• The Korean Journal of Pain
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• v.35 no.2
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• pp.129-139
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• 2022

C-arm fluoroscopy is a useful tool for interventional pain management. However, with the increasing use of C-arm fluoroscopy, the risk of accumulated radiation exposure is a significant concern for pain physicians. Therefore, efforts are needed to reduce radiation exposure. There are three types of radiation exposure sources: (1) the primary X-ray beam, (2) scattered radiation, and (3) leakage from the X-ray tube. The major radiation exposure risk for most medical staff members is scattered radiation, the amount of which is affected by many factors. Pain physicians can reduce their radiation exposure by use of several effective methods, which utilize the following main principles: reducing the exposure time, increasing the distance from the radiation source, and radiation shielding. Some methods reduce not only the pain physician's but also the patient's radiation exposure. Taking images with collimation and minimal use of magnification are ways to reduce the intensity of the primary X-ray beam and the amount of scattered radiation. It is also important to carefully select the C-arm fluoroscopy mode, such as pulsed mode or low-dose mode, for ensuring the physician's and patient's radiation safety. Pain physicians should practice these principles and also be aware of the annual permissible radiation dose as well as checking their radiation exposure. This article aimed to review the literature on radiation safety in relation to C-arm fluoroscopy and provide recommendations to pain physicians during C-arm fluoroscopy-guided interventional pain management.

• Archives of Craniofacial Surgery
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• v.16 no.3
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• pp.119-124
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• 2015

Background: The Kirschner wire (K-wire) technique allows stable fixation of bone fragments without periosteal dissection, which often lead to bone segment scattering and loss. The authors used the K-wire fixation to simplify the treatment of laborious comminuted zygomatic bone fracture and report outcomes following the operation. Methods: A single-institution retrospective review was performed for all patients with comminuted zygomatic bone fractures between January 2010 and December 2013. In each patient, the zygoma was reduced and fixed with K-wire, which was drilled from the cheek bone and into the contralateral nasal cavity. For severely displaced fractures, the zygomaticofrontal suture was first fixated with a microplate and the K-wire was used to increase the stability of fixation. Each wire was removed approximately 4 weeks after surgery. Surgical outcomes were evaluated for malar eminence, cheek symmetry, K-wire site scar, and complications (based on a 4-point scale from 0 to 3, where 0 point is 'poor' and 3 points is 'excellent'). Results: The review identified 25 patients meeting inclusion criteria (21 men and 4 women). The mean age was 52 years (range, 15-73 years). The mean follow up duration was 6.2 months. The mean operation time was 21 minutes for K-wire alone (n=7) and 52 minutes for K-wire and plate fixation (n=18). Patients who had received K-wire only fixation had severe underlying diseases or accompanying injuries. The mean postoperative evaluation scores were 2.8 for malar contour and 2.7 for K-wire site scars. The mean patient satisfaction was 2.7. There was one case of inflammation due to the K-wire. Conclusion: The use of K-wire technique was associated with high patient satisfaction in our review. K-wire fixation technique is useful in patient who require reduction of zygomatic bone fractures in a short operating time.

• Polymer(Korea)
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• v.30 no.6
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• pp.512-518
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• 2006

A biodegradable polymer poly((R) -3-hydroxybutyric acid) (PHB) was conjugated with a hydrophilic polymer poly(ethylene glycol) (PEG) by the ttansesterification reaction to form the amphiphilic block copolymer. PHB with low molecular weight ($3000{\sim}30000$) was appropriated for the drug delivery materials. High molecular weight PHB was hydrolyzed by an acid-catalyst to produce the low molecular weight one. Amphiphilic block copolymer was formed the self-assembled polymeric micelle system in the aqueous solution that the hydrophillic PEG was wraped the hydrophobic PHB. Generally, polymeric micelle forms the small particle between $10{\sim}200nm$. These polymeric micelle systems have been widely used for the drug delivery systems because they were biodegradable, biocompatible, non-toxic and patient compliant. The hydroxyl group of PEG was substituted with carboxyl group which has the reactivity to the ester group of PHB. Amphiphilic block copolymer was conjugated between PHB, and modified PEG at $176^{\circ}C$ which was higher than the melting point of PHB. Transesterification reaction was verified with DSC, FTIR, $^1H-NMR$. In the aqueous solution, critical micelle concentration (CMC) of the mPEG-co-PHB copolymer measured by the fluororescence scanning spectrometer was $5{\times}10^{-5}g/L$. The shape and size of the nanoparticle was taken by dynamic light scattering and atomic force microscopy. The size of the nanoparticle was about 130 nm and the shape was spherical. Our polymeric micelle system can be used as the passive targeting drug delivery system.

• Journal of the Korean Society of Radiology
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• v.14 no.7
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• pp.1003-1011
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• 2020

This study aims to compare and evaluate the image differences between single and dual sources in applying a technique to reduce metal artifacts using dual energy CT. Discovery CT 256 (GE, USA) as a single source device and Somatom Definition Flash (Siemens Health Care, Forchheim, Germany) as a dual source device. The self-made phantom (pigs with medical titanium screws inserted) was quantitative and qualitatively evaluated under the same conditions by varying the dose under the same conditions using a dual energy CT. The evaluation method was compared by measuring SNR for metal artifacts (scattering, stripe) generated by metal inserts, divided around bones and around tissues. There was a difference in images in the method of reducing metal artifacts between single-source and dual-source devices. In a single source device, the linearized prosthesis by metal implantation showed a greater decrease than the image obtained from a double source device, and the surrounding tissue was well observed without interference from the artifact. In dual-source devices, scattering and stripe artifacts caused by metal inserts decreased more than on a single source device, and signals from adjacent tissues surrounding the metal implant were well observed without diminishing. If the examination is conducted separately between single source and dual source devices depending on whether the area to which the patient is intended to be viewed during the examination is adjacent to the metal insert or the total tissue surrounding the metal insert, it is believed that diagnostic helpful images can be obtained.

• Progress in Medical Physics
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• v.30 no.4
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• pp.112-119
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• 2019

Purpose: The advantages of ocular proton therapy are that it spares the optic nerve and delivers the minimal dose to normal surrounding tissues. In this study, it developed a solid eye phantom that enabled us to perform quality assurance (QA) to verify the dose and beam range for passive single scattering proton therapy using a single phantom. For this purpose, a new solid eye phantom with a polymethyl-methacrylate (PMMA) wedge was developed using film dosimetry and an ionization chamber. Methods: The typical beam shape used for eye treatment is approximately 3 cm in diameter and the beam range is below 5 cm. Since proton therapy has a problem with beam range uncertainty due to differences in the stopping power of normal tissue, bone, air, etc, the beam range should be confirmed before treatment. A film can be placed on the slope of the phantom to evaluate the Spread-out Bragg Peak based on the water equivalent thickness value of PMMA on the film. In addition, an ionization chamber (Pin-point, PTW 31014) can be inserted into a hole in the phantom to measure the absolute dose. Results: The eye phantom was used for independent patient-specific QA. The differences in the output and beam range between the measurement and the planned treatment were less than 1.5% and 0.1 cm, respectively. Conclusions: An eye phantom was developed and the performance was successfully validated. The phantom can be employed to verify the output and beam range for ocular proton therapy.

• Nuclear Engineering and Technology
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• v.47 no.4
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• pp.472-478
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• 2015

The patient dose incurred from diagnostic procedures during advanced radiotherapy has become an important issue. Many researchers in medical physics are using computational simulations to calculate complex parameters in experiments. However, extended computation times make it difficult for personal computers to run the conventional Monte Carlo method to simulate radiological images with high-flux photons such as images produced by computed tomography (CT). To minimize the computation time without degrading imaging quality, we applied a deterministic adaptation to the Monte Carlo calculation and verified its effectiveness by simulating CT image reconstruction for an image evaluation phantom (Catphan; Phantom Laboratory, New York NY, USA) and a human-like voxel phantom (KTMAN-2) (Los Alamos National Laboratory, Los Alamos, NM, USA). For the deterministic adaptation, the relationship between iteration numbers and the simulations was estimated and the option to simulate scattered radiation was evaluated. The processing times of simulations using the adaptive method were at least 500 times faster than those using a conventional statistical process. In addition, compared with the conventional statistical method, the adaptive method provided images that were more similar to the experimental images, which proved that the adaptive method was highly effective for a simulation that requires a large number of iterations-assuming no radiation scattering in the vicinity of detectors minimized artifacts in the reconstructed image.

• Journal of the Korean Society of Radiology
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• v.14 no.6
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• pp.733-740
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• 2020

As the use of radiation for medical purposes increases, the exposure dose of medical workers is also increasing. To reduce this dose, various studies on changing the shielding material have been conducted. Recently, a new method to reduce the dose at the entrance of the radiation treatment room was proposed by using the photoelectric effect that occurs when the radiation is scattered. Because this method is particularly effective for low-energy photons, in this study, a slit-type structure was proposed as a excellent shielding structure against scattered x-ray in a general photography room, and was evaluated the shielding effect by Monte Carlo simulation. As a result of the calculation, this study found that in the case of a structure in which steel plates with a thickness of 2 mm and a width of 5 cm are stacked at 2 mm intervals, a shielding effect was approximately 99.9% or more, excluding the heights of the floor and the patient where scattering occurs directly.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.545-552
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• 2020

The purpose of this study is to derive a lead thickness calculation formula for direct-shielded doors based on NCRP Report No.151 and IAEA Safety Report Series N0.47. After deriving the dose rate calculation formula for the direct shielded door, this formula was substituted for the lead shielding thickness calculation formula to derive the shielding thickness calculation formula at the door. The lead shielding thickness calculated from the derived direct shielded door shielding thickness calculation formula was about 6% lower than that calculated by the NCRP and IAEA secondary barrier shielding thickness calculation methods. This result is interpreted as meaning that the thickness calculation is more conservative from the NCRP and IAEA secondary barrier shielding thickness calculation methods and fits well for secondary beam shielding. In conclusion, it is thought that the formula for calculating lead shielding thickness of the direct shielded door derived in this study can be usefully used in the shield design of the door.

• Journal of Radiation Protection and Research
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• v.47 no.3
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• pp.152-157
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• 2022

Background: The hemi-body electron beam irradiation (HBIe^-) technique has been proposed for the treatment of mycosis fungoides. It spares healthy skin using an electron shield. However, shielding electrons is complicated owing to electron scattering effects. In this study, we developed a thimble-like head bolus shield that surrounds the patient's entire head to prevent irradiation of the head during HBIe^-. Materials and Methods: The feasibility of a thimble-like head bolus shield was evaluated using a simplified Geant4 Monte Carlo (MC) simulation. Subsequently, the head bolus was manufactured using a three-dimensional (3D) printed mold and Ecoflex 00-30 silicone. The fabricated head bolus was experimentally validated by measuring the dose to the Rando phantom using a metal-oxide-semiconductor field-effect transistor (MOSFET) detector with clinical configuration of HBIe^-. Results and Discussion: The thimble-like head bolus reduced the electron fluence by 2% compared with that without a shield in the MC simulations. In addition, an improvement in fluence degradation outside the head shield was observed. In the experimental validation using the inhouse-developed bolus shield, this head bolus reduced the electron dose to approximately 2.5% of the prescribed dose. Conclusion: A thimble-like head bolus shield for the HBIe^- technique was developed and validated in this study. This bolus effectively spares healthy skin without underdosage in the region of the target skin in HBIe^-.

• The Journal of Korean Society for Radiation Therapy
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• v.25 no.2
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• pp.153-158
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• 2013

Purpose: After making two plans, the Double Scattering (DS) Mode and The Pencil Beam Scanning (PBS) Mode, of patients on early prostate cancer, we not only compare the dose conformity and the dose homogeneity by analyzing each DVH, CN and HI, but also evaluate normal structures's sparing effect on each mode. Materials and Methods: Planes about nine patients, who did proton therapy, on prostate cancer was setted using the Eclipse proton external beam planning system. The prescription dose, every $2.5 Gy{\times}28$ fractions=70 Gy, was delivered to the PTV. The CN and the HI were getted by anlazing each DVHs for the DS Plan and the PBS Plan. Also, normal structures' %volumes according to dose of the PBS are campared with those of the DS. Results: The average CN of the PTV is increase 16.63% from DS $0.68{\pm}0.07$ to PBS $0.79{\pm}0.01$, and the average IN of the PTV is decrease -22.66 % from DS $0.12{\pm}0.03$ to PBS $0.09{\pm}0.01$. The PBS has litter %Volumes of normal structures than the DS about every patient except Rectum. The average %Volume of Left Femoral Head receiving ${\geq}30$ Gy shows most high decreasing rate, -79.93%, from DS to PBS and the average %Volume of Rectum receiving ${\geq}70$ Gy shows most low decreasing rate, -3.03%, from DS to PBS. Conclusion: Therefore, the PBS is more effective achieving the dose conformity and the dose Homogeneity than DS, and better to reduce unnecessary dose arriving normal structures, especially the femoral heads.