• Title/Summary/Keyword: treatment planning

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Accuracy of F-18 FDG PET/CT in Preoperative Assessment of Cervical Lymph Nodes in Head and Neck Squamous Cell Cancer: Comparison with CT/MRI (두경부 편평상피암 환자에서 수술 전 경부림프절 전이 평가에 대한 F-18 FDG PET/CT의 정확도: CT/MRI와의 비교)

  • Choi, Seung-Jin;Byun, Sung-Su;Park, Sun-Won;Kim, Young-Mo;Hyun, In-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.309-315
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    • 2006
  • Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

The evaluation of custo-made EWHA Breast Device(EBD) (EWHA Breast Device(EBD)의 제작 및 유용성 평가)

  • Byun Young-Sik;Oh Tae-Sung;Park Chong-Yil;Shin Hyun-Kyoh
    • The Journal of Korean Society for Radiation Therapy
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    • v.17 no.1
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    • pp.33-40
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    • 2005
  • Purpose : We recently perform the latest radiotheraphy (3D conformal, IMRT,etc.) with the development of 3D CT planning technology. However, in case patients with breast cancer, it is difficult to acquire the CT image with the limitation of CT hole size and tilting of breast immobilization device. The Ewha Breast Device(EBD) was constructed to improve the problem in the treatment of patients with breast cancer and we are intend to introduce the procedure of the EBD construction in this study and compare the EBD with conventional breast device in the view point of usefulness. Materials and Methods : We have constructed the EBD with acryl, analyze the skull size with CT data, consider the skin folder in SCL field and evaluated the EBD usefulness from the view point of set-up reproducibility, dose distribution, skin reaction in comparison with conventional breast device. Results : In the case of patients set-up error analysis, the EBD is superior to conventional device in portal film repetition($\%$) check (80pt.), equal to that in simulation & CT image coincidence check(5pt.). There is no difference between the two systems in dose distribution and skin reaction in SCL field is better the EBD than conventional device. Conclusions : The construction of the EBD enable us to perform the latest radiotheraphy in breast treatments, relieve the pains in simulation, and reduce, the skin reaction. In the future, we expect that modification of the EBD is useful in treating for patients with breast cancer.

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Application of Modified Mupit for the Recurrent Vulva Cancer in Brachytherapy (재발한 Vulvar 종양의 근접치료 시 Modified Mupit Applicator의 적용)

  • Kim, Jong-Sik;Jung, Chun-Young;Oh, Dong-Gyoon;Song, Ki-Won;Park, Young-Hwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.1
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    • pp.13-19
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    • 2006
  • Purpose: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Materials and Methods: Modified MUPIT applicator basically consists of an acrylic cylinder with flexible brain applicator, an acrylic template with a predrilled array of holes that serve as guides for interstitial needles and interstitial needles. CT scan was peformed to determine tumor volume and the position of interstitial needles. Modified MUPIT applicator was applied to patient in operation room and the accuracy for position of interstitial needles in tumor volume was confirmed by CTscan. Brachytherapy was delivered using modified MUPIT applicator and RALS(192-lr HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3,000 cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Results: The application of modified MUPIT applicator improved dramatically dose distributions in tumor volume and follow-up of 3 month for this patient was clinically partial response without normal tissue complication, Rectal dose was measured 34.1 cGy, 57.1 cGy, 103.8 cGy, 162.7 cGy, 165.7 cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1 cGy, 57.1 cGy. Conclusion: Patients with locally recurrent tumor in uterine cervix cancel treated with modified MUPIT applicator can expect reasonable rates of local control. The advantages of the system are the fixed geometry provided by the template and cylinders. and improved dose distributions in irregular tumor volume without rectal complication.

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Evauation of Injury Mechanism and Clinical Outcome Between Non-Traumatic and Traumatic Type II Slap Lesions (제 2형 SLAP 병변의 외상 유무에 따른 손상 기전 및 치료 결과의 분석)

  • Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Kwan-Hee;Choi, Sung-Hyun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.244-249
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    • 2010
  • Purpose: Our goal of this study was to compare the mechanism of injury and the clinical outcomes between the non-traumatic and traumatic type II SLAP lesions. Materials and Methods: From January 2007 to May 2009, the sunjects of this study were 27 patients who had undergone operations for isolated type II SLAP lesions. The lesions were classified according to Burkhart's method. The lesions that were located on the anterior-superior labrum were classified as type I, those lesions located on the posterior-superior labrum were classified as type II and those lesions located on the anterior-posterior labrum were classified as type III. The clinical outcomes were evaluated by the UCLA score and the KSS score preoperatively and postoperatively. Results: Of the 27 cases, 16 cases were traumatic and eleven cases were non-traumatic. In the traumatic group, there were 12, 2 and 2 cases of type I, type II and type III, respectively (p=0.013). In non-traumatic group, there were 2, 6 and 3 cases of type I, type II and type III (p=0.026). Anterior lesions were more frequent in the traumatic group and posterior lesions were more frequent in the non-traumatic group. For the clinical outcomes, the mean preoperative UCLA score and KSS score were 18 (range: 14~23) and 48 (range: 32~76), respectively, and the postoperative UCLA score and KSS score were 32 (range: 28~33) and 86 (range: 71~92), respectively, in the traumatic group, and the preoperative UCLA score and KSS score were 21 (18~25) and 58 (41~68), respectively, and the postoperative UCLA score and KSS score were 29 (26~31) and 81 (68~89), respectively in the non-traumatic group. There was no significant statistical difference of clinical outcomes between the two groups (p=0.317, 0.405). Conclusion: In this study, the anatomical feature of type II SLAP lesion was associated with a trauma mechanism. Therefore, a trauma mechanism must be considered when planning the surgical treatment for type II SLAP lesions.

Quality Characteristics of Pine Mushroom Yanggaeng Prepared by Different Addition of Frozen Pine Mushroom According to Different Pre-treatment (전처리를 달리한 냉동송이의 첨가량에 따른 송이양갱의 품질 특성)

  • Park, Mi-Lan;Byun, Gwang-In
    • Journal of the Korean Society of Food Culture
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    • v.20 no.6
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    • pp.738-743
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    • 2005
  • This study was performed to investigate the quality characteristics of pine mushroom yanggaeng prepared with different additions and different preparations of pine mushroom. Yanggaeng was prepared with three concentration of pine mushroom after different preparations of pine mushroom, A hot wind drying 0.1%, 0.3%, 0.5%, Frozen pine mushroom grinding 0.1%, 0.3%, 0.5%, Freezed drying 0.1%, 0.3%, 0.5%, to which was added cooked red bean, agar, oligosaccharide, salt and water. Proximate composition, hunter's color, texture profile analysis and sensory evaluation of yanggaeng were examined. Lightness of pine mushroom yangaeng increased with increasing pine mushroom content and frozen pine mushroom grinding products were higher than those of the preparation products. In the texture profile analysis, hardness of pine mushroom yangaeng increased with increasing pine mushroom content and cohesiveness, springiness of Frozen pine mushroom grinding 0.1% were the highest. In sensory evaluation, the taste and viscosity scores of Freezed drying 0.1% higher than those of the other products. Also the overall acceptability of freezed drying 0.1% pine mushroom yanggaeng was the highest of the all products.

Comparison of Size Criteria in Mediastinal Lymph Node Involvement of Adenocarcinoma of Lungs (폐 선암의 종격동 림프절 전이에 있어서 림프절 크기 기준의 비교)

  • Gu, Ki-Seon;Kuk, Hiang;Koh, Hyeck-Jae;Yang, Sei-Hun;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.4
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    • pp.542-547
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    • 1999
  • Background: Decision in mediastinal lymph node involvement of lung cancer by CT scan is very important and valuable for the treatment planning and prognosis prediction. In general, long diameter of mediastinal lymph node more than 15mm is used as criterion of lung cancer involvement. Adenocarci-noma has a tendency of early distant metastasis and micrometastasis, so adenocarcinoma may involve lymph node earlier and cannot be detected before lymph nodes are enlarged enough. The authors tried to determine the difference between two size criteria(15mm, 10mm) in adenocarcinoma for the detection of cancer involvement. Methods: Numbers of sample are 60 cases(male 46, female 14, median age: 61.5 years). According to pathology, squamous cancer 41, large cell cancer 2, adenocarcinoma 17. According to TNM stage, I 23, III 24, IIIA 13. Results : Mean long diameter of lymph node involvement is 16.0($\pm8.0$) mm in non-adenocarcinoma group, and that of adenocarcinoma group is 12.0($\pm3.2$) mm(p<0.05). If long diameter of lymph node larger than 15mm as involvement criterion is applied, sensitivity, specificity, positive predictive index, negative predictive index, accuracy of nonadenocarcinoma group are 54%, 100%, 100%, 83%, 86%, and those of adenocarcinoma group are 43%, 90%, 75%, 69%, 71%. If long diameter of lymph node larger than 10mm as involvement criterion is applied, sensitivity, specificity, positive predictive index. negative predictive index. accuracy of nonadenocarcinoma group are 65%, 77%, 61%, 92%, 79%, and those of adenocarcinoma group are 100%, 80%, 78%, 100%, 88%. Conclusion: Long diameter of lymph node larger than 10mm is more valuable criterion as lymph node involvement in adenocarcinoma of lungs.

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Quantitative Evaluation of the Accuracy of 3D Imaging with Multi-Detector Computed Tomography Using Human Skull Phantom (두개골 팬텀을 이용한 다검출기 CT 3차원 영상에서의 거리측정을 통한 정량적 영상특성 평가)

  • 김동욱;정해조;김새롬;유영일;김기덕;김희중
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.131-140
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    • 2003
  • As the importance of accuracy in measurings of 3-D anatomical structures continues to be stressed, an objective and quantitative of assessing image quality and accuracy of 3-D volume-rendered images is required. The purpose of this study was to evaluate the quantitative accuracy of 3-D rendered images obtained with MDCT, scanned at various scanning parameters (scan modes, slice thicknesses and reconstruction slice thickness). Twelve clinically significant points that play an important role for the craniofacial bone in plastic surgery and dentistry were marked on the surface of a dry human skull. The direct distances between the reference points were defined as gold standards to assess the measuring errors of 3-D images. Then, we scanned the specimen with acquisition parameters of 300 mA, In kVp, and 1.0 sec scan time in axial and helical scan modes (pitch 3:1 and 6:1) at 1,25 mm, 2.50 mm, 3.75 mm and 5.00 mm slice thicknesses. We performed 3-D visualizations and distance measurements with volumetric analysis software and statistically evaluated the quantitative accuracy of distance measurements. The accuracy of distance measurements on the 3-D images acquired with 1.25, 2.50, 3,75 and 5.00 mm slice thickness were 48%, 33%, 23%, 14%, respectively, and those of the reconstructed 1.25 mm were 53%, 41%, 43%, 36% respectively. Meanwhile, there were insignificant statistical differences (P-value<0.05) in the accuracy of the distance measurements of 3-D images reconstructed with 1.25 mm thickness. In conclusion, slice thickness, rather than scan mode, influenced the quantitative accuracy of distance measurements in 3-D rendered images with MDCT. The quantitative analysis of distance measurements may be a useful tool for evaluating the accuracy of 3-D rendered images used in diagnosis, surgical planning, and radiotherapeutic treatment.

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A Morphological Study of Fingerprints and Palm Prints in Sasang Constitution (사상체질(四象體質) 유형(類型)과 지문(指紋), 손바닥문(紋)의 관련성(關聯性)에 대(對)한 연구(硏究))

  • Park, Seong-sik;Choi, Jae-young;Chung, Min-suk;Kim, Yi-suk;Lee, Je-man;Lee, Kyung-ae;Cho, Gyu-seon;Lee, Ji-young;Park, Eun-kyung
    • Journal of Sasang Constitutional Medicine
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    • v.10 no.1
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    • pp.81-99
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    • 1998
  • 1. Background : Sasang Constitutional Medicine divides mankind into Taeyangin(太陽人), Taeumin(太陰人), Soyangin(少陽人) and Soeumin(少陰人) according to appearance, moral nature and characteristic of constitutional symptoms, and it is a medical science to study about different treatment for each constitution. In Sasang Constitutional Medicine, diagnosis of constitution was so important that we had the necessity of studying constitutional diagnostic method which had presented wholly and intuitively in Dongyi Soose Bowon(東醫壽世保元) with objective and analytic thinking. There were several attempts to classify Sasang Constitutional Types through morphological investigation of each parts of body. The one of them was to use measuring the body. In this study, we purposed to make clear whether the analysis of fingerprints and palm, one of the physical anthropologic methods would be helpful to classify Sasang Constitution. 2. Method : After practicing Questionnaire I and QSCC(Questionnaire of Sasang Constitution) II from 347 healthy Korean adults(242 males and 106 females), we analyzed fingerprints and palm prints of 208 people(142 males and 66 females) who were classified same constitution from two questionnaires. We analyzed the types of fingerprints according to the number of triradius and counted the number of dermal ridges from fingerprint center to triradius. We found triradius in the lower part of each finger and analyzed the courses of dermal ridges and counted the number of dermal ridges between each triradius. We mesured angle atd, and then researched relationship between fingerprints, palm prints and Sasang Constitution. 3. Result and Conclusion : The results of Sasang Constitution analysis of 208 Korean adults showed 76 Taeumin(36.5%), 81 Soeumin(39.0%) and 51 Soyangin(24.5%). The analytic results of fingerprints and palm prints are as follows : The types of fingerprints were helpful to sort Taeumin and the types of palm prints were helpful to sort Soyangin and Soeumin especially. In addition, the number of dermal ridges in fingerprints and palm prints were helpful to sort Soyangin. Fingerprints and palm prints have characteristic in each constitutions, so the investigation of fingerprints and palm prints seems to helpful to classify Sasang Constitution. We are planning to report fingerprints and palm prints of more subjects.

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The Use of Normal Tissue Complication Probability to Predict Radiation Hepatitis (간암의 정상조직손상확률을 이용한 방사선간염의 발생여부 예측가능성에 관한 연구)

  • Keum Ki Chang;Seong Jinsil;Suh Chang Ok;Lee Sang-wook;Chung Eun Ji;Shin Hyun Soo;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.18 no.4
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    • pp.277-282
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    • 2000
  • Purpose : Though It has been known that the to tolerance of the liver to external beam irradiation depends on the irradiated volume and dose, few data exist which Quantify this dependence. However, recently, with the development of three dimensional (3-D) treatment planning, have the tools to Quantify the relationships between dose, volume, and normal tissue complications become available. The objective of this study is to investigate the relationships between normal tissue complication probabili쇼 (WCP) and the risk of radiation hepatitis for patients who received variant dose partial liver irradiation. Materials and Methods : From March 1992 to December 1994, 10 patients with hepatoma and 10 patients with bile duct cancer were included in this study. Eighteen patients had normal hepatic function, but 2 patients (prothrombin time 73$\%$, 68$\%$) had mild liver cirrhosis before irradiation. Radiation therapy was delivered with 10MV linear accelerator, 180$\~$200 cGy fraction per day. The total dose ranged from 3,960 cGy to 6,000 cGy (median dose 5,040 cGy). The normal tissue complication probability was calculated by using Lyman's model. Radiation hepatitis was defined as the development of anicteric elevation of alkaline phosphatase of at least two fold and non-malignant ascites in the absence of documented progressive. Results: The calculated NTCP ranged from 0.001 to 0.840 (median 0.05). Three of the 20 patients developed radiation hepatitis. The NTCP of the patients with radiation hepatitis were 0.390, 0.528, 0.844(median : 0.58$\pm$0.23), but that of the patients without radiation hepatitis ranged fro 0.001 to 0.308 (median .0.09$\pm$0.09). When the NTCP was calculated by using the volume factor of 0.32, a radiation hepatitis was observed only in patients with the NTCP value more than 0.39. By contrast, clinical results of evolving radiation hepatitis were not well correlated with NTCP value calculated when the volume factor of 0.69 was applied. On the basis of these observations, the volume factor of 0.32 was more correlated to predict a radiation hepatitis. Conclusion : The risk of radiation hepatitis was increased above the cut-off value. Therefore the NTCP seems to be used for predicting the radiation hepatitis.

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Socio-Medical Approach to the Welfare of Rural Residents Through the Education of Community Health Personnel (농촌지역사회 보건요원의 교육을 통한 주민의 보건복지향상에 관한 사회의학적 연구)

  • Yum, Yong-Tae;Lee, Myung-Sook;Cho, Byung-Hee
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.34-45
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    • 1992
  • In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

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