• Proceedings of the Korean Society of Medical Physics Conference
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• 2003.09a
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• pp.72-72
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• 2003

Purpose: To prove feasibility of proton chemical shift imaging (lH CSI) during stereotactic procedure, authors performed IH CSI in combination with a stereotactic headframe and selected targets according to local metabolic information, evaluated the pathologic results. Methods: The 1H CSI directed stereotactic biopsy was performed in five patients. 1H CSI was performed before conventional stereotactic MRI with gadolinium enhancement for stereotactic coordinates. The metabolite images expressed as integral ratios, Cho/Cr and Lac/Cr, were displayed in different colors. The stereotactic target coordinates were correlated with the coordinates from the 1H CSI images. Results: The final pathologic results obtained were concordant with the local metabolic information from 1H CSI. We believe that 1H CSI-directed stereotatic biopsy has the potential to significantly improve the accuracy of stereotactic biopsy targeting. Conclusions : Metabolic signals derived from 1H CSI could give us more direct clues for stereotactic target selection during the subsequent conventional stereotactic MR imaging. 1H CSI was feasible with the stereotatic headframe in place. The final pathologic results obtained were concordant with the local metabolic information from 1H CSI. Acknowledgement: This study was supported by a grant of the Center for Functional and Metabolic Imaging Technology, Ministry of Health & Welfare, Republic of Korea (02-PJ3-PG6-EV07-0002).

• Radiation Oncology Journal
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• v.13 no.4
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• pp.403-409
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• 1995

Purpose : Authors tried to enhance the safety and accuracy of radiosurgery by verifying stereotacitc target point in actual treatment position prior to irradiation. Materials and Methods : Before the actual treatment, several sections of anthropomorphic head phantom were used to create a condition of unknown coordinates of the target point. A film was sandwitched between the phantom sections and punctured by sharp needle tip. The tip of the needle represented the target point. The head phantom was fixed to the stereotactic ring and CT scan was done with CT localizer attached to the ring. After the CT scanning, the stereotactic coordinates of the target point were determined. The head phantom was secured to accelerator's treatment couch and the movement of laser isocenter to the stereotactic coordinates determined by CT scanning was performed using target positioner. Accelerator's anteroposterior and lateral portal films were taken using angiographic localizers. The stereotactic coordinates determined by analysis of portal films were compared with the stereotactic coordinates previously determined by CT scanning. Following the correction of discrepancy the head phantom was irradiated using a stereotactic technique of several arcs. After the irradiation, the film which was sandwitched between the phantom sections was developed and the degree of coincidence between the center of the radiation distribution with the target point represented by the hole in the film was measured. In the treatment of the actual patients, the way of determining the stereotactic coordinates with CT localizers and angiograuhic localizers was the same as the phantom study. After the correction of the discrepancy between two sets of coordinates, we proceeded to the irradiation of the actual patient. Results : In the phantom study, the agreement between the center of the radiation distribution and the localized target point was very good. By measuring optical density profiles of the sandwitched film along axes that intersected the target point, authors could confirm the discrepancy was 0.3 mm. In the treatment of an actual patient, the discrepancy between the stereotactic coordinates with CT localizers and angiographic localizers was 0.6 mm. Conclusion : By verifying stereotactic target point in actual treatment position prior to irradiation, the accuracy and safety of streotactic radiosurgery procedure were established.

• The Journal of Korean Society for Radiation Therapy
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• v.12 no.1
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• pp.20-25
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• 2000

The accuracy of the target localization was evaluated by conventional and spiral CT in stereotactic radiosurgerv. Conventional and spiral CT images were obtained with geometrical phantom, which was designed to produce exact three-dimensional coordinates of several objects within 0.1mm error range. Geometrical phantom was attached by BRW headframe, intermediate head ring, and CT localizer. Twentv-seven slices of conventional CT image were scanned at 3 mm slice thickness. Spiral CT images were scanned at 3 mm slice thickness from the pitch value 1 to 3, and twenty-seven slices of image were obtained per each the pitch value. These CT images were transferred to a treatment planning system(X-knife, Radionics) by ethernet, Three-dimensional coordinates of these images measured from the treatment planning system were compared to known values of geometrical phantom. The mean localization error of the target localization of conventional CT was 1.4mm. In case of spiral CT, the error of the target localization was within 1.6mm from the pitch value 1 to 1.3, but was more than 30mm above the pitch value 1.5. In conclusion, as the localization error of spiral CT was increased in high pitch value compared to conventional CT, the application of spiral CT will be with caution in stereotactic radiosurgery.

• Progress in Medical Physics
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• v.3 no.1
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• pp.53-62
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• 1992

Stereotactic implantation of intracranial lesions, and the development of stereotactic convergent irradiation, radiosurgery, techniques have to obtain the accurate coordinates of the tumor locations and that of critical organ. Computed tomography(CT) provides relatively precise imformations of tumor localization and surround the normal organs for conventional radiotherapy. This CT image use to extend for stereotactic radiosurgery procedures. Since the convergent irradiation technique in linear accelerator requires the target center coincident with gantry isocenter or radosurgery frame, the target coordinates must be described in accurately. We used the BRW stereotactic system for describing the target position in CT images This algorithm provides the coordinate conversions for orthogonal or non-orthogonal CT scan image. In this experiments, the target positions have shown the small discripancy within :to.3mm uncertanty in several known target positions in the phantom through the provided programs and it compared to that of BRW stereotactic systems.

• Journal of Radiation Protection and Research
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• v.20 no.1
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• pp.25-36
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• 1995

The purpose of this research is to develop stereotactic localization and radiation measurement system for the efficient and precise radiosurgery. The algorithm to obtain a 3-D stereotactic coordinates of the target has been developed using a Fisher CT or angio localization. The procedure of stereotactic localization was programmed with PC computer, and consists of three steps: (1) transferring patient images into PC; (2) marking the position of target and reference points of the localizer from the patient image; (3) computing the stereotactic 3-D coordinates of target associated with position information of localizer. Coordinate transformation was quickly done on a real time base. The difference of coordinates computed from between Angio and CT localization method was within 2 mm, which could be generally accepted for the reliability of the localization system developed. We measured dose distribution in small fields of NEC 6 MVX linear accelerator using various detector; ion chamber, film, diode. Specific quantities measured include output factor, percent depth dose (PDD), tissue maximum ratio (TMR), off-axis ratio (OAR). There was small variation of measured data according to the different kinds of detectors used. The overall trends of measured beam data were similar enough to rely on our measurement. The measurement was performed with the use of hand-made spherical water phantom and film for standard arc set-up. We obtained the dose distribution as we expected. In conclusion, PC-based 3-D stereotactic localization system was developed to determine the stereotactic coordinate of the target. A convenient technique for the small field measurement was demonstrated. Those methods will be much helpful for the stereotactic radiosurgery.

• Progress in Medical Physics
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• v.15 no.4
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• pp.197-201
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• 2004

Stereotactic brain biopsy using stereotactic head frame such as CRW (Radionics, USA) has demonstrated a precise lesion localizing accuracy. In this study, we developed the target point calculation program for brain lesion biopsy using CRW stereotactic head frame and designed a phantom for verify the new developed program. The phantom was designed to have capability to simulate clinical stereotactic brain biopsy. The phantom has 10 vertical rods whose diameters are 6mm and tip of each rods are 2mm. Each rod has different length, 150 mm x 4 ea, 130 mm x 4 ea, 110 mm x 2 ea. CT images were acquired with Simens CT scanner as continuous transverse slice, 1 mm thickness in a 25 cm field of view and stored in a dicom file as a 256 x 256 matrix. As a result, the developed new target localization program will be useful for planning and training in complicated 3 dimensional stereotactic brain biopsy.

• Progress in Medical Physics
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• v.13 no.1
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• pp.15-20
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• 2002

Optimum field size for the whole body stereotactic radiosurgery was studied. Dose distributions from the various sizes of targets (diameter 1cm to 7cm, icm interval) were used for this study. Planing scores, expressed as the Target Coverage Index (TCI), were calculated for various target Margin ranged 0cm to 0.5cm. Highest scores were obtained for no Margin to the target size. The target Margin -0.5cm to 0cm to the target showed best TCI the cases of the target size larger than 6cm diameter. No Margin or 0.5cm Margin generated best TCI for less than 2cm cases. Prescription to 80~90% gives best results.

• Journal of radiological science and technology
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• v.38 no.3
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• pp.213-220
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• 2015

This research was study the accuracy of three-dimensional stereotactic breast biopsy, using a core Needle Biopsy and to assess the accuracy of Stereotactic biopsy and Sono guided biopsy. Using Stereotactic QC phantom to measure the accuracy of the 3D sterotactic machine. CT Scan and equipment obtained in the measured X, Y, Z and compares the accuracy of the length. Using Agar power phantom compare the accuracy of the 3D sterotactic machine and 2D ultrasound machine. Z axis measured by the equipment to compare the accuracy and reliability. Check the accuracy by using visual inspection and Specimen Medical application phantom. The accuracy of the 3D sterotactic machine measured by Stereotactic QC phantom was 100%. Accuracy as compared to CT, all of X, Y, Z axis is p > 0.05. The accuracy of the two devices was 100% as measured by Agar powder phantom. There was no difference between t he t wo d evices as C T and p > 0.05. 3D sterotactic machine of the ICC was 0.954, 2D ultrasound machine was 0.785. 2D ultrasound machine was different according to the inspector. Medical application phantom experiments in 3D sterotactic machine could not find the Sliced boneless ham. 2D ultrasound machine has not been able to find a small chalk powder group. The reproducibility of the three-dimensional stereotactic breast biopsy was better than effect of Sono guided biopsy.

• Proceedings of the KSMRM Conference
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• 2003.10a
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• pp.86-86
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• 2003

Purpose： To prove feasibility of proton chemical shift. imaging (1H CSI) during stereotactic procedure, authors peformed 1H CSI in combination with a stereotactic headframe and selected targets according to local metabolic information, evaluated the pathologic results Materials and methods： The 1H CSI directed stereotactic biopsy was performed in five patients. 1H CSI was performed before conventional stereotactic MRI with gadolinium enhancement for stereotactic coordinates. The metabolite images expressed as integral ratios, Cho/Cr and Lac/Cr, were displayed in different colors. The stereotactic target coordinates were correlated with the coordinates from the 1H CSI images.

• Progress in Medical Physics
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• v.35 no.1
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• pp.1-9
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• 2024

Margin inclusion or exclusion remains the most critical and controversial aspect of stereotactic radiosurgery (SRS) for metastatic brain tumors. This review aimed to examine the available literature on the impact of margins in SRS of brain metastasis and to assess the response of some medical physicists on the use of these margins. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used to review articles published in PubMed, Embase, and Science Direct databases from January 2012 to December 2022 using the following keywords: planning target volume, brain metastasis, margin, and stereotactic radiosurgery. A simple survey consisting of five questions was completed by ten medical physicists with experience in SRS treatment planning. The results were analyzed using IBM SPSS Statistics version 26.0. Of the 1,445 articles identified, only 38 articles were chosen. Of these, eight papers were deemed relevant to the focus of this review. These papers showed an increase in the risk of radionecrosis, whereas differences in local control were variable as the margin increased. In the survey, the response rate to whether or not to use margins in SRS, a critical question, was 50%. Margin addition increases the risk of radio necrosis. The local control rate varies among treatment modalities and cannot be generalized. From the survey, no consensus was reached regarding the use of these margins. This calls for further deliberations among professionals directly involved in SRS.