1.Fundamental Study of Reduced Radiation Exposure of Virtual Endoscopy by 16 DAS MDCT
Yasuji YAMADA ; Masanori KATOH ; Makoto NAGAI ; Shingo OKAZAKI ; Shunichi NAKAMURA ; Tsukasa SUGAWARA ; Norio KONDOH ; Kencho MIYASHITA ; Akira FUJINAGA
Journal of the Japanese Association of Rural Medicine 2006;55(5):459-464
Our aim was to study the scan protocol of 16 DAS (Data Acquisition System) multidetector-row CT (MDCT) and to ascertain whether we could reduce radiation exposure and scanning time, while maintaing image quality in the Virtual endoscopy (VE).We made a mimic gastrointestinal tract and examined the result by changing a scan protocol of 16 DAS MDCT.We found that a reduction of radiation exposure and scanning time depended on slice width, angle of the table, rotation time, table speed, mAs/slice and resolution.The study confirmed that it was possible to use the scan protocol of MDCT with a radiographic dose of 40% and scanning time of 50%, without changing image quality in the VE.
Radiation
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amsonic acid
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Protocols documentation
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Endoscopy
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Accident due to exposure to weather conditions
2.High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy.
Hee Chul PARK ; Shinichi SHIMIZU ; Akio YONESAKA ; Kazuhiko TSUCHIYA ; Yasuhiko EBINA ; Hiroshi TAGUCHI ; Norio KATOH ; Rumiko KINOSHITA ; Masayori ISHIKAWA ; Noriaki SAKURAGI ; Hiroki SHIRATO
Yonsei Medical Journal 2010;51(1):93-99
PURPOSE: The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients. MATERIALS AND METHODS: Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy. RESULTS: All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient. CONCLUSION: The use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.
Adult
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Aged
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*Brachytherapy
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Female
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Humans
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Middle Aged
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Radiotherapy Planning, Computer-Assisted/adverse effects/*methods
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Treatment Outcome
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Uterine Cervical Neoplasms/mortality/pathology/*radiotherapy
3.Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy
Yusuke UCHINAMI ; Koichi YASUDA ; Hideki MINATOGAWA ; Yasuhiro DEKURA ; Noboru NISHIKAWA ; Rumiko KINOSHITA ; Kentaro NISHIOKA ; Norio KATOH ; Takashi MORI ; Manami OTSUKA ; Naoki MIYAMOTO ; Ryusuke SUZUKI ; Keiji KOBASHI ; Yasushi SHIMIZU ; Jun TAGUCHI ; Nayuta TSUSHIMA ; Satoshi KANO ; Akihiro HOMMA ; Hidefumi AOYAMA
Radiation Oncology Journal 2024;42(1):74-82
Purpose:
To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT).
Materials and Methods:
Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival.
Results:
The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541).
Conclusion
Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.