• Title/Summary/Keyword: 환자촬영자세

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전신 정위 프레임을 이용한 환자의 움직임 및 외부자세 setup 오차 분석

  • 정진범;정원균;서태석;최경식;지영훈;이형구;최보영
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2003.09a
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    • pp.59-59
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    • 2003
  • 목적 : 환자의 호흡에 의한 움직임 및 부정확한 환자 자세 setup 때문에 3 차원 전신 정위 방사선치료,3 차원 입체조형 방사선치료 IMRT와 같은 방사선 치료기술에서 병소에 대한 정확한 표적 위치측정은 매우 어려운 실정이다. 그러므로 본 연구는 방사선 치료시 환자의 움직임을 최대한 고정시켜 줄 수 있으며 환자 자세에 대한 setup 오차를 감소시키고 환자 전신에 산재한 병소의 위치를 좌표화할 수 있는 전신 정위 프레임 제작과 제작한 프레임에 대한 고정효과 및 재현성을 나타내는 환자 자세의 setup 오차를 평가하는데 있다. 재료 및 방법 : 자체 제작한 전신 정위 프레임 구조는 CT 영상 촬영 가능성에 중점을 두고 병소 표적의 좌표실현 및 환자체형에 따른 다양성 그리고 프레임에 대한 견고성 및 안정성 확인에 초점화하여 제작하였다. 이렇게 제작된 전신 정위 프레임에 대한 방사선 투과율 측정 실험과 CCTV 카메라와 DVR(Digital Video Recorder)를 이용해 환자 자세 변화에 대한 영상을 획득하여 matlab으로 구현한 오차분석용 프로그램으로 환자 외부자세에 대한 오차 비교 평가하고 CT 촬영에 의한 가상표적 위치측정 실험을 수행하였다. 또 한 고정벨트 추가 사용으로 인한 환자의 고정효과 정도를 살펴보았다. 결과 : 제작된 전신 정위 프레임에 대한 방사선 투과율은 마그네트론 10, 21 MeV의 에너지에서 95, 96% 의 투과율이 측정되었고 30 $^{\circ}$. 60 。각도의 경사로 빔이 전달될 때는 90.3, 94.4% 가 측정되었다. CCTV 카메라를 이용하여 흉부 및 복부의 움직임을 촬영한 영상을 Matlab프로그램으로 구현한 오차분석 프로그램을 적용한 결과, 환자 자세에 대한 오차의 평균값은 흉부의 lateral 방향에서는 3.63$\pm$1.4 mm, AP 방향에서는 2.1$\pm$0.82 mm이었다. 그리고 복부의 later의 방향에서는 7.0$\pm$2.1 mm, AP 방향에서는 6.5$\pm$2.2 mm 이었다. 또한 표적 위치측정을 위해서 환자의 피부에 임의의 가상표적을 부착하고 CT 촬영한 영상결과, 프레임으로 가상표 적에 대한 위치를 정확히 파악할 수 있었다. 결론 : 제작된 프레임을 적용하여 방사선투과율 측정실험, 환자 외부자세에 대한 오차 측정실험, 가상표적 위치측정 실험 등을 수행하였다. 환자 외부자세에 대한 오차 측정실험 경우, 더 많은 Volunteer를 적용하여 보다 정확한 오차 측정실험이 수행되어야 할 것이며 정확한 표적 위치 측정실험을 위해서 내부 마커를 삽입한 환자를 적용한 임상실험이 수행되어야 할 것이다. 또한 위치결정에서 획득한 좌표값의 정확성을 알아보기 위해서 팬톰을 이용한 방사선조사 실험이 추후에 실행되어져야 할 것이다. 그리고 제작된 프레임에 Rotating X선 시스템과 내부 장기의 움직임을 계량화하고 PTV에서의 최적 여유폭을 설정함으로써 정위 방사선수술 및 3 차원 업체 방사선치료에 대한 병소 위치측정과 환자의 자세에 대한 setup 오차측정 결정에 도움이 될 수 있을 것이라고 사료된다.

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Technical Improvement for Spine Radiography by Comparing Scoliotic and Lordotic Angle with Different Positioning Methods (촬영자세별 척추측만각과 척추전만각의 비교 분석에 따른 개선 방안)

  • Jung, Jae-Yeon;Son, Soon-Yong;Lee, Jong-Seok;Yoo, Beong-Gyu
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.263-269
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    • 2011
  • Since the spine radiography were explained differently at every several hospitals and textbooks. the technique has not been accurately defined and interfered each other. We would like to define the most appropriate positioning for clinical cases, and reference books, by comparing scoliotic angle and lordotic angle. From Mar 2009 to Sep 2011, 85 patient cases were studied, who had not been undergone surgical treatment among spondylopathy patients. Scoliotic angle and lordotic angle were measured, using Cobb's method. We analyzed statistically using t-test(SPSS 18), and evaluated spine general radiography position. Moreover, we researched on the actual condition at 10 university hospitals in Seoul. The results of scoliotic angle measurement, the value at erect position showed 20.98% higher than supine position, and it has statistical significance (p<.01). In lordotic angle measurement, the value at neutral holding position represented 29.3% higher than supine position, and it also has statistical significance(p<.01). The results of clinical survey, supine posine(70.0%) took much higher possession than erect position(30.0%). In conclusion, compare to supine position, erect position shows increased scoliotic and lordotic angle. It was agreed with the importance of clinical erect position radiography, which gravity affects. So clinical radiologist must recognize the difference, and conduct an accurate study.

The Study on Ejection Fraction Change According to Patient Position Difference in Gated Blood Pool Scan (게이트심장혈액풀 스캔에서 환자의 자세 변화에 따른 심박출계수의 변화 연구)

  • Choi, Ho-Yong;Kim, Da-Eun;Jeong, Jae-Hun;Yun, Sang-Hyeok;Kim, Yeong-Seok;Won, Woo-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.1
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    • pp.91-95
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    • 2012
  • Purpose: In this study, we evaluated the ejection fraction (EF) according to the difference of patient position in Gated Blood Pool (GBP) scan. Material and Methods: The analysis was performed to 80 patients ($51.2{\pm}17.4$ years old) who examined GBP scan in Department of nuclear medicine, National Cancer Center from March 2011 to August 2011. We divided the patients into two groups; one group received conventional position (raise left arm up supine) and supine position (group 1) and the other group received conventional position and left arm back down supine position (group 2). To observe the change EF according to patient position difference, the image was reconstructed and analyzed by Xeleris (GE, USA). We measured body mass index (BMI) of patients. Result: In group 1, EF error less than 3% occurred at a rate of 72.5% (29 of the 40 patients). In group 2, EF error less than 3% occurred at a rate of 79% (32 of the 40 patients). The patient's BMI did not affect ejection fraction. Conclusion: The EF error of left arm back down supine position closer to conventional position than in supine position shows the results.

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Utility Comparison of Chest Lateral Decubitus Projection with AP and PA Position (흉부 측와위 촬영 시 전후방향과 후전방향 검사의 유용성 비교)

  • Choi, Guirack
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.233-238
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    • 2013
  • Chest lateral decubitus radiation exposure PA be carried out in general, but emergency patient or the patient's discomfort in the body examination had a lot of inconvenience. In this study, we compared AP and PA image quality, patient safety, and analysis of the examination effectiveness between the two tests was to evaluate the usefulness. Pleurisy or pneumothorax in patients with suspected or diagnosed chest lateral decubitus radiation exposure 30 consecutive patients (male 20 patients, 10 females) were included in the study. Image quality evaluation method microstructure of lung, wide areas of diagnosis, a clear air-fluid interface, the patient rotate, cardiac shadow and sharp diaphragmatic was based on Department of Radiology specialist, division of pulmonology resident blind test was evaluated by four people. Chest decubitus by radiation exposure the AP and PA position examination the usefulness of comparative analysis Image quality in the AP and PA, whereas there was no significant difference in attitude, Stability of the patient and Radiation's examination efficiency AP position compared to the position of PA scores were higher. PA position does not require a examination may be of AP position in a position to suggest that.

A Study of Radiographic Methods to X-ray Study of Patients with Spinal Scoliosis and Vertebrae Bone Fracture of Lumbar Spine (척주측만증과 허리뼈 골절 수술 환자의 엑스선 촬영법 연구)

  • Ahn, Byung-Ju;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.13 no.3
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    • pp.425-431
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    • 2019
  • The Study In order to obtain images of overlap of the two iron cores in the spinal cord simple x-ray scan after surgery of patients with ulcer lateral sclerosis and a fractured backbone, the researcher conducted a subjective evaluation on five radiographers of the university hospital's imaging department for more than 10 years. The results of the experiment showed that the lateral shot of lateral scoliosis of the spinal cord was taken with the middle face of the IR plane, and then the X-ray tube angle was taken vertically with the vertical spinal column fan-tom position, resulting in two overlapping images and high scores in the subjective evaluation. In addition, lateral shots of the lumbar dislocation fractured lumbar vertebrae were taken with the forehead aligned with the center of the IR plane and then with the X-ray angle perpendicular to the fourth waistline and the angle of the spinal cord perpendicular to the fourth waistline, the image of the two iron cores could be obtained from the radiographer.

Evaluated the L-spine Magnetic Resonance Imaging for the Scanning Method of the Lateral Recumbent Position with to the Embarrassed Control of the Acute Low Back Pain (자기공명검사에서 통증제어가 불가능한 급성 요통 환자의 옆으로 누운 자세에 대한 영상평가)

  • Lee, Jaeheun;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.255-260
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    • 2014
  • The acute lumbar pain patients who were unavoidable to take MRI examination were made to take altered lateral recumbent position. they were also not able to control their painfulness and to be in supine position. In this study, it is supposed to increase success rate of the MRI examination through taking the altered lateral recumbent position in using spine and body matrix coil. This altered position made relaxing lumber pain and fatigue for the patients who suffered from sever lumber pain. In these reasons, it decreases the motion artifacts through correcting uncomfortable posture. As a result, qualitative analysis for the image quality was estimated to have average points of supine position A group(lateral recumbent position) of normal candidates and B group(lateral recumbent position) of the abnormal candidates who have sever pain at 4.64, 3.44, and 3.40, respectively. In conclusion, while qualitative analysis in the examination with supine position of the normal patients had significantly high points, the qualitative analysis in the examination with lateral recumbent position of the normal patients and abnormal patients who had sever lumbar pain was almost same. In addition, it was judged that radiologists' imagery interpretation had no other problems in the image evaluation of B group who had acute lumbar pain of abnormal patients. Hereupon, if this technique becomes generalized for the patients who suffer from supine position in the examination, it is supposed to be useful in medical field.

Radiological Projection for Diagnosis of Shoulder Subluxation in Patients with Post-Stroke Hemiplegia (편마비 환자에서의 견관절 아탈구 진단에 유용한 촬영법)

  • Cho, Kwang-Ho;Kang, Yeong-Han
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.253-259
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    • 2009
  • Purpose : The purpose of this study was to find out useful radiological projection of shoulder subluxation in patients with post-stroke hemiplegia. Methods : A total of 33 patients with post-stroke hemiplegia were included(20 men and 13 women, mean age 62.3 years) and having the subluxed shoulder over one finger breath. The shoulder subluxation was determined as the ratio of the radiographic vertical and horizontal distance. The vertical distance was determined by measuring the distance between the most inferolateral point of the acromion and the central point of the humeral head. The horizontal distance was determined by measuring the distance between the central point of the glenoid fossa and the central point of the humeral head. To measure of the shoulder subluxation, the shoulder AP, axial and transthoracic lateral projections were taken on both affected and unaffected shoulders. We analyzed the difference of subluxation distance by t-test. Results : When patients was in sitting position, the average time of being shoulder subluxation was 123 second. There was significant difference between supine($49.90{\pm}13.6\;mm$) and sitting position($60.72{\pm}16.3\;mm$) in the vertical distance of shoulder anterior-posterior projection. Also, there was significant difference on transthoracic lateral projections, Affected $35.92{\pm}6.2\;mm$, Unaffected $28.76{\pm}5.4\;mm$. But in case of shoulder axial projection(supine position), there was no significant difference (Unaffected and affected was $23.01{\pm}9.0\;mm$, $22.45{\pm}8.2\;mm$ each). Conclusion : Radiological projection of shoulder subluxation has diagnostic value when it goes after check out the process of subluxation through finger breadth test. For this, patients must be in sitting and shoulder neutral position about 2 minutes. In addition, Shoulder anterior-posterior and transthoracic projection were significant to diagnose subluxation. But in axial projection, there wasn't meaningful differences.

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A Study on Projection for Apophyseal Joints Diagnosis in X-ray Thoracic Bone Oblique Projection (X-ray 등뼈의 사위 촬영에서 돌기사이관절의 진단을 위한 촬영법 연구)

  • Jun-Heang Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.351-357
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    • 2023
  • This Study Rreceived Subjective Evaluation ROC Evaluation from five projection. of projection. at a University Hospital to Obtain and Diagnose Sharp images of apophyseal joints and Vertral arch of Thoracic vertebrae from thoracic X-ray projection. In the Subjective evaluation, the highest Score was obtained by raising the phantom from Supine to LAO by 70° and scoring 20 points at 5° with the X-ray Tube facing the head. In addition, he scored the highest score of 19 points at 8° with the Prone Phantom standing 60° with RAO and the X-ray Tube facing the head. For Objective Evaluation, the Signal-to-noise ratio, was calculated. ROI was set at 1,564 mm2 to obtain the image signal average value (Mean value) and the Standard deviation (SD value). Objective Evaluation The signal-to-noise ratio, was the highest at 5° toward the head in the LPO 70° position of the phantom in the lying position of the Thoracic spine projection, and the Thoracic Spine was the highest at 8° toward the head of the RAO posture of 5,645.

Examination about Utility of Prone Position in PET/CT of Stomach Cancer Patient (위암 환자의 양전자 방출 컴퓨터 단층 검사에서 복와위(伏臥位) 촬영의 유용성에 대한 연구)

  • NamKoong, Hyuk;Park, Hoon-Hee;Oh, Shin-Hyun;Bahn, Yung-Kag;Kim, Jung-Yul;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.93-99
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    • 2010
  • Purpose: Currently, PET/CT scan has been known to provide useful information to both preoperative and postoperative examination of cancer patients. Contracted stomach by the long fasting could cause difficulties of interpretation because of its size on reconstructed image data. To solve this problem, after the whole body PET/CT scan, patients were administrated in drinking 300 mL of water to expand stomach and performed additional scan on stomach region. Not only PET/CT scan but also CT performs this water-administration, and patients were take oral solution to make stomach expand for stomach cancer. When this scan performed, patients lay supine position. In this study, we evaluated the capacity of stomach through PET/CT scan with drinking water performed in supine and prone position so that we can distinguish exact location of cancer around pylorus and inferior wall of stomach. Furthermore, image data from supine and prone positions were analyzed the difference of volume of stomach through the change of standardized uptake values. Materials and Methods: From July 2009 to January 2010 in severance hospital, 30 patients who were diagnosed as early gastric cancer or advanced gastric cancer were chosen. All patients had PET/CT scan before the operation and have had follow-up PET/CT. The patients fast for at least 8 hours, and had an injection intravenously with $^{18}F$-FDG, 7.4 MBq (0.2 mCi/kg) per kilogram. They were rested for 60 minutes. Before the examination, all patients were administrated to drink water for 300 mL Patients had PET/CT scan with supine position around the region of stomach, whole body, and around the region of stomach with prone position after drinking another 300 mL of water respectively. Results: As a results of comparison between stomach capacity of 30 patients in supine and prone position, the study draw results that average capacity of stomach body was 460.29 $mm^2$ in supine position, and 641.39 $mm^2$ in prone position for 30 patients. The change of capacity shows 41.3% expanded in prone position. And there was no noticeable difference at maximum standardized uptake values in supine position and prone position. Conclusion: As results, stomach would have more expanded capacity in prone position than supine position. For patients who have physical disabilities to move freely, additional scan in prone position will be obstacle to perform. However, if additional scan in supine position add with the scan in prone position, it will be easier to diagnose stomach cancer. Moreover, we believe that this study will help the research for inventing support tools for patients who have physical disabilities in prone position.

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Effectiveness of Bellyboard Device for Displacement of Small Bowel in Pelvic Irradiation (골반 방사선치료 시 소장의 위치변화를 위한 벨리보드의 유용성)

  • Lee, Rena;Lee, Kyung-Ja;Suh, Hyunsuk
    • Progress in Medical Physics
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    • v.18 no.4
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    • pp.202-208
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    • 2007
  • Various techniques were evaluated to determine the best method for reducing small bowel involvement in pelvic irradiation. Fourteen patients receiving radiation in pelvic area were enrolled for this study. Five sets of small bowel images were obtained. Patients were positioned on a simulation couch with full bladder in prone and supine positions and 2 sets of images were taken. Then they were asked to empty their bladder and 2 sets of images were taken in prone and supine positions. A belly board device (BBD) was placed and one set of images was obtained. Using a software, the area of small bowel inside treatment field was contoured, measured, and analyzed. In both full and empty bladder cases, small bowel area reduction was observed in prone position as compared to supine position. Especially statistically significant reduction is noted in lateral film. An average decreases of 13% in PA and 26% in lateral direction were noted with bladder distention as compared to empty bladder. With the use of BBD for empty bladder, a significant reduction of $62.8{\pm}27.1%$ and $63.1{\pm}32.9%$ in PA and lateral directions were observed as compared to without BBD in prone position, respectively. In conclusion, the best sparing of small bowel concerning the area included in the treatment fields was achieved with BBD in prone position with empty bladder. However, further reduction is expected if the bladder was filled fully because the analysed data with empty vs full bladder study shows increased sparing of small bowel with distended bladder.

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