• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.1159-1166
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• 2009

The use of cone-beam computed tomography(CBCT) has been proposed for guiding the delivery of radiation therapy. A kilovoltage imaging system capable of radiography, fluoroscopy, and cone-beam computed tomography(CT) has been integrated with a medical linear accelerator. A standard clinical linear accelerator, operating in arc therapy mode, and an amorphous-silicon (a-Si) with an on-board electronic portal imager can be used to treat palliative patient and verify the patient's position prior to treatment. On-board CBCT images are used to generate patient geometric models to assist patient setup. The image data can also, potentially, be used for dose reconstruction in combination with the fluence maps from treatment plan. In this study, the accuracy of Hounsfield Units of CBCT images as well as the accuracy of dose calculations based on CBCT images of a phantom and compared the results with those of using CT simulator images. Phantom and patient studies were carried out to evaluate the achievable accuracy in using CBCT and CT stimulator for dose calculation. Relative electron density as a function of HU was obtained for both planning CT stimulator and CBCT using a Catphan-600 (The Phantom Laboratory, USA) calibration phantom. A clinical treatment planning system was employed for CT stimulator and CBCT based dose calculations and subsequent comparisons. The dosimetric consequence as the result of HU variation in CBCT was evaluated by comparing MU/cCy. The differences were about 2.7% (3-4MU/100cGy) in phantom and 2.5% (1-3MU/100cGy) in patients. The difference in HU values in Catphan was small. However, the magnitude of scatter and artifacts in CBCT images are affected by limitation of detector's FOV and patient's involuntary motions. CBCT images included scatters and artifacts due to In addition to guide the patient setup process, CBCT data acquired prior to the treatment be used to recalculate or verify the treatment plan based on the patient anatomy of the treatment area. And the CBCT has potential to become a very useful tool for on-line ART.)

• Journal of the Korean Geographical Society
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• v.41 no.1 s.112
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• pp.106-120
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• 2006

Natural or man-made disaster has been expected to be one of the potential themes that can integrate human geography and physical geography. Typhoons like Rusa and Maemi caused great loss to insurance companies as well as public sectors. We have implemented a natural disaster management system for a private insurance company to produce better estimation of hazards from high wind as well as calculate vulnerability of damage. Climatic gauge sites and addresses of contract's objects were geo-coded and the pressure values along all the typhoon tracks were vectorized into line objects. National GIS topog raphic maps with scale of 1: 5,000 were updated into base maps and digital elevation model with 30 meter space and land cover maps were used for reflecting roughness of land to wind velocity. All the data are converted to grid coverage with $1km{\times}1km$. Vulnerability curve of Munich Re was ad opted, and preprocessor and postprocessor of wind velocity model was implemented. Overlapping the location of contracts on the grid value coverage can show the relative risk, with given scenario. The wind velocities calculated by the model were compared with observed value (average $R^2=0.68$). The calibration of wind speed models was done by dropping two climatic gauge data, which enhanced $R^2$ values. The comparison of calculated loss with actual historical loss of the insurance company showed both underestimation and overestimation. This system enables the company to have quantitative data for optimizing the re-insurance ratio, to have a plan to allocate enterprise resources and to upgrade the international creditability of the company. A flood model, storm surge model and flash flood model are being added, at last, combined disaster vulnerability will be calculated for a total disaster management system.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.85-90
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• 2009

Introduction: There has been an increasing interest in the relationship between sleep and suicidality. In addition, suicidal patients habitually report their sleep problems. Although sleep-related complaints and electroencephalographic changes are generally encountered in psychiatric disorders, sleep complaints such as insomnia, hypersomnia and nightmares are more common in suicidal patients. In current study, we aimed at investigating the relationship between self-reported sleep duration and suicidality in general population. Methods: One thousand general population (male:female=500:500, mean age=$39.6{\pm}11.6$ years, ranged age=20-77 years) completed Center for Epidemiologic Study-Depression (CES-D), Beck Suicide Intent scale (BSI), Spielberger State-Trait Anger Expression Inventory (STAXI), Barratt Impulsiveness Scale (BIS), Morningness-Eveningness Scale (MES) and brief questionnaire of sleep habits. Results: After controlling for age and sex, score of BSI was correlated positively with the score of CES-D, STAXI and BIS on partial correlation analysis ($r_p$=0.251; p<0.001, $r_p$=0.352; p<0.001, and $r_p$=0.175; p<0.001, respectively). In addition, score of BSI was inversely correlated with the score of MES (rp=-0.066; p=0.037). However, score of BSI showed no significant correlation with sleep duration. However, regression analysis revealed that short (<6 hrs) or long (>10 hrs) sleep duration, the family history of psychiatric illness, the score of CES-D, and the score of STAXI predicted higher score of BSI significantly in total subjects (F=17.837, adjusted $R^2$=0.166; p=0.003, p=0.003, p<0.001, and p=0.003, respectively). This model was explained better in depressed subjects with 16 or higher score of CES-D (F=9.920, adjusted $R^2$=0.298). Conclusion: Current result suggested that not only short sleep duration (<6 hrs) but also long sleep duration (>10 hrs) might be related to suicidality.

• Progress in Medical Physics
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• v.8 no.2
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• pp.3-17
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• 1997

Because a wedged beam consists of attenuated primary photons and scattered radiations from wedge, the spectrum of the wedged beam does not coincide with that of an open beam with same geometry. The aims of current report are to get exact information about whether effects of 15-60$^{\circ}$ wedge for 4 -10 MV photon beams should be considered for dose calculation or not, and to suggest a reference condition for measurement of wedge transmission factor. Percent depth dose of both open and wedged fields with angles of 15, 30, 45, 60$^{\circ}$ for beams of 4 MV(Clinac 4/100, Varian), two 6 MV(Clinac 6/100 and Clinac 2100C, Varian), 10 MV(Clinac 2100C, Varian) X-rays were measured to 30cm deep in water using ionization chambers. Hardening factors of photon beams were calculated with measured PDDs. Both field size factors and transmission factors of wedge filters were measured at d$_{max}$ in water. Beam hardening factors of wedged fields of 4 and 6 MV X-ray were larger than 1 for all wedge angles, field sizes and depths deeper than d$_{max}$ Beam hardening factors for wedge angles 15, 30, 45, 60$^{\circ}$ for 10$\times$10cm were respectively 1.010, 1.014, 1.023 and 1.034 for 4MV X-ray, 1.005, 1.008, 1.019, and 1.024 for 6MV X-ray of Clinac 6/100, 1.011, 1.021, 1.032, 1.036 for 6MV X-ray of Clinac 2100C, and 1.008, 1.012, 1.012 and 1.012 for 10MV X-ray. Beam hardening factors of 10MV X-ray were 1 within 1.2％ difference for all wedge angles, depths and field sizes. It was made clear that for 6MV X-rays, the beam hardening factor depends on treatment machine. The relationship of the factor and depth was linear. Field size factor at d$_{max}$ was independent of wedge angle except for the field of 15$\times$15cm. and maximum difference of the field size factors for the field size was 1.4％ for 4MV X-ray. When the wedge factor is determined, dependence of the factor on field size is negligible at d$_{max}$ but should be considered at deeper depth. Calculating dose distribution or MU, the beam hardening factor should be applied for 4~6MV X-ray beams, but might not be considered for 10MV beam. When wedge transmission factor was determined at d$_{max}$ or in air, field size factors for open field are also applicable to wedged fields, but otherwise, field size factor for each wedge or wedge factor depending on field size should be applied.

• Progress in Medical Physics
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• v.8 no.2
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• pp.87-102
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• 1997

The absolute absorbed dose can be determined according to the measurement conditions; measurement material, detector, energy and calibration protocols. The purpose of this study is to compare the absolute absorbed dose due to the differences of measurement condition and calibration protocols for photon beams. Dosimetric measurements were performed with a farmer type PTW and NEL ionization chambers in water, solid water, and polystyrene phantoms using 6MV photon beams from Siemens linear accelerator. Measurements were made along the central axis of 10cm $\times$ 10cm field size for constant target to surface distance of 100cm for water, solid water and polystyrene phantom. Theoretical absorbed dose intercomparisons between TG21 and IAEA protocol were performed for various measurement combinations of phantom, ion chamber, and electrometer. There were no significant differences of absorbed dose value between TG21 and IAEA protocol. The differences between two protocols are within 1％ while the average value of IAEA protocol was 0.5％ smaller than TG21 protocol. For the purpose of comparison, all the relative absorbed dose were nomalized to NEL ion chamber with Keithley electrometer and water phantom, The average differences are within 1％, but individual discrepancies are in the range of - 2.5％ to 1.2％ depending upon the choice of measurement combination. The largest discrepancy of - 2.5％ was observed when NEL ion chamber with Keithley electrometer is used in solid water phantom. The main cause for this discrepancy is due to the use of same parameters of stopping power, absorption coeficient, etc. as used in water phantom. It should be mentioned that the solid water phantom is not recommended for absolute dose calibration as the alternative of water, since absorbed dose show some dependency on phantom material other than water. In conclusion, the trend of variation was not much dependent on calibration protocol. However, it shows that absorbed dose could be affected by phantom material other than water.

• Progress in Medical Physics
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• v.20 no.3
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• pp.132-138
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• 2009

Studies on target motion in 4-dimensional radiotherapy are being world-widely conducted to enhance treatment record and protection of normal organs. Prediction of tumor motion might be very useful and/or essential for especially free-breathing system during radiation delivery such as respiratory gating system and tumor tracking system. Neural network is powerful to express a time series with nonlinearity because its prediction algorithm is not governed by statistic formula but finds a rule of data expression. This study intended to assess applicability of neural network method to predict tumor motion in 4-dimensional radiotherapy. Scaled Conjugate Gradient algorithm was employed as a learning algorithm. Considering reparation data for 10 patients, prediction by the neural network algorithms was compared with the measurement by the real-time position management (RPM) system. The results showed that the neural network algorithm has the excellent accuracy of maximum absolute error smaller than 3 mm, except for the cases in which the maximum amplitude of respiration is over the range of respiration used in the learning process of neural network. It indicates the insufficient learning of the neural network for extrapolation. The problem could be solved by acquiring a full range of respiration before learning procedure. Further works are programmed to verify a feasibility of practical application for 4-dimensional treatment system, including prediction performance according to various system latency and irregular patterns of respiration.

• Progress in Medical Physics
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• v.15 no.3
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• pp.161-166
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• 2004

A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.32-49
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• 1998

For estimation of regional myocardial blood flow with O-15 water PET, a few modifications considering partial volume effect based on single compartment model have been proposed. In this study, we attempted to quantify the degree of heterogeneity and to show the effect of tissue flow heterogeneity on partition coefficient(${\lambda}$) and to find the relation between perfusable tissue index(PTI) and ${\lambda}$ by computer simulation using two modified models. We simulated tissue curves for the regions with homogeneous and heterogeneous blood flow over a various flow range(0.2-4.0ml/g/min). Simulated heterogeneous tissue composed of 4 subregions of the same or different size of block which have different homogeneous flow and different degree of slope of distribution of blood flow. We measured the index representing heterogeneity of distribution of blood flow for each heterogeneous tissue by the constitution heterogeneity(CH). For model I, we assumed that tissue recovery coefficient ($F_{MME}$) was the product of partial volume effect($F_{MMF}$) and PTI. Using model I, PTI, flow, and $F_{MM}$ were estimated. For model II, we assumed that partition coefficient was another variable which could represent tissue characteristics of heterogeneity of flow distribution. Using model II, PTI, flow and ${\lambda}$ were estimated. For the simulated tissue with homogeneous flow, both models gave exactly the same estimates, of three parameters. For the simulated tissue with heterogeneous flow distribution, in model I, flow and $F_{MM}$ were correctly estimated as CH was increased moderately. In model II, flow and ${\lambda}$ were decreased curvi-linearly as CH was increased. The degree of underestimation of ${\lambda}$ obtained using model II, was correlated with CH. The degree of underestimation of flow was dependent on the degree of underestimation of ${\lambda}$. PTI was somewhat overestimated and did not change according to CH. We conclude that estimated ${\lambda}$ reflect the degree of tissue heterogeneity of flow distribution. We could use the degree of underestimation of ${\lambda}$ to find the characteristic heterogeneity of tissue flow and use ${\lambda}$ to recover the underestimated flow.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.247-257
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• 2014

Purpose: It is reported that most senior people consume a high carbohydrate diet, while a high carbohydrate diet could contribute to the risk of chronic disease. The aim of this study is to determine whether a high carbohydrate diet can increase the risk of chronic disease in elderly Koreans. Methods: Using the 2007-2009 Korean National Health Nutrition Examination Survey data, out of a total of 3,917 individuals aged 65 and above, final 1,535 subjects were analyzed, divided by dietary carbohydrate energy ratio into two groups of moderate carbohydrate ratio (MCR, 55-70%) and excessive carbohydrate ratio (ECR, > 70%). All data were processed after the application of weighted value, using a general linear model or logistic regression. Results: Eighty one percent of elderly Koreans consumed diets with carbohydrate energy ratio above 70%. The ECR group included more female subjects, rural residents, lower income, and lower education level. The ECR group showed lower waist circumference, lower diastolic blood pressure, and lower frequency of consumption of meat and egg, milk, and alcohol. The intake of energy and most nutrients, with the exception of fiber, potassium, vitamin A, and carotene, was lower in the ECR group compared to the MCR group. When analyzed by gender, the ECR group showed lower risk of dyslipidemia in male and obesity in female subjects, even though the ECR group showed low intake of some nutrients. No difference in the risk of hypertension, diabetes, and anemia was observed between the two groups in male or female subjects. Conclusion: This result suggested that a high carbohydrate diet would not be a cause to increase the risk of chronic disease in the elderly. Further study is needed in order to determine an appropriate carbohydrate energy ratio for elderly Koreans to reduce the risk of chronic disease.

• Progress in Medical Physics
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• v.17 no.2
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• pp.105-113
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• 2006

This study peformed to confirm the corrected dose In different electron density materials using the superposition/FFT convolution method in radiotherapy Planning system. The experiments of the $K_2HPO_4$ diluted solution for bone substitute, Cork for lung and n-Glucose for soft tissue are very close to effective atomic number of tissue materials. The image data acquisited from the 110 KVp and 130 KVp CT scanner (Siemes, Singo emotions). The electron density was derived from the CT number (H) and adapted to planning system (Xio, CMS) for heterogeneity correction. The heterogeneity tissue phantom used for measurement dose comparison to that of delivered computer planning system. In the results, this investigations showed the CT number is highly affected in photoelectric effect in high Z materials. The electron density in a given energy spectrum showed the relation of first order as a function of H in soft tissue and bone materials, respectively. In our experiments, the ratio of electron density as a function of H was obtained the 0.001026H+1.00 in soft tissue and 0.000304H+1.07 for bone at 130 KVp spectrum and showed 0.000274H+1.10 for bone tissue in low 110 KVp. This experiments of electron density calibrations from CT number used to decide depth and length of photon transportation. The Computed superposition and FFT convolution dose showed very close to measurements within 1.0% discrepancy in homogeneous phantom for 6 and 15 MV X rays, but it showed -5.0% large discrepancy in FFT convolution for bone tissue correction of 6 MV X rays. In this experiments, the evaluated doses showed acceptable discrepancy within -1.2% of average for lung and -2.9% for bone equivalent materials with superposition method in 6 MV X rays. However the FFT convolution method showed more a large discrepancy than superposition in the low electron density medium in 6 and 15 MV X rays. As the CT number depends on energy spectrum of X rays, it should be confirm gradient of function of CT number-electron density regularly.