• Title/Summary/Keyword: 가상환자

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A Comparative Study on the Head and Neck Radiation Therapy for Dynamic Conformal Arc Therapy and Volumetric Modulated Arc Therapy (두경부 방사선 치료 시 입체조형동적회전조사치료와 용적변조회전조사치료에 관한 연구)

  • Kim, Deok-Ki;Choi, CheonWoong;Choi, Jae-hyock;Won, Hui-su;Park, Cheol-soo
    • Journal of the Korean Magnetics Society
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    • v.25 no.6
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    • pp.208-218
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    • 2015
  • Recently, radiation therapy is used in the CT existing conventional two-dimensional radiation image, and set the size and location of the tumor in a manner that the image is going to change the treatment plan. After using the simulation using CT, radiation therapy it is four-dimensional or three-dimensional treatment made possible. and radiation therapy became the more effective ever before. High technology radiation therapy such as the treatment of SRS,IMRT, IGRT, SBRT, is a need to try contemplating the possibility to apply appropriate analysis and situation, so it has its own characteristics. and then it is believed that it is necessary to analyze and try it worries the proper applicability of the situation. The configuration of the various treatment that is applicable in many hospitals is necessary to try to determine how to practically apply the patients. Critical organs surrounding tumor give a small dose to avoid side effects and then the tumor has the therapeutic effect by providing a larger dose than before the radiation treatment.

Development of Target-Controlled Infusion System in Plasma Concentration. PART1 : Establishment of Pharmacokinetic Model and Verification (혈중 목표 농도 자동 조절기(TCI) 개발 PART1 : 약동학적 모델의 수립과 검증)

  • 안재목;길호영
    • Journal of Biomedical Engineering Research
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    • v.23 no.5
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    • pp.341-349
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    • 2002
  • The target controlled infusion(TCI) pump system is a logical approach to the development of improved administration techniques of an intravenous anaesthetic agent. The principle of TCI system is based on an understanding of the pharmacokinetic properties, three or four compartment model. The TCI system is optimal and flexible control of the plasma drug concentration. But the clinical goal is always to achieve a therapeutic drug effect, not a therapeutic concentration. So we developed the algorithm to target the concentration at the site of drug effect rather than the concentration in the plasma. If impulse drug is inputted into body, the decline of plasma concentration with time is shown, resulting in the expression of the differential equation. Therefore, we must reformulate our three-compartment model as four-compartment model with the effect compartment. And we tested plasma targeting and effect targeting algorithm by computer simulation using four-compartment model. So we developed the TCI capable of applying all intravenous drugs by adjusting individual pharmacokinetic parameters independently.

A Study on the Quality of Image of Ultrasound Using the Tissue-mimicking Phantom - in some hospitals jeju province (조직등가팬텀을 이용한 임상초음파 영상의 질에 관한 연구 - 제주도 내 병원을 중심으로 -)

  • Yang, Jeong-Hwa;Lee, Kyung-Sung
    • Journal of radiological science and technology
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    • v.29 no.2
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    • pp.63-69
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    • 2006
  • In diagnostic ultrasound, the quality of image affect to diagnose. To maintain suboptimal imaging uniformly, Quality Assurance of Ultrasound equipment should take periodically. This is article about examination the quality of image in diagnostic ultrasound to understand conditions of probes in hospitals. There is comparative study of convex and linear probes on ultrasound using tissue-mimicking phantom included simulated cysts, echogenic structures. The ultrasonic attenuation coefficient versus frequency of 0.5 dB is representative of normal liver and 0.7 dB is representative of fatty liver condition in ultrasound phantom. There are results of convex probe, 0.5 dB, vertical group, cystic masses, high contrast masses are mostly shown but 0.7 dB, mid level in vertical group, cystic masses and high contrast masses are nearly visible. In linear probe, 0.5 dB, mid level in vertical group, two or four of them are shown in cystic masses and high contrast masses but there are not visible in 11 of cases. 0.7 dB, there are mostly appear under 6 in vertical group, two or four of them show in cystic masses and high contrast masses and there are not shown in 40 of cases, besides. Linear probes in fatty liver condition of ultrasound instrument are not good in the quality of image practically. So there needs to be replace and fix of probes. Actually management of ultrasound probes is inadequate in hospitals. So if there are program of evaluation to check probes periodically in hospitals from establishment of the ultrasound equipment, there will get better image and have a suitable condition of instruments further more.

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Effects of Physical Therapy Combined with Virtual Reality Games on Pain, Function, Quality of Life, And Engagement in Post-Knee-Surgery Patients (가상현실 게임을 적용한 물리치료가 무릎 수술 후 환자의 통증, 기능 변화, 삶의 질, 동기부여에 미치는 영향)

  • Hong-Gil Kim;Ju-Hyeon Jung
    • PNF and Movement
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    • v.21 no.3
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    • pp.345-356
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    • 2023
  • Purpose: The aim of this study was to investigate the effects of physical therapy combined with a virtual reality (VR) game on pain, quality of life (QOL), engagement, and knee function in post-knee-surgery patients. Methods: Twenty-four patients who had undergone knee surgery four weeks or more before the study were recruited. Two withdrew from the study during the four-week experimental period, and a total of 22 patients were included in the final analysis. Routine physical therapy consisting of electrostimulation (10 min.) and therapeutic massage (10 min.) was the base intervention for all groups. The experimental group (n = 10) was additionally exposed to a VR game intervention, while the control group (n = 12) underwent an intervention involving similar motions as the experimental intervention but with no VR. The intervention for the experimental group used the game Rig Fit Adventure on Nintendo switch. Both groups underwent their respective interventions 3 times a week (35 min. per session) for 4 weeks. Pain was assessed using the numeric rating scale (NRS), and QOL was assessed using the EuroQol five-dimensional five-level questionnaire (EQ-5D-5L). Engagement was assessed using the Korea flow state scale (K-FSS). Finally, knee movement and function were assessed based on knee flexion and extension, range of motion (ROM), and Western Ontario and McMaster Universities Arthritis Index (WOMAC). Results: After the four-week physical therapy, both groups showed significant reductions in pain (on the NRS), increased knee ROM (flexion), better WOMAC scores, and increased EQ-5D-5L scores (p < 0.05), with the experimental group showing significantly better improvements in EQ-5D-5L and K-FSS scores (p < 0.05). Conclusion: The results of this study confirm that a VR-game-integrated intervention is effective for improving pain, QOL, engagement, and knee function in post-knee surgery patients and that VR-game-integrated interventions could be therapeutic alternatives for patients bedridden for prolonged periods with little motivation for rehabilitation.

Imaging Findings of Peripheral Arterial Disease on Lower-Extremity CT Angiography Using a Virtual Monoenergetic Imaging Algorithm (가상의 단일 에너지 영상 재구성 기법을 이용한 하지 단층촬영 혈관조영술에서 말초 동맥 질환 영상 소견)

  • Jun Seong Kim;So Hyun Park;Suyoung Park;Jung Han Hwang;Jeong Ho Kim;Seong Yong Pak;Kihyun Lee;Bernhard Schmidt
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1032-1045
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    • 2022
  • Peripheral arterial disease (PAD) is common in elderly patients. Lower-extremity CT angiography (LE-CTA) can be useful for detecting PAD and planning its treatment. PAD can also be accurately evaluated on reconstructed monoenergetic images (MEIs) from low kiloelectron volt (keV) to high keV images using dual-energy CT. Low keV images generally provide higher contrast than high keV images but also feature more severe image noise. The noise-reduced virtual MEI reconstruction algorithm, called the Mono+ technique, was recently introduced to overcome such image noise. Therefore, this pictorial review aimed to present the imaging findings of PAD on LE-CTA and compare low and high keV images with those subjected to the Mono+ technique. We found that, in many cases, the overall and segmental image qualities were better and metal artifacts and venous contamination were decreased in the high keV images.

Development of a Java Compiler for Verification System of DTV Contents (DTV 콘텐츠 검증 시스템을 위한 Java 컴파일러의 개발)

  • Son, Min-Sung;Park, Jin-Ki;Lee, Yang-Sun
    • Proceedings of the Korea Information Processing Society Conference
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    • 2007.05a
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    • pp.1487-1490
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    • 2007
  • 디지털 위성방송의 시작과 더불어 본격적인 데이터 방송의 시대가 열렸다. 데이터방송이 시작 되면서 데이터방송용 양방향 콘텐츠에 대한 수요가 급속하게 증가하고 있다. 하지만 양방향 콘텐츠 개발에 필요한 저작 도구 및 검증 시스템은 아주 초보적인 수준에 머물러 있는 것이 현실이다. 그러나 방송의 특성상 콘텐츠 상에서의 오류는 방송 사고에까지 이를 수 있는 심각한 상황이 연출 될 수 있다. 본 연구 팀은 이러한 DTV 콘텐츠 개발 요구에 부응하여, 개발자의 콘텐츠 개발 및 사업자 또는 기관에서의 콘텐츠 검증이 원활이 이루어 질수 있도록 하는 양방향 콘텐츠 검증 시스템을 개발 중이다. 양방향 콘텐츠 검증 시스템은 Java 컴파일러, 디버거, 미들웨어, 가상머신, 그리고 IDE 등으로 구성된다. 본 논문에서 제시한 자바 컴파일러는 양방향 콘텐츠 검증 시스템에서 데이터 방송용 자바 애플리케이션(Xlet)을 컴파일하여 에뮬레이팅 하거나 런타임 상에서 디버깅이 가능하도록 하는 바이너리형태의 class 파일을 생성한다. 이를 위해 Java 컴파일러는 *.java 파일을 입력으로 받아 어휘 분석과 구문 분석 과정을 거친 후 SDT(syntax-directed translation)에 의해 AST(Abstract Syntax Tree)를 생성한다. 클래스링커는 생성된 AST를 탐색하여 동적으로 로딩 되는 파일들을 연결하여 AST를 확장한다. 의미 분석과정에서는 확장된 AST를 입력으로 받아 참조된 명칭의 사용이 타당한지 등을 검사하고 코드 생성이 용이하도록 AST를 변형하고 부가적인 정보를 삽입하여 ST(Semantic Tree)를 생성한다. 코드 생성 단계에서는 ST를 입력으로 받아 이미 정해 놓은 패턴에 맞추어 Bytecode를 출력한다.ovoids에서도 각각의 점들에 대한 선량을 측정하였다. SAS와 SSAS의 직장에 미치는 선량차이는 실제 임상에서의 관심 점들과 가장 가까운 25 mm(R2)와 30 mm(R3)거리에서 각각 8.0% 6.0%였고 SAS와 FWAS의 직장에 미치는 선량차이는 25 mm(R2) 와 30 mm(R3)거리에서 각각 25.0% 23.0%로 나타났다. SAS와 SSAS의 방광에 미치는 선량차이는 20 m(Bl)와 30 mm(B2)거리에서 각각 8.0% 3.0%였고 SAS와 FWAS의 방광에 미치는 선량차이는 20 mm(Bl)와 30 mm(B2)거리에서 각각 23.0%, 17.0%로 나타났다. SAS를 SSAS나 FWAS로 대체하였을 때 직장에 미치는 선량은 SSAS는 최대 8.0 %, FWAS는 최대 26.0 %까지 감소되고 방광에 미치는 선량은 SSAS는 최대 8.0 % FWAS는 최대 23.0%까지 감소됨을 알 수 있었고 FWAS가 SSAS 보다 차폐효과가 더 좋은 것으로 나타났으며 이 두 종류의 shielded applicator set는 부인암의 근접치료시 직장과 방광으로 가는 선량을 감소시켜 환자치료의 최적화를 이룰 수 있을 것으로 생각된다.)한 항균(抗菌) 효과(效果)를 나타내었다. 이상(以上)의 결과(結果)로 보아 선방활명음(仙方活命飮)의 항균(抗菌) 효능(效能)은 군약(君藥)인 대황(大黃)의 성분(成分) 중(中)의 하나인 stilbene 계열(系列)의 화합물(化合物)인 Rhapontigenin과 Rhaponticin의 작용(作用)에 의(依)한 것이며, 이는 한의학(韓醫學) 방제(方劑) 원리(原理)인 군신좌사(君臣佐使) 이론(理論)에서 군약(君藥)이 주증(主症)에 주(主)로 작용(作用)하는 약물(藥物)이라는 것을 밝혀주는 것이라고

Visualization and Localization of Fusion Image Using VRML for Three-dimensional Modeling of Epileptic Seizure Focus (VRML을 이용한 융합 영상에서 간질환자 발작 진원지의 3차원적 가시화와 위치 측정 구현)

  • 이상호;김동현;유선국;정해조;윤미진;손혜경;강원석;이종두;김희중
    • Progress in Medical Physics
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    • v.14 no.1
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    • pp.34-42
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    • 2003
  • In medical imaging, three-dimensional (3D) display using Virtual Reality Modeling Language (VRML) as a portable file format can give intuitive information more efficiently on the World Wide Web (WWW). The web-based 3D visualization of functional images combined with anatomical images has not studied much in systematic ways. The goal of this study was to achieve a simultaneous observation of 3D anatomic and functional models with planar images on the WWW, providing their locational information in 3D space with a measuring implement using VRML. MRI and ictal-interictal SPECT images were obtained from one epileptic patient. Subtraction ictal SPECT co-registered to MRI (SISCOM) was performed to improve identification of a seizure focus. SISCOM image volumes were held by thresholds above one standard deviation (1-SD) and two standard deviations (2-SD). SISCOM foci and boundaries of gray matter, white matter, and cerebrospinal fluid (CSF) in the MRI volume were segmented and rendered to VRML polygonal surfaces by marching cube algorithm. Line profiles of x and y-axis that represent real lengths on an image were acquired and their maximum lengths were the same as 211.67 mm. The real size vs. the rendered VRML surface size was approximately the ratio of 1 to 605.9. A VRML measuring tool was made and merged with previous VRML surfaces. User interface tools were embedded with Java Script routines to display MRI planar images as cross sections of 3D surface models and to set transparencies of 3D surface models. When transparencies of 3D surface models were properly controlled, a fused display of the brain geometry with 3D distributions of focal activated regions provided intuitively spatial correlations among three 3D surface models. The epileptic seizure focus was in the right temporal lobe of the brain. The real position of the seizure focus could be verified by the VRML measuring tool and the anatomy corresponding to the seizure focus could be confirmed by MRI planar images crossing 3D surface models. The VRML application developed in this study may have several advantages. Firstly, 3D fused display and control of anatomic and functional image were achieved on the m. Secondly, the vector analysis of a 3D surface model was defined by the VRML measuring tool based on the real size. Finally, the anatomy corresponding to the seizure focus was intuitively detected by correlations with MRI images. Our web based visualization of 3-D fusion image and its localization will be a help to online research and education in diagnostic radiology, therapeutic radiology, and surgery applications.

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The Feasibility Study of MRI-based Radiotherapy Treatment Planning Using Look Up Table (Look Up Table을 이용한 자기공명영상 기반 방사선 치료계획의 타당성 분석 연구)

  • Kim, Shin-Wook;Shin, Hun-Joo;Lee, Young-Kyu;Seo, Jae-Hyuk;Lee, Gi-Woong;Park, Hyeong-Wook;Lee, Jae-Choon;Kim, Ae-Ran;Kim, Ji-Na;Kim, Myong-Ho;Kay, Chul-Seung;Jang, Hong-Seok;Kang, Young-Nam
    • Progress in Medical Physics
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    • v.24 no.4
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    • pp.237-242
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    • 2013
  • In the intracranial regions, an accurate delineation of the target volume has been difficult with only the CT data due to poor soft tissue contrast of CT images. Therefore, the magnetic resonance images (MRI) for the delineation of the target volumes were widely used. To calculate dose distributions with MRI-based RTP, the electron density (ED) mapping concept from the diagnostic CT images and the pseudo CT concept from the MRI were introduced. In this study, the look up table (LUT) from the fifteen patients' diagnostic brain MRI images was created to verify the feasibility of MRI-based RTP. The dose distributions from the MRI-based calculations were compared to the original CT-based calculation. One MRI set has ED information from LUT (lMRI). Another set was generated with voxel values assigned with a homogeneous density of water (wMRI). A simple plan with a single anterior 6MV one portal was applied to the CT, lMRI, and wMRI. Depending on the patient's target geometry for the 3D conformal plan, 6MV photon beams and from two to five gantry portals were used. The differences of the dose distribution and DVH between the lMRI based and CT-based plan were smaller than the wMRI-based plan. The dose difference of wMRI vs. lMRI was measured as 91 cGy vs. 57 cGy at maximum dose, 74 cGt vs. 42 cGy at mean dose, and 94 cGy vs. 53 at minimum dose. The differences of maximum dose, minimum dose, and mean dose of the wMRI-based plan were lower than the lMRI-based plan, because the air cavity was not calculated in the wMRI-based plan. These results prove the feasibility of the lMRI-based planning for brain tumor radiation therapy.

Dose Planning of Forward Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer using Compensating Filters (보상여과판을 이용한 비인강암의 전방위 강도변조 방사선치료계획)

  • Chu Sung Sil;Lee Sang-wook;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.53-65
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    • 2001
  • Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

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Quality Assurance for Intensity Modulated Radiation Therapy (세기조절방사선치료(Intensity Modulated Radiation Therapy; IMRT)의 정도보증(Quality Assurance))

  • Cho Byung Chul;Park Suk Won;Oh Do Hoon;Bae Hoonsik
    • Radiation Oncology Journal
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    • v.19 no.3
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    • pp.275-286
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    • 2001
  • Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

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