• Title/Summary/Keyword: 가상환자

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The evaluation of properties for radiation therapy techniques with flattening filter-free beam and usefulness of time and economy to a patient with the radiation therapy (Flattening filter-free beam을 이용한 방사선 치료 기법의 특성 및 환자의 시간적.경제적 유용성 평가)

  • Goo, Jang Hyeon;Won, Hui Su;Hong, Joo Wan;Chang, Nam Jun;Park, Jin Hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.363-368
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    • 2014
  • Purpose : The aim of this study was to appraise properties for radiation therapy techniques and effectiveness of time and economy to a patient in the case of applying flattening filter-free (3F) and flattening filter (2F) beam to the radiation therapy. Materials and Methods : Alderson rando phantom was scanned for computed tomography image. Treatment plans for intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and stereotactic body radiation therapy (SBRT) with 3F and 2F beam were designed for prostate cancer. To evaluate the differences between the 3F and 2F beam, total monitor units (MUs), beam on time (BOT) and gantry rotation time (GRT) were used and measured with $TrueBeam^{TM}$ STx and Surveillance And Measurement (SAM) 940 detector was used for photoneutron emitted by using 3F and 2F. To assess temporal and economical aspect for a patient, total treatment periods and medical fees were estimated. Results : In using 3F beam, total MUs in IMRT plan increased the highest up to 34.0% and in the test of BOT, GRT and photoneutron, the values in SBRT plan decreased the lowest 39.8, 38.6 and 48.1%, respectively. In the temporal and economical aspect, there were no differences between 3F and 2F beam in all of plans and the results showed that 10 days and 169,560 won was lowest in SBRT plan. Conclusion : According as the results, total MUs increased by using 3F beam than 2F beam but BOT, GRT and photoneutron decreased. From above the results, using 3F beam can decrease intra-fraction setup error and risk of radiation-induced secondary malignancy. But, using 3F beam did not make the benefits of temporal and economical aspect for a patient with the radiation therapy.

Transmission Dose Estimation Algorithm for Tissue Deficit (조직 결손에 대한 투과선량 계산 알고리즘 보정)

  • Yun Hyong Geun;Chie Eui Kyu;Huh Soon Nyung;Lee Hyoung Koo;Woo Hong Gyun;Shin Kyo Chul;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.186-192
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.

Effect of the Angle of Ventricular Septal Wall on Left Anterior Oblique View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 심실중격 각도에 따른 좌전사위상 변화에 대한 연구)

  • You, Yeon Wook;Lee, Chung Wun;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae;Bang, Ji-In;Lee, Soo Jin;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.13-19
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    • 2016
  • Purpose In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (${\theta}$) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view. Materials and Methods From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (${\theta}$) between ventricular septum and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of ${\theta}$ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO ${\theta}$ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed. Results $Mean{\pm}SD$ of ${\theta}$ on total 253 patients was $37.0{\pm}8.5^{\circ}$. Among them, the patients whose difference between 45 and ${\theta}$ degrees were more than ${\pm}10$ degrees were 88 patients ($29.3{\pm}6.1^{\circ}$). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=62.0{\pm}6.6%$ vs. LVEF ${\theta}=64.0{\pm}5.6%$; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=66.7{\pm}7.2%$ vs. LVEF ${\theta}=69.0{\pm}6.4%$; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO ${\theta}$, there was no significant difference statistically. Conclusion We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO ${\theta}$ view.

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The establishment of orthodontic web server multimedia database system for continuing education (임상교정 교육용 멀티미디어 데이터베이스 웹서버 구축에 관한 연구)

  • Park, Jae-Woo;Lee, Jong-Ki;Chang, Young-Il;Nahm, Dong-Suk;Kim, Myung-Ki;Yang, Won-Sik;Kim, Tae-Woo;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.245-260
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    • 2000
  • The Objective of this research was to construct the multimedia database system that was necessary for the education of the practitioners and the students. To establish this system, there were technical problems as follows 1) The processing of the images, 2) The rapid processing of the information with the computer network, 3) The development of diagnosis tools, 4) The technique to establish the database system, 5) The link between the database system and the internet, and 6) The method to educate through many cases. The analysis for diagnosis and treatment planning were provided as two parts : model analysis and cephalometric analysis. As a model analysis, arch length discrepancy and Bolton tooth ratio were provided for the part of patient information. Cephalometric analyses were provided in the part of initial diagnosis. The Cephalometric analysis ver 2.0 and the PowerCeph pro 3.3.5 were used to show Tweed, Steiner and Jarabak analysis. In the main part, Kim's analysis and some measurements were added. In the post-treatment or retention part, we show the superimposition of the cephalometrics with which you can find the effectiveness of the various orthodontic treatment The address of this home page is "http://damis.snu.ac.kr/orthodontics"

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Effect of Anteromedial Cortex Oblique Angle on Change of Tibial Posterior Slope Angle in High Tibial Osteotomy Using Computer Assisted Surgery (CAS) (Computer Assisted Surgery(CAS)를 이용한 개방형 근위경골절골술 시 전내측피질골경사각이 경골후방경사각에 미치는 영향)

  • Lee, Ho-Sang;Kim, Jay-Jung;Wang, Joon-Ho;Kim, Cheol-Woong
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.36 no.3
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    • pp.351-361
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    • 2012
  • The leading surgical method for correcting the misalignment of the varus and valgus in the knee joint is the high tibial osteotomy (HTO). In the opening wedge HTO (OWHTO), there is no concern about damaging the peroneal nerve on the lateral tibia of the proximal fibula. OWHTO has been the preferred choice, as the opening of the correction angle can be modulated during the operation. The correction of the varus and valgus on the coronal plane are performed adroitly. Nevertheless, there have been numerous reports of unintended changes in the medial tibial plateau and posterior slope angle (PSA). The authors have developed an HTO method using computer-assisted surgery with the aim of addressing the abovementioned problems from an engineer's perspective. CT images of the high tibia were reconstructed three-dimensionally, and a virtual osteotomy was performed on a computer. In addition, this study recommends a surgical method that does not cause changes in the PSA after OWHTO. The results of the study are expected to suggest a clear relationship between the anteromedial cortex oblique angle of each patient and the PSA, and an optimal PSA selection method for individuals.

Development of Ideal Model Based Optimization Procedure with Heuristic Knowledge (정위적 방사선 수술에서의 이상표적모델과 경험적 지식을 활용한 수술계획 최적화 방법 개발)

  • 오승종;송주영;최경식;김문찬;이태규;서태석
    • Progress in Medical Physics
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    • v.15 no.2
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    • pp.84-93
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    • 2004
  • Stereotactic radiosurgery (SRS) is a technique that delivers a high dose to a target legion and a low dose to a critical organ through only one or a few irradiations. For this purpose, many mathematical methods for optimization have been proposed. There are some limitations to using these methods: the long calculation time and difficulty in finding a unique solution due to different tumor shapes. In this study, many clinical target shapes were examined to find a typical pattern of tumor shapes from which some possible ideal geometrical shapes, such as spheres, cylinders, cones or a combination, are assumed to approximate real tumor shapes. Using the arrangement of multiple isocenters, optimum variables, such as isocenter positions or collimator size, were determined. A database was formed from these results. The optimization procedure consisted of the following steps: Any shape of tumor was first assumed to an ideal model through a geometry comparison algorithm, then optimum variables for ideal geometry chosen from the predetermined database, followed by a final adjustment of the optimum parameters using the real tumor shape. Although the result of applying the database to other patients was not superior to the result of optimization in each case, it can be acceptable as a plan starling point.

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Level of perception of changed lip protrusion and asymmetry of the lower facial height (하안면부에서 입술의 돌출 정도와 안면 비대칭의 인지도에 관한 연구)

  • Kim, Kyu-Sun;Kim, Young-Jin;Lee, Keun-Hye;Kook, Yoon-Ah;Kim, Young-Ho
    • The korean journal of orthodontics
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    • v.36 no.6
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    • pp.434-441
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    • 2006
  • Objective: While one of the most prevailing motivations for seeking orthodontic treatment is to achieve good facial esthetics, understanding the level of a person's perception to the changes that have occurred on the face after orthodontic treatment is critical to the process of orthodontic diagnosis and treatment planning. Methods: 40 students attending art school participated in determining the level of their perception of changed lip position and facial asymmetry. Computer-graphic frontal face and facial profile photographs with balanced proportions were used to evaluate the level of a participant's perception of the changes in facia! asymmetry and in lip position. Results: Change of lip position over 2 mm and over a 3 mm change of facial asymmetry was perceived significantly. Conclusion: The results indicated that at least a 2 mm change of lip position was needed to be perceived after orthodontic treatment. The level of perception of the change in facial asymmetry was lower than that of the change in lip position. Information about facial changes given prior to the evaluation enhanced the level of perception.

Comparison of Linac-based VMAT Stereotatic Radiosurgery and Conventional Stereotatic Radiosurgery for Multiple Brain Lesions (Linac 기반 VMAT 정위적 수술 뇌 병변 연구와 기존의 정위적 방사선 수술 비교)

  • Jang, Eun-Sung;Chang, Bo-Seok
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.239-246
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    • 2021
  • Portal Dosimetry was verified using EPID to secure the clinical application and reliability of the existing research dose evaluation. The dose distribution of Geant4 was compared with the measured value by 360° rotational irradiation with a 2.5 cm cone for stereotactic brain surgery. To confirm the dose distribution of patients with brain metastasis, the dose distribution investigated by inserting a Gafchromic EBT film into the parietal phantom and the dose distribution obtained from the parietal phantom using VMAT are compared and applied to actual patients. As a result of the analysis, it was confirmed that the accuracy of the beam center and the center of the couch coincide accurately with an error within 1mm as a result of QA through a pin ball. In addition, it was confirmed that the EBT3 film has excellent linearity in the range of 0 to 10 Gy according to various dose irradiation. In the same setting as the two cervical phantoms, we confirm that the implementation and simulation results calculations of dose calculations based on Geant4 using photon beams match the experimental data within the treatment planning volume (PTV). Therefore, volume modulated arc treatment (VMAT) 360° rotational irradiation was performed, and the result of iso-dose distribution analysis by rotational irradiation confirmed that it is appropriate to include a virtual tumor.

Estimating the Willingness-To-Accept for Cash Benefit of Long-Term Care Insurance (노인장기요양보험제도의 현금급여 도입 필요성 - WTA를 통한 적정 현금급여액 추정 -)

  • Shin, Hye Jeong
    • 한국노년학
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    • v.29 no.1
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    • pp.177-194
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    • 2009
  • Korea government has launched long-term care insurance from 2008. However, one of the most important issues, whether or not providing cash benefit, is still unresolved. In this paper, in order to provide policy guidelines for the long-term care insurance, I attempt to estimate the Willingness-To-Accept (WTA) of the cash subsidy for informal care by using Double Bounded Dichotomous Choice method, a branch of Contingent Valuation Method (CVM). In doing so, I also estimated the determinants of the preference for cash benefit. Data were obtained from face-to-face survey interviews with 300 informal care-givers at three major general hospitals in Seoul, Korea. The questionnaire was constructed with two scenarios (mild/severe symptom). The results from logistic regression analyses and the estimation of WTA indicate that informal care-givers are willing to accept the cash benefit as low as 628 thousands won for mild fragile elderly and 1,072 thousands won for severe fragile elderly. The strength of this paper is that I estimated the WTA of the cash benefit by reflecting the changes in preferences of informal care-givers. The analytic results from the this paper suggest that the cash benefit in long-term care insurance is indispensible in achieving the goal of the long-term care system.

Effects of wax rim in image registration of intraoral and face scan in edentulous arch condition (무치악 악궁에서 구강과 안면 스캔의 정합을 위한 왁스림의 활용 효과)

  • Sang-Hyeok Seo;Cheong-Hee Lee;Kyu-Bok Lee;So-Yeun Kim;Du-Hyeong Lee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.40 no.3
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    • pp.135-141
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    • 2024
  • Purpose: The purpose of this study was to investigate the accuracy of image merging of an intraoral scan of an edentulous arch to a facial scan using wax rim and markers. Materials and Methods: For registration of oral scan to face scan, a wax rim with markers was made. The markers were cuboid and divided into four groups according to size (5, 10 mm) and attachment location (midline, canine region). The evaluation of registration accuracy was compared with a standard created using cone-beam computed tomography data. Anterior linear variation of the edentulous arch and the 3D variation of the overall arch were measured. Kruskal-Wallis test and Mann-Whitney U test were used for statistics, and the significance level was set at 0.05 and evaluated under Bonferroni correction (0.05/6 = 0.083). Results: In the anterior deviation and global deviation results, there was no statistically significant difference in the oral scan position displacement values between the 5 mm and 10 mm groups. When the midline marker was used, the intraoral scan position displacement value was significantly lower than when only the canine marker was used. Conclusion: Marker attached wax rim can be used for image matching between facial and intraoral scans of the edentulous arch. Marker location at the middle area increases the accuracy of image matching.