• 대한방사선치료학회지
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• 제25권2호
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• pp.131-136
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• 2013

목 적: 비인두암(Nasopharyngeal cancer) 환자를 세기조절 방사선치료(IMRT)시 영상유도 촬영(MVCT & kV-CBCT)에서의 수정체 흡수선량(absorbed dose)을 평가하고자 한다. 대상 및 방법: 인체모형팬텀(Anderson rando phantom, Alderson Reserch Laboratories Inc., USA)을 대상으로 전산화 단층촬영(lightspeed ultra 16, General Electric, USA)을 실시하였고 획득되어진 이미지를 비인두암 환자의 치료계획에 동일한 조건으로 토모세라피 치료계획장치(Tomotherapy, Inc, USA)와 선형가속기 치료계획장치(Pinnacle 8.0, philips Medicle System)로 동일하게 수립하였다. 열형광선량계(TLD100 Harshaw USA)를 수정체 위치에 위치시키고 토모세라피 MVCT를 세 가지 조건(fine, normal, coarse)에서 촬영, kV-CBCT를 두 가지 조건(low dose head, standard dose head)에서 각각 좌우 3번씩 반복 측정하였다. 결 과: 토모세라피와 선형가속기를 이용하여 실시한 MVCT와 kV-CBCT 촬영 시 수정체의 흡수선량을 측정한 결과 토모세라피 MVCT에서 coarse의 경우 RT 0.8257 cGy, LT 0.8137 cGy, normal의 경우 RT 1.089 cGy, LT 1.188 cGy, fine의 경우 RT 2.154 cGy, LT 2.082 cGy라는 결과를 얻을 수 있었다. 선형가속기 kV-CBCT에선 standard mode의 경우 RT 0.2875 cGy, LT 0.1676 cGy, Low-dose mode의 경우 RT 0.1648 cGy, LT 0.1212 cGy로 나타났다. MVCT와 kV-CBCT의 최대 차이는 약20배 이상인 것을 알 수 있다. 결 론: kV-CBCT가 MVCT을 통해 영상유도 이미지를 얻는 것보다 수정체 흡수선량만으로 고려하였을 때 세기조절 방사선 치료 시 환자가 치료 이외에 받는 선량을 줄일 수 있다고 판단된다. 또한 동일한 치료 장비라 하더라도 다양한 촬영조건에 따라 선량차이가 있다는 것을 알 수 있다.

• 대한방사선치료학회지
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• 제21권2호
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• pp.67-74
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• 2009

목 적: 전립선암 환자를 대상으로 kV 콘빔CT를 이용한 영상유도방사선치료 시 촬영조건에 따른 인체의 각 장기들에 미치는 흡수선량(absorbed dose)과 유효선량(effective dose)을 비교 평가해 보고자 한다. 대상 및 방법: 환자를 대상으로 직접 실험할 수 없으므로 인체의 구성과 조직이 흡사한 인체 모형 팬텀(Anderson rando Phantom, Alderson Research Laboratories Inc., USA)과 전산화 단층 모의치료기(Lightspeed RT CT, GE, USA)를 이용하여 국제 방사선 방호 위원회(International Commission on Radiological Protection, ICRP)에서 권고된 신체 내 중요 장기들을 묘사하였다. 팬텀 내부의 묘사된 주요 장기에 선량 측정을 위하여 열형광선량계(TLD 100 Lif rods, Harshaw Chemical Co., USA)를 1~8개 삽입한 후 팬텀의 중심을 전립선에 위치시키고, On board imager (OBI) System이 부착된 의료용 선형 가속기(Clinac iX, Varian, USA)를 이용하여 두 가지 촬영모드인 표준모드(Standard-mode, A-mode)와 저선량모드(Low-dose mode, B-mode)에서 kV 콘빔 CT 촬영을 각 3회씩 반복해서 측정하였다. 결 과: 인체 모형 팬텀을 이용하여 전립선암 환자를 대상으로 한 kV 콘빔 CT 촬영을 시행한 결과 전립선, 방광, 직장에 대한 흡수선량은 A-mode인 경우 각각 5.5 cGy/1회, 6.5 cGy/1회, 5.7 cGy/1회, B-mode인 경우 1.1 cGy/1회, 1.3 cGy/1회, 1.2 cGy/1회 결과를 보였다. 각 장기에 대한 조직가중치를 고려한 유효선량은 A-mode와 B-mode에서 19.1 mSv, 4.4 mSv의 결과로 나타났다. kV 콘빔CT 촬영 시 인체에 미치는 유효선량을 측정한 결과, 전립선암 영상유도방사선치료 시 A-mode 콘빔CT는 B-mode 콘빔CT보다 환자가 받는 선량이 약 4배 이상 증가하는 것을 알 수 있었다. 결 론: 그러므로 전립선암 영상유도방사선치료 시 환자가 받는 치료 이외의 선량을 고려했을 때 가능한 B-mode 또는 낮은 촬영 조건을 설정하여 환자가 받는 치료이외선량을 가능한 한 줄일 필요가 있다고 사료된다.

• 한국방사선학회논문지
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• 제12권4호
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• pp.467-474
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• 2018

CBCT는 치료부위의 정확도 향상에 유용하지만, 반복적인 사용으로 피폭선량이 높아지는 단점이 있다. 이에 본 연구에서는 차폐체를 사용한 모의실험과 선량감소 효과를 데이터화하여 CBCT 시행 시 선량 저감화를 위한 기초자료를 제공하고자 한다. 본 연구에서는 MCNPX를 통해 CBCT를 모사하여 광자선을 분석한 후, UF-revised 인체 모의 피폭체를 대상으로 흉복부 촬영 시 장기의 흡수선량을 계산하였다. 이 때, 차폐체(납, 안티몬, 황산바륨, 텅스텐, 비스무스) 유무와 차폐 재질에 따른 장기선량을 평가하였다. 차폐를 하지 않고 CBCT 촬영을 하였을 경우 유방 과 척추에서 선량이 높게 계산되었으며, 식도와 폐에서 선량이 낮게 계산되었다. 차폐체 재질에 따른 선량 은 황산바륨, 안티몬, 비스무스, 납, 텅스텐 순으로 선량이 높게 계산되었다. 차폐체 유무에 따른 선량 감소율을 평가해 보면 흉선(73.6%), 유방(59.9%)에서 가장 차폐율이 높고, 폐(2.1%), 척추(12.6%)에서 가장 낮은 차폐율을 보였다.

• 대한디지털의료영상학회논문지
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• 제14권2호
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• pp.15-22
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• 2012

The purpose of this study was to measure the absorbed dose and calculate the effective dose for cone beam computed tomography (CBCT) and panorama units and to estimate usefulness of x-ray protective. Rando phantom and glass dosimeters were used for dosimetry. The absorbed doses were measured at 15 organs and 14 remainder from correspond to ICRP 2007 recommendations. The absorbed dose was highest in salivary glands as measured CBCT 2.420mGy, panorama 0.307mGy. Absorbed dose in another organs were high in order of thyroid, brain, skin, esophagus. The effective dose was CBCT 0.100mSv, panorama 0.011mSv and effective dose of panorama was higher than that of CBCT by 10 times. In case of wearing x-ray protective, reducing effective dose of CBCT by 0.066mSv (66%) and panorama by 0.008mSv (72%). Effective dose were reduced by radiological shielding but it needs further optimization studies, where dosimetric data are analyzed in combination with image quality with keep the patients' exposure as low as possible.

• 한국의학물리학회지:의학물리
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• 제29권4호
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• pp.150-156
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• 2018

This study aims to develop an improved Feldkamp-Davis-Kress (FDK) reconstruction algorithm using anisotropic total variation (ATV) minimization to enhance the image quality of low-dose cone-beam computed tomography (CBCT). The algorithm first applies a filter that integrates the Shepp-Logan filter into a cosine window function on all projections for impulse noise removal. A total variation objective function with anisotropic penalty is then minimized to enhance the difference between the real structure and noise using the steepest gradient descent optimization with adaptive step sizes. The preserving parameter to adjust the separation between the noise-free and noisy areas is determined by calculating the cumulative distribution function of the gradient magnitude of the filtered image obtained by the application of the filtering operation on each projection. With these minimized ATV projections, voxel-driven backprojection is finally performed to generate the reconstructed images. The performance of the proposed algorithm was evaluated with the catphan503 phantom dataset acquired with the use of a low-dose protocol. Qualitative and quantitative analyses showed that the proposed ATV minimization provides enhanced CBCT reconstruction images compared with those generated by the conventional FDK algorithm, with a higher contrast-to-noise ratio (CNR), lower root-mean-square-error, and higher correlation. The proposed algorithm not only leads to a potential imaging dose reduction in repeated CBCT scans via lower mA levels, but also elicits high CNR values by removing noisy corrupted areas and by avoiding the heavy penalization of striking features.

• Journal of Radiation Protection and Research
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• 제49권2호
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• pp.68-77
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• 2024

Background: Cone beam computed tomography (CBCT) is essential for correcting and verifying patient position before radiation therapy. However, it poses additional radiation exposure during CBCT scans. Therefore, this study aimed to evaluate radiological safety for the human body through dose assessment for CBCT. Materials and Methods: For CBCT dose assessment, the depth dose was evaluated using a cheese phantom, and the dose in the orbital area was evaluated using a human body phantom self-fabricated with a three-dimensional printer. Results and Discussion: The evaluation of radiation doses revealed maximum doses of 14.14 mGy and minimum doses of 6.12 mGy for pelvic imaging conditions. For chest imaging conditions, the maximum doses were 4.82 mGy, and the minimum doses were 2.35 mGy. Head imaging conditions showed maximum doses of 1.46 mGy and minimum doses of 0.39 mGy. The eyeball doses using a human body phantom model averaged at 2.11 mGy on the left and 2.19 mGy on the right. The depth dose ranged between 0.39 mGy and 14.14 mGy, depending on the change in depth for each imaging mode, and the average dose in the orbit area using a human body phantom was 2.15 mGy. Conclusion: Based on the experimental results, CBCT did not significantly affect the radiation dose. However, it is important to maintain a minimal radiation dose to optimize radiation protection following the as low as reasonable achievable principle.

• 대한치과의사협회지
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• 제52권3호
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• pp.153-163
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• 2014

3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

• Imaging Science in Dentistry
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• 제42권2호
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• pp.65-70
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• 2012

Purpose : The aim of this study was to compare the effective dose for imaging of mandible between multi-detector computed tomography (MDCT) and cone-beam computed tomography (CBCT). An MDCT with low dose technique was also compared with them. Materials and Methods : Thermoluminescent dosimeter (TLD) chips were placed at 25 organ sites of an anthropomorphic phantom. The mandible of the phantom was exposed using 2 different types of MDCT units (Somatom Sensation 10 for standard-dose MDCT, Somatom Emotion 6 for low-dose MDCT) and 3 different CBCT units (AZ3000CT, Implagraphy, and Kavo 3D eXaM). The radiation absorbed dose was measured and the effective dose was calculated according to the ICRP 2007 report. Results : The effective dose was the highest for Somatom Sensation 10 (425.84 ${\mu}Sv$), followed by AZ3000CT (332.4 ${\mu}Sv$), Somatom Emotion 6 (199.38 ${\mu}Sv$), and 3D eXaM (111.6 ${\mu}Sv$); it was the lowest for Implagraphy (83.09 ${\mu}Sv$). The CBCT showed significant variation in dose level with different device. Conclusion : The effective doses of MDCTs were not significantly different from those of CBCTs for imaging of mandible. The effective dose of MDCT could be markedly decreased by using the low-dose technique.

• Imaging Science in Dentistry
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• 제53권1호
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• pp.69-75
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• 2023

Purpose: Maxillofacial trauma predominantly affects young adults between 20 and 40 years of age. Although radioprotection is a legal requirement, the significant potential of dose reduction in computed tomography (CT) is still underused in the clinical routine. The objective of this study was to evaluate whether maxillofacial fractures can be reliably detected and classified using ultra-low-dose CT. Materials and Methods: CT images of 123 clinical cases with maxillofacial fractures were classified by two readers using the AOCOIAC software and compared with the corresponding results from post-treatment images. In group 1, consisting of 97 patients with isolated facial trauma, pre-treatment CT images at different dose levels (volumetric computed tomography dose index: ultra-low dose, 2.6 mGy; low dose, <10 mGy; and regular dose, <20 mGy) were compared with post-treatment cone-beam computed tomography (CBCT). In group 2, consisting of 31 patients with complex midface fractures, pre-treatment shock room CT images were compared with post-treatment CT at different dose levels or CBCT. All images were presented in random order and classified by 2 readers blinded to the clinical results. All cases with an unequal classification were re-evaluated. Results: In both groups, ultra-low-dose CT had no clinically relevant effect on fracture classification. Fourteen cases in group 2 showed minor differences in the classification code, which were no longer obvious after comparing the images directly to each other. Conclusion: Ultra-low-dose CT images allowed the correct diagnosis and classification of maxillofacial fractures. These results might lead to a substantial reconsideration of current reference dose levels.

• Imaging Science in Dentistry
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• 제45권4호
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• pp.263-265
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• 2015

Cone-beam computed tomography (CBCT) is routinely recommended for dental diagnosis and treatment planning. CBCT exposes patients to less radiation than does conventional CT. Still, lack of proper education among dentists and specialists is resulting in improper referral for CBCT. In addition, aiming to generate high-quality images, operators may increase the radiation dose, which can expose the patient to unnecessary risk. This letter advocates appropriate radiation dosing during CBCT to the benefit of both patients and dentists, and supports moving from the concept of "as low as reasonably achievable" (ALARA) to "as low as diagnostically acceptable" (ALADA).