• 한국의학물리학회지:의학물리
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• 제32권4호
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• pp.107-115
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• 2021

Purpose: The purpose of this study was to compare the clinical quality assurance results of portal dosimetry using an electronic portal imaging device, a method that is extensively used for patient-specific quality assurance, and the newly released Mobius3D for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). Methods: This retrospective study includes data from 122 patients who underwent IMRT and VMAT on the Novalis Tx and VitalBeam linear accelerators between April and June 2020. We used a paired t-test to compare portal dosimetry using an electronic portal imaging device and the average gamma passing rates of MobiusFX using log files regenerated after patient treatment. Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm) were 99.43%±1.02% and 99.32%±1.87% in VitalBeam and 97.53%±3.34% and 96.45%±13.94% in Novalis Tx, respectively. Comparison of the gamma passing rate results of portal dosimetry (3%/3 mm) and MobiusFX (5%/3 mm as per the manufacturer's manual) does not show any statistically significant difference. Conclusions: Log file-based patient-specific quality assurance, including independent dose calculation, can be appropriately used in clinical practice as a second-check dosimetry, and it is considered comparable with primary quality assurance such as portal dosimetry.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.108-115
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• 2022

Background: This study was aimed at comparing and analyzing the results of FractionLab (Varian/Mobius Medical System) with those of portal dosimetry that uses an electronic portal imaging device. Portal dosimetry is extensively used for patient-specific quality assurance (QA) in intensity-modulated radiotherapy (IMRT). Methods: The study includes 29 patients who underwent IMRT on a Novalis-Tx linear accelerator (Varian Medical System and Brain-LAB) between June 2019 and March 2021. We analyzed the multileaf collimator DynaLog files generated after portal dosimetry to evaluate the same condition using FractionLab. The results of the recently launched FractionLab at various gamma indices (0.1%/0.1 mm-1%/1 mm) are analyzed and compared with those of portal dosimetry (3%/3 mm). Results: The average gamma passing rates of portal dosimetry (3%/3 mm) and FractionLab are 98.1% (95.5%-100%) and 97.5% (92.3%-99.7%) at 0.6%/0.6 mm, respectively. The results of portal dosimetry (3%/3 mm) are statistically comparable with the QA results of FractionLab (0.6%/0.6 mm-0.9%/0.9 mm). Conclusion: This paper presents the clinical performance of FractionLab by the comparison of the QA results of FractionLab using portal dosimetry with various gamma indexes when performing patient-specific QA in IMRT treatment. Further, the appropriate gamma index when performing patient-specific QA with FractionLab is provided.

• 한국의학물리학회지:의학물리
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• 제30권4호
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• pp.120-127
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• 2019

Purpose: This study was designed to evaluate the dosimetric performance of Mobius3D by comparison with an aSi-based electronic portal imaging device (EPID) and Octavius 4D, which are conventionally used for patient-specific prescription dose verification. Methods: The study was conducted using nine patients who were treated by volumetric modulated arc therapy. To evaluate the feasibility of Mobius3D for prescription dose verification, we compared the QA results of Mobius3D to an aSi-based EPID and the Octavius 4D dose verification methods. The first was the comparison of the Mobius3D verification phantom dose, and the second was to gamma index analysis. Results: The percentage differences between the calculated point dose and measurements from a PTW31010 ion chamber were 1.6%±1.3%, 2.0%±0.8%, and 1.2%±1.2%, using collapsed cone convolution, an analytical anisotropic algorithm, and the AcurosXB algorithm respectively. The average difference was found to be 1.6%±0.3%. Additionally, in the case of using the PTW31014 ion chamber, the corresponding results were 2.0%±1.4%, 2.4%±2.1%, and 1.6%±2.5%, showing an average agreement within 2.0%±0.3%. Considering all the criteria, the Mobius3D result showed that the percentage dose difference from the EPID was within 0.46%±0.34% on average, and the percentage dose difference from Octavius 4D was within 3.14%±2.85% on average. Conclusions: We conclude that Mobius3D can be used interchangeably with phantom-based dosimetry systems, which are commonly used as patient-specific prescription dose verification tools, especially under the conditions of 3%/3 mm and 95% pass rate.

• 한국통신학회논문지
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• 제33권7B호
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• pp.575-582
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• 2008

기존의 환자 모니터링 시스템은 환자가 자신의 정보를 원하는 경우 의료 기관을 통해서 정보 확인이 가능 하였다. 그러나 U-Healthcare 기반의 환자 모니터링 시스템에서는 RFID 시스템을 의료 환경에 적용하여 언제 어디서나 자신의 정보를 RFID 리더가 탑재된 모바일 장치를 통하여 확인이 가능하다. 환자의 태그 정보를 읽어 들여 환자가 원하는 서비스를 제공하기 위해서는 RFID 미들웨어 설계가 필요하다. 임베디드 리눅스 기반의 RFID미들웨어는 크게 RFID 모듈, ARM 프로세서, RS-232 인터페이스 등으로 구성된다. RFID 모듈은 사용자의 정보를 입력받기 위하여 사용되며, RS-232 인터페이스를 통하여 RFID 미들웨어로 정보를 전달한다. 또한 본 시스템은 임베디드 전용 ARM 프로세서를 사용하여 환자 모니터링 시스템에 특화된 시스템을 구현하였다. 본 논문에서 제안한 U-Healthcare 기반의 환자 모니터링 시스템은 임베디드 리눅스 기반의 Qt를 사용하여 RFID 미들웨어를 구현하였다.

• 한국의학물리학회지:의학물리
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• 제21권2호
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• pp.127-136
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• 2010

최근 시행되고 있는 호흡동조 방사선치료는 환자의 호흡의 주기를 이용하여 일정 주기에만 방사선을 조사하는 최신 방사선치료기술로 4D Computed Tomography와 RPM (Real-time Position Management) 시스템과 같은 호흡 모니터링 시스템의 개발로 환자들에게 시행이 되고 있다. 그러나 이러한 호흡동조 방사선치료에 대한 정도 관리는 아직 체계적으로 수행되고 있지 않으며 특히 환자에게 계획된 방사선치료선량이 환자의 호흡에 따라서 치료계획된 대로 조사되는지에 대한 정도관리에 대한 필요성이 요구되고 있다. 따라서 본 기관에서는 환자의 호흡신호를 사용하여 환자의 움직임을 동일하게 모사할 수 있는 팬텀을 제작하여 호흡동조 방사선치료의 2차원적 선량 분포를 평가할 수 있는 시스템을 구축하였고 특정환자의 호흡신호와 방사선치료계획을 이용하여 검증하였다. 환자의 호흡신호는 LabVIEW 7.0을 이용하여 모사하였고, 자체 제작한 팬텀 및 Kodak EDR2 필름을 사용하여 방사선을 조사한 뒤 gamma index를 사용하여 2차원 선량 분포를 비교 분석하였다. 본 연구에서 개발된 4D 정도관리 시스템을 좀 더 보완하여 호흡동조 방사선치료 과정에 있어서 조사선량의 적정성을 평가할 수 있는 정도관리 시스템으로 사용할 수 있을 것이라 생각된다.

• 한국의학물리학회지:의학물리
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• 제28권2호
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• pp.54-60
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• 2017

This study was designed to measure transit dose with an electronic portal imaging device (EPID) in eight patients treated with intensity modulated radiotherapy (IMRT), and to verify the accuracy of dose delivery to patients. The calculated dose map of the treatment planning system (TPS) was compared with the EPID based dose measured on the same plane with a gamma index method. The plan for each patient was verified prior to treatment with a diode array (MapCHECK) and portal dose image prediction (PDIP). To simulate possible patient positioning errors during treatment, outcomes were evaluated after an anthropomorphic phantom was displaced 5 and 10 mm in various directions. Based on 3%/3 mm criteria, the $mean{\pm}SD$ passing rates of MapCHECK, PDIP (pre-treatment QA) for 47 IMRT were $99.8{\pm}0.1%$, $99.0{\pm}0.7%$, and, respectively. Besides, passing rates using transit dosimetry was $90.0{\pm}1.5%$ for the same condition. Setup errors of 5 and 10 mm reduced the mean passing rates by 1.3% and 3.0% (inferior to superior), 2.2% and 4.3% (superior to inferior), 5.9% and 10.9% (left to right), and 8.9% and 16.3% (right to left), respectively. These findings suggest that the transit dose-based IMRT verification method using EPID, in which the transit dose from patients is compared with the dose map calculated from the TPS, may be useful in verifying various errors including setup and/or patient positioning error, inhomogeneity and target motions.

• 대한치과의사협회지
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• 제56권9호
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• pp.479-490
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• 2018

3D printing technology supporting the specific patient medical services is actively being implemented in dentistry. The purpose of this study is to introduce the legal and institutional considerations to the medical practitioners in dentistry who must observe when they manufacture medical devices using 3D printers, and to provide a ways to activate and enhance their utilization in the domestic approval point of view for medical devices. Through the public data of government agencies and related organizations, the statutory system and compliance matters related to the manufacture of 3D printing medical devices have been examined and reviewed for the government's improvement efforts. Through the study, the government has been actively improving the system and making policy, but the active interest and participation of medical professionals and related workers are continually required to solve the problems which are scattered. 3D printing technology is expected to be more frequently utilized in the field of dentistry in near future. Therefore, it is essential to establish measures to improve the regulation through continuous cooperation with the related ministries with the long-term point of view enhancing smooth entry to the market for the medical devices by taking data from the continued research.

• 대한의용생체공학회:의공학회지
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• 제44권1호
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• pp.19-24
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• 2023

Due to the spread of COVID-19, many patients with severe respiratory diseases have occurred worldwide, and accordingly, the use of mechanical ventilators has exploded. However, hospitals do not have systematic risk management, and the Medical Device Regulation also provides medical device risk management standards for manufacturers, but does not apply to devices in use. In this paper, we applied the Failure Mode Effects Analysis (FMEA) risk analysis technique based on the International Standard ISO 14971 (Medical Devices-Application of risk management to medical devices) for 85 mechanical ventilators of a specific model in use in hospitals. Failure modes and effects of each parts were investigated, and risk priority was derived through multiplication of each score by preparing criteria for severity, occurrence, and detection for each failure mode. As a result, it was confirmed that the microprocessor-based Patient Unit/Monitoring board in charge of monitoring scored the highest score with 36 points, and that reliability management is possible through systematic risk management according to priority.

• 대한방사선치료학회지
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• 제35권
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• pp.15-21
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• 2023

목 적: 전자포탈영상장치 기반의 환자특이적 정도관리를 위한 portal dose image prediction (PDIP)와 anisotropic analytical algorithm (AAA)을 비교하여 성능을 분석하고, AAA를 사용한 portal dosimetry의 임상적 사용 가능성을 평가하고자 한다. 대상 및 방법: 폐암 환자 15명과 간암 환자 17명, 총 32명의 환자를 후향적으로 선정하였다. PDIP와 AAA를 사용하여 검증용 치료계획을 생성하였다. 계산된 분포와 측정된 분포를 비교한 감마통과율(Gamma passing rate, GPR)과 다엽콜리메이터(Multileaf collimator, MLC) 위치 차이를 얻었다. 결 과: 폐암 환자군의 GPR 평균값은 PDIP 사용시 3%/3 mm에 대해 99.5% ± 1.1%, 1%/1 mm에 대해 90.6% ± 5.8%였다. AAA 사용시 3%/3 mm에 대해 98.9% ± 1.7%, 1%/1 mm에 대해 87.8% ± 5.2%였다. 간암 환자군의 GPR 평균값은 PDIP 사용시 3%/3 mm에 대해 99.9% ± 0.3%, 1%/1 mm에 대해 96.6% ± 4.6%였다. AAA 사용시 3%/3 mm에 대해 99.6% ± 0.5%, 1%/1 mm에 대해 89.5% ± 6.4%였다. MLC 위치 차이는 0.013 mm ± 0.002 mm로 적었으며, 감마통과율과 상관관계를 보이지 않았다. 결 론: 전자포탈영상장치 기반 환자특이적 정도관리를 수행할 때 AAA를 임상적으로 portal dosimetry 계산 알고리즘으로써 사용할 수 있다.

• 품질경영학회지
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• 제51권3호
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• pp.381-401
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• 2023

Purpose: The purpose of this study was to understand the perception of medical staff to propose an infected patient transport robot as a means of responding to infectious diseases. Methods: The data collected through the survey was analyzed through AHP analysis. The measurement tools used in this study were derived through the SERVQUAL model and Focus Group Interview(FGI), and consisted of four detailed questions for each of five classes: tangible, reliability, responsiveness, assurance, and empathy. Results: As a result of the study, there are concerns about risk factors that may occur in areas where medical staff intervention is minimized. Above all, we confirmed the consensus that safety should be the top priority during the process of robots to transport patients. In particular, highlighted were the resolution of device errors that may occur during the process for transporting patients and easy provision of the first aid. Additionally, the ability to monitor patients and suppress infection factors turned out to be important, which was directly related to the simplification of the role of medical staff and work efficiency. Conclusion: As one of the means of effectively controlling infectious diseases in a pandemic situation, a robot to transport the infected patient was considered. However, in order to commercialize this, specific verification of the safety of medical staff and patients is needed, and empirical data on providing the first aid, patient monitoring, and infection factor suppression should be presented.