• Progress in Medical Physics
• /
• v.21 no.3
• /
• pp.253-260
• /
• 2010

Most brachytherapy treatment planning systems employ a dosimetry formalism based on the AAPM TG-43 report which does not appropriately consider tissue heterogeneity. In this study we aimed to set up a simple Monte Carlo-based intracavitary high-dose-rate brachytherapy (IC-HDRB) plan verification platform, focusing particularly on the robustness of the direct Monte Carlo dose calculation using material and density information derived from CT images. CT images of slab phantoms and a uterine cervical cancer patient were used for brachytherapy plans based on the Plato (Nucletron, Netherlands) brachytherapy planning system. Monte Carlo simulations were implemented using the parameters from the Plato system and compared with the EBT film dosimetry and conventional dose computations. EGSnrc based DOSXYZnrc code was used for Monte Carlo simulations. Each $^{192}Ir$ source of the afterloader was approximately modeled as a parallel-piped shape inside the converted CT data set whose voxel size was $2{\times}2{\times}2\;mm^3$. Bracytherapy dose calculations based on the TG-43 showed good agreement with the Monte Carlo results in a homogeneous media whose density was close to water, but there were significant errors in high-density materials. For a patient case, A and B point dose differences were less than 3%, while the mean dose discrepancy was as much as 5%. Conventional dose computation methods might underdose the targets by not accounting for the effects of high-density materials. The proposed platform was shown to be feasible and to have good dose calculation accuracy. One should be careful when confirming the plan using a conventional brachytherapy dose computation method, and moreover, an independent dose verification system as developed in this study might be helpful.

• Progress in Medical Physics
• /
• v.14 no.2
• /
• pp.90-98
• /
• 2003

Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

• Journal of the Korean Society of Radiology
• /
• v.13 no.4
• /
• pp.653-659
• /
• 2019

The purpose of this study is to measure the (air dose rate of radiation dose) the discharged patient who was administrated high dose $^{131}I$ treatment, and to predict exposure radiation dose in public person. The dosimetric evaluation was performed according to the distance and angle using three copper rings in 30 patients who were treated with over 200mCi high dose Iodine therapy. The two observer were measured using a GM surverymeter with 8 point azimuth angle and three difference distance 50, 100, 150cm for precise radion dose measurement. We set up three predictive simulations to calculate the exposure dose based on this data. The most highest radiation dose rate was showed measuring angle $0^{\circ}$ at the height of 1m. The each distance average dose rate was used the azimuth angle average value of radiation dose rate. The maximum values of the external radiation dose rate depending on the distance were $214{\pm}16.5$, $59{\pm}9.1$ and $38{\pm}5.8{\mu}Sv/h$ at 50, 100, 150cm, respectively. If high dose Iodine treatment patient moves 5 hours using public transportation, an unspecified person in a side seat at 50cm is exposed 1.14 mSv radiation dose. A person who cares for 4days at a distance of 1 meter from a patient wearing a urine bag receives a maximum radiation dose of 6.5mSv. The maximum dose of radiation that a guardian can receive is 1.08mSv at a distance of 1.5m for 7days. The annual radiation dose limit is exceeded in a short time when applied the our developed radiation dose predictive modeling on the general public person who was around the patients with Iodine therapy. This study can be helpful in suggesting a reasonable guideline of the general public person protection system after discharge of high dose Iodine administered patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.3
• /
• pp.177-189
• /
• 2016

This study examined the effectiveness of maternity nursing simulations using a high-fidelity simulator for undergraduate nursing students. One-group pretest-posttest design was used. The simulation-based education program consisted of three sessions, including the clinical scenarios about prenatal, childbearing and postpartum care. The program provided for 3 weeks in November 2014. Data was collected before and after the simulation education using self-reported questionnaires, which included simulation effectiveness, problem solving ability, communication skills and self-confidence in maternity nursing. The data of 83 participants were analyzed using the IBM SPSS 20.0 program. After simulation education, the overall score of the simulation effectiveness was 17.4 out of 26.0. Communication skill (t=4.58, p=<.001) and self-confidence in maternity nursing (t=9.70, p=<.001) increased significantly in the posttest. On the other hand, there was no significant change in the problem solving ability. The simulation effectiveness correlated significantly with the problem solving ability (r=.494, p<.001), communication skill (r=.361, p<.001), and self-confidence in maternity nursing (r=.497, p<.001) after simulation-based education. These findings suggest that the high-fidelity simulation in maternity nursing education could be used not only to enhance the nursing competency, but also to deal with the limitations of the clinical practicum in the current situation.

• The Journal of the Korea Contents Association
• /
• v.15 no.3
• /
• pp.206-218
• /
• 2015

This single-blinded, nonequivalent control group pretest-posttest study was undertaken to evaluate the effectiveness of simulation education on clinical judgement, collaboration, communication skills, and perceived education practices and simulation design characteristics among student nurses in Korea. Participants were 47 students (19 in the experimental group and 28 in the control group) recruited by convenience sampling. The simulation based clinical reasoning education consisted of seven weekly, 120-minute high fidelity simulations. All participants completed the pretest and 7-week post measurements of a clinical judgment, collaboration, and communication skills with 4-week post measurement of collaboration, and participants in the experimental group provided a measurements of perceived education practices and simulation design characteristics. Data were analyzed using repeated measured ANOVA, and mixed linear model with SAS 9.2. Significant improvements were found in the experimental group for clinical judgment, collaboration, communication skill, and perceived education practices and simulation design characteristics. The study results show the impact of the perceived education practices and simulation design characteristics on facilitating the effectiveness of simulation education. The findings suggest a feasible and sound teaching method for student nurses and the need for further studies with a larger sample.

• Journal of the Korean Society of Radiology
• /
• v.16 no.3
• /
• pp.273-279
• /
• 2022

In order to reduce the absorbed dose given to the patient during dental radiography, a sensor that inserts a shield into the intraoralsensor was designed. Using the designed sensor, the change in absorbed dose depending on whether or not a shield was used was evaluated. The system used to evaluate the absorbed dose is VEX-S300C from Vatech, and the energy spectrum of X-rays was obtained through SPEKTR simulation based on the irradiation conditions of 65 kV, 3 mA, and 0.15 sec, and the number of photons for each energy was derived. After designing the system through Genat4 Application for Tomographic Emission(GATE) simulation, the energy spectrum obtained was used as a radiation source to calculate the absorbed dose. Lead was used for the shield, and simulations were performed at 0.1 mm thickness intervals from 0.1 mm to 0.5 mm was evaluated. In the case of using an X-ray field with a diameter of 60 mm, the decrease in absorbed dose according to the presence or absence of a shield decreased exponentially as the thickness of the shield increased. In addition, when a 20 mm × 30 mm field was used, the absorbed dose was significantly reduced even when no shield was used, and it was confirmed that the absorbed dose was further reduced when a shield was used.

• KIPS Transactions on Software and Data Engineering
• /
• v.12 no.6
• /
• pp.275-284
• /
• 2023

Virtual reality simulations are used for education and training in various fields, and are especially widely used in the medical field recently. The education/training simulator consists of tactile/force feedback generation and image/sound output hardware that provides a sense similar to a doctor's treatment of a real patient using real surgical tools, and software that produces realistic images and tactile feedback. Existing simulators are complicated and expensive because they have to use various types of hardware to simulate various surgical instruments used during surgery. In this paper, we propose a dental surgical simulation system using a force feedback device and a morphable haptic controller. Haptic hardware determines whether the surgical tool collides with the surgical site and provides a sense of resistance and vibration. In particular, haptic controllers that can be deformed, such as length changes and bending, can express various senses felt depending on the shape of various surgical tools. When the user manipulates the haptic feedback device, events such as movement of the haptic feedback device or button clicks are delivered to the simulation system, resulting in interaction between dental surgical tools and oral internal models, and thus haptic feedback is delivered to the haptic feedback device. Using these basic techniques, we provide a realistic training experience of impacted wisdom tooth extraction surgery, a representative dental surgery technique, in a virtual environment represented by sophisticated three-dimensional models.

• Journal of the Korean Burn Society
• /
• v.21 no.1
• /
• pp.17-21
• /
• 2018

Purpose: This study aimed to evaluate the thermal protective function of firefighter clothes and gloves through real scale fire simulations. Methods: Firstly, the fire simulation by real scale flame was performed for firefighter clothes. A manikin equipped with firefighter clothes was directly exposed to flames which energy average is 84 Kw/m². for 22 seconds. Heat flux gauges attached on the body measured surface temperature elevation. Secondly, we also performed the other fire simulation by hot plate exposure to firefighter gloves. Firefighter gloves with heat flux gauges exposed hot plate which temperature is 300℃ in both dry and moist conditions. Primary outcome was surface temperature change of manikin body (first simulation) and hand (second simulation) over times. Results: In the first flame simulation, the surface temperature of face and shoulders elevated more rapidly comparing with the other body surface area when initial period of flame shutter open. After 18sec of shutter open, the surface temperature of upper trunk elevated rapildy. After shutter closure, high surface temperature kept continuously on right side of face and left shoulder. In the second hot plate simulation, fingers and palms showed higher surface temperature than the other areas of hands in the both dry and wet conditions. Conclusion: This study suggests that the real scale flame enables firefighter clothes to lose their heat protective function suddenly after 18 seconds. Additionally, the protective function of firefighter gloves were relatively weaker in the palmar side of fingers than the other parts of hand. There should be additional study for evaluate thermal protection performance of firefighter clothes. And, further effort for reinforce palmar side of fingers of firefighter gloves should be done.

• Journal of the Korean Society of Radiology
• /
• v.12 no.1
• /
• pp.23-30
• /
• 2018

To evaluate the effect of patient size on effective dose and image quality for Digital Chest Tomosynthesis(DTS) using additional 0.3 mm copper filtration. Eighty artificial nodules were placed in the thorax phantom("Lungman," Kyoto Kagaku, Japan), and Digital Chest Tomosynthesis(DTS) images of the phantom were acquired both with and without added 0.3 mm Cu filtration. To simulate patients of three sizes: small, average size and oversize, one or two 20-mm-thick layer of PMMA(polymethyl methacrylatek) blocks were placed on the phantom. The Effective dose was calculated using Monte Carlo simulations. Two evaluations of image quality methods have been employed. Three readers counted the number of nodules detected in the lung, and the measured contrast-to-noise ratios(CNRs) were used. Data were analyzed statistically. The ED reduced $26{\mu}Sv$ in a phantom, $33{\mu}Sv$ in one 20-mm-thick layer of PMMA block placed on the phantom, and $48{\mu}Sv$ in two 20-mm-thick layer of PMMA blocks placed on the phantom. The Effective dose(ED) differences between DTS with and without filtration were significant(p<0.05). In particular, when we used two 20-mm-thick layer of PMMA blocks placed on the phantom, the ED was significantly reduced by 36% compared with those without additional filtration. Nodule detection sensitivities were not different between with and without added filtration. Differences of CNRs were statistically insignificant(p>0.05). Use of additional filtration allows a considerable dose reduction during Digital Chest Tomosynthesis(DTS) without loss of image quality. In particular, additional filtration showed outstanding result for effective dose reduction on two 20-mm-thick layer of PMMA blocks placed on the phantom. It applies to overweight patients.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.1
• /
• pp.127-135
• /
• 2014

Purpose : By taking advantage of each imaging modality, the use of fused CT/MRI image has increased in prostate cancer radiation therapy. However, fusion uncertainty may cause partial target miss or normal organ overdose. In order to complement such limitation, our hospital acquired MRI image (Planning MRI) by setting up patients with the same fixing tool and posture as CT simulation. This study aims to evaluate the usefulness of the Planning MRI through comparing and analyzing the diagnostic MRI image and Planning MRI image. Materials and Methods : This study targeted 10 patients who had been diagnosed with prostate cancer and prescribed nonhormone and definitive RT 70 Gy/28 fx from August 2011 to July 2013. Each patient had both CT and MRI simulations. The MRI images were acquired within one half hour after the CT simulation. The acquired CT/MRI images were fused primarily based on bony structure matching. This study measured the volume of prostate in the images of Planning MRI and diagnostic MRI. The diameters at the craniocaudal, anteroposterior and left-to-right directions from the center of prostate were measured in order to compare changes in the shape of prostate. Results : As a result of comparing the volume of prostate in the images of Planning MRI and diagnostic MRI, they were found to be $25.01cm^3$(range $15.84-34.75cm^3$) and $25.05cm^3$(range $15.28-35.88cm^3$) on average respectively. The diagnostic MRI had an increase of 0.12 % as compared with the Planning MRI. On the planning MRI, there was an increase in the volume by $7.46cm^3$(29 %) at the transition zone directions, and there was a decrease in the volume by $8.52cm^3$(34 %) in the peripheral zone direction. As a result of measuring the diameters at the craniocaudal, anteroposterior and left-to-right directions in the prostate, the Planning MRI was found to have on average 3.82cm, 2.38cm and 4.59cm respectively and the diagnostic MRI was found to have on average 3.37cm, 2.76cm and 4.51cm respectively. All three prostate diameters changed and the change was significant in the Planning MRI. On average, the anteroposterior prostate diameter decrease by 0.38cm(13 %). The mean right-to-left and craniocaudal diameter increased by 0.08cm(1.6 %) and 0.45cm(13 %), respectively. Conclusion : Based on the results of this study, it was found that the total volumes of prostate in the Planning MRI and the diagnostic MRI were not significantly different. However, there was a change in the shape and partial volume of prostate due to the insertion of prostate balloon tube to the rectum. Thus, if the Planning MRI images were used when conducting the fusion of CT/MRI images, it would be possible to include the target in the CTV without a loss as much as the increased volume in the transition zone. Also, it would be possible to reduce the radiation dose delivered to the rectum through separating more clearly the reduction of peripheral zone volume. Therefore, the author of this study believes that acquisition of Planning MRI image should be made to ensure target delineation and localization accuracy.