Æó¾Ï ȯÀÚ¿¡¼­ Electronic Portal lmaging Device¸¦ ÀÌ¿ëÇÑ ÀÚ¼¼ ¿ÀÂ÷ ¹× Á¾¾ç À̵¿ °Å¸®ÀÇ °´°üÀû ÃøÁ¤
Objective Analysis of the Set-up Error and Tumor Movementin Lung Cancer Patients using Electronic Portal Imaging Device

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±è¿ìö(Kim Woo-Cheol) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
Á¤ÀºÁö(Chung Eun-Ji) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
ÀÌâ°É(Lee Chang-Geol) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
Ãß¼º½Ç(Chu Sung-Sil) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
±è±Í¾ð(Kim Gwi-Eon) - ¿¬¼¼´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú

Abstract

¸ñ Àû: electronic portal imaging device(EPID)¸¦ ÀÌ¿ëÇÏ¿© Æó¾Ï ȯÀÚ¿¡¼­ ½ÃÇàÇÑ °ËÁõ ¿µ»óÀ» ºÐ¼®ÇÏ¿© 3Â÷¿ø ÀÔü Á¶ÇüÄ¡·á°èȹ ½Ã ÀÚ¼¼ ¿ÀÂ÷(set-up error)¿Í Á¾¾çÀÇ À̵¿ °Å¸®¸¦ °í·ÁÇÑ ÀûÀýÇÑ Â÷Æó ¿©À¯¸¦ Æò°¡ÇØ º¸°íÀÚ ÇÑ´Ù.

´ë»ó ¹× ¹æ¹ý: 1995³â ¿¬¼¼¾Ï¼¾ÅÍ Ä¡·á¹æ»ç¼±°ú¿¡ ³»¿øÇÏ¿© EPID°¡ ÀåÂøµÈ Clinac 2100C/D¸¦ ÀÌ¿ëÇÏ¿© Ä¡·á¹ÞÀº Æó¾Ï ȯÀÚ 10¸íÀ» ´ë»óÀ¸·Î ÇÏ¿´´Ù. ȯÀÚ 1ÀÎ ´ç 1 port¿¡ ´ëÇÑ °ËÁõ ¿µ»óÀ» ¸ÅÀÏ ¾ò¾î random ¿ÀÂ÷¿Í systematic ¿ÀÂ÷¸¦ ±¸Çß°í, Ä¡·á 1ȸ ´ç Áߺ¹ ¿µ»óÀ» ¾ò¾î Á¾¾çÀÇ ¿òÁ÷ÀÓÀ» ±¸Çß´Ù. ¸ÅÀÏ ¾òÀº °ËÁõ ¿µ»óÀº 103°³À̾ú°í, Áߺ¹ ¿µ»óÀº 10°³À̾ú´Ù.

°á °ú: Àüü 10 ¸íÀÇ È¯ÀÚÀÇ x Ãà, y ÃàÀ¸·ÎÀÇ Æò±Õ À̵¿Àº °¢°¢ 1.41mm, 1.78mm À̾ú°í systematic À̵¿Àº Ç¥ÁØÆíÂ÷°¡ x Ãà, y ÃàÀ¸·Î °¢°¢ 4.63mm, 4.11mmÀ̾ú´Ù. random À̵¿Àº °¢ ȯÀÚÀÇ Æò±Õ À̵¿À¸·ÎºÎÅÍ x Ãà, y ÃàÀ¸·Î Ç¥ÁØÆíÂ÷°¡ °¢°¢ 4.17 mm, 3.31 mm À̾ú´Ù. È£Èí¿¡ ÀÇÇÑ yÃàÀ¸·ÎÀÇ À̵¿Àº Æò±Õ 12.2mmÀ̾ú°í, Ç¥ÁØÆíÂ÷´Â 4.03mm À̾ú´Ù.

°á ·Ð: Æó¾Ï ȯÀÚ¿¡¼­ 3Â÷¿ø ¹æ»ç¼±Ä¡·á¸¦ ½ÃÇàÇÏ·Á°í ÇÒ °æ¿ì Ä¡·á °èȹ ½Ã clinical targer Volume¿¡¼­ x,yÃàÀ¸·Î °¢°¢ 10 mm, 25 mm Á¤µµÀÇ ¿©À¯°¡ ÇÊ¿äÇÏ´Ù°í º¸À̸ç, Ä¡·á Ãʱ⿡ °¢ ȯÀÚº°·Î ¸ÅÀÏ EPID¸¦ ÀÌ¿ëÇÏ¿© ¾òÀº °ËÁõ ¿µ»ó°ú, Áߺ¹ ¿µ»óÀ¸·Î Â÷Æó ¿©À¯¸¦ ÀûÀýÈ÷ Á¶ÀýÇØ ÁÖ¾î¾ß ÇÒ °ÍÀÌ´Ù.
Purpose: The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy.

Methods and Materials: The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its gantry. AP or PA field portal images were only analyzed. Radiation therapy field included the tumor, mediastinum, and supraclavicular lymph nodes. A total of 103 portal images wereanalyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion.

Results: The average values of setup displacements in the x, y direction was 1.41 mm, 1.78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11mm along the x,y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm

Conclusion: The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x,y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be madeand analyzed during first week of treatment, individually.

Å°¿öµå

3-Dimensional conformal radiation therapy, Electronic portal imaging device, Set-up error
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The average values of setup displacements in the x, y direction was 1.41 mm, 1.78 mm, respectively.
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DOI
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ICD 03
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