• Journal of radiological science and technology
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• v.46 no.6
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• pp.527-533
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• 2023

The purpose of this study is to evaluate the clinical risk of spinal radiosurgery by calculating the dose difference due to dose calculation algorithm and multi-leaf collimator positioning error. The images acquired by the CT simulator were recalculated by correcting the multi-leaf collimator position in the dose verification program created using MATLAB and applying stoichiometric calibration and Monte Carlo algorithm. With multi-leaf collimator positioning error, the clinical target volume (CTV) showed a dose difference of up to 13% in the dose delivered to the 95% volume, while the gross tumor volume (GTV) showed a dose difference of 9%. The average dose delivered to the total volume showed dose variation from -8.9% to 9% and -10.1% to 10.2% for GTV and CTV, respectively. The maximum dose delivered to the total volume of the spinal cord showed a dose difference from -14.2% to 19.6%, and the dose delivered to the 0.35 ㎤ volume showed a dose difference from -15.5% to 19.4%. In future research, automating the linkage between treatment planning systems and dose verification programs would be useful for spinal radiosurgery.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.187-191
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• 2019

Spinal epidural hematoma (SEH) can occur naturally or traumatically and is most common in patients with an underlying disease of the vascular structure or coagulation disorder. Most SEHs occur naturally for no apparent reason, and epidural hematoma caused by trauma is less common, comprising 1.0%-1.7% of total spinal injuries. Few reports of SEH induced cauda equine syndrome resulting from low-energy injury caused by osteoporotic vertebral compression fractures are available. The authors experienced a case of delayed SEH after hemorrhage due to a low-energy injury in an elderly patient. No cases in Korea have been reported; therefore, this case is reported with a review of the relevant literature.

• The Journal of Korean Society for Radiation Therapy
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• v.34
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• pp.51-60
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• 2022

Objectives: The purpose is to evaluate dosimetric performance and delivery efficiency of VMAT with Halcyon LINAC for double target spine SBRT Materials and Methods: 12 patients with spine oligometastases were retrospectively studied. Single-isocenter spine SBRT plans was established using Halcyon® with Dual Layer MLC and Truebeam® with High Definition MLC. All patients' plans were created in Eclipse TPS through the identical conditions and optimization. C.I, H.I, G.I (Gradient Index), maximal and volumetric doses to spinal cord and low dose area were evaluated for comparison of both plans. Also, total MU and BOT(Beam On Time) were evaluated. Results: Halcyon plans was no Statistical differences in C.I and H.I. However, the average of G.I was 4.64 for Halcyon, which decreased to 5.5% compared to Truebeam (P<0.001). Halcyon plans demonstrated statistically significant reduced G.I. The average of 50% and 25% isodose volume was 487.56 cc (-3.82%, P<0.001), 1859.45 cc (-4.75%, P<0.001) in Halcyon, respectively. Significantly reduced low dose spill were observed in Halcyon plans. In the evaluation of the spinal cord, the average of Dmean and V10 of Halcyon plans in the sample group with an overlap volume of less than 1 cc was 6.802 Gy (-3.504%, P=0.067), 5.766±1.683 cc (-8.199%, P=0.002), respectively. Halcyon plans demonstrated statistically significant reduced D_mean and V10. For delivery efficiency, MU and BOT(maximum dose rate for each machine), on average, increased in Halcyon plans. However, the average of BOT(800MU/min for each machine) was 648.33 sec for Halcyon (-1.74%, P<0.001). Conclusion: Halcyon plan for double-target spine SBRT demonstrated advantages in the low dose area with a steep dose gradient, while having dosimetrically equivalent target dose distribution and spinal cord protective effect. As a result, Halcyon LINAC produced a dosimetrically improved plan for double-target spine SBRT.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.24.1-24
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• 1987

척색종은 1856년 루스카(Luschka)에 의해 발견된 이후 1977년까지 약 1000례가 보고되었으며 매년 10∼15례의 새로운 환자가 보고되고 있다. 이는 notochord의 잔유물에서 발생하는 종양으로 척추의 양 끝에서 주로 발생한다. 그러나 경추의 발생은 다른 부위에 비해 드물다. 저자들은 경부 척색종 1례를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다.

• Journal of Digital Convergence
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• v.13 no.1
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• pp.331-339
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• 2015

The purpose of this study is to evaluate utility of rotating adjustment using Xsight spine tracking system in 3D DOF location adjusting method, to minimize error between 6D DOF and 3D DOF in fiducial tracking system. In this study, the result of 6D DOF target location error is $0.124{\pm}0.058mm$, using fiducial inside tumor 3D DOF $0.673{\pm}0.142mm$, outside tumor $1.126{\pm}0.253mm$, apply with Xsight spine tracking system 3D DOF $0.542{\pm}0.103mm$. As the experiment shows, it was demonstrated that rotating adjustment through Xsight spine tracking system is valuable in case of treatment in 3D DOF location error that makes increasing accuracy and dose distribution each approximately 48% and 3%. In accordance with result of this study is useful rotation.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.133-138
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• 2001

Purpose : To analyze the clinical behaviors and survivorship of metastatic bone tumors. Materials and Methods : One hundred and ninty-eight metastatic bone tumors had been diagnosed from January 1982 to December 1998. Age and sex distribution, primary cancer types. metastatic sites, duration from diagnosed of primary tumors to bony metastases and survivorship were analysed. Results : Mean age was 57(24~86) years old. Lung(32.3%) and breast(16.2%) cancers were two most common primary foci. The spines was the most common site of metastases especially lumbar region(38%). Survivorship analysis was done in one hundred and fifteen patients who had been followed up. The mean survival period was 15.3 months. The survivorship of hepatoma(7.1 Mons), lung(8.72 Mons) and renal cell(4.8 Mons)cancers was relatively shorter and breast cancer(54.1 Mons) longest. Conclusion : The mean age of metastatic bone tumors of this study was older than the past reports. The axial skeletons especially spine was predominant metastatic site. The survivorship of metastatic bone tumor decreased sharply as time goes by, so early diagnosis is clue for longer survival after bony metastases.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.1-6
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• 2009

The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.2
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• pp.87-90
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• 2011

Osteoblastoma is rare, benign, bone-forming tumor that often occur in the spine. There are few reports of osteoblastomas resulting in pathologic fractures involving long bones. Authos report a unique case of a pathologic fracture due to an osteoblastoma of the humerus shaft. The tumor was treated successfully by curettage, intramedullary nailing and bone allograft.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.384-390
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• 1994

Authors retrospectively compared the 99mTc MDP bone scans and corresponding MR imagings in 20 patients with histologically proven malignancy, Mean interval of the two studies was 16.6 days, Cancer diagnosis Included 8 lung, 2 each of colon, breast, stomach, 1 each of prostate, thyroid, malignant lymphoma and 3 adenocarcinoma of unknown primary site. Of the 105 regions compared, :t6 regions were positive for metastases in bone scans or MR imagings. 30 regions(65.2%) were positive by bone scan and 44 regions(95.7%) by MR imaging. 87 regions(82.9%) were concordantly positive or negative by bone scan and MR imaging, but 18 regions(17.1%) were discordant. In the discordant regions, 16 regions positive in MR imaging were negative in bone scan. The greatest number of discordant findings occured in the cervical region and in the patient with stomach cancer. Our results suggest that the sensitivity of MR Imaging is greater than that of bone scan in detecting spinal metastases. And bone scan is useful screening test of metastasis for evaluating entire skeleton including spine.

• Journal of the Korean Society of Radiology
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• v.79 no.6
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• pp.323-331
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• 2018

Purpose: The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods: All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl $25{\mu}g$ (up to $100{\mu}g$), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results: Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion: US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.