• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.414-419
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• 2022

Florid reactive periostitis (FRP) is a rare benign fibro-osseous proliferation, occurring mostly in the short tubular bones of hands and rarely in the long tubular bones. We report a surgically confirmed case of FRP involving the clavicle in a 26-year-old male. On MRI scans, a soft tissue mass with T2 high signal intensity was found that originated from the periosteum of the clavicle and included surrounding a periosteal elevation and perilesional soft tissue edema. Strong contrast enhancement was noted inside the mass and along the periosteum involving more than half of the circumference of the clavicle. Serial radiographs revealed a soft tissue mass without mineralization that turned into an ossified mass with a solid periosteal reaction within a month.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.61-72
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• 2022

Purpose: Conventional CBCT(Cone-beam Computed-tomography) caused an error in the target volume due to organ movement in the area affected by respiratory movement. The purpose of this paper is to evaluate the usefulness of accuracy and time spent using the Gated CBCT function, which reduces errors when performing RGRT(respiratory gated radiation therapy), and to examine the appropriateness of phase. Materials and methods: To evaluate the usefulness of Gated CBCT, the QUASAR^TM respiratory motion phantom was used in the Truebeam STx^TM. Using lead marker inserts, Gated CBCT was scaned 5 times for every 20~80% phase, 30~70% phase, and 40~60% phase to measure the blurring length of the lead marker, and the distance the lead marker moves from the top phase to the end of the phase was measured 5 times. Using Cedar Solid Tumor Inserts, 4DCT was scanned for every phase, 20-80%, 30-70%, and 40-60%, and the target volume was contoured and the length was measured five times in the axial direction (S-I direction). Result: In Gated CBCT scaned using lead marker inserts, the axial moving distance of the lead marker on average was measured to be 4.46cm in the full phase, 3.11cm in the 20-80% phase, 1.94cm in the 30-70% phase, 0.90cm in the 40-60% phase. In Fluoroscopy, the axial moving distance of the lead marker on average was 4.38cm and the distance on average from the top phase to the beam off phase was 3.342cm in the 20-80% phase, 3.342cm in the 30-70% phase, and 0.84cm in the 40-60% phase. Comparing the results, the difference in the full phase was 0.08cm, the 20~80% phase was 0.23cm, the 30~70% phase was 0.10cm, and the 40~60% phase was 0.07cm. The axial lengths of ITV(Internal Target Volume) and PTV(Planning Target Volume) contoured by 4DCT taken using cedar solid tumor inserts were measured to be 6.40cm and 7.40cm in the full phase, 4.96cm and 5.96cm in the 20~80% phase, 4.42cm and 5.42cm in the 30~70% phase, and 2.95cm and 3.95cm in the 40~60% phase. In the Gated CBCT, the axial lengths on average was measured to be 6.35 cm in the full phase, 5.25 cm in the 20-80% phase, 4.04 cm in the 30-70% phase, and 3.08 cm in the 40-60% phase. Comparing the results, it was confirmed that the error was within ±8.5% of ITV Conclusion: Conventional CBCT had a problem that errors occurred due to organ movement in areas affected by respiratory movement, but through this study, obtained an image similar to the target volume of the setting phase using Gated CBCT and verified its usefulness. However, as the setting phase decreases, the scan time was increases. Therefore, considering the scan time and the error in setting phase, It is recommended to apply it to patients with respiratory coordinated stereotactic radiation therapy using a wide phase of 30-70% or more.