• Progress in Medical Physics
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• v.22 no.1
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• pp.28-34
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• 2011

To perform the Adaptive Radiation Therapy (ART), a high degree of deformable registration accuracy is essential. The purpose of this study is to identify whether the change of MV CBCT intensity can improve registration accuracy using predefined modification level and filtering process. To obtain modification level, the cheese phantom images was acquired from both kilovoltage CT (kV CT), megavoltage cone-beam CT (MV CBCT). From the cheese phantom images, the modification level of MV CBCT was defined from the relationship between Hounsfield Units (HUs) of kV CT and MV CBCT images. 'Gaussian smoothing filter' was added to reduce the noise of the MV CBCT images. The intensity of MV CBCT image was changed to the intensity of the kV CT image to make the two images have the same intensity range as if they were obtained from the same modality. The demon deformable registration which was efficient and easy to perform the deformable registration was applied. The deformable lung phantom which was intentionally created in the laboratory to imitate the changes of the breathing period was acquired from kV CT and MV CBCT. And then the deformable lung phantom images were applied to the proposed method. As a result of deformable image registration, the similarity of the correlation coefficient was used for a quantitative evaluation of the result was increased by 6.07% in the cheese phantom, and 18% in the deformable lung phantom. For the additional evaluation of the registration of the deformable lung phantom, the centric coordinates of the mark which was inserted into the inner part of the phantom were measured to calculate the vector difference. The vector differences from the result were 2.23, 1.39 mm with/without modification of intensity of MV CBCT images, respectively. In summary, our method has quantitatively improved the accuracy of deformable registration and could be a useful solution to improve the image registration accuracy. A further study was also suggested in this paper.

• Proceedings of the KIEE Conference
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• 2005.10b
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• pp.3-5
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• 2005

Vessel boundary detection and modeling is a difficult but a necessary task in analyzing the mechanics of inflammation and the structure of the microvasculature. In this paper we present a method of analyzing the structure by means of an active contour model(using GVF Snake) for vessel boundary detection and 3D reconstruction. For this purpose we used a virtual vessel model and produced a phantom model. From these phantom images we obtained the contours of the vessel by GVF Snake and then reconstructed a 3D structure by using the coordinates of snakes.

• Progress in Medical Physics
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• v.28 no.1
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• pp.1-10
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• 2017

The difference between three-dimensional (3D) and four-dimensional (4D) dose could be affected by factors such as tumor size and motion. To quantitatively analyze the effects of these factors, a phantom that can independently control each factor is required. The purpose of this study is to develop a deformable lung phantom with the above attributes and evaluate the characteristics. A phantom was designed to simulate diaphragm motion with amplitude in the range 1~7 cm and period up to ${\geq}2s$ of regular breathing. To simulate different tumors sizes, custom molds were created using a 3D printer and filled with liquid silicone. The accuracy of the phantom diaphragm motion was assessed by comparing measured motion with predicted motion. Because the phantom diaphragm motion is not identical to the tumor motion, the correlation between the diaphragm and tumor motions was calculated by a curve fitting method to emulate user-intended tumor motion. Tumors of different sizes were located at same position, and tumor set-up positions were evaluated. The accuracy of phantom diaphragm motion was better than 1 mm. The diaphragm-tumor correlation showed that the tumor motion in the superior-inferior direction increased with increasing diaphragm motion. The tumor motion was larger in the $10cm^3$ tumor than in the $90cm^3$ tumor. The range of difference between the tumor set-up positions was 0 to 0.45 cm. This phantom showed independently adjusting factors such as tumor size and motion to facilitate quantitative analysis of the dosimetric impact of respiratory motion according to these factors.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2006.08a
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• pp.64-64
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• 2006

• Progress in Medical Physics
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• v.25 no.3
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• pp.139-142
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• 2014

The purpose of this study was to develop a system of clinical application of reconstructed dose that includes dose reconstruction, reconstructed dose registration between fractions of treatment, and dose-volume-histogram generation and to demonstrate the system on a deformable prostate phantom. To achieve this purpose, a deformable prostate phantom was embedded into a 20 cm-deep and 40 cm-wide water phantom. The phantom was CT scanned and the anatomical models of prostate, seminal vesicles, and rectum were contoured. A coplanar 4-field intensity modulated radiation therapy (IMRT) plan was used for this study. Organ deformation was simulated by inserting a "transrectal" balloon containing 20 ml of water. A new CT scan was obtained and the deformed structures were contoured. Dose responses in phantoms and electronic portal imaging device (EPID) were calculated by using the XVMC Monte Carlo code. The IMRT plan was delivered to the two phantoms and integrated EPID images were respectively acquired. Dose reconstruction was performed on these images using the calculated responses. The deformed phantom was registered to the original phantom using an in-house developed software based on the Demons algorithm. The transfer matrix for each voxel was obtained and used to correlate the two sets of the reconstructed dose to generate a cumulative reconstructed dose on the original phantom. Forwardly calculated planning dose in the original phantom was compared to the cumulative reconstructed dose from EPID in the original phantom. The prescribed 200 cGy isodose lines showed little difference with respect to the "prostate" and "seminal vesicles", but appreciable difference (3%) was observed at the dose level greater than 210 cGy. In the rectum, the reconstructed dose showed lower volume coverage by a few percent than the plan dose in the dose range of 150 to 200 cGy. Through this study, the system of clinical application of reconstructed dose was successfully developed and demonstrated. The organ deformation simulated in this study resulted in small but observable dose changes in the target and critical structure.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.83-95
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• 2018

Purpose : After planning the Respiratory Gated Radiotherapy for Lung cancer, the movement and volume change of sparing normal structures nearby target are not often considered during dose evaluation. This study carried out 4-D dose evaluation which reflects the movement of normal structures at certain phase of Respiratory Gated Radiotherapy, by using Deformable Image Registration that is well used for Adaptive Radiotherapy. Moreover, the study discussed the need of analysis and established some recommendations, regarding the normal structures's movement and volume change due to Patient's breathing pattern during evaluation of treatment plans. Materials and methods : The subjects were taken from 10 lung cancer patients who received Respiratory Gated Radiotherapy. Using Eclipse(Ver 13.6 Varian, USA), the structures seen in the top phase of CT image was equally set via Propagation or Segmentation Wizard menu, and the structure's movement and volume were analyzed by Center-to Center method. Also, image from each phase and the dose distribution were deformed into top phase CT image, for 4-dimensional dose evaluation, via VELOCITY Program. Also, Using $QUASAR^{TM}$ Phantom(Modus Medical Devices) and $GAFCHROMIC^{TM}$ EBT3 Film(Ashland, USA), verification carried out 4-D dose distribution for 4-D gamma pass rate. Result : The movement of the Inspiration and expiration phase was the most significant in axial direction of right lung, as $0.989{\pm}0.34cm$, and was the least significant in lateral direction of spinal cord, as -0.001 cm. The volume of right lung showed the greatest rate of change as 33.5 %. The maximal and minimal difference in PTV Conformity Index and Homogeneity Index between 3-dimensional dose evaluation and 4-dimensional dose evaluation, was 0.076, 0.021 and 0.011, 0.0 respectfully. The difference of 0.0045~2.76 % was determined in normal structures, using 4-D dose evaluation. 4-D gamma pass rate of every patients passed reference of 95 % gamma pass rate. Conclusion : PTV Conformity Index was more significant in all patients using 4-D dose evaluation, but no significant difference was observed between two dose evaluations for Homogeneity Index. 4-D dose distribution was shown more homogeneous dose compared to 3D dose distribution, by considering the movement from breathing which helps to fill out the PTV margin area. There was difference of 0.004~2.76 % in 4D evaluation of normal structure, and there was significant difference between two evaluation methods in all normal structures, except spinal cord. This study shows that normal structures could be underestimated by 3-D dose evaluation. Therefore, 4-D dose evaluation with Deformable Image Registration will be considered when the dose change is expected in normal structures due to patient's breathing pattern. 4-D dose evaluation with Deformable Image Registration is considered to be a more realistic dose evaluation method by reflecting the movement of normal structures from patient's breathing pattern.

• Journal of Radiation Protection and Research
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• v.47 no.3
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• pp.111-133
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• 2022

The exciting advancement related to the "modeling of digital human" in terms of a computational phantom for radiation dose calculations has to do with the latest hype related to deep learning. The advent of deep learning or artificial intelligence (AI) technology involving convolutional neural networks has brought an unprecedented level of innovation to the field of organ segmentation. In addition, graphics processing units (GPUs) are utilized as boosters for both real-time Monte Carlo simulations and AI-based image segmentation applications. These advancements provide the feasibility of creating three-dimensional (3D) geometric details of the human anatomy from tomographic imaging and performing Monte Carlo radiation transport simulations using increasingly fast and inexpensive computers. This review first introduces the history of three types of computational human phantoms: stylized medical internal radiation dosimetry (MIRD) phantoms, voxelized tomographic phantoms, and boundary representation (BREP) deformable phantoms. Then, the development of a person-specific phantom is demonstrated by introducing AI-based organ autosegmentation technology. Next, a new development in GPU-based Monte Carlo radiation dose calculations is introduced. Examples of applying computational phantoms and a new Monte Carlo code named ARCHER (Accelerated Radiation-transport Computations in Heterogeneous EnviRonments) to problems in radiation protection, imaging, and radiotherapy are presented from research projects performed by students at the Rensselaer Polytechnic Institute (RPI) and University of Science and Technology of China (USTC). Finally, this review discusses challenges and future research opportunities. We found that, owing to the latest computer hardware and AI technology, computational human body models are moving closer to real human anatomy structures for accurate radiation dose calculations.

• Journal of Radiation Protection and Research
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• v.44 no.3
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• pp.103-109
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• 2019

Background: Four-dimensional computed tomographic (4DCT) images are increasingly used in clinic with the growing need to account for the respiratory motion of the patient during radiation treatment. One of the reason s that makes the dose evaluation using 4DCT inaccurate is a change of the patient respiration during the treatment session, i.e., intrafractional uncertainty. Especially, when the amplitude of the patient respiration is greater than the respiration range during the 4DCT acquisition, such an organ motion from the larger respiration is difficult to be represented with the 4DCT. In this paper, the method to generate images expecting the organ motion from a respiration with extended amplitude was proposed and examined. Materials and Methods: We propose a method to generate extra-phase images from a given set of the 4DCT images using deformable image registration (DIR) and linear extrapolation. Deformation vector fields (DVF) are calculated from the given set of images, then extrapolated according to respiratory surrogate. The extra-phase images are generated by applying the extrapolated DVFs to the existing 4DCT images. The proposed method was tested with the 4DCT of a physical 4D phantom. Results and Discussion: The tumor position in the generated extra-phase image was in a good agreement with that in the gold-standard image which is separately acquired, using the same 4DCT machine, with a larger range of respiration. It was also found that we can generate the best quality extra-phase image by using the maximum inhalation phase (T0) and maximum exhalation phase (T50) images for extrapolation. Conclusion: In the present study, a method to construct extra-phase images that represent expanded respiratory motion of the patient has been proposed and tested. The movement of organs from a larger respiration amplitude can be predicted by the proposed method. We believe the method may be utilized for realistic simulation of radiation therapy.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.14 no.4
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• pp.1738-1756
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• 2020

To improve the accuracy and realism of the virtual surgical simulation system, this paper proposes an optimized mass-spring model with shape restoration ability based on volume conservation to simulate soft tissue deformation. The proposed method constructs a soft tissue surface model that adopts a new flexion spring for resisting bending and incorporates it into the mass-spring model (MSM) to restore the original shape. Then, we employ the particle swarm optimization algorithm to achieve the optimal solution of the model parameters. Besides, the volume conservation constraint is applied to the position-based dynamics (PBD) approach to maintain the volume of the deformable object for constructing the soft tissue volumetric model base on tetrahedrons. Finally, we built a simulation system on the PHANTOM OMNI force tactile interaction device to realize the deformation simulation of the virtual liver. Experimental results show that the proposed model has a good shape restoration ability and incompressibility, which can enhance the deformation accuracy and interactive realism.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.177-183
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• 2018

Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.