Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.
Keum Ki Chang;Lee Sang-wook;Shin Hyun Soo;Kim Gwi Eon;Sung Jinsil Seong;Lee Chang Geol;Chu Sung Sil;Chang Sei-Kyung;Suh Chang Ok
Radiation Oncology Journal
/
v.18
no.2
/
pp.107-113
/
2000
Purpose : The goal of this study 닌as to improve the accuracy of three-dimensional conformal radiotherapy (3-D CRT) by measuring the treatment setup error and physiological movement of liver based on the analysis of images which were obtained by electronic portal imaging device (EPID). Materials and Methods : For 10 patients with hepatocellular carcinoma, 4-7 portal images were obtained by using EPID during the radiotherapy from each patient daiiy. We analyzed the setup error and physiological movement of liver based on the verification data. We also determined the safety margin of the tumor in 3-D CRT through the analysis of physiological movement. Results : The setup errors were measured as 3mm with standard deviation 1.70 mm in x direction and 3.7 mm with standard deviation 1.88 mm in y direction respectively. Hence, deviation were smaller than 5mm from the center of each axis. The measured range of liver movement due to the physiological motion was 8.63 mm on the average. Considering the motion of liver and setup error, the safety margin of tumor was at least 15 mm. Conclusion : EPID is a very useful device for the determination of the optimal margin of the tumor, and thus enhance the accuracy and stability of the 3-D CRT in patients with hepatocellular carcinoma.
Kim, Woo-Cheol;Chung, Eun-Ji;Lee, Chang-Geol;Chu, Sung-Sil;Kim, Gwi-Eon
Radiation Oncology Journal
/
v.14
no.1
/
pp.69-76
/
1996
Purpose : The aim of this study is to investigate the random and systematic errors and tumor movement using electronic portal imaging device in lung cancer patients for the adequate margin in the treatment planning of 3-dimensional conformal therapy. Material and Methods : The electronic portal imaging device is matrix ion chamber type(Portal Vision, Varian). Ten patients of lung cancer treated with chest irradiation were selected for this study. Patients were treated in the supine position without immobilization device. All treatments were delivered by an 10 MV linear accelerator that had the portal imaging system mounted to its ganrty. AP or PA field Portal images were only analyzed. Radiation therapy field included the tumor, mediastinum and supraclavicular lymph nodes. A total of 103 portal images were analyzed for set-up deviation and 10 multiple images were analyzed for tumor movement because of respiration and cardiac motion. Result : The average values of setup displacements in the x, y direction was 1.41 mm, 1 78 mm, respectively. The standard deviation of systematic component was 4.63 mm, 4.11 mm along the x, y axis, respectively while the random component was 4.17 mm in the x direction and 3.31 mm in the y direction. The average displacement from respiratory movement was 12.2 mm with a standard deviation of 4.03 mm. Conclusion : The overall set-up displacement includes both random and systematic component and respiratory movement. About 10 mm, 25 mm margins along x, y axis which considered the set-up displacement and tumor movement were required for initial 3-dimensional conformal treatment planning in the lung cancer patients and portal images should be made and analyzed during first week of treatment, individually.
Purpose: Lymphoscintigraphy is absolutely being used standard examination in lymphatic diagnosis, evaluation after treatment, and it is useful for lymphedema to plan therapy. In case of lymphoscintigraphy of lower-extremity lymphedema, it had an effect on results if patients had not pose same position on the examination of 1 min, 1 hour and 2 hours after injection. So we'll study the methods to improve confidence with minimized quantitative analysis errors by influence factors. Materials and Methods: Being used the Infinia of GE Co. we injected $^{99m}Tc$-phytate 37 MBq (1.0 mCi) 4 sylinges into 40 people's feet hypodermically from June to August 2010 in Samsung Medical Center. After we acquired images of fixed and unfixed condition, we confirmed the count values change by attenuation of soft tissue and bone according to different feet position. And we estimated 5 times increasing 2 cm of distance between $^{99m}Tc$ point source and detector each time to check counts difference according to distance change by different feet position. Finally, we compared 1 and 6 min lymphoscintigraphy images with same position to check the effect of quantitative analysis results owing to difference of amounts of movement of the $^{99m}Tc$-phytate in the lymphatic duct. Results: Percentage difference regarding error values showed minimum 2.7% and maximum 25.8% when comparing fixed and unfixed feet position of lymphoscintigraphy examination at 1 min after injection. And count values according to distance were 173,661 (2 cm), 172,095 (4 cm), 170,996 (6 cm), 167,677 (8 cm), 169,208 counts (10 cm) which distance was increased interval of 2 cm and basal value was mean 176,587 counts, and percentage difference values were not over 2.5% such as 1.27, 1.79, 2.04, 2.42, 2.35%. Also, Assessment results about amounts of movement in lymphatic duct within 6 min until scanning after injection showed minimum 0.15%, and maximum 2.3% which were amounts of movement. We can recognize that error values represent over 20% due to only attenuation of soft tissue and bone except for distance difference (2.42%) and amounts of movement in lymphatic duct (2.3%). Conclusion: It was show that if same patients posed different feet position on the examination of 1 min, 1 hour and 2 hours after injection in the lymphoscintigraphy which is evaluating lymphatic flow of patients with lymphedema and analyzing amount of intake by lymphatic system, maximum error value represented 25.8% due to attenuation of soft tissue and bone, and PASW (Predictive Analytics Software) showed that fixed and unfixed feet position was different each other. And difference of distance between detector and feet and change of count values by difference of examination beginning time after injection influence on quantitative analysis results partially. Therefore, we'll make an effort to fix feet position and make the most of fixing board in lymphoscintigraphy with quantitative analysis.
The Journal of Korean Society for Radiation Therapy
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v.20
no.1
/
pp.1-9
/
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.
Journal of rehabilitation welfare engineering & assistive technology
/
v.8
no.4
/
pp.313-318
/
2014
In this paper, we propose a method for correcting the measurement axis twist that occurs in the process of wearing and each estimation method of joint in which the inertial measurement unit based in health arm by the method of operation upper limb rehabilitation equipment of hemiplegic patients. In order to verify the proposed method, it is fitted with a inertial measurement unit of the upper arm and forearm of the experimenter left arm, verified by comparing actual joint angle is detected by photographing the arbitrary posture, the angle that the estimated joint. Then, it was verified by comparing the applied front / rear techniques for correcting the measurement axis twist. A result of the experiment, before applying the measurement axis twist correction, joint, after but each match rate showed a weak concordance rate in 89.16% and were corrected, measurement axis twist, each concordance rate of joint agreement of 93.28% I understand that it has been 4.12% improvement in the rate.
This study purpose is to know about the effect of Cobb's angle of scoliosis patient by Pilates ecercise. It was executed for prove this exercise with Pilates Postural Correct Exercise(PCE), Spine Stretching Exercis(SSE), Muscle Strengthing Exercise(MSE). PCE is useful for unbalanced muscle energy and SSE gives relax for hypertensioned muscles and MSE is correcting balance for prime mover and secondary mover and so it will be recovery for elasticity and flexibility of paraspine muscles. The method study was proved with a Cobb's angle measurement of Lumbar spine by X-ray test before and after. As a result for the test, Cobb's angle by X-ray it shows reduced about 5 degree in statistics(p=0.005). And so It shows the Pilates exercise gives reduce for Scoliosis.
In Order to Diagnose Maxillary Bone and Maxillary Sinus in the X-Ray Paranasal Sinus Projection test, this Study used Skull Rando Phantom to Change the Posture and X-ray tube Angle to 5° of the Head or 5° of ROC Who worked for more than 10 years. The Significance of the Evaluated score was Verified through SPSS Ver. 3.0, and the Cronbach value was Significantly higher at 0.712. In addition, as a Result of Calculating SNR by Setting the ROI(Receiver Operation Characteristic) of the Maxillary bone and Maxillary sinus images, it was the Highest at 6,449 in the Examination by tilting 5° toward the Head or Leg of the X-ray tube. In the study, it is believed that among the X-Ray simple Paranasal Sinus projection tests, a sharp Image can be Obtained during the Examination by Tilting the X-ray tube 5° toward the Head or Leg.
For patients receiving chemotherapy and radiation therapy treatment progresses as vomiting, nausea, weight of the patient because of a loss of appetite it is reduced. The patient's weight and the distance from the skin and the treatment site is expected to be closer, thereby reducing the change in the skin because of this dose. This study tests using a loose see the difference between the volume change appears as the weight of the patient using the same phantom and the phantom body of the patient. To using the same as the position EBT film is attached to the skin of the treatment site and was adjusted to the thickness of the Bolus. And using a computerized treatment planning only tomotherapy equipment was passed under the conditions according to the thickness of the radiation dose. To baseline for accurate reproduction position using the MVCT was applied to treated with verification. By passing a total of three dose reduced the error, it was a measure of the film by using a dedicated scanner, EBT VIDAR scanner. Got an increase in the skin dose is displayed each time the thickness of the bolus reduced, in a bolus was completely removed with the highest value. If the changes appeared dose was greater weight loss patients to chemotherapy and therefore bolus thickness variation considering the weight loss of the patient when applying the tomotherapy of nasopharynx cancer was found that the increase in skin dose be increased. This large patient before treatment due to weight loss over the image verification is considered to be established should consider how to re-create your mask and treatment plan for fixing it.
In this paper. the pneumatic service robot with a hybrid type is developed. A pneumatic has the advantages of good compliance , high Payload-to-weight and payload-to-volume ratios. high speed and force capabilities. Using pneumatic actuators. which have low stiffness. the service robot can guarantee safety. By suggesting a new serial-parallel hybrid type for the service robot which separates into Positioning motion and orienting motion, we can achieve large workspace and high strength-to-moving-weight ratio at the same time. A sliding mode controller can be designed for tracking the desired output using the Lyapunov stability theory and structural properties of pneumatic servo systems. Through many experiments of circular trajectory. the Pneumatic service robot is evaluated and verified.
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