• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.115-122
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• 2023

The hip joint device is an important immobilization device for internal rotation in the diagnosis of bone density test, microfracture, and arthritis. These fixing mechanisms have limitations in maintaining reproducibility due to the use of Velcro. In this study, we developed an improved hip joint device and evaluated its usefulness. For 30 students enrolled in the Department of Radiology, we evaluated the reproducibility through medical imaging and the time required for positioning by applying the conventionaling and improved device. Changes over time were also evaluated. As a result, compared to the conventional device, the improved device showed a 32% reduction in positioning time and improved reproducibility by about 6.2 times. As for the amount of change over time, the positioning time increased in the conventional device, but decreased in the improved device, and the reproducibility of the conventional device was lower than that of the improved device. Through this, it can be said that the use of the improved device improved the image quality and reduced the radiologist's workload.

• The Journal of the Korea Contents Association
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• v.7 no.4
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• pp.184-191
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• 2007

Our objective was to develop and evaluate a non-invasive device for rigid immobilization and surface disease non-contact of the table in the lower extremity during CT angiography. The immobilization device consists of two components. The patient's lower limb device stabilizing elements made of polyethylene resin soft materials, and pelvis parts foam pad is used for non-contact surface. In a Prospective study the lower extremity device was used in patients who underwent a CT angiography of the lower limb. Immobilization with our device was well tolerated by all patients. The quality of the resulting images in the popliteal and infrapopliteal region was rated by five-point scale. The rigid immobilization resulted in a complete absence of motion artifacts. The new device is an effective, well tolerated and easily used immobilization that is suitable of use in 3D lower extremity CT angiography.

• Radiation Oncology Journal
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• v.25 no.2
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• pp.134-144
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• 2007

[ $\underline{Purpose}$ ]: Immobilization devices that improve the setup reproducibility of pelvic cancer patients and that provide comfort to patients during radiotherapy were designed and the feasibility of the devices was evaluated. $\underline{Materials\;and\;Methods}$: A customized device was designed to immobilize a knee, thigh, and foot of a patient. Sixty-one patients with prostate cancer were selected and were divided into two groups-with or without devices. The setup errors were measured with respect to bony landmarks. The difference between digitally reconstructed radiographs (DRR) and simulation films, and the differences between DRR and portal films were measured. $\underline{Results}$: The left-right (LR), anterior-posterior (AP) and craniocaudal (CC) errors between the DRR and simulation films were $1.5{\pm}0.9\;mm$, $3.0{\pm}3.6\;mm$, and $1.6{\pm}0.9\;mm$, respectively without devices. The errors were reduced to $1.3{\pm}1.9\;mm$, $1.8{\pm}1.5\;mm$ and $1.1{\pm}1.1\;mm$, respectively with the devices. The errors between DRR and portal films were $1.6{\pm}1.2\;mm$, $4.0{\pm}4.1\;mm$, and $4.2{\pm}5.5\;mm$, respectively without the devices and were reduced to $1.0{\pm}1.8\;mm$, $1.2{\pm}0.9\;mm$, and $1.2{\pm}0.8\;mm$, respectively, with the devices. The standard deviations among the portal films were 1.1 mm, 2.1 mm, and 1.0 mm at each axis without the devices and 0.9 mm, 1.6 mm and 0.8 mm with the devices. The percentage of setup errors larger than 3 mm and 5 mm were significantly reduced by use of the immobilization devices. $\underline{Conclusion}$: The designed devices improved the setup reproducibility for all three directions and significantly reduced critical setup errors.

• Journal of Radiation Protection and Research
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• v.25 no.1
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• pp.31-36
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• 2000

In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.1-9
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• 2008

Purpose: For head and neck cancer patients treated with radiation therapy, proper immobilization of intra-oral structures is crucial in reproducing treatment positions and optimizing dose distribution. We produced a man-made tongue immobilization device for each patient subjected to this study. Reproducibility of treatment positions and dose distributions at air-and-tissue interface were compared using man-made tongue immobilization devices and conventional tongue-bites. Materials and Methods: Dental alginate and putty were used in producing man-made tongue immobilization devices. In order to evaluate reproducibility of treatment positions, all patients were CT-simulated, and linac-gram was repeated 5 times with each patient in the treatment position. An acrylic phantom was devised in order to evaluate safety of man-made tongue immobilization devices. Air, water, alginate and putty were placed in the phantom and dose distributions at air-and-tissue interface were calculated using Pinnacle (version 7.6c, Phillips, USA) and measured with EBT film. Two different field sizes (3$\times$3 cm and 5$\times$5 cm) were used for comparison. Results: Evaluation of linac grams showed reproducibility of a treatment position was 4 times more accurate with man-made tongue immobilization devices compared with conventional tongue bites. Patients felt more comfortable using customized tongue immobilization devices during radiation treatment. Air-and-tissue interface dose distributions calculated using Pinnacle were 7.78% and 0.56% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Dose distributions measured with EBT (international specialty products, USA) film were 36.5% and 11.8% for 3$\times$3 cm field and 5$\times$5 cm field respectively. Values from EBT film were higher. Conclusion: Using man-made tongue immobilization devices made of dental alginate and putty in treatment of head and neck cancer patients showed higher reproducibility of treatment position compared with using conventional mouth pieces. Man-made immobilization devices can help optimizing air-and-tissue interface dose distributions and compensating limited accuracy of radiotherapy planning systems in calculating air-tissue interface dose distributions.

• The Journal of Korean Society for Radiation Therapy
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• v.35
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• pp.33-39
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• 2023

Purpose: The purpose of this study is to find out the dose variation according to thickness of the air gap between the patient's body surface and immobilization device in the treatment plan. Materials and Methods : Four conditions were created by adjusting the air gap thickness using 5 mm bolus, ranging from 0 mm to 3 mm bolus. Immobilization was placed on top in each case. And computed tomography was used to acquire images. The treatment plan that 430 cGy (Relative Biological Effectiveness,RBE) is irradiated 6 times and the dose of 2580 cGy (RBE) is delivered to 95% of Clinical Target Volume (CTV). The dose on CTV was evaluated by Full Width Half Maximum (FWHM) of the lateral dose profile and skin dose was evaluated by Dose Volume Histogram (DVH). Result: Results showed that the FWHM values of the lateral dose profile of CTV were 4.89, 4.86, 5.10, and 5.10 cm. The differences in average values at the on the four conditions were 3.25±1.7 cGy (RBE) among D_95% and 1193.5±10.2 cGy (RBE) among D_95% respectively. The average skin volume at 1% of the prescription dose was 83.22±4.8%, with no significant differences in both CTV and skin. Conclusion: When creating a solid-type immobilization device for carbon particle therapy, a slight air gap is recommended to ensure that it does not extend beyond the dose application range of the CTV.

• Progress in Medical Physics
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• v.26 no.4
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• pp.286-293
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• 2015

The purpose of this study was to evaluate the set up accuracy using stereotactic body frame and frameless immobilizer for lung stereotactic body radiation therapy (SBRT). For total 40 lung cancer patients treated by SBRT, 20 patients using stereotactic body frame and other 20 patients using frameless immobilizer were separately enrolled in each group. The setup errors of each group depending on the immobilization methods were compared and analyzed. All patients received the dose of 48~60 Gy for 4 or 5 fractions. Before each treatment, a patient was first localized to the treatment isocenter using room lasers, and further aligned with a series of image guidance procedures; orthogonal kV radiographs, cone-beam CT, orthogonal fluoroscopy. The couch shifts during these procedures were recorded and analyzed for systematic and random errors of each group. Student t-test was performed to evaluate significant difference depending on the immobilization methods. The setup reproducibility was further analyzed using F-test with the random errors excluding the systematic setup errors. In addition, the ITV-PTV margin for each group was calculated. The setup errors for SBF were $0.05{\pm}0.25cm$ in vertical direction, $0.20{\pm}0.38cm$ in longitudinal direction, and $0.02{\pm}0.30cm$ in lateral direction, respectively. However the setup errors for frameless immobilizer showed a significant increase of $-0.24{\pm}0.25cm$ in vertical direction while similar results of $0.06{\pm}0.34cm$, $-0.02{\pm}0.25cm$ in longitudinal and lateral directions. ITV-PTV margins for SBF were 0.67 cm (vertical), 0.99 cm (longitudinal), and 0.83 cm (lateral), respectively. On the other hand, ITV-PTV margins for Frameless immobilizer were 0.75 cm (vertical), 0.96 cm (longitudinal), and 0.72 cm (lateral), indicating less than 1 mm difference for all directions. In conclusion, stereotactic body frame improves reproducibility of patient setup, resulted in 0.1~0.2 cm in both vertical and longitudinal directions. However the improvements are not substantial in clinic considering the effort and time consumption required for SBF setup.

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.259-259
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• 2002

• The Journal of the Korea Contents Association
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• v.22 no.7
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• pp.676-683
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• 2022

Minimizing patient movement during CT-guided lung biopsy is an important factor in the procedure. To minimize movement, a vacuum cushion was used to evaluate its effectiveness. The subjects of this study were 116 patients aged 40 years or older who had good coordination with postural fixation and breathing control. Posture measurements were performed in the supine position, prone position, oblique position, and lateral position according to each position of the lung lesion biopsy lesion. Measurement positions were measured in the anterior, posterior, right, and left positions based on the anatomical posture. In the prone position, the mean difference between the non-use and the use of the posterior was 1.7905, and t=2.913 (p<0.01), and the mean difference between the non-use/use was statistically significant. The difference between the unused and used averages of left was 2.4105, and the difference between the left averages was also significant with t=3.684 (p<0.01). The difference between the unused and used averages of the right was 2.3263, with t=3.791 (p<0.01). The mean difference between unused and used is statistically significant. As a result of statistical analysis, the biopsy of the lung lesion using a fixation device showed less movement in all postures. It is considered that it is meaningful in that it is possible to conduct a more accurate biopsy procedure and minimize the patient's posture movement by using a fixation device during the CT-guided biopsy of the lung lesion.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.35-36
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• 2008