Purpose: To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. Materials and Methods: 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. Results: The mean length of incisive canal was 15.87 mm±2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm±0.76 and 3.89 mm± 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3°±6.96 and 117.45°±7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r= 0.258). Conclusion : This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.
Purpose: To evaluate whether cone beam computed tomography can depict the distribution, position, frequency, relative vertical dimension, and the diameter of the lingual foramen and direction of lingual bone canal. Materials and Methods : Cone beam computed tomography of mandible was performed on 25 males and 25 females with no history of any orthodontic treatments or any other dental surgeries. A statistical comparison was done on the mean values of males and females. Results: In the location and distribution of lingual foramina, median lingual foramen was found in all subjects and lateral lingual foramen in 58%. In the lateral lingual foramen, bilateral type was found in 28% and unilateral type in 30%. In the number of lingual foramina, median lingual foramen had two foramina and lateral lingual foramen had one foramen, mostly. In the relative mean vertical dimension of lingual foramina, median lingual foramen was 0.03±0.08, and both lateral lingual foramina was 0.20±0.04. The mean diameter of lingual foramina, median lingual foramen was 0.9mm±0.28, right lateral lingual foramen was 0.92mm±0.23, and left lateral lingual foramen was 0.88mm±0.27. The most frequent direction of the lingual bone canals, median lingual bone canal proceeded in anteroinferior direction and lateral lingual bone canal in anterosuperolateral direction. Conclusion : Cone beam computed tomography can be helpful for surgery and implantation on the mandibular area. Radiologist should be aware of this anatomical feature and its possible implications.
Purpose : The purpose of this study is to develop a surgical stent for dental implant procedure that can be easily applied and affordable by using cone beam computerized tomography (CBCT). Materials and Methods : Aluminum, Teflon-PFA (perfluoroalkoxy), and acetal (polyoxymethylene plastic) were selected as materials for the surgical stent. Among these three materials, the appropriate material was chosen using the CBCT images. The surgical stent, which could be easily placed into an oral cavity, was designed with chosen material. CBCT images of the new surgical stent on mandible were obtained using Alphard-3030 dental CT system (Asahi Roentgen Co., Ltd., Kyoto, Japan). The point of insertion was prescribed on the surgical stent with the multiplanar reconstruction software of OnDemand3D (CyberMed Inc., Seoul, Korea). Guide holes were made at the point of insertion on the surgical stent using newly designed guide jig. CBCT scans was taken for the second time to verify the accuracy of the newly designed surgical stent. Results : Teflon-PFA showed radiologically excellent image characteristics for the surgical stent. High accuracy and reproducibility of implantation were confirmed with the surgical stent. Conclusion : The newly designed surgical stent can lead to the accurate implantation and achieve the clinically predictable result.
Purpose : The purpose of this study was to accurately analyze the radiographic characteristics of dentigerous cyst (DC) with multiplanar images of cone beam computed tomography (CBCT). Materials and Methods : Thirty eight radiographically and histopathologically proven cases of DCs were analyzed with panoramic radiograph and CBCT, retrospectively. The radiographic CT pattern, symmetry of radiolucency around the unerupted tooth crown, ratio of long length to short length, degree of cortical bone alternation, effects on adjacent tooth, and cyst size were analyzed. Relative frequencies of these radiographic features were evaluated. In order to compare the CBCT features of DC with those of odontogenic keratocyst (OKC), 9 cases of OKCs were analyzed with the same method radiographically. Results : DCs consisted of thirty unilocular cases (79.0%), seven lobulated cases (18.4%) and one multilocular case (2.6%). Eight were asymmetric (21.0%) and thirty were symmetric (79.0%). Maxillary DC showed rounder shape than mandibular DC (L/S ratio; maxilla 1.32, mandible 1.67). Alternations of lingual cortical bone (14 cases, 48.2%) were more frequent than those of buccal side (7 cases, 24.1%). CBCT images of DC showed definite root resorption and bucco-lingual tooth displacement. These findings were hardly observed on panoramic radiographs of DCs. Comparison of CBCT features of DC with those of OKC showed several different features. Conclusions : CBCT images of DC showed various characteristic radiographic features. Therefore, CBCT can be helpful for the diagnosis of DC radiographically.
Purpose: To examine the danger zone of mesial root of mandibular first molar of patient without extraction using CBCT (cone-beam computed tomography) to avoid the risk of root perforation. Materials and Methods: 20 mandibular first molars without caries and restorations were collected, CT images were obtained by CBCT ($PSR9000N^{TM}$, Asahi Roentgen Co., Japan), reformed and analyzed by V-work 5.0 (CyberMed Inc., Korea), Distance between canal orifice and furcation was measured. In cross sectional images at 3, 4 and 5 mm below the canal orifice, distal wall thickness of mesiobuccal canal (MB-D), distal wall thickness of mesiolingual canal (ML-D), distal wall thickness of central part (C-D), mesial wall thickness of mesiobuccal canal (MB-M) and mesial wall thickness of mesiolingual canal (ML-M) were measured, Results: The mean distance between the canal orifice and the furcation of the roots is 2.40 mm, Distal wall is found to be thinner than mesial wall. Mean dentinal wall thickness of distal wall is about 1 mm, The wall thickness is thinner as the distance from the canal orifice is farther. But significant differences are not noted between 4 mm and 5 mm in MB-D and C-D, MB-D is thinner than ML-D although the differences is not significant. Conclusion: The present study confirmed the anatomical weakness of distal surface of the coronal part of the mesial roots of mandibular first molar by CBCT and provided an anatomical guide line of wall thickness during endodontic treatment.
CareDose 4D which is the Siemens's Automatic Exposure Control (AEC) can adjust the level of radiation dose distribution which is based on organ characteristic unlike other manufacturer's AEC. Currently, a wide scan range containing different organs is sometimes examined at once (defined as one scan). The purpose of this study was to figure out which organ characteristic option is suitable when one scan method is utilized. Two types of anthropomorphic phantoms were scanned in the same range which were from frontal bone to carina level according to three different organ characteristics such as Thorax, Abdomen, and Neck. All scans and image reconstruction parameters were equally applied and radiation dose were compared. Radiation dose with Thorax organ characteristic was lower than that with Neck. Also, that with Abdomen oran characteristic was lower than Thorax. There were significant differences in radiation dose according to different organ characteristics at the same parameters (P<0.05). Usage of Neck organ characteristic had a result of the highest radiation dose to all phantom. On the other hand, utilization of Abdomen organ characteristic showed the lowest radiation dose. As a result, it is desirable to set appropriate organ characteristic according to examined body part when you checkup patients. Also, when you implement one scan method, selection of Abdomen-based organ characteristic has reduced more radiation dose compared with two different organ characteristic.
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.)
We aim to offer basic materials about infection management through conducting bacterial contamination test about general radiography equipment and CT equipment installed in ER of three general hospitals with 100 sickbeds or more located in Gyeongsangbuk-do Province, and suggest management plan. It had been conducted from 1st December 2015 to 31st December, and objects were general radiography equipment and CT equipment of emergency room located in Gyeongsangbuk-do Province. For general radiography equipment, sources were collected from 4 places such as upper side of control box which employees use most, upper side of exposure button, whole upper side of table which is touching part of patient's skin, upper side of stand bucky's grid, and where patients put their jaws on. For CT equipment, sources were collected from 3 places such as upper side of control box which radiography room employees use most, X-ray exposure button, whole upper side of table which is touching part of patient's skin, and gantry inner. Surface contamination strain found at general radiography equipment in emergency room of radiology are Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), and ungrown bacteria at incubator after 48 hours of incubation (67%) which is the biggest. Most bacteria were found at upper side of stand bucky-grid and stand bucky of radiology's general radiography equipment, and most sources of CT equipment were focused at patient table, which means it is contaminated by patients who have various diseases, and patients who have strains with decreased immunity may get severe diseases. Thus infection prevention should be made through 70% alcohol disinfection at both before test and after test.
The objective of this study was to find the optimum test device for the cerebral blood vessels by comparing and analyzing the SNR and CNR methods for images of three devices (i.e., MRA, CTA, and DSA). The study targeted 90 patients who underwent cerebral angiography from November 2016 to May 2017. The measuring parts were measured by using Rt MCA, Lt MCA, and ACA Image J. The results of quantitative analysis showed that the mean SNR of MRA, the CNR of MRA, the signal strength of MRA, the mean SNR of CTA, the CNR of CTA, the signal strength of CTA, the SNR of DSA, the CNR of DSA, and the signal strength of DSA were evaluated as 254.87, 178.13, 326.81, 74.75, 62.2, 356.66, 26.85, 25.89, and 4400.69, respectively (p<0.05). As a result, both SNR and CNR methods measured it in the order of MRA>CTA>DSA. Statistical significance was determined by using ANOVA analysis at p<0.05 and Bonferroni method was used as a post-hoc analysis SPSS. In conclusion, the results of this study revealed that the optimum imaging devices were MRA, CTA, and DSA after evaluating randomly selected patients with cerebrovascular disease.
The Journal of Korean Society for Radiation Therapy
/
v.18
no.2
/
pp.113-117
/
2006
Purpose: Post-mastectomy radiotherapy (PMR) is known to decrease loco-regional recurrence. Adequate skin and dermal dose are achieved by adding bolus. The more difficult clinical issue is determining the necessary number of bolus treatment, given the limits of normal skin tolerance. The aim of this study is to evaluate the necessary number of bolus treatment after PMR in patients with breast cancer. Materials and Methods: Four female breast cancer patients were included in the study. The median age was 53 years(range, $38{\sim}74$), tumor were left sided in 2 patients and right sided in 2patients. All patients were treated with postoperative radiotherapy after MRM. Radiotherapy was delivered to the chest wall (C.W) and supraclavicular lymph nodes (SCL) using 4 MV X-ray. The total dose was 50 Gy, in 2 Gy fractions (with 5 times a week). CT was peformed for treatment planning, treatment planning was peformed using $ADAC-Pinnacles^3$ (Phillips, USA) for all patients without and with bolus. Bolus treatment plans were generated using image tool (0.5 cm of thickness and 6 cm of width). Dose distribution was analyzed and the increased skin dose rate in the build-up region was computed and the skin dose using TLD-100 chips (Harshaw, USA) was measured. Results: No significant difference was found in dose distribution without and with bolus; C.W coverage was $95{\sim}100%$ of the prescribed dose in both. But, there was remarkable difference in the skin dose to the scar. The skin dose to the scar without and with bolus were $100{\sim}105%\;and\;50{\sim}75%$. The increased skin dose rates in the build-up region for Pt. 1, Pt. 2. Pt. 3 and Pt. 4 were 23.3%, 35.6%, 34.9%, and 41.7%. The results of measured skin dose using TLD-100 chips in the cases without and with bolus were 209.3 cGy and 161.1 cGy, 200 cGy and 150.2 cGy, 211.4 cGy and 160.5 cGy, 198.6 cGy and 155.5 cGy for Pt. 1, Pt. 2, Pt. 3, and Pt. 4. Conclusion: It was concludes through this analysis that the adequate number of bolus treatments is 50-60% of the treatment program. Further, clinical trial is needed to evaluate the benefit and toxicity associated with the use of bolus in PMR.
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