significantly lower monitor units (1726 vs. 4188; P<0.001) and shorter treatment delivery time in comparison with intensity-modulated radiation therapy (22.5min vs. 52.4min; P<0.001). Regarding target volume coverage, both modalities demonstrated comparable results (V95%, 99.3% vs. 99.4%; P=0.796). Both modalities satisfied the dosimetric determinants for duodenal toxicity and the maximum and mean doses administered to normal organ were also statistically similar. CONCLUSION In comparison with 9-field intensity-modulated radiation therapy, volumetric-modulated arc therapy significantly reduces the number of monitoring units and treatment delivery times while administering similar dosimetric quality. Based on these results, volumetric-modulated arc therapy might be an appropriate treatment for locally advanced pancreatic cancer when combined with stereotactic body radiation therapy.
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Affiliation(s)
- I Cho
- Division of Heavy-ion Clinical Research, Korea Institute of Radiological and Medical Sciences, 75, Nowon-ro, Nowon-gu, Seoul, Republic of Korea
| | - J W Park
- Department of Radiation Oncology, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu, Republic of Korea
| | - B Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05505 Songpa-gu, Seoul, Republic of Korea
| | - J Kwak
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05505 Songpa-gu, Seoul, Republic of Korea
| | - S M Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05505 Songpa-gu, Seoul, Republic of Korea
| | - J P Nesseler
- Department of Radiation Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - J Park
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05505 Songpa-gu, Seoul, Republic of Korea.
| | - J H Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05505 Songpa-gu, Seoul, Republic of Korea
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Lopes G, Wu Y, Kudaba I, Kowalski D, Cho B, Turna H, De Castro G, Srimuninnimit V, Laktionov K, Bondarenko I, Kubota K, Lubiniecki G, Zhang J, Kush D, Mok T. PS1 Phase 3 KEYNOTE-042 Study: Pembrolizumab vs Platinum-Based Chemotherapy as 1l Therapy for Advanced NSCLC with a PD-L1 TPS ≥1%. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Affiliation(s)
- Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kato K, Shah M, Enzinger P, Bennouna J, Shen L, Adenis A, Sun J, Cho B, Ozguroglu M, Kojima T, Kostorov V, Hierro C, Zhu Y, Shah S, Bhagia P, Doi T. A phase 3 study of chemotherapy + pembrolizumab versus chemotherapy + placebo as first-line therapy for patients with advanced esophageal or esophagogastric junction (E/EGJ) cancer: KEYNOTE-590 - Trial in progress. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jung J, Kim H, Yoon SM, Cho B, Kim YJ, Kwak J, Kim JH. Targeting Accuracy of Image-Guided Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma in Real-Life Clinical Practice: In Vivo Assessment Using Hepatic Parenchymal Changes on Gd-EOB-DTPA-Enhanced Magnetic Resonance Images. Int J Radiat Oncol Biol Phys 2018; 102:867-874. [PMID: 29934276 DOI: 10.1016/j.ijrobp.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/22/2018] [Accepted: 05/02/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma (HCC) has emerged as an alternative treatment option when curative treatment modalities cannot be applied. Although excellent local tumor control has been achieved with SBRT, the targeting accuracy in real-life practice remains poorly understood. We proposed an in vivo assessment of targeting accuracy using hepatic parenchymal changes observed on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) images and applied this method to investigate the "real-life" targeting accuracy of image-guided SBRT. METHODS AND MATERIALS We selected 29 patients with available follow-up MR images acquired 2 to 4 months after completion of SBRT. All patients were administered 45 Gy in 3 fractions. The treated HCC and the region of hepatic parenchymal changes in the hepatobiliary phase of MR images were delineated. We evaluated the discrepancies between the center of the HCC and that of the parenchymal change area (intercenter discrepancy [ICD]). We also analyzed the difference in ICDs between those who underwent SBRT with intrahepatic marker guidance and those with diaphragm guidance. RESULTS The median ICD in the 3-dimensional direction was 6.81 mm (interquartile range [IQR], 4.27-9.61 mm). Those for the craniocaudal, left-right, and anteroposterior components were 2.70 mm (IQR, 1.83-4.06 mm), 1.63 mm (IQR, 0.76-3.49), and 4.12 mm (IQR, 1.20-6.96 mm), respectively. The median ICD for patients who underwent treatment with intrahepatic marker guidance and those with diaphragm guidance was 7.53 mm (IQR, 6.63-10.86 mm) and 5.60 mm (IQR, 4.28-8.18 mm), respectively. There was no significant difference in ICD between those who underwent treatment with intrahepatic marker guidance and those with diaphragm guidance (P = .296). CONCLUSIONS The hepatic parenchymal changes observed on Gd-EOB-DTPA-enhanced MR images can be used to assess the targeting accuracy after SBRT for HCC.
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Affiliation(s)
- Jinhong Jung
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hojin Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Min Yoon
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeon Joo Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong Hoon Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Cho B, Ha D, Han S, Yi Y. The effect of exosome from human adipose tissue-derived mesenchymal stem cells on cisplatin-induced acute kidney injury. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cho B, Ha D, Yi Y. The stable production and isolation of exosome from human adipose tissue-derived mesenchymal stem cells. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cho B, Ha D, Kim J, Kang H, Han S, Lee D, Lee H, Yi Y. The effect of exosome from human adipose tissue-derived mesenchymal stem cells on atopic dermatitis in the house dust mite antigen-induced mouse model. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jeong Y, Jung J, Cho B, Kwak J, Jeong C, Kim JH, Park JH, Kim SY, Shim JH, Kim KM, Lim YS, Lee HC, Yoon SM. Stereotactic body radiation therapy using a respiratory-gated volumetric-modulated arc therapy technique for small hepatocellular carcinoma. BMC Cancer 2018; 18:416. [PMID: 29653562 PMCID: PMC5899378 DOI: 10.1186/s12885-018-4340-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/08/2018] [Indexed: 12/23/2022] Open
Abstract
Background Volumetric-modulated arc therapy (VMAT) is a highly sophisticated linear accelerator-based treatment method, and allows dose rate-changing intensity modulation with gantry rotation. We report our clinical experiences with stereotactic body radiation therapy (SBRT) using a respiratory-gated VMAT technique for patients with hepatocellular carcinoma (HCC) when established curative treatments cannot be applied. Methods A total of 119 patients (139 lesions) with HCC who were treated with SBRT were registered between March 2012 and July 2013 at our institution. A dose of 10–15 Gy per fraction was applied over 3–4 consecutive days, resulting in a total dose of 30–60 Gy. Results The median follow-up period was 25.8 months (range, 3.2–36.8 months). The overall 3-year survival rate was 83.8%. The local control rate at 3 years was 97.0% in all treated lesions. Multivariate analysis revealed that the Child-Pugh class before SBRT had significant effects on overall survival (Child-Pugh A: hazard ratio = 0.463; 95% CI, 0.262–0.817; p = 0.008). Conclusions SBRT using a respiratory-gated VMAT technique was an excellent ablative treatment modality for patients with HCC. SBRT is a good alternative treatment for patients with small HCCs that are unsuitable for surgical resection or local ablative therapy. Electronic supplementary material The online version of this article (10.1186/s12885-018-4340-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuri Jeong
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jinhong Jung
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jungwon Kwak
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Chiyoung Jeong
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jong Hoon Kim
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - Jin-Hong Park
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Radiology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ju Hyun Shim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kang Mo Kim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Suk Lim
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han Chu Lee
- Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Min Yoon
- Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, Republic of Korea.
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Abstract
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.
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Affiliation(s)
- Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee S, Song SY, Kim SS, Choi W, Je HU, Back GM, Cho B, Jeong SY, Choi EK. Feasible Optimization of Stereotactic Ablative Radiotherapy Dose by Tumor Size for Stage I Non–small-cell Lung Cancer. Clin Lung Cancer 2018; 19:e253-e261. [DOI: 10.1016/j.cllc.2017.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 10/18/2022]
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Hong S, Kim J, Jeong S, Park K, Song D, Baik T, Kim J, Cho B, Lee S. Effects of Ketamine on Icam-1 Expression during Lipopolysaccharide Induced Acute Lung Injury in Rats. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791101800605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Intercellular adhesion molecule-1 (ICAM-1) serves very important roles in lung injury, and increases in ICAM-1 are associated with severity of lung injury. We intended to examine whether ketamine could have favourable effects on ICAM-1 expression in lipopolysaccharide (LPS)-induced acute lung injury in the rat. Methods The acute lung injury was induced by instilling LPS into the tracheas of 72 anaesthetised rats. The animals were divided into four groups including a sham group with intratracheal saline, an LPS group with intratracheal LPS and intraperitoneal saline, and two ketamine treatment groups with intratracheal LPS and treated with 1 mg/kg or 10 mg/kg doses of intraperitoneal ketamine hydrochloride. Half of the animals were sacrificed at three hours and the remaining animals were sacrificed at six hours. Real time PCR was performed on the lung tissues obtained. Concentration of the soluble ICAM-1 was measured in the bronchoalveolar lavage fluid. Expression of ICAM-1 was measured. Results The transcriptional activity of ICAM-1 mRNA increased 9.92 fold in the LPS group compared to the sham group but decreased by 84.1% and 83.3%, respectively, in the 1 and 10 mg/kg ketamine treatment groups. The concentration of soluble ICAM-1 in bronchoalveolar lavage fluid increased 2.23 fold in the LPS group compared to the sham group while decreasing by 75.0% and 74.5% respectively in the 1 mg/kg and 10 mg/kg ketamine treatment groups. The intensity of immunohistochemical staining for ICAM-1 was also decreased in both ketamine treatment groups. Conclusion Ketamine attenuates ICAM-1 expression during acute lung injury in rats. (Hong Kong j.emerg.med. 2011;18:397-405)
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Affiliation(s)
- S Hong
- The Catholic University of Korea College of Medicine, Department of Emergency Medicine, Seoul, Republic of Korea 137701
| | - J Kim
- Deajeon Health Sciences College, Department of Emergency of Medical Services Technology, Deajeon, Republic of Korea 300711
| | - S Jeong
- The Catholic University of Korea College of Medicine, Department of Emergency Medicine, Seoul, Republic of Korea 137701
| | - K Park
- The Catholic University of Korea College of Medicine, Department of Emergency Medicine, Seoul, Republic of Korea 137701
| | - D Song
- Eulji University College of Medicine, Department of Anatomy and Neurology, Daejeon, Republic of Korea 301746
| | - T Baik
- Eulji University College of Medicine, Department of Anatomy and Neurology, Daejeon, Republic of Korea 301746
| | - J Kim
- Dankook University College of Medicine, Department of Clinical Laboratory, Cheonan, Republic of Korea 330715
| | - B Cho
- Deajeon Health Sciences College, Department of Emergency of Medical Services Technology, Deajeon, Republic of Korea 300711
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Yoon K, Cho B, Kwak J, Lee D, Kwon D, Ahn S, Lee S, Kim C, Roh S, Cho Y. Optimization of Robotic Radiosurgery Dosimetric Planning Using a Dose-Limiting Auto-Shell Method for Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kim S, Shin D, Cho B, Won C, Hong Y, Son K. SELF-REPORTED HEALTH AS A PREDICTOR OF FUNCTIONAL DECLINE IN A COMMUNITY-DWELLING ELDERLY POPULATION. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S. Kim
- Seoul National University Bundang Hospital, Gyunggi-do, Korea (the Republic of),
- Kyung Hee University, Seoul, Korea (the Republic of),
| | - D. Shin
- Samsung Medical Center, Seoul, Korea (the Republic of),
| | - B. Cho
- Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - C. Won
- Kyung Hee University, Seoul, Korea (the Republic of),
| | - Y. Hong
- Kyung Hee University, Seoul, Korea (the Republic of),
| | - K. Son
- Seoul National University Hospital, Seoul, Korea (the Republic of)
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Cho B. HEALTHY AGEING: A CHALLENGE TO KOREA. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B. Cho
- Family Medicine, Seoul National University, Seoul, Chongno-gu, Korea (the Republic of),
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Kim I, Koo T, Cho B, Choi E, Lee D, Kim H, Kim D, Park J. PV-0370: MicroRNA-200c radiosensitizes Human Cancer Cells with Activated EGFR or HER2-associated Signaling. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30812-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chung H, Poulsen PR, Keall PJ, Cho S, Cho B. Reconstruction of implanted marker trajectories from cone-beam CT projection images using interdimensional correlation modeling. Med Phys 2017; 43:4643. [PMID: 27487881 DOI: 10.1118/1.4958678] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Cone-beam CT (CBCT) is a widely used imaging modality for image-guided radiotherapy. Most vendors provide CBCT systems that are mounted on a linac gantry. Thus, CBCT can be used to estimate the actual 3-dimensional (3D) position of moving respiratory targets in the thoracic/abdominal region using 2D projection images. The authors have developed a method for estimating the 3D trajectory of respiratory-induced target motion from CBCT projection images using interdimensional correlation modeling. METHODS Because the superior-inferior (SI) motion of a target can be easily analyzed on projection images of a gantry-mounted CBCT system, the authors investigated the interdimensional correlation of the SI motion with left-right and anterior-posterior (AP) movements while the gantry is rotating. A simple linear model and a state-augmented model were implemented and applied to the interdimensional correlation analysis, and their performance was compared. The parameters of the interdimensional correlation models were determined by least-square estimation of the 2D error between the actual and estimated projected target position. The method was validated using 160 3D tumor trajectories from 46 thoracic/abdominal cancer patients obtained during CyberKnife treatment. The authors' simulations assumed two application scenarios: (1) retrospective estimation for the purpose of moving tumor setup used just after volumetric matching with CBCT; and (2) on-the-fly estimation for the purpose of real-time target position estimation during gating or tracking delivery, either for full-rotation volumetric-modulated arc therapy (VMAT) in 60 s or a stationary six-field intensity-modulated radiation therapy (IMRT) with a beam delivery time of 20 s. RESULTS For the retrospective CBCT simulations, the mean 3D root-mean-square error (RMSE) for all 4893 trajectory segments was 0.41 mm (simple linear model) and 0.35 mm (state-augmented model). In the on-the-fly simulations, prior projections over more than 60° appear to be necessary for reliable estimations. The mean 3D RMSE during beam delivery after the simple linear model had established with a prior 90° projection data was 0.42 mm for VMAT and 0.45 mm for IMRT. CONCLUSIONS The proposed method does not require any internal/external correlation or statistical modeling to estimate the target trajectory and can be used for both retrospective image-guided radiotherapy with CBCT projection images and real-time target position monitoring for respiratory gating or tracking.
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Affiliation(s)
- Hyekyun Chung
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea and Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, South Korea
| | - Per Rugaard Poulsen
- Department of Oncology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
| | - Paul J Keall
- Radiation Physics Laboratory, Sydney Medical School, University of Sydney, NSW 2006, Australia
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, Daejeon 34141, South Korea
| | - Byungchul Cho
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, South Korea
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