Fabio Mancino;Andreas Fontalis;Ahmed Magan;Ricci Plastow;Fares S. Haddad
Hip & pelvis
/
v.36
no.1
/
pp.26-36
/
2024
Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional (3D) imaging and computed tomography (CT)-based navigation are valuable tools in both the preoperative planning and intraoperative execution. The aim of this study is to provide a thorough overview on the applications of CT scans in both the preoperative and intraoperative settings of primary THA. Preoperative planning using CT-based 3D imaging enables greater accuracy in prediction of implant sizes, leading to enhancement of surgical workflow with optimization of implant inventory. Surgeons can perform a more thorough assessment of posterior and anterior acetabular wall coverage, acetabular osteophytes, anatomical landmarks, and thus achieve more functional implant positioning. Intraoperative CT-based navigation can facilitate precise execution of the preoperative plan, to attain optimal positioning of the prosthetic components to avoid impingement. Medial reaming can be minimized preserving native bone stock, which can enable restoration of femoral, acetabular, and combined offsets. In addition, it is associated with greater accuracy in leg length adjustment, a critical factor in patients' postoperative satisfaction. Despite the higher costs and radiation exposure, which currently limits its widespread adoption, it offers many benefits, and the increasing interest in robotic surgery has facilitated its integration into routine practice. Conducting additional research on ultra-low-dose CT scans and examining the potential for translation of 3D imaging into improved clinical outcomes will be necessary to warrant its expanded application.
Jang, Eui Sun;Kwak, In Suk;Park, Sun Myung;Choi, Choon Ki;Lee, Hyuk;Kim, Soo Young;Choi, Sung Wook
The Korean Journal of Nuclear Medicine Technology
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v.17
no.2
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pp.67-71
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2013
Purpose: The Change of CT exposure condition have a effect on image quality and patient exposure dose. In this study, we evaluated effect CT image quality and SUV when CT parameters (Pitch, Rotation time) were changed. Materials and Methods: Discovery Ste (GE, USA) was used as a PET/CT scanner. Using GE QA Phantom and AAPM CT Performance Phantom for evaluate Noise of CT image. Images are acquired by using 24 combinations that four stages pitch (0.562, 0.938, 1.375, 1.75:1) and six stages X-ray tube rotation time (0.5s-1.0s). PET images are acquired using 1994 NEMA PET Phantom ($^{18}F-FDG$ 5.3 kBq/mL, 2.5 min/frame). For noise test, noise are evaluated by standard deviation of each image's CT numbers. And then we used expectation noise according to change of DLP (Dose Length Product) to experimental noise ratio for index of effectiveness. For spatial resolution test, we confirmed that it is possible to identify to 1.0 mm size of the holes at the AAPM CT Performance Phantom. Finally we evaluated each 24 image's SUV. Results: Noise efficiency were 1.00, 1.03, 1.01, 0.96 and 1.00, 1.04, 1.02, 0.97 when pitch changes at the QA Phantom and AAPM Phantom. In case of X-ray tube rotation time changes, 0.99, 1.02, 1.00, 1.00, 0.99, 0.99 and 1.01, 1.01, 0.99, 1.01, 1.01, 1.01 at the QA Phantom and AAPM Phantom. We could identify 1.0 mm size of the holes all 24 images. Also, there were no significant change of SUV and all image's average SUV were 1.1. Conclusion: 1.75:1 pitch is the most effective value at the CT image evaluation according to pitch change and It doesn't affect to the spatial resolution and SUV. However, the change of rotation time doesn't affect anything. So, we recommend to use the effective pitch like 1.75:1 and adequate X-ray tube rotation time according to patient size.
The Journal of Korean Society for Radiation Therapy
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v.22
no.2
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pp.135-144
/
2010
Purpose: The purpose of this study is that through production of phantom for respiration gated radiotherapy, assessing appropriacy of exposure dose for the therapy using RPM (Real-time Position Management). Materials and Methods: We located measurement object on the phantom for respiration gated radiotherapy made of 2 linear actuator, acrylic panel, stanchion, iron plate ets. to drive (up, down, front, back). Using 4D CT scan, we analyzed patient's respiration and reproduced the movement by computer. On the phantom, we located a 2D-Array (PTW) and an White water phantom (4.5 cm) and used DMLC (interval 2 cm) in the field size $10{\times}10\;cm$, then exposed 21EX X-ray 100 MU, in the case of phantom was (1) static (2) moving (3) gated using RPM respectively gantry $0^{\circ}$ and $90^{\circ}$ We measured with a 0.125 CC ionization chamber (PTW) on the phantom (7.5 cm) in the same condition. Results: Ionization chamber: There were within 0.3% of error with gating respiration and approximately 2% of error without gating in the same condition. 2D-Array: Gantry $90^{\circ}$, field size $10{\times}10\;cm$, using DMLC. There were within 3% of error with gating respiration and approximately 16% of error without gating. Conclusion: The phantom for respiration gated radiotherapy makes plans considering patient's movement, quantitative analysis of exposure dose and proper assessment therapy for IMRT patients using RPM possible.
The purpose of this study was first to analyze the utilization of dental examination through questionnaire to develop a diagnostic reference level of patient doses for dental radiography in korea. 77 dental institutions were classified into three groups: A group for the dental hospitals of the college of dentistry (11 institutions), B group for dental hospitals (30 institutions) and C group for dental clinics (36 institutions). The results were as follows : The mean numbers of unit chairs and medical staffs were 140.2, 15.3 and 5.8 sets, 112.6, 7.3 and 1.7 dentists, 3.1, 0.5 and no one radiologic technologists, and 19.7, 12.5 and 3.3 dental hygienists in A, B and C groups, respectively. The mean numbers of dental X-ray equipments were 14.64, 3.21 and 2.19 in A, B and C groups, respectively. Intraoral dental X-ray unit was used the most, the following equipments were panoramic, cephalometric, and cone-beam CT units. The most used X-ray imaging system was also digital system (above 50%) in all three groups. Insight dental film (Kodak, USA) having high sensitivity was routinely used for periapical radiography. The automatic processor was not used in many dental institutions, but the film-holding device was used in many dental institutions. The utilization rates of PACS in A, B and C groups were 90.9%, 83.3% and 16.7% respectively, and the PACS software program was used the most PiView STAR (Infinitt, Korea). The annual mean number of radiographic cases in one dental institution in 2008 for A group was 6.8 times and 21.2 times more than those for B and C groups, and periapical and panoramic radiographs were taken mostly. Tube voltage (kVp) and tube current (mA) for periapical radiography were similar in all three groups, but exposure time in C group was 12.0 times and 3.5 times longer than those in B and C groups. The amount of radiation exposure in C group, in which dental hygienists take dental radiographs, was more than those in other groups. The exposure parameters for panoramic radiography were similar in all three groups. In conclusion, the exposure parameters in dental radiography should be determined with reference level, not past experiences. Use of automatic processor and film-holding devices reduces the radiation exposure in film system. The quality assurance of dental equipments are necessary for the reduction of the patient dose and the improvement of X-ray image quality.
Radium is rock or soil of crust or uranium of building materials and thorium after radioactivity collapse process are created colorless and odorless inert gas that accrue well in sealed space like mine or basement. It inflow to lung circulate respiratory organ and caused lung cancer because of deposition of lung or bronchial tubes. Radium sheath of medical institution treat person's life is possible big danger to professional regarding radioactivity who has much amount exposed radioactivity and weaker immune patient. so we do this test. Using measuring instrument at test is real time radium measuring instrument, Professional Continuous Radon monitor, and measuring places are basement first floor and second floor of two hospitals and measure from 10 a.m to 3 p.m. Measurement result of Professional Continuous Radon monitor is minimum 14.8 Bq/$m^3$ to maximum 70.3 Bq/$m^3$ and show domestic baseline below 148 Bq/$m^3$, effective dose-rate is minimum 0.296 mSv to maximum 1.406 mSv that show 2.4 mSv, 10~58.3% level, exposed radiation amount from nature radiation one year.
There are many concerns about radiation exposure in Korea after Fukushima Nuclear Plant Accident on 2011 in Japan. As some isotope materials are detected in Korea, people get worried about the radioactive material. In addition, the mass media create an air of anxiety that jump on the people's fear instead of scientific approach. Therefore, for curbing this flow, health, medical institute from the world provide a variety of information about medical radiation safety and hold the campaign which can give people the image that medical radiation is safe. At this, the Korean Food and Drug Administration(KFDA) suggested that make the alliance of medical radiation safety and culture on August, 2011. Seven societies and institutions related medical radiation started to research and advertise the culture of medical radiation safety in Korea. In this report, mainly introduce the activities of the Korean Alliance for Radiation Safety and Culture in Medicine(KARSM) for spreading culture of medical radiation safety from 2011 to 2012.
Kim, Yun-Cheol;Yu, Yeon-Uk;Seo, Young-Deok;Moon, Jong-Woon;Kim, Yeong-Seok;Won, Woo-Jae;Kim, Seok-Ki
The Korean Journal of Nuclear Medicine Technology
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v.14
no.1
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pp.78-82
/
2010
Purpose: Recently, South Korea has seen a rapidly increased incidence of both breast and thyroid cancers. As a result, the I-131 scan and lymphoscintigraphy have been performed more frequently. Although this type of diagnostic imaging is prominent in that visualizes pathological conditions, which is similar to previous nuclear diagnostic imaging techniques, there is not much anatomical information obtained. Accordingly, it has been used in different ways to help find anatomical locations by transmission scan, however the results were unsatisfactory. Therefore, this study aims to realize an imaging technique which shows more anatomical information through the fusion of gamma and realistic imaging. Materials and Methods: We analyzed the data from patients who were examined by the lymphoscintigraphy and I-131 additional scan by Symbia Gamma camera (SIEMENS) in the nuclear medicine department of the National Cancer Center from April to July of 2009. First, we scanned the same location in patients by using a miniature camera (R-2000) in hyVISION. Afterwards, we scanned by gamma camera. The data we obtained was evaluated based on the scanning that measures an agreement of gamma and realistic imaging by the Gamma Ray Tool fusion program. Results: The amount of radiation technicians and patients were exposed was generated during the production process of flood source and applied transmission scan. During this time, the radiation exposure dose of technicians was an average of 14.1743 ${\mu}Sv$, while the radiation exposure dose of patients averaged 0.9037 ${\mu}Sv$. We also confirmed this to matching gamma and realistic markers in fusion imaging. Conclusion: Therefore, we found that we could provide imaging with more anatomical information to clinical doctors by fusion of system of gamma and realistic imaging. This has allowed us to perform an easier method in which to reduce the work process. In addition, we found that the radiation exposure can be reduced from the flood source. Eventually, we hope that this will be applicable in other nuclear medicine studies. Therefore, in order to respect the privacy of patients, this procedure will be performed only after the patient has agreed to the procedure after being given a detailed explanation about the process itself and its advantages.
Kim, Yeong Seon;Seo, Myung Deok;Lee, Wan Kyu;Kim, Ki Joon;Song, Jae Beom
The Korean Journal of Nuclear Medicine Technology
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v.16
no.2
/
pp.12-17
/
2012
Purpose : The patient's clothes and sheet after radioiodine therapy must be disposed of by related regulation. That must be disposed of as radioactive wastes, but that is reusing after radioactivity decay by keeping for the certain period of time. In general, The minimum storage period calculate by standard of take radioactive substance out of radiation controlled area based on measured surface contamination level. But the measurements of surface contamination level are able to differ by measurement method. In this paper, I wish to calculate the minimum storage period of patient's clothes and sheet after radioiodine therapy by measure nuclide concentration offered by the regulation on self-disposal of radioactive wastes. Materials and Methods : The whole area of patient's clothes and sheet measured 31 patients(male:9 patients, female:22 patients), who had radioiodine therapy(3.7 GBq:13 patients, 5.55 GBq:16 patients, 7.4 GBq:2 patients) from july 2011 to march 2012. The minimum storage period is calculated by the regulation on self-disposal of radioactive waste(100 Bq/g) and standard of take radioactive substance out of radiation controlled area(4 kBq/m2) Results : The minimum storage period of pillow sheet, upper uniform, lower uniform by standard of take radioactive substance out of radiation controlled area were each 4.6 days, 63days, 78 days. The minimum storage period of pillow sheet, upper uniform, lower uniform by the regulation on self-disposal of radioactive waste were each 18.1 days, 43 days, 62 days. Conclusion : We can verify that patient's clothes and sheet after radioiodine therapy exists a great deal of radioactive contamination. The minimum storage period calculation of patient's clothes and sheet is better suited to applying nuclide concentration offered by the regulation on self-disposal of radioactive waste. I recommend, To keep for at least 2 months of the patient's clothes and sheet contaminated radioactivity, for prevent contamination and unnecessary radiation exposure.
Kim, Kyotae;Heo, Yeji;Oh, Kyungmin;Noh, Sicheul;Kang, Sangsik;Nam, Sanghee;Park, Jikoon
Journal of the Korean Society of Radiology
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v.7
no.6
/
pp.383-387
/
2013
Diagnostic imaging systems play a critical role in obtaining anatomical images, which increases the frequency of inspection all over the world. However the likelihood that patients are exposed to relatively high radiation dose increases, which may lead to an increase of patient dose due to unnecessary radiation exposure unless appropriate management is accompanied. Thus the revised edition of IEC 60601-2-44 which is constancy tests for CT equipment which is designated as special medical equipment and is subject to safety management was studied. The results suggested the 3rd has been revised rationally in order to overcome the limitations in the 2nd by adopting clear and enhanced references, which implies the replacement of IEC 60601-2-44 2nd edition with IEC 60601-2-44 3rd will prevent the patients from the harm from improper medical equipment.
Yang, Won Seok;Choi, Jun-Hyeok;Shin, Woon-Jae;Min, Byung-In
The Journal of the Korea Contents Association
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v.13
no.11
/
pp.768-777
/
2013
The purpose of this study is to minimize radiation exposure to the workers and public members during CT examination. The objects are seven of the CT rooms in university hospitals and four of the CT rooms in clinics located in Busan and Gyung-nam area. The places of measurement for radiation leakage are 1) 3 m above the ground of shielding wall in the control room 2) particular space in the control room 3) worker's gate in the control room 4) the patient gate. Its values were calculated maximum leakage radiation per week(MLRW). As a result, the worker's gate of M clinic displayed the highest dose. When it was calculated by MLRW in classic method, it showed 1) $5.97{\pm}0.23$, 2) $0.50{\pm}0.02$, 3) $10.00{\pm}0.11$, 4) $2.37{\pm}0.47$ mR/week. All of them did not exceed limit for maximum permissible dose per week(MPDW). However, When MLRW of M clinic was calculated by empirical method, its value displayed $118.31{\pm}17.72$ mR/week.(MPDW>100 mR/week). Radiation leakage influenced in the control room(p<0.05). Therefore, The way of calculating MLRW must be developed and shielding wall in control room is designed 3 m above the ground for reducing dangerous of leakage radiation.
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