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Image Evaluation for Optimization of Radiological Protection in CBCT during Image-Guided Radiation Therapy (영상유도 방사선 치료 시 CBCT에서 방사선 방호최적화를 위한 영상평가)

  • Min-Ho Choi;Kyung-Wan Kim;Dong-Yeon Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.305-314
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    • 2023
  • With the development of medical technology and radiation treatment equipment, the frequency of high-precision radiation therapy such as intensity modulation radiation therapy has increased. Image-guided radiation therapy has become essential for radiation therapy in precise and complex treatment plans. In particular, with the introduction of imaging equipment for diagnosis in a linear accelerator, CBCT scanning became possible, which made it possible to calibrate and correct the patient's posture through 3D images. Although more precise reproduction of the patient's posture has become possible, the exposure dose delivered to the patient during the image acquisition process cannot be ignored. Radiation optimization is necessary in the field of radiation therapy, and efforts to reduce exposure are necessary. However, when acquiring 3D CBCT images by changing the imaging conditions to reduce exposure, there should be no image quality or artefacts that would make it impossible to align the patient's position. In this study, Rando phantom was used to scan and evaluate images for each shooting condition. The highest SNR was obtained at 100 kV 80 mA 25 ms F1 filter 180°. As the tube voltage and tube current increased, the noise decreased, and the bowtie filter showed the optimal effect at high tube current. Based on the actual scanned images, it was confirmed that patient alignment was possible under all imaging conditions, and that image-guided radiation therapy for patient alignment was possible under the condition of 70 kV 10 mA 20 ms F0 filter 180°, which showed the lowest SNR. In this study, image evaluation was conducted according to the imaging conditions, and low tube voltage, tube current, and small rotation angle scan are expected to be effective in reducing radiation exposure. Based on this, the patient's exposure dose should be kept as low as possible during CBCT imaging.

A Study of Psychometric Function Curve for Korean Standard Monosyllabic Word Lists for Preschoolers (KS-MWL-P) (한국표준 학령전기용 단음절어표 (Korean Standard Monosyllabic Word Lists for Preschoolers, KS-MWL-P)의 심리음향기능곡선 연구)

  • Shin, Hyun-Wook;Kim, Jin-Sook
    • The Journal of the Acoustical Society of Korea
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    • v.28 no.6
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    • pp.534-541
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    • 2009
  • Word recognition test (WRT) for the children can be useful for diagnosing the degree of communication disability, prescribing hearing instruments, planning aural rehabilitation and speech therapy, and determination of site of lesions. The Korean standard monosyllabic word lists for preschoolers (KS-MWL-P) were developed considering the criteria given by the literatures. However, the authors of KS-MWL-P suggested more children should be included to verify homogeneity of the lists using psychometric function curve since only 8 children participated in the developing process. The purpose of this study was to explore the homogeneity of KS-MWL-P for supplementing the limitations of the lists employing psychometric analysis. To 23 preschoolers who have normal-hearing, 100 monosyllabic KS-MWL-P words were examined with the pictures. Psychometric function curve with linear slopes of 20% and 80%'s correct rates through accounting recognition scores of each monosyllabic word at variable intensities from -10 to 40 dBHL was obtained and analyzed. As a result, s-shaped psychometric function curve was presented with increasing correct rate depending on intensity and showed no statistical significant differences among each word and list. The congruous graph shapes among lists also indicated good homogeneity and the list 1,2,3,4's average slopes were 4.48, 3.86, 4.65, 4.50. It was verified that the homogeneity was suitable because the analysis of variance showed no statistical significance among lists (p>0.05). However, KS-MWL-P's order of slope according to the order of the number of items, $1{\sim}10$, $1{\sim}20$, $1{\sim}25$ showed no difference with the p-value of 0.93, 0.59, 0.91, 0.70 for the lists 1,2,3, and 4, respectively. Although KS-MWL-P was assumed that the lower-numbered items were easy for testing younger ages, this study's results could not agree with the author's conclusion. Considering this matter, rearranging of the number of items should be performed according to the analysis of slope suggested by this study for testing younger children with easier items. Other than this, in conclusion, KS-MWL-P was proved to be useful for clinical and rehabilitative evaluating and training tools for preschoolers.

The Gradient Variation of Thermal Environments on the Park Woodland Edge in Summer - A Study of Hadongsongrim and Hamyangsangrim - (여름철 공원 수림지 가장자리의 온열환경 기울기 변화 - 하동송림과 함양상림을 대상으로 -)

  • Ryu, Nam-Hyong;Lee, Chun-Seok
    • Journal of the Korean Institute of Landscape Architecture
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    • v.43 no.6
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    • pp.73-85
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    • 2015
  • This study investigated the extent and magnitude of the woodland edge effects on users' thermal environments according to distance from woodland border. A series of experiments to measure air temperature, relative humidity, wind velocity, MRT and UTCI were conducted over six days between July 31 and August 5, 2015, which corresponded with extremely hot weather, at the south-facing edge of Hadongsongrim(pure Pinus densiflora stands, tree age: $100{\pm}33yr$, tree height: $12.8{\pm}2.7m$, canopy closure: 75%, N $35^{\circ}03^{\prime}34.7^{{\prime}{\prime}}$, E $127^{\circ}44^{\prime}43.3^{{\prime}{\prime}}$, elevation 7~10m) and east-facing edge of Hamyangsangrim (Quercus serrata-Carpinus tschonoskii community, tree age: 102~125yr/58~123yr, tree height: tree layer $18.6{\pm}2.3m/subtree$ layer $5.9{\pm}3.2m/shrub$ layer $0.5{\pm}0.5m$, herbaceous layer coverage ratio 60%, canopy closure: 96%, N $35^{\circ}31^{\prime}28.1^{{\prime}{\prime}}$, E $127^{\circ}43^{\prime}09.8^{{\prime}{\prime}}$, elevation 170~180m) in rural villages of Hadong and Hamyang, Korea. The minus result value of depth means woodland's outside. The depth of edge influence(DEI) on the maximum air temperature, minimum relative humidity and wind speed at maximum air temperature time during the daytime(10:00~17:00) were detected to be $12.7{\pm}4.9$, $15.8{\pm}9.8$ and $23.8{\pm}26.2m$, respectively, in the mature evergreen conifer woodland of Hadongsongrim. These were detected to be $3.7{\pm}2.2$, $4.9{\pm}4.4$ and $2.6{\pm}7.8m$, respectively, in the deciduous broadleaf woodland of Hamyansangrim. The DEI on the maximum 10 minutes average MRT, UTCI from the three-dimensional environment absorbed by the human-biometeorological reference person during the daytime(10:00~17:00) were detected to be $7.1{\pm}1.7$ and $4.3{\pm}4.6m$, respectively, in the relatively sparse woodland of Hadongsongrim. These were detected to be $5.8{\pm}4.9$ and $3.5{\pm}4.1m$, respectively, in the dense and closed woodland of Hadongsongrim. Edge effects on the thermal environments of air temperature, relative humidity, wind speed, MRT and UTCI in the sparse woodland of Hadongsongrim were less pronounced than those recorded in densed and closed woodland of Hamyansangrim. The gradient variation was less steep for maximum 10 minutes average UTCI with at least $4.3{\pm}4.6m$(Hadongsongrim) and $3.5{\pm}4.1m$(Hamyansangrim) being required to stabilize the UTCI at mature woodlands. Therefore it is suggested that the woodlands buffer widths based on the UTCI values should be 3.5~7.6 m(Hamyansangrim) and 4.3~8.9(Hadongsongrim) m on each side of mature woodlands for users' thermal comfort environments. The woodland edge structure should be multi-layered canopies and closed edge for the buffer effect of woodland edge on woodland users' thermal comfort.

Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy (근치목적 방사선치료를 받은 식도암 환자의 림프절 재발양상과 치료성적)

  • Lee, Sun-Young;Kwon, Hyoung-Cheol;Lee, Heui-Hwan;Kim, Jung-Soo;Kim, Soo-Geon
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.77-82
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    • 2008
  • Purpose: We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women(mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion(17 patients), and mid portion(65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0(7 patients), T2N0-1M0(18 patients), T3N0-1M0(44 patients) and T4N0-1M0(13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response(48 patients), partial response(31 patients) and no response(3 patients). The failure patterns of the lymph node were comprised of the regional lymph node(23 patients) and the distance lymph node which included celiac axis and gastric lymph node(13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the patients who appeared for regional and distant lymph node metastasis was 14.4 and 7.0 months, respectively. Conclusion: In locally advanced esophageal cancer patients, who were treated by definitive radiotherapy without celiac axis and gastric lymph node irradiation, the distant lymph node metastasis rate was high and the overall survival rate was lower compared to the regional lymph node metastasis. The incidence of regional and distant lymph node metastasis was high in patients who appeared beyond clinical stage T2 and received radiotherapy alone.

Development of Adjustable Head holder Couch in H&N Cancer Radiation Therapy (두경부암 방사선 치료 시 Set-Up 조정 Head Holder 장치의 개발)

  • Shim, JaeGoo;Song, KiWon;Kim, JinMan;Park, MyoungHwan
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.1
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    • pp.43-50
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    • 2014
  • In case of all patients who receive radiation therapy, a treatment plan is established and all steps of treatment are planned in the same geometrical condition. In case of head and neck cancer patients who undergo simulated treatment through computed tomography (CT), patients are fixed onto a table for planning, but laid on the top of the treatment table in the radiation therapy room. This study excogitated and fabricated an adjustable holder for head and neck cancer patients to fix patient's position and geometrical discrepancies when performing radiation therapy on head and neck cancer patients, and compared the error before and after adjusting the position of patients due to difference in weight to evaluate the correlation between patients' weight and range of error. Computed tomography system(High Advantage, GE, USA) is used for phantom to maintain the supine position to acquire the images of the therapy site for IMRT. IMRT 4MV X-rays was used by applying the LINAC(21EX, Varian, U.S.A). Treatment planning system (Pinnacle, ver. 9.1h, Philips, Madison, USA) was used. The setup accuracy was compared with each measurement was repeated five times for each weight (0, 15, and 30Kg) and CBCT was performed 30 times to find the mean and standard deviation of errors before and after the adjustment of each weight. SPSS ver.19.0(SPSS Inc., Chicago, IL,USA) statistics program was used to perform the Wilcoxon Rank test for significance evaluation and the Spearman analysis was used as the tool to analyze the significance evaluation of the correlation of weight. As a result of measuring the error values from CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.4{\pm}0.8mm$, $0.8{\pm}0.4mm$, 0 for 0Kg before the adjustment. In 15Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.2{\pm}0.8mm$, $1.2{\pm}0.4mm$, $2.0{\pm}0.4mm$. After adjusting position was X,Y,Z axis was $0.2{\pm}0.4mm$, $0.4{\pm}0.5mm$, $0.4{\pm}0.5mm$. In 30Kg CBCT before and after adjusting the position due to the weight difference, X,Y,Z axis was $0.8{\pm}0.4mm$, $2.4{\pm}0.5mm$, $4.4{\pm}0.8mm$. After adjusting position was X,Y,Z axis was $0.6{\pm}0.5mm$, $1.0{\pm}0mm$, $0.6{\pm}0.5mm$. When the holder for the head and neck cancer was used to adjust the ab.0ove error value, the error values from CBCT were $0.2{\pm}0.8mm$ for the X axis, $0.40{\pm}0.54mm$ for Y axis, and 0 for Z axis. As a result of statistically analyzing each value before and after the adjustment the value was significant with p<0.034 at the Z axis with 15Kg of weight and with p<0.038 and p<0.041 at the Y and Z axes respectively with 30Kg of weight. There was a significant difference with p<0.008 when the analysis was performed through Kruscal-Wallis in terms of the difference in the adjusted values of the three weight groups. As it could reduce the errors, patients' reproduction could be improved for more precise and accurate radiation therapy. Development of an adjustable device for head and neck cancer patients is significant because it improves the reproduction of existing equipment by reducing the errors in patients' position.

Development of Yóukè Mining System with Yóukè's Travel Demand and Insight Based on Web Search Traffic Information (웹검색 트래픽 정보를 활용한 유커 인바운드 여행 수요 예측 모형 및 유커마이닝 시스템 개발)

  • Choi, Youji;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.23 no.3
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    • pp.155-175
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    • 2017
  • As social data become into the spotlight, mainstream web search engines provide data indicate how many people searched specific keyword: Web Search Traffic data. Web search traffic information is collection of each crowd that search for specific keyword. In a various area, web search traffic can be used as one of useful variables that represent the attention of common users on specific interests. A lot of studies uses web search traffic data to nowcast or forecast social phenomenon such as epidemic prediction, consumer pattern analysis, product life cycle, financial invest modeling and so on. Also web search traffic data have begun to be applied to predict tourist inbound. Proper demand prediction is needed because tourism is high value-added industry as increasing employment and foreign exchange. Among those tourists, especially Chinese tourists: Youke is continuously growing nowadays, Youke has been largest tourist inbound of Korea tourism for many years and tourism profits per one Youke as well. It is important that research into proper demand prediction approaches of Youke in both public and private sector. Accurate tourism demands prediction is important to efficient decision making in a limited resource. This study suggests improved model that reflects latest issue of society by presented the attention from group of individual. Trip abroad is generally high-involvement activity so that potential tourists likely deep into searching for information about their own trip. Web search traffic data presents tourists' attention in the process of preparation their journey instantaneous and dynamic way. So that this study attempted select key words that potential Chinese tourists likely searched out internet. Baidu-Chinese biggest web search engine that share over 80%- provides users with accessing to web search traffic data. Qualitative interview with potential tourists helps us to understand the information search behavior before a trip and identify the keywords for this study. Selected key words of web search traffic are categorized by how much directly related to "Korean Tourism" in a three levels. Classifying categories helps to find out which keyword can explain Youke inbound demands from close one to far one as distance of category. Web search traffic data of each key words gathered by web crawler developed to crawling web search data onto Baidu Index. Using automatically gathered variable data, linear model is designed by multiple regression analysis for suitable for operational application of decision and policy making because of easiness to explanation about variables' effective relationship. After regression linear models have composed, comparing with model composed traditional variables and model additional input web search traffic data variables to traditional model has conducted by significance and R squared. after comparing performance of models, final model is composed. Final regression model has improved explanation and advantage of real-time immediacy and convenience than traditional model. Furthermore, this study demonstrates system intuitively visualized to general use -Youke Mining solution has several functions of tourist decision making including embed final regression model. Youke Mining solution has algorithm based on data science and well-designed simple interface. In the end this research suggests three significant meanings on theoretical, practical and political aspects. Theoretically, Youke Mining system and the model in this research are the first step on the Youke inbound prediction using interactive and instant variable: web search traffic information represents tourists' attention while prepare their trip. Baidu web search traffic data has more than 80% of web search engine market. Practically, Baidu data could represent attention of the potential tourists who prepare their own tour as real-time. Finally, in political way, designed Chinese tourist demands prediction model based on web search traffic can be used to tourism decision making for efficient managing of resource and optimizing opportunity for successful policy.