Park, Sung-Yong;Shin, Kyung-Hwan;Park, Dahl;Cho, Jung-Keun;Kim, Dae-Yong;Kim, Jong-Won;Cho, Kwan-Ho;Kim, Tae-Hyun;Chie, Eui-Kyu
Proceedings of the Korean Society of Medical Physics Conference
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2002.09a
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pp.154-156
/
2002
Brachytherapy has a long history in the treatment of cancer. However, the treatment planning technique for brachytherapy has lagged somewhat behind the corresponding developments for external beam therapy as far as the imaging technique is concerned. Currently, the orthogonal-film-based treatment planning is performed at most institutions even though the CT-based planning is available. The aim of this study is to evaluate the CT-based vs. the orthogonal-film-based treatment planning in cervix cancer. The doses to point A, point B, rectum and bladder points according to ICRU 38 were calculated for the two methods above. In addition, the volumetric studies such as 3D dose computation and DVH were obtained for the CT-based planning. For the bulky tumor, the isodose lines of point A prescription were not fairly covered for the CTV. The CT -based dose planning can overestimate the maximum dose delivered to bladder and rectum by 30%. The CT-based planning has several advantages over the orthogonal-film-based such as 3D dose display, DVH, and more accurate target delineation. It is suggested that the prescription point in cervix cancer be revised especially for the bulky tumor.
KSII Transactions on Internet and Information Systems (TIIS)
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v.16
no.7
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pp.2191-2208
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2022
Motion blur in PET (Positron emission tomography) images induced by respiratory motion will reduce the quality of imaging. Although exiting methods have positive performance for respiratory motion correction in medical practice, there are still many aspects that can be improved. In this paper, an improved 3D unsupervised framework, Res-Voxel based on U-Net network was proposed for the motion correction. The Res-Voxel with multiple residual structure may improve the ability of predicting deformation field, and use a smaller convolution kernel to reduce the parameters of the model and decrease the amount of computation required. The proposed is tested on the simulated PET imaging data and the clinical data. Experimental results demonstrate that the proposed achieved Dice indices 93.81%, 81.75% and 75.10% on the simulated geometric phantom data, voxel phantom data and the clinical data respectively. It is demonstrated that the proposed method can improve the registration and correction performance of PET image.
The KISTI (Korea Institute of Science and Technology Information) began to produce the Korean human information called Visible Korean and Digital Korean since 2000 because there was no human information in Korea which could represent the physical characteristics of Korean human body. The Visible Korean consists of CT, MR, sectioned and segmented images of Korean human body. We obtained the serially sectioned images by grinding the Korean cadaver in horizontal direction and segmented these images by outlining the inner organs of human. We have produced the sectioned images of Korean male whole body, male head, and female pelvis in2008. The segmentation and 3D reconstruction of these images are now in proceeding. The Digital Korean consists of CT images of about 100 Korean cadavers. These CT images were segmented by individual bone, reconstructed to produce the 3D bone models and the skin surface model was also added. The mechanical properties of individual bones were obtained by measuring the property of individual bone sample. We have distributed these Korean human informations to users in domestic and abroad. About 70 institutes in domestic, and 20 institutes in abroad have used our data in research use and nearly 160 proceedings and articles were published since 2001. We think these human informations have a role of medical information infrastructure that could be used in the field of medical education, biomechanics, virtual reality etc.
Park, Byoung Suk;Ahn, Jong Ho;Kim, Jong Sik;Song, Ki Won
The Journal of Korean Society for Radiation Therapy
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v.26
no.2
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pp.289-295
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2014
Purpose : Cone Beam Computed Tomography(CBCT) in Image Guided Radiation Therapy(IGRT), Set-up error can be reduced but exposure dose of the patient due to CBCT will increase. Through this study, we are to evaluate by making a scenario with the implementation period of CBCT as every other day. Materials and Methods : Of prostate cancer patients, 9 patients who got a Intensity Modulated Radiation Therapy(IMRT) with CBCT in IGRT were analyzed. Based on values corrected by analyzing set-up error by using CBCT every day during actual treatment, we created a scenario that conducts CBCT every other day. After applying set-up error values of the day not performing CBCT in the scenario to the treatment planning system(Pinnacle 9.2, Philips, USA) by moving them from the treatment iso-center during actual treatment, we established re-treatment plan under the same conditions as actual treatment. Based on this, the dose distribution of normal organs and Planning Target Volume(PTV) was compared and analyzed. Results : In the scenario that performs CBCT every other day based on set-up error values when conducting CBCT every day, average X-axis : $0.2{\pm}0.73mm$, Y-axis : $0.1{\pm}0.58mm$, Z-axis : $-1.3{\pm}1.17mm$ difference was shown. This was applied to the treatment planning to establish re-treatment plan and dose distribution was evaluated and as a result, Dmean : -0.17 Gy, D99% : -0.71 Gy of PTV difference was shown in comparison with the result obtained when carrying out CBCT every day. As for normal organs, V66 : 1.55% of rectal wall, V66 : -0.76% of bladder difference was shown. Conclusion : In case of a CBCT perform every other day could reduce exposure dose and additional treatment time. And it is thought to be able to consider the application depending on the condition of the patient because the difference in the dose distribution of normal organs, PTV is not large.
[ $\underline{Purpose}$ ]: 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.
Purpose Various methods for reducing radiation exposure have been continuously being developed. The aim of this study is to evaluate effectiveness of dose reduction, image quality and PET SUV changes by applying combination of automatic exposure dose(AEC), automated dose-optimized selection of X-ray tube voltage(CAREkV) and sinogram affirmed iterative reconstruction(SAFIRE) which can be controled by user. Materials and Methods Torso, AAPM CT performance and IEC body phantom images were acquired using biograph mCT64, (Siemens, Germany) PET/CT scanner. Standard CT condition was 120 kV, 40 mAs. Radiation exposure and noise were evaluated by applying AEC, CAREkV(120 kV, 40 mAs) and SAFIRE(120 kV, 25 mAs) with torso phantom compare to standard CT condition. And torso, AAPM and IEC phantom images were acquired with combination of 3 methods in condition of 120 kV, 25 mAs to evaluate radiation exposure, noise, spatial resolution and SUV changes. Results When applying AEC, CTDIvol and DLP were decreased by 50.52% and 50.62% compare to images which is not applying AEC. mAs was increased by 61.5% to compensate image quality according to decreasing 20 kV when applying CAREkV. However, CTDIvol and DLP were decreased by 6.2% and 5.5%. When reference mAs was the lower and strength was the higher, reduction of radiation exposure rate was the bigger. Mean SD and DLP were decreased by 2.2% and 38% when applying SAFIRE even though mAs was decreased by 37.5%(from 40 mAs to 25 mAs). Combination of 3 methods test, SD decreased by 5.17% and there was no significant differences in spatial resolution. And mean SD and DLP were decreased by 6.7% and 36.9% compare to 120 kV, 40 mAs with AEC. For SUV test, there was no statistical differences(P>0.05). Conclusion Combination of 3 methods shows dose reduction effect without degrading image quality and SUV changes. To reduce radiation exposure in PET/CT study, continuous effort is needed by optimizing various dose reduction methods.
The difference of radiation dose of MDCT due to different protocols between hospitals was analyzed by CTDI, DLP, the number of Slice and the number of DLP/Slice in 30 cases of the head, the abdomen and the chest that have 10 cases each from MDCT examination of the department of diagnostic imaging of three general hospitals in Gyeongsangbuk-do. The difference of image quality, CTDI, DLP, radiation dose in the eye and radiation dose in thyroid was analyzed after both helical scan and normal scan for head CT were performed because a protocol of head CT is relatively simple and head CT is the most frequent case. Head CT was significantly higher in two-thirds of hospitals compared to A hospital that does not exceed a CTDI diagnostic reference level (IAEA 50mGy, Korea 60mGy) (p<0.001). DLP was higher in one-third of hospitals than a diagnostic reference level of IAEA 1,050mGy.cm and Korea 1,000mGy.cm and two-thirds exceeded the recommendation of Korea and those were significantly higher than A hospital that does not exceed a diagnostic reference level (p<0.001). Abdomen CT showed 119mGy that was higher than a diagnostic reference level of IAEA 25mGy and Korea 20mGy in one-third. DLP in all hospitals was higher that Korea recommendation of 700mGy.cm. Among target hospitals, C hospital showed high radiation dose in all tests because MPR and 3D were of great importance due to low pitch and high Tube Curren. To analyze the difference of radiation dose by scan methods, normal scan and helical scan for head CT of the same patient were performed. In the result, CTDI and DLP of helical CT were higher 63.4% and 93.7% than normal scan (p<0.05, p<0.01). However, normal scan of radiation dose in thyroid was higher 87.26% (p<0.01). Beam of helical CT looked like a bell in the deep part and the marginal part so thyroid was exposed with low radiation dose deviated from central beam. In addition, helical scan used Gantry angle perpendicularly and normal scan used it parallel to the orbitomeatal line. Therefore, radiation dose in thyroid decreased in helical scan. However, a protocol in this study showed higher radiation dose than diagnostic reference level of KFDA. To obey the recommendation of KFDA, low Tube Curren and high pitch were demanded. In this study, the difference of image quality between normal scan and helical scan was not significant. Therefore, a standardized protocol of normal scan was generally used and protective gear for thyroid was needed except a special case. We studied a part of CT cases in the local area. Therefore, the result could not represent the entire cases. However, we confirmed that patient's radiation dose in some cases exceeded the recommendation and the deviation between hospitals was observed. To improve this issue, doctors of diagnostic imaging or technologists of radiology should perform CT by the optimized protocol to decrease a level of CT radiation and also reveal radiation dose for the right to know of patients. However, they had little understanding of the situation. Therefore, the effort of relevant agencies with education program for CT radiation dose, release of radiation dose from CT examination and addition of radiation dose control and open CT contents into evaluation for hospital services and certification, and also the effort of health professionals with the best protocol to realize optimized CT examination.
Control of bone cement volume (PMMA) may be critical for preventing complications in vertebroplasty, the percutaneous injection of PMMA into vertebra. The purpose of this study was to predict the optimal volume of PMMA injection based on CT images. For this, correlation between PMMA volume and textural features of CT images was examined before and after surgery to evaluate the appropriate PMMA amount. The gray level run length analysis was used to determine the textural features of the trabecular bone. Extimation of PMMA volume was done using 3D visualization with semi-automatic segmentation on postoperative CT images. Then, finite element (FE) models were constructed based on the CT image data of patients and PMMA volume. Appropriate material properties for the trabecular bone were assigned by converting BMD to elastic modulus. Structural reinforcement due to the changes in PMMA volume and BMD was assessed in terms of axial displacement of the superior endplate. A strong correlation was found between the injected PMMA volume and the area of the intertrabecular space and that of trabecular bone calculated from the CT images (r=0.90 and -0.90, respectively). FE results suggested that vertebroplasty could effectively reinforce the osteoporotic vertebra regardless of BMD or PMMA volume. Effectiveness of additional PMMA injection tended to decrease. For patients with BMD well lower than 50mg/ml, injection of up to 30% volume of the vertebral body is recommended. However, less than 30% is recommended otherwise to avoid any complications from excessive PMMA because the strength has already reached the normal level.
Purpose The purpose of this study was to evaluate image quality change by truncated region in field of view (FOV) of attenuation correction computed tomography (AC-CT) in brain PET/CT. Materials and Methods Biograph Truepoint 40 with TrueV (Siemens) was used as a scanner. $^{68}Ge$ phantom scan was performed with and without applying brain holder using brain PET/CT protocol. PET attenuation correction factor (ACF) was evaluated according to existence of pallet in FOV of AC-CT. FBP, OSEM-3D and PSF methods were applied for PET reconstruction. Parameters of iteration 4, subsets 21 and gaussian 2 mm filter were applied for iterative reconstruction methods. Window level 2900, width 6000 and level 4, 200, width 1000 were set for visual evaluation of PET AC images. Vertical profiles of 5 slices and 20 slices summation images applied gaussian 5 mm filter were produced for evaluating integral uniformity. Results Patient pallet was not covered in FOV of AC-CT when without applying brain holder because of small size of FOV. It resulted in defect of ACF sinogram by truncated region in ACF evaluation. When without applying brain holder, defect was appeared in lower part of transverse image on condition of window level 4200, width 1000 in PET AC image evaluation. With and without applying brain holder, integral uniformities of 5 slices and 20 slices summation images were 7.2%, 6.7% and 11.7%, 6.7%. Conclusion Truncated region by small FOV results in count defect in occipital lobe of brain in clinical or research studies. It is necessary to understand effect of truncated region and apply appropriate accessory for brain PET/CT.
PET/CT is taken 1 hour after $^{18}F$-FDG(F-18-fluoro-2-deoxy-D-glucose) injection. However, these would be often delayed for more than 2 or 3 hours due to equipment fault or unexpected situation. In the study, SUV(standardized uptake value) were measured from got image over time according to the parts of the body. As a result, there were great and small decrease in liver(middle of the right hepatic lobe), fat(Lt pelvis), lung (Rt upper lobe), aorta(ascending aorta level) of the body in delayed image, and ${\Delta}$SUVmax was increase of 37% in bone only(L5 vertebral body) of the body. ${\Delta}$SUVmax was increase of 37.6% in lesion, and the contrast degree was greater because of uptake increase in lesion and uptake decrease in the normal body.
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