• Title/Summary/Keyword: Image guidance

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Evaluation of Set-up Accuracy for Frame-based and Frameless Lung Stereotactic Body Radiation Therapy (폐암 정위체부방사선치료 시 고정기구(frame) 사용 유무에 따른 셋업 정확성 평가)

  • Ji, Yunseo;Chang, Kyung Hwan;Cho, Byungchul;Kwak, Jungwon;Song, Si Yeol;Choi, Eun Kyung;Lee, Sang-wook
    • Progress in Medical Physics
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    • v.26 no.4
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    • pp.286-293
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    • 2015
  • The purpose of this study was to evaluate the set up accuracy using stereotactic body frame and frameless immobilizer for lung stereotactic body radiation therapy (SBRT). For total 40 lung cancer patients treated by SBRT, 20 patients using stereotactic body frame and other 20 patients using frameless immobilizer were separately enrolled in each group. The setup errors of each group depending on the immobilization methods were compared and analyzed. All patients received the dose of 48~60 Gy for 4 or 5 fractions. Before each treatment, a patient was first localized to the treatment isocenter using room lasers, and further aligned with a series of image guidance procedures; orthogonal kV radiographs, cone-beam CT, orthogonal fluoroscopy. The couch shifts during these procedures were recorded and analyzed for systematic and random errors of each group. Student t-test was performed to evaluate significant difference depending on the immobilization methods. The setup reproducibility was further analyzed using F-test with the random errors excluding the systematic setup errors. In addition, the ITV-PTV margin for each group was calculated. The setup errors for SBF were $0.05{\pm}0.25cm$ in vertical direction, $0.20{\pm}0.38cm$ in longitudinal direction, and $0.02{\pm}0.30cm$ in lateral direction, respectively. However the setup errors for frameless immobilizer showed a significant increase of $-0.24{\pm}0.25cm$ in vertical direction while similar results of $0.06{\pm}0.34cm$, $-0.02{\pm}0.25cm$ in longitudinal and lateral directions. ITV-PTV margins for SBF were 0.67 cm (vertical), 0.99 cm (longitudinal), and 0.83 cm (lateral), respectively. On the other hand, ITV-PTV margins for Frameless immobilizer were 0.75 cm (vertical), 0.96 cm (longitudinal), and 0.72 cm (lateral), indicating less than 1 mm difference for all directions. In conclusion, stereotactic body frame improves reproducibility of patient setup, resulted in 0.1~0.2 cm in both vertical and longitudinal directions. However the improvements are not substantial in clinic considering the effort and time consumption required for SBF setup.

A Study on the Temperature fronts observed in the South-West Sea of Korea and the Northern Area of the East China Sea (한국 남$\cdot$서해 및 동중국해 북부해역에 출현하는 수온전선)

  • YANG Young Jin;KIM Sang Hyun;RHO Hong Kil
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.31 no.5
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    • pp.695-706
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    • 1998
  • SST (Sea Surface. Temperature) fronts which were found in the South-West Sea of Korea and the northern area of the East China Sea were examined in order to clarify their positions, shapes, seasonal changes and the formation mechanism, For this study used SST data rearranged from the SST IR image during 1991 to 1996 and oceanographical data obtained by National Fisheries Research and Development Institute. Temperature front in the Cheju Strait was analyzed by the data obtained from a fisheries guidance ship of Cheju Provincial Government, The coastal frontal zone in the South-West Sea of Korea and the offshore frontal zone in the northern area of the East China Sea can be divided into several types (Type of Winter, Summer, Spring, Autumn and late Autumn), Short term variations of SST fronts have a tendency not to move to any Bleat extent for several days. The location of the frontal zone in the southwestern sea of Cheju Island changes on a much large scale than that of the one in the southern coast of Korea, The frontal Tone, formed every year in the southern sea of Korea approaches closer to the coastal area in winter, and moves closer to the south in spring and autumn. The frontal zone of the southwestern sea of Cheju Island moves in a westerly direction from the east, and reaches its most westerly point in the winter and its most easterly point in the summer related to the seasonal change of the Tsushima Current. Additionally, the frontal zone of the southwestern sea of Korea becomes extremely weak in March, April and November. SST fronts are formed every year around the line connecting Cheju Island to Yeoseo Island or to Chungsan Island in the Cheju Strait. A Ring-shaped tidal mixing front appears along the coastal area of Cheju Island throughout the year except during the months from November to January. Especially, in May and October fronts are formed between the coastal waters of Cheju Island and the Tsushima currents connecting the frontal zone of the coastal region in the southern sea of Korea with that of the southwestern sea of Cheju Island.

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The Differentiation Process of the Soul and the Opposites in God in The Red Book (『레드 북』에 나타나는 심혼의 분화 과정과 신의 대극성의 문제)

  • Ki-Hwan Kim
    • Sim-seong Yeon-gu
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    • v.36 no.2
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    • pp.105-159
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    • 2021
  • The Red Book is a personal record that contains Jung's psychological self-experiment and describes his own experiences of the individuation process. Throughout The Red Book, Jung describes how he got caught by the spirit of the depths and dethroned the spirit of this time, how he regained his lost soul by getting to the bottom of inner processes, how he differentiated the soul upon encountering the various aspects of his soul, and finally how he confronted God approaching Jung in the form of the divine opposites. The spirit of the depths as a personification of the collective unconscious caught up with Jung and launched him into the individuation process. The spirit of the depths was "the God yet to come". Jung realized that he had been driven by the collective spirit of his time and then set off on a journey into a new territory of life under the guidance of the spirit of the depths. Jung first encountered his lost soul, afterwards experiencing various aspects of the soul-spirit duo such as Salome-Elijah, Helena-Simon, and Baucis-Philemon. In the process of individuation, the initial experience of the soul can appear to the ego as a Satanic force which darkens the consciousness. The Red Book describes how Jung consciously integrated the Satanic force and came to realize the meaning of it. Jung's experience of emotionally gripping aspects of the soul led him to the awareness of the dark side of God, Satan, while the insights he gained from that Satanic emotionality led him to the awareness of the bright side of God, Christ. Through this process, he finally encountered the opposites in God. Jung also referred to the Self as an image of God which manifests itself in the psyche. Jung later discovered God as a phenomenal psychic reality which incarnates itself from the unconscious into the conscious. He did it in terms of strict empirical science. Although the incarnation process of the deity is the main cause of psychological conflict and distress of a human being, if accepted consciously, we come to realize that the incarnation process of the deity in the psyche is the ultimate teleology and meaning of our life as well.

Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels (주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성)

  • Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1207-1217
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    • 2021
  • Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.