• Radiation Oncology Journal
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• v.25 no.1
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• pp.54-61
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• 2007

[ $\underline{Purpose}$ ]: The purpose of this study is to develop a practical method for determining accurate marker positions for prostate cancer radiotherapy using CT images and kV x-ray images obtained from the use of the on- board imager (OBI). $\underline{Materials\;and\;Methods}$: Three gold seed markers were implanted into the reference position inside a prostate gland by a urologist. Multiple digital image processing techniques were used to determine seed marker position and the center-of-mass (COM) technique was employed to determine a representative reference seed marker position. A setup discrepancy can be estimated by comparing a computed $COM_{OBI}$ with the reference $COM_{CT}$. A proposed algorithm was applied to a seed phantom and to four prostate cancer patients with seed implants treated in our clinic. $\underline{Results}$: In the phantom study, the calculated $COM_{CT}$ and $COM_{OBI}$ agreed with $COM_{actual}$ within a millimeter. The algorithm also could localize each seed marker correctly and calculated $COM_{CT}$ and $COM_{OBI}$ for all CT and kV x-ray image sets, respectively. Discrepancies of setup errors between 2D-2D matching results using the OBI application and results using the proposed algorithm were less than one millimeter for each axis. The setup error of each patient was in the range of $0.1{\pm}2.7{\sim}1.8{\pm}6.6\;mm$ in the AP direction, $0.8{\pm}1.6{\sim}2.0{\pm}2.7\;mm$ in the SI direction and $-0.9{\pm}1.5{\sim}2.8{\pm}3.0\;mm$ in the lateral direction, even though the setup error was quite patient dependent. $\underline{Conclusion}$: As it took less than 10 seconds to evaluate a setup discrepancy, it can be helpful to reduce the setup correction time while minimizing subjective factors that may be user dependent. However, the on-line correction process should be integrated into the treatment machine control system for a more reliable procedure.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.31-42
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• 2009

Purpose: As the number of domestic medical institutions installing PET/CT is increasing rapidly, the transfer of PET/CT images among medical institutions is also increasing. Thus, it is necessary to collect the comparative SUV data from several medical institutions' PET/CT systems through a phantom study which semi-quantitatively compares the SUV on one bed, the change scale of the SUV on the slices, and the time of measuring. The phantom study to find differences among the SUVs from various PET/CT offers the opportunity to obtain the reliability of the SUV in PET/CT images. Materials and Methods: Ten PET/CT systems from medical institutions in Korea were used. To obtain the accurate data, the study has been using the radiation detector of Korea Research Institute of Standards and Science to verify. The internal structures of NEMA $phantom^{TM}$ were removed and Six thousand milliliters of distilled water which has 1mCi of $^{18}F$-FDG put into the phantom. The water was properly integrated with $^{18}F$-FDG using magnetic stirrer. The images were acquired at 60, 70, 80, 90, 100, 110 and 120-minutes for 3 minute each. Two hundred square centimeters of region of interests were placed and analyzed. To confirm the usefulness, the correction-table came out from patients' data. Results: The coefficient of variability of the SUV from -11.0 to 9.90 % fell into the range of international standards(${\pm}10%$) along with the SUV on a bed, the change scale of the SUV on the slices, and the time of measuring, except one PET/CT system. Using the data of the differences among the SUVs, we came to withdraw the correction-table ranging from 0.803 to 1.246. The correction-table was confirmed its usefulness through Linear Regression Analysis which was applied to normal cases. Conclusions: Although studies have been made on the variation of the SUV, there is little attention on the standardization of the SUV. Based on this study of the quantitatively comparable data about the SUV accommodating the correction-table, it would help to have more corrective diagnosis.

• Progress in Medical Physics
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• v.11 no.1
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• pp.59-71
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• 2000

It is possible to obtain a fast CT scan during breath holding with spiral technique. But the risk of radiation is increased due to detailed and repeated scans. However, the limitation of X-ray doses is not fully specified on CT, yet. Therefore, the purpose of the present study is to define the limitation of X-ray doses on CT The CT unit was somatom plus 4. Alderson Rando phantom, Solenoid water phantom, TLD, and reader were used. For determining adequate position and size of organs, the measurement of distance(${\pm}$2mm) from the midline of vertebral body was performed in 40 women(20~40 years). On the brain scan for 8:8(8mm slice thickness, 8mm/sec movement velocity of the table) and 10:10(10mm slice thickness, 10mm/sec movement velocity of the table) methods, the absorption doses of exposed area of the 10:10 were slightly higher than those of 8:8. The doses of unexposed uterus were negligible on the brain scan for both 8:8 and 10:10. On the chest scan for 8:8, 8:10(8mm slice thickness, 10mm/sec movement velocity of the table), 10:10, 10:12(10mm slice thickness, 12mm/sec movement velocity of the table) and 10:15(10mm slice thickness, 15mm/sec movement velocity of the table) methods, 8:8 method of the absorption doses of exposure area was the most highest and 10:15 method was the most lowest. The absorption doses of 8:10 method was relatively lower than those of the other methods. In conclusion, the 8:10 method is the most suitable to give a low radiation burden to patient without distorting image quality.

• Progress in Medical Physics
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• v.6 no.2
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• pp.71-81
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• 1995

Consecutive brain 〔Tc-99m〕ECD SPECT studies before and after acetazolamide (Diamox) administration have been performed with patients for the evaluation of cerebrovascular hemodynamic reserve. However, the quantitaitve potential of SPECT Diamox imaging is limited as a result of degrading fractors such as finite detector resolution, attenuation, scatter, poor counting statistics, and methods of data analysis. Making physical measurements in phantoms filled with known amounts of radioactivity can help characterize and potentially quantify the sensitivities. However, it is often very difficult to make a realistic phantom simulating patients in clinical situations. By computer simulation, we studied the sensitivities of ECD SPECT before and after Diamox administration. The sensitivity is defined as ($\Delta$N/N)/($\Delta$S/S)$\times$100％, where $\Delta$N denotes the differences in mean counts between post-and pre-Diamox in the measured data, N denotes the mean counts before Diamox in the measure data, $\Delta$S denotes the differences in mean counts between post-and pre-Diamox in the model, and S denotes the mean counts before Diamox in the model. In clinical Diamox studies, the percentage changes of radioactivity could be determined to measure changes in radioactivity concentration by Diamox after subtracting pre-from post-Diamox data. However, the optimal amount of subtraction for 100％ sensitivity is not known since this requires a thorough sensitivity analysis by computer simulation. For consecutive brain SPECT imaging model before and after Diamox, when 30％ increased radioactivity concentrations were assingned for Diamox effect in model, the sensitivities were measured as 51.03, 73.4, 94.00, 130.74％ for 0, 100, 150, 200％ subtraction, respectively. Sensitivity analysis indicated that the partial voluming effects due to finite detector resolution and statistical noise result in a significant underestimation of radioactivity measurements and the amount of underestimation depends on the. ％ increase of radioactivity concentration and ％ subtraction of pre-from post-Diamox data. The 150％ subtraction appears to be optimal in clinical situations where we expect approximately 30％ changes in radioactivity concentration. The computer simulation may be a powerful technique to study sensitivities of ECD SPECT before and after Diamox administration.

• Progress in Medical Physics
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• v.23 no.3
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• pp.177-187
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• 2012

Magnetic resonance angiography (MRA) techniques are widely used in diagnosis of vascular disorders such as hemadostenosis and aneurism. Especially, phase contrast (PC) MRA technique, which is a typical non contrast-enhanced MRA technique, provides not only the anatomy of blood vessels but also flow velocity. In this study, we developed the 2- and 3-dimensional PC MRA pulse sequences for a low magnetic field MRI system. Vessel images were acquired using 2D and 3D PC MRA and the velocities of the blood flow were measured in the superior sagittal sinus, straight sinus and the confluence of the two. The 2D PC MRA provided the good quality of vascular images for large vessels but the poor quality for small ones. Although 3D PC MRA gave more improved visualization of small vessels than 2D PC MRA, the image quality was not enough to be used for diagnosis of the small vessels due to the low SNR and field homogeneity of the low field MRI system. The measured blood velocities were $25.46{\pm}0.73cm/sec$, $24.02{\pm}0.34cm/sec$ and $26.15{\pm}1.50cm/sec$ in the superior sagittal sinus, straight sinus and the confluence of the two, respectively, which showed good agreement with the previous experimental values. Thus, the developed PC MRA technique for low field MRI system is expected to provide the useful velocity information to diagnose the large brain vessels.

• Progress in Medical Physics
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• v.20 no.2
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• pp.72-79
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• 2009

Scatter correction for I-131 plays a very important role to improve image quality and quantitation. I-131 has multiple and higher energy gamma-ray emissions. Image quality and quantitative accuracy in I-131 imaging are degraded by object scatter as well as scatter and septal penetration in the collimator. The purpose of this study was to estimate scatter and septal penetration and investigate two scatter correction methods using Monte Carlo simulation. The gamma camera system simulated in this study was a FORTE system (Phillips, Nederland) with high energy, general-purpose, parallel hole collimator. We simulated for two types of high energy collimators. One is composed of lead, and the other is composed of artificially high Z number and high density. We simulated energy spectrum using a point source in air. We estimated both full width at half maximum (FWHM) and full width at tenth maximum (FWTM) using line spread function (LSF) in cylindrical water phantom. We applied two scatter correction methods, triple energy window scatter correction (TEW) and extended triple energy window scatter correction (ETEW). The TEW method is a pixel-by pixel based correction which is easy to implement clinically. The ETEW is a modification of the TEW which corrects for scatter by using abutted scatter rejection window, which can overestimate or the underestimate scatter. The both FWHM and FWTM were estimated as 41.2 mm and 206.5 mm for lead collimator, respectively. The FWHM and FWTM were estimated as 27.3 mm and 45.6 mm for artificially high Z and high density collimator, respectively. ETEW showed that the estimation of scatter components was close to the true scatter components. In conclusion, correction for septal penetration and scatter is important to improve image quality and quantitative accuracy in I-131 imaging. The ETEW method in scatter correction appeared to be useful in I-131 imaging.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.233-241
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• 1994

Purpose : This study was performed to verify dose distribution with the tissue compensator which is used for uniform dose distribution in total body irradiation(TBI). Materials and methods : The compensators were made of lead(0.8mm thickness) and aluminum(1mm or 5mm thickness) plates. The humanoid phantom of adult size was made of paraffin as a real treatment position for bilateral total body technique. The humanoid phantom was set at 360cm of source-axis distance(SAD) and irradiated with geographical field size(FS) $144{\times}144cm^2(40{\times}40cm^2$ at SAD 100cm) which covered the entire phantom. Irradiation was done with 10MV X-ray(CLINAC 1800, Varian Co., USA) of linear accelerator set at Department of Therapeutic Radiology, Chonnam University Hospital. The midline absorbed dose was checked at the various regions such as head, mouth, mid-neck, sternal notch, mid-mediastinum, xiphoid, umbilicus, pelvis, knee and ankle with or without compensator, respectively. We used exposure/exposure rate meter(model 192, Capintec Inc., USA) with ionization chamber(PR 05) for dosimetry, For the dosimetry of thorax region TLD rods of $1x1x6mm^3$ in volume(LiF, Harshaw Co., Netherland) was used at the commercially available humanoid phantom. Results : The absorbed dose of each point without tissue compensator revealed significant difference(from $-11.8\%\;to\;21.1\%$) compared with the umbilicus dose which is a dose prescription point in TBI. The absorbed dose without compensator at sternal notch including shoulder was $11.8\%$ less than the dose of umbilicus. With lead compensator the absorbed doses ranged from $+1.3\%\;to\;-5.3\%$ except mid-neck which revealed over-compensation($-7.9\%$). In case of aluminum compensator the absorbed doses were measured with less difference(from $-2.6{\%}\;to\;5.3\%$) compared with umbilicus dose. Conclusion : Both of lead and aluminum compensators applied to the skull or lower leg revealed a good compensation effect. It was recognized that boost irradiation or choosing reference point of dose prescription at sternal notch according to the lateral thickness of patient in TBI should be considered.

• Journal of Biomedical Engineering Research
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• v.25 no.4
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• pp.261-268
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• 2004

Osteoporosis is a clinical condition in which the amount of bone tissue is reduced and the likelihood of fracture is increased. It is known that the electrical property of the bone is related to its density, and, in particular, the electrical resistance of the bone decreases as the bone loss increases. This implies that the electrical property of bone may be an useful parameter to diagnose osteoporosis, provided that it can be readily measured. The study attempted to evaluate the electrical conductivity of bone using a technique of electrical impedance tomography (EIT). It nay not be easy in general to get an EIT for the bone due to the big difference (an order of 2) of electrical properties between the bone and the surrounding soft tissue. In the present study, we took an adaptive mesh regeneration technique originally developed for the detection of two phase boundaries and modified it to be able to reconstruct the electrical conductivity inside the boundary provided that the geometry of the boundary was given. Numerical simulation was carried out for a tibia phantom, circular cylindrical phantom (radius of 40 mm) inside of which there is an ellipsoidal homeogenous tibia bone (short and long radius are 17 mm and 15 mm, respectively) surrounded by the soft tissue. The bone was located in the 15 mm above from the center of the circular cross section of the phantom. The electrical conductivity of the soft tissue was set to be 4 mS/cm and varies from 0.01 to 1 ms/cm for the bone. The simulation considered measurement errors in order to look into its effects. The simulated results showed that, if the measurement error was maintained less than 5 %, the reconstructed electrical conductivity of the bone was within 10 % errors. The accuracy increased with the electrical conductivity of the bone, as expected. This indicates that the present technique provides more accurate information for osteoporotic bones. It should be noted that tile simulation is based on a simple two phase image for the bone and the surrounding soft tissue when its anatomical information is provided. Nevertheless, the study indicates the possibility that the EIT technique may be used as a new means to detect the bone loss leading to osteoporotic fractures.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.13-19
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• 2011

Purpose: It's essential to minimize the tumor motion and identify the exact location of the lesions to achieve the improvement in radiation therapy efficiency during SBRT. In this study, we made the established compression belt to reduce respiratory motion and evaluated the usefulness of clinical application in SBRT. Materials and Methods: We analyzed the merits and demerits of the established compression belt to reduce the respiratory motion and improved the reproducibility and precision in use. To evaluate the usefulness of improved compression belt for respiratory motion reduction in SBRT, firstly, we reviewed the spiral CT images acquired in inspiration and expiration states of 8 lung cancer cases, respectively, and analyzed the three dimensional tumor motion related to respiration. To evaluate isodose distribution, secondly, we also made the special phantom using EBT2 film (Gafchronic, ISP, USA) and we prepared the robot (Cartesian Robot-2 Axis, FARARCM4H, Samsung Mechatronics, Korea) to reproduce three dimensional tumor motion. And analysis was made for isodose curves and two dimensional isodose profiles with reproducibility of respiratory motion on the basis of CT images. Results: A respiratory motion reduction compression belt (Velcro type) that has convenient use and good reproducibility was developed. The moving differences of three dimensional tumor motion of lung cancer cases analyzed by CT images were mean 3.2 mm, 4.3 mm and 13 mm each in LR, AP and CC directions. The result of characteristic change in dose distribution using the phantom and rectangular coordinates robot showed that the distortion of isodose has great differences, mean length was 4.2 mm; the differences were 8.0% and 16.8% each for cranio-caudal and 8.1% and 10.9% each for left-right directions in underdose below the prescribed dose. Conclusion: In this study, we could develop the convenient and efficient compression belt that can make the organs' motion minimize. With this compression belt, we confirmed that underdose due to respiration can be coped with when CTV-PTV margins of mean 6 mm would be used. And we conclude that the respiratory motion reduction compression belt we developed can be used for clinical effective aids along with the gating system.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.41-49
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• 2011

Purpose: This study is designed to investigate radiotherapic valuation of Paraffin Wax, which is newly formed for this study and generally utilized in dentistry, and Mouth Piece and Putty impression, which are commonly used in radiotherapy, for oral cavity as a compensator. Materials and Methods: Each compensator was formed by $10{\times}10{\times}1cm$ and measured radiation dose attenuation ratio with reference of water phantom which is made of tissue-equivalent materials. Two patients with oral cancer underwent DRR (Digitally Reconstructed Radiogrph) of Offline Review Program of Aria System and Portal vision for 5 times for each material to evaluate reproducibility by each filling materials. Moreover, MU (monitor unit) changes by dose absorption were considered in the case of inevitable implication of an filling materials in the range for radiotherapy. Results: Radiation dose attenuation ratios were shown -0.7~+3.7% for Mouth Piece, +0.21~+0.39% for Paraffin Wax and -2.71~-1.76% for Putty impression. Error ranges of reproducibility of positions were measured ${\pm}3mm$ for Mouth Piece, ${\pm}2mm$ for Paraffin Wax and ${\pm}2mm$ mm for Putty impression. Difference of prescription MU from dose absorption with an filling material increased +7.8% (250 MU) in Putty impression and -0.9% (230 MU) in Paraffin Wax as converted into a percentage from the standard phantom, Water 232 MU. Conclusion: Dose reduction of boundary between cavity and tissue was observed for Mouth Piece. Mouth Piece also had low reproducibility of positions as it had no reflection of anatomy of oral cavity even though it was a proper material to separate Maxilla and Mandible during therapy. On the other hand, Putty impression was a suitable material to correctly re-position oral cavity as before. However, it risked normal tissues getting unnecessary over irradiation and it caused radiation dose decrease by -2.5% for 1cm volume in comparison of it of water phantom. Dose reduction in Paraffin Wax, Fat Tissue-Equivalent Material, was smaller than other impressions and position reproducibility of it was remarkable as it was possible to make an anatomy reflected impression. It was also well fitted to oral cavity to transfer radiation dose planned in radiotherapy. Thus, Paraffin Wax will be an ideal material in radiotherapy for patients with oral cancer.