• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.118-125
• /
• 2008

Purpose: On-line image guided radiation therapy(on-line IGRT) and(kV X-ray images or cone beam CT images) were obtained by an on-board imager(OBI) and cone beam CT(CBCT), respectively. The images were then compared with simulated images to evaluate the patient's setup and correct for deviations. The setup deviations between the simulated images(kV or CBCT images), were computed from 2D/2D match or 3D/3D match programs, respectively. We then investigated the correctness of the calculated deviations. Materials and Methods: After the simulation and treatment planning for the RANDO phantom, the phantom was positioned on the treatment table. The phantom setup process was performed with side wall lasers which standardized treatment setup of the phantom with the simulated images, after the establishment of tolerance limits for laser line thickness. After a known translation or rotation angle was applied to the phantom, the kV X-ray images and CBCT images were obtained. Next, 2D/2D match and 3D/3D match with simulation CT images were taken. Lastly, the results were analyzed for accuracy of positional correction. Results: In the case of the 2D/2D match using kV X-ray and simulation images, a setup correction within $0.06^{\circ}$ for rotation only, 1.8 mm for translation only, and 2.1 mm and $0.3^{\circ}$ for both rotation and translation, respectively, was possible. As for the 3D/3D match using CBCT images, a correction within $0.03^{\circ}$ for rotation only, 0.16 mm for translation only, and 1.5 mm for translation and $0.0^{\circ}$ for rotation, respectively, was possible. Conclusion: The use of OBI or CBCT for the on-line IGRT provides the ability to exactly reproduce the simulated images in the setup of a patient in the treatment room. The fast detection and correction of a patient's positional error is possible in two dimensions via kV X-ray images from OBI and in three dimensions via CBCT with a higher accuracy. Consequently, the on-line IGRT represents a promising and reliable treatment procedure.

• Radiation Oncology Journal
• /
• v.20 no.2
• /
• pp.165-171
• /
• 2002

Purpose : In order to perform craniospinal irradiation (CSI) in the supine position on patients who are unable to lie in the prone position, a new simulation technique using a CT simulator was developed and its availability was evaluated. Materials and Method : A CT simulator and a 3-D conformal treatment planning system were used to develop CSI in the supine position. The head and neck were immobilized with a thermoplastic mask in the supine position and the entire body was immobilized with a Vac-Loc. A volumetrie image was then obtained using the CT simulator. In order to improve the reproducibility of the patients' setup, datum lines and points were marked on the head and the body. Virtual fluoroscopy was peformed with the removal of visual obstacles such as the treatment table or the immobilization devices. After the virtual simulation, the treatment isocenters of each field were marked on the body and the immobilization devices at the conventional simulation room. Each treatment field was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR)/digitally composite radiography (DCR) images from the virtual simulation. The port verification films from the first treatment were also compared with the DRR/DCR images for a geometrical verification. Results : CSI in the supine position was successfully peformed in 9 patients. It required less than 20 minutes to construct the immobilization device and to obtain the whole body volumetric images. This made it possible to not only reduce the patients' inconvenience, but also to eliminate the position change variables during the long conventional simulation process. In addition, by obtaining the CT volumetric image, critical organs, such as the eyeballs and spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. The differences between the DRRs and the portal films were less than 3 mm in the vertebral contour. Conclusion : CSI in the supine position is feasible in patients who cannot lie on prone position, such as pediatric patienta under the age of 4 years, patients with a poor general condition, or patients with a tracheostomy.

• Radiation Oncology Journal
• /
• v.13 no.4
• /
• pp.403-409
• /
• 1995

Purpose : Authors tried to enhance the safety and accuracy of radiosurgery by verifying stereotacitc target point in actual treatment position prior to irradiation. Materials and Methods : Before the actual treatment, several sections of anthropomorphic head phantom were used to create a condition of unknown coordinates of the target point. A film was sandwitched between the phantom sections and punctured by sharp needle tip. The tip of the needle represented the target point. The head phantom was fixed to the stereotactic ring and CT scan was done with CT localizer attached to the ring. After the CT scanning, the stereotactic coordinates of the target point were determined. The head phantom was secured to accelerator's treatment couch and the movement of laser isocenter to the stereotactic coordinates determined by CT scanning was performed using target positioner. Accelerator's anteroposterior and lateral portal films were taken using angiographic localizers. The stereotactic coordinates determined by analysis of portal films were compared with the stereotactic coordinates previously determined by CT scanning. Following the correction of discrepancy the head phantom was irradiated using a stereotactic technique of several arcs. After the irradiation, the film which was sandwitched between the phantom sections was developed and the degree of coincidence between the center of the radiation distribution with the target point represented by the hole in the film was measured. In the treatment of the actual patients, the way of determining the stereotactic coordinates with CT localizers and angiograuhic localizers was the same as the phantom study. After the correction of the discrepancy between two sets of coordinates, we proceeded to the irradiation of the actual patient. Results : In the phantom study, the agreement between the center of the radiation distribution and the localized target point was very good. By measuring optical density profiles of the sandwitched film along axes that intersected the target point, authors could confirm the discrepancy was 0.3 mm. In the treatment of an actual patient, the discrepancy between the stereotactic coordinates with CT localizers and angiographic localizers was 0.6 mm. Conclusion : By verifying stereotactic target point in actual treatment position prior to irradiation, the accuracy and safety of streotactic radiosurgery procedure were established.

• Journal of the Korean Society of Radiology
• /
• v.16 no.7
• /
• pp.889-896
• /
• 2022

This study attempted to evaluate the usefulness of the air mattress by analyzing the subjective comfort of the patient due to the application of the air mattress to the table of computed tomography through a questionnaire and analyzing the change in image quality through quantitative and qualitative evaluation of the patient's clinical images. The subjects who participated in the study were 221 men and 229 women, and the age range was from 18 to 86. To evaluate the change in image quality, a total of 150 patients, 50 patients per group, were selected for quantitative evaluation, and 20 patients per group, a total of 60 patients were selected for qualitative evaluation. As a result of this study, the subjective comfort of patients increased due to air mattresses, and there was no difference in image quality as a result of quantitative and qualitative evaluation of clinical images. From the above results, it is believed that the air mattress can be usefully applied in a way that can increase the subjective comfort of the patient without any harm to the diagnostic image.

• The Journal of the Korea Contents Association
• /
• v.9 no.11
• /
• pp.280-288
• /
• 2009

This study is to design and produce a detailed model for volume variety of three dimensional reconstruction images and to evaluate the changes of volume, area and the length of the model in the process of the reconstruction of RTP system. CT simulation was operated at the thickness of 1.25, 2.5, 5, 10mm and average, standard deviation of scan direction(X), thickness(Y), table movement direction(Z), area(A), and volume(V) of the three dimensional volume rendering, were measured according to the shape and thickness of the phantoms. As a result, at the thickness of 1.25, 2.5min, the phantom's shape decreased maximum 0.13cm(p<0.05) to the direction of X, Y, Z and length, area, volume decreased 0.1cm, $0.8cm^2$, $3.99cm^3$ which led to an approximate image of the phantoms. However, at the thickness of 5, 10mm, the phantom of the original form decreased maximum 0.58cm(p<0.05) and volume, area, length decreased maximum 0.45cm, $8.21cm^2$, $11.03cm^3$. Volume varieties according to the thickness and shape of the phantoms have occurred diversely, when CT simulation was operated, and it is considered that a clinically appropriate volume rendering can be obtained only when the thickness is below 3mm.

• Archives of Plastic Surgery
• /
• v.38 no.5
• /
• pp.594-601
• /
• 2011

Purpose: The frontal sinuses are a pair of triangularly shaped, air-filled chambers lined by mucoperiosteum and located between the inner and outer tables of the frontal bone. Until recently, our understanding of gender variations in craniofacial anatomy has been chiefly built upon anthropometric studies, which typically employ facial surface measurements or plain film radiography. The aim of this study i to determine the sizes of the frontal sinus in both sexes in Koreans. Methods: 95 Korean subjects who underwent maxillofacial 3-Dimensional computed tomography (CT) between January 2009 and December 2009 were enrolled. Frontal sinus dimensions and forehead measurements were taken at midline and at 10, 20, and 30 mm to the left and right of midline using sagittal, coronal, and axial images. The data was analyzed for significant differences between measurements made at the selected points in the frontal sinus, for left to right variations, for gender variations, and for racial differences. Results: The mean thickness of the anterior table ranged from 2.31 to 3.23 mm. Mean anteroposterior depth of the frontal sinus ranged from 7.38 to 9.45 mm and did not vary significantly at any distance from midline. Frontal sinus height was greatest at midline (mean=29.24 mm) and progressively lessened at lateral distances. Mean total width at the level of the supraorbital ridge was 53.66 mm. For all measurements, no significant left to right variation was noted. Comparing the sexes, males were found to have greater dimensions in most frontal sinus measurements, though these differences were only found to be significant at or close to midline. The male forehead was marked by more acute nasofrontal angle ($133.3^{\circ}$ versus $141.6^{\circ}$) and a steeper posterior forehead inclination ($14.9^{\circ}$ versus $7.7^{\circ}$). Conclusion: Using CT imaging, forehead and frontal sinus dimensions have been described. Generally, males had larger overall frontal sinus dimensions. And Korean had similar sized frontal sinus to Caucasian in height and width. But in AP distance Korean had lesser measurement. The result of this study may be helpful in the comprehension of normal size of frontal sinus in Korean.

• The Journal of the Korea Contents Association
• /
• v.7 no.4
• /
• pp.206-212
• /
• 2007

To evaluate the HU value of the IV catheter fragment of CT on the accuracy and size in the peripheral vein. Pilot study of profile and table functions on PC by software was calculated of HU value of IV catheter fragment. This study demonstrates the utility of volume rendering technique to localize a small, subtle IV catheter, which can easily be reformatted of MDCT reformations. IV catheter fragment optimal image described as threshold range. Volume rendering of HU using a MDCT is an excellent method for evaluation the IV catheter fragment in three dimension.

• Journal of Korean Neurosurgical Society
• /
• v.53 no.5
• /
• pp.300-302
• /
• 2013

Reports of traumatic leptomeningeal cysts (TLMC) are rare in adults. The standard treatment approach is craniectomy with careful exposure of the intact dural edges, followed by duroplasty. However, occasionally, the location of the TLMC makes achieving watertight duroplasty impossible. Herein, we report the case of a 28-year-old male who presented with a soft growing mass on the vertex of his head 16 months after the head trauma. Upon enhanced CT examination, a bony defect involving both the inner and outer table of the cranium was observed close to the sagittal sinus, and a well-defined cystic mass, 5 cm in diameter, was nested within the defect. The risks associated with extension craniotomy were high because the lesion was located superficial to the sagittal sinus, we opted to use fibrinogen-based collagen fleece (TachoCombR$^{(R)}$) to repair the dural defect. Two months after surgery, the patient remained asymptomatic with a good cosmetic result. In cases like ours, when the defect is near the major sinuses and the risk of rupturing the sinus during watertight dural closure is high, fibrinogen-based collagen fleece (TachoCombR$^{(R)}$) is an effective alternative approach to standard dural suture techniques.

• Journal of Food Hygiene and Safety
• /
• v.33 no.4
• /
• pp.280-288
• /
• 2018

In this study, an approach for the analysis of the five cephalopod species (octopus, long-arm octopus, squid, wet-foot octopus, beka squid) consumed in the Republic of Korea is developed. The samples were collected from the Southeast Asian countries Thailand, Indonesia, Vietnam, and China. The SYBR-green-based real-time qPCR method, based on the mitochondrial DNA genome of the five cephalopods was developed and validated. The intergroup variations in the mitochondrial DNA are evident in the bioinformatic analysis of the mitochondrial genomic DNA sequences of the five groups. Some of the highly-conserved and slightly-variated regions are identified in the mitochondrial cytochrome-c-oxidase subunit I (COI) gene, 16s ribosomal RNA (16s rRNA) gene, and 12s ribosomal RNA (12s rRNA) gene of these groups. To specify each five cephalopod groups, specific primer sets were designed from the COI, 16s rRNA and 12s rRNA regions. The specific primer sets amplified the DNA using the SYBR-green-based real-time PCR system and 11 commercially secured animal tissues: Octopus vulgaris, Octopus minor, Todarodes pacificus, Dosidicus gigas, Sepia esculenta, Amphioctopus fangsiao, Amphioctopus aegina, Amphioctopus marginatus, Loliolus beka, Loligo edulis, and Loligo chinensis. The results confirmed by a conveient way to calculate relative amplification levels between different samples in that it directly uses the threshold cycles (Ct)-value range generated by the qPCR system from these samples. This genomic DNA-based molecular technique provides a quick, accurate, and reliable method for the taxonomic classification of the animal tissues using the real-time qPCR.

• Asian Pacific Journal of Cancer Prevention
• /
• v.16 no.15
• /
• pp.6267-6272
• /
• 2015

Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.