The Journal of Korean Society for Radiation Therapy
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v.33
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pp.109-116
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2021
Purpose: The purpose of this study is to evaluate the usefulness of Surface-Guided Patient Setup by comparing the patient positioning accuracy when image-guided radiation therapy was used for Markerless patients(unmarked on the skin) using Surface-Guided Patient Setup and Marker patients(marked on the skin) using Laser-Based Patient Setup. Materials And Methods: The position error during IGRT was compared between a Markerless patient initially set up with SGPS using an optical surface scanning system using three cameras and a Marker patient initially set up with LBPS that aligns the laser with the marker drawn on the patient's skin. Both SGPS and LBPS were performed on 20 prostate cancer patients and 10 Stereotactic Radiation Surgery patients, respectively, and SGPS was performed on an additional 60 breast cancer patients. All were performed IGRT using CBCT or OBI. Position error of 6 degrees of freedom was obtained using Auto-Matching System, and comparison and analysis were performed using Offline-Review in the treatment planning system. Result: The difference between the root mean square (RMS) of SGPS and LBPS in prostate cancer patients was Vrt -0.02cm, Log -0.02cm, Lat 0.01cm, Pit -0.01°, Rol -0.01°, Rtn -0.01°, SRS patients was Vrt 0.02cm, Log -0.05cm, Lat 0.00cm, Pit -0.30°, Rol -0.15°, Rtn -0.33°. there was no significant difference between the two regions. According to the IGRT standard of breast cancer patients, RMS was Vrt 0.26, Log 0.21, Lat 0.15, Pit 0.81, Rol 0.49, Rtn 0.59. Conclusion:. As a result of this study, the position error value of SGPS compared to LBPS did not show a significant difference between prostate cancer patients and SRS patients. In the case of additionally performed SGPS breast cancer patients, the position error value was not large based on IGRT. Therefore, it is considered that it will be useful to replace LBPS with SGPS, which has the great advantage of not requiring patient skin marking..
Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
Journal of the Korean Society of Radiology
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v.82
no.5
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pp.1207-1217
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2021
Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.
Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.
Purpose In a cyclosporine experiment using a robotic liquid handing system has found a deviation of its standard curve and low reproducibility of patients's results. The difference of the test is that methanol is mixed with samples and the extractions are used for the test. Therefore, we assumed that the abnormal test results came from using methanol and conducted this test. In a manual of a robotic liquid handling system mentions that we can choose several setting parameters depending on the viscosity of the liquids being used, the size of the sampling tips and the motor speeds that you elect to use but there's no exact order. This study was undertaken to confirm pipetting ability depending on types of liquids and investigate proper setting parameters for the optimum dispensing ability. Materials and Methods 4types of liquids(water, serum, methanol, PEG 6000(25%)) and $TSH^{125}I$ tracer(515 kBq) are used to confirm pipetting ability. 29 specimens for Cyclosporine test are used to compare results. Prepare 8 plastic tubes for each of the liquids and with multi pipette $400{\mu}l$ of each liquid is dispensed to 8 tubes and $100{\mu}l$ of $TSH^{125}I$ tracer are dispensed to all of the tubes. From the prepared samples, $100{\mu}l$ of liquids are dispensed using a robotic liquid handing system, counted and calculated its CV(%) depending on types of liquids. And then by adjusting several setting parameters(air gap, dispense time, delay time) the change of the CV(%)are calcutated and finds optimum setting parameters. 29 specimens are tested with 3 methods. The first(A) is manual method and the second(B) is used robotic liquid handling system with existing parameters. The third(C) is used robotic liquid handling system with adjusted parameters. Pipetting ability depending on types of liquids is assessed with CV(%). On the basis of (A), patients's test results are compared (A)and(B), (A)and(C) and they are assessed with %RE(%Relative error) and %Diff(%Difference). Results The CV(%) of the CPM depending on liquid types were water 0.88, serum 0.95, methanol 10.22 and PEG 0.68. As expected dispensing of methanol using a liquid handling system was the problem and others were good. The methanol's dispensing were conducted by adjusting several setting parameters. When transport air gap 0 was adjusted to 2 and 5, CV(%) were 20.16, 12.54 and when system air gap 0 was adjusted to 2 and 5, CV(%) were 8.94, 1.36. When adjusted to system air gap 2, transport air gap 2 was 12.96 and adjusted to system air gap 5, Transport air gap 5 was 1.33. When dispense speed was adjusted 300 to 100, CV(%) was 13.32 and when dispense delay was adjusted 200 to 100 was 13.55. When compared (B) to (A), the result increased 99.44% and %RE was 93.59%. When compared (C-system air gap was adjusted 0 to 5) to (A), the result increased 6.75% and %RE was 5.10%. Conclusion Adjusting speed and delay time of aspiration and dispense was meaningless but changing system air gap was effective. By adjusting several parameters proper value was found and it affected the practical result of the experiment. To optimize the system active efforts are needed through the test and in case of dispensing new types of liquids proper test is required to check the liquid is suitable for using the equipment.
Purpose: As PET/CT come into wide use, it caused increasing of expose in clinical use. Therefore, Korea Food and Drug Administration issued Patient DRL (Diagnostic Reference Level) in CT scan. In this study, to build the basis of patient dose reduction, we analyzed effective dose in transmission scan with CT scan. Materials and Methods: From February, 2010 to March 180 patients (age: $55{\pm}16$, weight: $61.0{\pm}10.4$ kg) who examined $^{18}F$-FDG PET/CT in Asan Medical Center. Biograph Truepoint 40 (SIEMENS, GERMANY), Biograph Sensation 16 (SIEMENS, GERMANY) and Discovery STe8 (GE healthcare, USA) were used in this study. Per each male and female average of 30 patients doses were analyzed by one. Automatic exposure control system for controlling the dose can affect the largest by a patient's body weight less than 50 kg, 50-60 kg less, 60 kg more than the average of the three groups were divided doses. We compared that measured value of CT-expo v1.7 and ImPACT v1.0. The relationship between body weight and the effective dose were analyzed. Results: When using CT-Expo V1.7, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.46{\pm}1.18$ mSv, $9.36{\pm}1.96 $mSv and $9.36{\pm}1.96$ mSv for 30 male patients respectably $6.29{\pm}0.97$ mSv, $10.02{\pm}2.42$ mSv and $9.05{\pm}2.27$ mSv for 30 female patients respectably. When using ImPACT v1.0, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.54{\pm}1.21$ mSv, $8.36{\pm}1.69$ mSv and $9.74{\pm}2.55$Sv for 30 male patients respectably $5.87{\pm}1.09$ mSv, $8.43{\pm}1.89$ mSv and $9.19{\pm}2.29$ mSv for female patients respectably. When divided three groups which were under 50 kg, 50~60 kg and over 60 kg respectably were 6.27 mSv, 7.67 mSv and 9.33 mSv respectably using CT-Expo V1.7, 5.62 mSv, 7.22 mSv and 8.91 mSv respectably using ImPACT v1.0. Weight and the effective dose coefficient analysis showed a very strong positive correlation(r=743, r=0.693). Conclusion: Using such a dose evaluation programs, easier to predict and evaluate the effective dose possible without performing phantom study and such dose evaluation programs could be used to collect basic data for CT dose management.
Kim, Jung-Yul;Kang, Chung-Koo;Park, Min-Soo;Park, Hoon-Hee;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
The Korean Journal of Nuclear Medicine Technology
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v.14
no.1
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pp.83-89
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2010
Purpose: The Wide Beam Reconstruction (WBR) algorithms that UltraSPECT, Ltd. (U.S) has provides solutions which improved image resolution by eliminating the effect of the line spread function by collimator and suppression of the noise. It controls the resolution and noise level automatically and yields unsurpassed image quality. The aim of this study is WBR of whole body bone scan in usefulness of clinical application. Materials and Methods: The standard line source and single photon emission computed tomography (SPECT) reconstructed spatial resolution measurements were performed on an INFINA (GE, Milwaukee, WI) gamma camera, equipped with low energy high resolution (LEHR) collimators. The total counts of line source measurements with 200 kcps and 300 kcps. The SPECT phantoms analyzed spatial resolution by the changing matrix size. Also a clinical evaluation study was performed with forty three patients, referred for bone scans. First group altered scan speed with 20 and 30 cm/min and dosage of 740 MBq (20 mCi) of $^{99m}Tc$-HDP administered but second group altered dosage of $^{99m}Tc$-HDP with 740 and 1,110 MBq (20 mCi and 30 mCi) in same scan speed. The acquired data was reconstructed using the typical clinical protocol in use and the WBR protocol. The patient's information was removed and a blind reading was done on each reconstruction method. For each reading, a questionnaire was completed in which the reader was asked to evaluate, on a scale of 1-5 point. Results: The result of planar WBR data improved resolution more than 10%. The Full-Width at Half-Maximum (FWHM) of WBR data improved about 16% (Standard: 8.45, WBR: 7.09). SPECT WBR data improved resolution more than about 50% and evaluate FWHM of WBR data (Standard: 3.52, WBR: 1.65). A clinical evaluation study, there was no statistically significant difference between the two method, which includes improvement of the bone to soft tissue ratio and the image resolution (first group p=0.07, second group p=0.458). Conclusion: The WBR method allows to shorten the acquisition time of bone scans while simultaneously providing improved image quality and to reduce the dosage of radiopharmaceuticals reducing radiation dose. Therefore, the WBR method can be applied to a wide range of clinical applications to provide clinical values as well as image quality.
Trends of variation in groundwater levels, electrical conductivities and water temperatures obtained from the national groundwater monitoring stations (95 shallow and 169 deep wells) of Korea were evaluated. For the analysis, both parametric (linear regression) and non-parametric (Mann-Kendall test, Sen's test) methods were adopted. Results of linear regression analysis indicated that about 50% of the monitoring wells showed increasing trends of groundwater levels, electrical conductivities, and water temperatures and the others showed decreasing trends. However, the non-parametric analyses with monthly median values revealed that $14.8{\sim}20.0%$ of water levels were decreased, $24.2{\sim}36.9%$ of electrical conductivities were increased, and $27.4{\sim}32.5%$ of water temperatures were increased at a confidence level of 99%. Highly proportions of increasing or decreasing trends were unexpected and they resulted from the relatively short term of data collection (maximum 6 years). Meanwhile, the investigation of groundwater around the national groundwater monitoring stations showed that the decreasing or increasing trends of water levels, electrical conductivities, themselves, didn't indicate directly groundwater hazards such as groundwater depletion or groundwater contamination. Both the values and variation rates (slopes) of water level, electrical conductivity and temperature in the longer period are considered simultaneously. This study is the first comprehensive work in analyzing trends of groundwater data obtained from the national groundwater monitoring stations. Based on this study, the periodical and regular analysis of groundwater data is essentially required to grasp the overall variational trend of groundwater resources in the country.
The antioxidants activities in water and 95% ethanol extracts of wa-song (Orostachys japonicus A. Berger) dried by sun, hot air and lyophilization were measured in vitro reaction system. In reaction system containing linoleic acid, the antioxidant activities against lipid oxidation enhanced in proportion to storage time. The antioxidant activity of ethanol extracts was higher than that of water extracts. In the drying methods, wa-song extracts showed higher antioxidant activity in the other of hot air-dried, lyophilized and sun-dried. The lipid oxidation system containing the promoting factors, such as $Fe^{+2}$ and $Cu^{+2}$ions, also showed that the ethanol extract of hot air-dried wa-song possessed the highest antioxidant activity. Soybean oil and lard being added with various levels (0.1, 0.5 and 1.0 g/100 g) of the ethanol extract of hot air-dried wa-song were stored at $60^{\circ}C$ (for 28 days) or $180^{\circ}C$ (for 48 hr). Its extract appeared to lower the acid value of soybean oil, wheras it failed to lower the acid value for lard at early storage time, but it was lower than control and BHT after 28 days. Anicidine value and peroxide value were lower soybean and lard added wa-song extract than control and BHT for storage for 28 days at $60^{\circ}C$. In 28 days, its value was significantly decreased in proportion to sample concentration. TBA value was increased during storage time at $60^{\circ}C$, but it was significantly decreased by sample concentration after storage 36 hours at $180^{\circ}C$ storage. Therefore results suggest ethanol extract of hot air-dried wa-song could be potential candidates for natural antioxidants for materials containing lipid.
In recent years, mammography system is changed rapidly from conventional screen-film system to digital system for application to screening and diagnosis. Digital mammography system provides several advantages over screen-film mammography system. According to the information provided by the manufacturer, digital mammography system offers radiation dose reduction in comparison with screen-film mammography system, because of digital detector, particularly direct digital detector has higher x-ray absorption efficiency than screen-film combination or imaging plate(IP). We measured average glandular doses(AGD) in screen-film mammography(SFM) system with slow screen-film combination, computed mammography(CM) system, indirect digital mammography(IDM) system and direct digital mammography(DDM) system using brest tissue-equivalent phantom(glandularity 30%, 50% and 70%). The results were shown as follows : AGD values for DDM system were highest than those for other systems. Although automatic exposure control(AEC) mode was selected, the curve of the AGD values against thickness or glandularity increased significantly for the SFM system with the uniform target/filter(Mo/Mo) combination. Therefore, the AGD values for the high energy examinations were highest in the SFM system, and those for the low energy examinations were highest in the DDM system. But the curve of the AGD values against thickness and glandularity increased gently for CM system with the automatic selection of the target/filter combination (from Mo/Mo to Mo/Rh or from Mo/Rh to Rh/Rh), and the AGD values were lowest. Consequently, the parameters in mammography for each exposure besides detection efficiency play an important role in oder to estimate a patient radiation dose.
This study aimed to develop a modular smart clothing system for heart rate monitoring that reduces the inconvenience caused by battery charging and the large size of measurement devices. The heart rate monitoring system was modularized into a temporary device and a continuous device to enable heart rate monitoring depending on the requirement. The temporary device with near-field communication (NFC) and heart rate sensors was developed as a clothing attachment type that enables heart rate monitoring via smart phone tagging when required. The continuous device is based on Bluetooth Low Energy (BLE) communication and batteries and was developed to enable continuous heart rate measurement via a direct connection to the temporary device. Furthermore, the temporary device was configured to connect with a textile electrode made of a silver-based knitted fabric designed to be located below the pectoralis major muscle for heart rate measurement. Considering the user-experience factors, key functions, and the ease of use, we developed an application to automatically log through smart phone tagging to improve usability. To evaluate the accuracy of the heart rate measurement, we recorded the heart rate of 10 healthy male subjects with a modular smart clothing system and compared the results with the heart rate values measured by the Polar RS800. Consequently, the average heart rate value measured by the temporary system was 85.37, while that measured by the reference device was 87.03, corresponding to an accuracy of 96.73%. No significant difference was found in comparison with the reference device (T value = -1.892, p = .091). Similarly, the average heart rate measured by the continuous system was 86.00, while that measured by the reference device was 86.97, corresponding to an accuracy of 97.16%. No significant difference was found in terms of the heart rate value between the two signals (T value = 1.089, p = .304). The significance of this study is to develop and validate a modular clothing system that can measure heart rates according to the purpose of the user. The developed modular smart clothing system for heart rate monitoring enables dual product planning by reducing the price increase due to unnecessary functions.
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