• Title/Summary/Keyword: CT(Computed tomography)

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Optimal Density Assignment to 2D Diode Array Detector for Different Dose Calculation Algorithms in Patient Specific VMAT QA

  • Park, So-Yeon;Park, Jong Min;Choi, Chang Heon;Chun, Minsoo;Han, Ji Hye;Cho, Jin Dong;Kim, Jung-in
    • Journal of Radiation Protection and Research
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    • v.42 no.1
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    • pp.9-15
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    • 2017
  • Background: The purpose of this study is to assign an appropriate density to virtual phantom for 2D diode array detector with different dose calculation algorithms to guarantee the accuracy of patient-specific QA. Materials and Methods: Ten VMAT plans with 6 MV photon beam and ten VMAT plans with 15 MV photon beam were selected retrospectively. The computed tomography (CT) images of MapCHECK2 with MapPHAN were acquired to design the virtual phantom images. For all plans, dose distributions were calculated for the virtual phantoms with four different materials by AAA and AXB algorithms. The four materials were polystyrene, 455 HU, Jursinic phantom, and PVC. Passing rates for several gamma criteria were calculated by comparing the measured dose distribution with calculated dose distributions of four materials. Results and Discussion: For validation of AXB modeling in clinic, the mean percentages of agreement in the cases of dose difference criteria of 1.0% and 2.0% for 6 MV were $97.2%{\pm}2.3%$, and $99.4%{\pm}1.1%$, respectively while those for 15 MV were $98.5%{\pm}0.85%$ and $99.8%{\pm}0.2%$, respectively. In the case of 2%/2 mm, all mean passing rates were more than 96.0% and 97.2% for 6 MV and 15 MV, respectively, regardless of the virtual phantoms of different materials and dose calculation algorithms. The passing rates in all criteria slightly increased for AXB as well as AAA when using 455 HU rather than polystyrene. Conclusion: The virtual phantom which had a 455 HU values showed high passing rates for all gamma criteria. To guarantee the accuracy of patent-specific VMAT QA, each institution should fine-tune the mass density or HU values of this device.

Restoration of an Edentulous Patient with CAD/CAM Guided Implant Surgery ($NobelGuide^{TM}$) and Immediate Loading: Case Report (무치악 환자에서 CAD/CAM을 이용한 임플란트 식립($NobelGuide^{TM}$) 및 즉시하중 증례)

  • Ko, Kyoung-Ho;Lim, Kwang-Gil;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.233-245
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    • 2011
  • With the use of computed tomography (CT), computer-aided design/computer-assisted machining (CAD/CAM) technology and internet, the implant dentistry has been evolved. The surgical templates made by CAD/CAM technology and precise installation of implants, permit restorations to be inserted immediately after implants have been placed. The advantages of CAD/CAM guided implant procedures are flapless, minimally invasive surgery and shorter surgery time. With this technique, less postoperative morbidity and delivery of prosthesis for immediate function would be possible. A patient with an edentulous maxilla and mandible received 7 implants in mandible using CAD/CAM surgical templates. Prefabricated provisional fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics and function during 6 months. Definitive prostheses were fabricated. At 6 months recall appointment, patient's occlusion was slightly changed. To prevent additional adverse effect, regular check-up and occlusal adjustment would be needed.

Chest-wall Surface Dose During Post-mastectomy Radiation Therapy, with and without Nonmagnetic Bolus: A Phantom Study

  • Choi, Cheon Woong;Hong, Joo Wan;Park, Cheol Soo;Ahn, Jae Ouk
    • Journal of Magnetics
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    • v.21 no.2
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    • pp.293-297
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    • 2016
  • For mastectomy patients, sufficient doses of radiation should be delivered to the surface of the chest wall to prevent recurrence. A bolus is used to increase the surface dose on the chest wall, whereby the surface dose is confirmed with the use of a virtual bolus during the computerized treatment-planning process. The purpose of this study is an examination of the difference between the dose of the computerized treatment plan and the dose that is measured on the bolus. Part of the left breast of an Anderson Rando phantom was removed, followed by the attainment of computed tomography (CT) images that were used as the basis for computerized treatment plans that were established with no bolus, a 3 mm-thick bolus, a 5 mm-thick bolus, and a 10 mm-thick bolus. For the computerized treatment plan, a prescribed dose regimen was dispensed daily and planning target volume (PTV) coverage was applied according to the RTOG 1304 guidelines. Using each of the established computerized treatment plans, chest-wall doses of 5 points were measured; this chest-wall dose was used as the standard for the analysis of this study, while the level of significance was set at P < 0.05. The measurement of the chest-wall dose with no bolus is 1.6 % to 10.3 % higher, and the differences of the minimum average and the maximum average of the five measurement points are -13.8 and -1.9, respectively (P < 0.05); however, when the bolus was used, the dosage was measured as 3.7 % to 9.2 % lower, and the differences of the minimum average and the maximum average are 7.4 and 9.0, -1.2 and 17.4, and 8.1 and 19.8 for 3 mm, 5 mm, and 10 mm, respectively (P < 0.05). As the thickness of the bolus is increased, the differences of the average surface dose are further increased. There are a variety of factors that affect the surface dose on the chest wall during post-mastectomy radiation therapy, for which verification is required; in particular, a consideration of the appropriate thickness and the number of uses when a bolus is used, and which has the greatest effect on the surface dose on the chest wall, is considered necessary.

The Effect of Patients Positioning System on the Prescription Dose in Radiation Therapy (방사선치료 시 자세확인시스템이 처방선량에 미치는 영향)

  • Kim, Jeong-Ho;Bae, Seok-Hwan
    • Journal of radiological science and technology
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    • v.40 no.4
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    • pp.613-620
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    • 2017
  • Planning dose must be delivered accurately for radiation therapy. Also, It must be needed accurately setup. However, patient positioning images were need for accuracy setup. Then patient positioning images is followed by additional exposure to radiation. For 45 points in the phantom, we measured the doses for 6 MV and 10 MV photon beams, OBI(On Board Imager) and CBCT(Conebeam Computed Tomography) using OSLD(Optically Stimulated Luminescent Dosimeter). We compared the differences in the cases where posture confirmation imaging at each point was added to the treatment dose. Also, we tried to propose a photography cycle that satisfies the 5% recommended by AAPM(The American Association of Physicists in Medicine). As a result, a maximum of 98.6 cGy was obtained at a minimum of 45.27 cGy at the 6 MV, a maximum of 99.66 cGy at a minimum of 53.34 cGy at the 10 MV, a maximum of 2.64 cGy at the minimum of 0.19 cGy for the OBI and a maximum of 17.18 cGy at the minimum of 0.54 cGy for the CBCT.The ratio of the radiation dose to the treatment dose is 3.49% in the case of 2D imaging and the maximum is 22.65% in the case of 3D imaging. Therefore, tolerance of 2D image is 1 exposure per day, and 3D image is 1 exposure per week. And it is need to calculation of separate in the parallelism at additional study.

The Correlation between Radiologic Findings and Clinicopathological Prognostic Factors in Small Peripheral Adenocarcinoma of Lung (말초 폐 발생 소형 선암에서 화상적 소견과 병리적, 임상적 예후와의 관계)

  • Park, Jae-Kil;Cho, Kyu-Do;Park, Kuhn;Moon, Seok-Whan;Rha, Suk-Joo;Choi, Si-Young;Jung, Jung-Im
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.423-431
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    • 2004
  • Background : Tumor size in lung cancer is not as good a prognostic factor for adenocarcinoma as it is for other types of lung cancer; therefore it is difficult to estimate the prognosis preoperative. However, there have recently been some reports on the radiologic findings correlating to the clinicopathologic prognostic factors in peripheral small adenocarcinoma of lung. We tried to evaluate the prognostic importance of High-Resolution CT (HRCT) findings of such adenoearcinoma, Material and Method: One houndred and seventy-six surgically resected small peripheral adenocarcinoma measuring 3 cm or less in greatest dimension were reviewed radiologically and clinicopathologically. Result: The patients with greater extent of ground-glass attenuation (GGA) had better clinico-pathological factors. The tumors with gross appearance of GGA or bubble-like shape showed better clinicopathological prognostic factors than scar-like or solid shape. Conclusion: HRCT findings of small peripheral adenocarcinomas of the lung correlated well with the histologic and clinical prognostic factors. We can predict the post-operative prognosis with the radiologic findings.

Duration of Regain of Deep Pain Perception after Decompression Surgery as a Parameter of Surgical Outcome for Acute Thoracolumbar Disc Herniation Hansen Type I with Loss of Deep Pain Perception in Dogs

  • Park, Sung-Su;Lim, Ji-Hey;Byeon, Ye-Eun;Jang, Byung-Jun;Ryu, Hak-Hyun;Uhm, Ji-Yong;Kang, Byung-Jae;Kim, Wan-Hee;Kweon, Oh-Kyeong
    • Journal of Veterinary Clinics
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    • v.25 no.6
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    • pp.529-532
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    • 2008
  • The object of this study was to evaluate the durations from onset of neurological sign until surgery and regaining of the deep pain perception (DPP) after decompression as prognostic indicators for the outcome of decompression surgery in dogs with thoracolumbar intervertebral disc disease (IVDD). The compression lesions in the thoracolumbar vertebrae were localized by plain radiograph, computed tomography and neurological examination in 28 dogs with hindlimb paralysis. The follow up was carried out for 6 months after laminectomy. During the follow up, regaining DPP and walking ability were evaluated. Improvement to normal or paretic gait after surgery was judged as success of the surgical treatment.The success rate of surgical treatment was 70 % (7 out of 10 dogs) when surgical intervention was carried out within 24 hours but 38.9 % (7 out of 18) over 24 hours (P<0.05). The success rate of surgical treatment was 87.5 % (14 out of 16 dogs) when DDP was regained within 5 weeks after surgery but there was 0 % (0 out of 12 dogs) when DDP was not regained within 5 weeks after surgery (P<0.05). Other parameters such as compression rate in CT scan and laminectomy methods did not related with the success of the surgery. These results suggested that the time of surgery after onset and duration of regaining of DPP after decompression were useful parameter to predict the success of surgical treatment for thoracolumbar disc herniation in dogs.

A Novel Method for Automated Honeycomb Segmentation in HRCT Using Pathology-specific Morphological Analysis (병리특이적 형태분석 기법을 이용한 HRCT 영상에서의 새로운 봉와양폐 자동 분할 방법)

  • Kim, Young Jae;Kim, Tae Yun;Lee, Seung Hyun;Kim, Kwang Gi;Kim, Jong Hyo
    • KIPS Transactions on Software and Data Engineering
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    • v.1 no.2
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    • pp.109-114
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    • 2012
  • Honeycombs are dense structures that small cysts, which generally have about 2~10 mm in diameter, are surrounded by the wall of fibrosis. When honeycomb is found in the patients, the incidence of acute exacerbation is generally very high. Thus, the observation and quantitative measurement of honeycomb are considered as a significant marker for clinical diagnosis. In this point of view, we propose an automatic segmentation method using morphological image processing and assessment of the degree of clustering techniques. Firstly, image noises were removed by the Gaussian filtering and then a morphological dilation method was applied to segment lung regions. Secondly, honeycomb cyst candidates were detected through the 8-neighborhood pixel exploration, and then non-cyst regions were removed using the region growing method and wall pattern testing. Lastly, final honeycomb regions were segmented through the extraction of dense regions which are consisted of two or more cysts using cluster analysis. The proposed method applied to 80 High resolution computed tomography (HRCT) images and achieved a sensitivity of 89.4% and PPV (Positive Predictive Value) of 72.2%.

The Clinical Features and Risk Factors of Seizure After Doxylamine Intoxication (독실라민 중독시 발생할 수 있는 발작의 특성과 위험인자)

  • Song, Beom-Soo;Lee, Ki-Man;Kim, Sun-Wook;You, Je-Sung;Chung, Tae-Nyung;Park, Yoo-Seok;Jung, Sung-Phil;Goo, Hong-Du;Park, In-Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.2
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    • pp.88-96
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    • 2010
  • Purpose: Doxylamine is antihistamine drug that is used as a hypnotic. It is also used for suicidal attempts because it can be easily purchased at the pharmacy without a prescription. There were many articles about the complications after doxylamine intoxication such as a rhabdomyolysis, but only a few articles have reported on seizure. We reviewed the cases of doxylamine intoxication with seizure that were treated in the emergency department. Methods: We reviewed the medical records of the patients who were over 15 years old and who were intoxicated by doxylamine at 3 emergency medical centers from January 2006 to June 2010. We reviewed the patients' age, gender, the dose of doxylamine ingested, if gastrointestinal decontamination was done, the time from intoxication to hospital arrival, the seizure history, treatment of seizure, the electroencephalography (EEG) results, the brain computed tomography (CT) results and the blood test results. Results: There were 168 patients who were intoxicated by doxylamine during the study period. Twelve patients had a seizure episode. The differences between the patients who developed seizure and the patients who did not were the dose and the serum levels of sodium and creatinine. The only clinically meaningful difference was the amount of doxylamine. The amount of doxylamine ingested (>29 mg/kg) predicted the development of seizure with a sensitivity of 75% and a specificity of 92% on the ROC curve. One patient among the seizure patients expired in the emergency department. Conclusion: In case of doxylamine intoxicated patients, there is close relationship between seizure and ingested amount, so close observation needs to be done for the patients who ingest too much because doxylamine can cause death. Further prospective studies are needed for doxylamine intoxicated patients with a seizure episode.

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Positional changes of the mandibular condyle in unilateral sagittal split ramus osteotomy combined with intraoral vertical ramus osteotomy for asymmetric class III malocclusion

  • Park, Jun;Hong, Ki-Eun;Yun, Ji-Eon;Shin, Eun-Sup;Kim, Chul-Hoon;Kim, Bok-Joo;Kim, Jung-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.5
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    • pp.373-381
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    • 2021
  • Objectives: In the present study, the effects of sagittal split ramus osteotomy (SSRO) combined with intraoral vertical ramus osteotomy (IVRO) for the treatment of asymmetric mandible in class III malocclusion patients were assessed and the postoperative stability of the mandibular condyle and the symptoms of temporomandibular joint disorder (TMD) evaluated. Materials and Methods: A total of 82 patients who underwent orthognathic surgery for the treatment of facial asymmetry or mandibular asymmetry at the Department of Oral and Maxillofacial Surgery, Dong-A University Hospital, from 2016 to 2021 were selected. The patients that underwent SSRO with IVRO were assigned to Group I (n=8) and patients that received bilateral SSRO (BSSRO) to Group II (n=10, simple random sampling). Preoperative and postoperative three-dimensional computed tomography (CT) axial images obtained for each group were superimposed. The condylar position changes and degree of rotation on the superimposed images were measured, and the changes in condyle based on the amount of chin movement for each surgical method were statistically analyzed. Results: Group I showed a greater amount of postoperative chin movement. For the amount of mediolateral condylar displacement on the deviated side, Groups I and II showed an average lateral displacement of 0.07 mm and 1.62 mm, respectively, and statistically significantly correlated with the amount of chin movement (P=0.004). Most of the TMD symptoms in Group I patients who underwent SSRO with IVRO showed improvement. Conclusion: When a large amount of mandibular rotation is required to match the menton to the midline of the face, IVRO on the deviated side is considered a technique to prevent condylar torque. In the present study, worsening of TMD symptoms did not occur after orthognathic surgery in any of the 18 patients.

Flapless implant placement with digital 3D imaging and planning system in fully edentulous patient: A case report and 5-year follow-up (완전무치악 환자에서 디지털 가이드 수술 방식을 이용한 무피판절개 임플란트 식립증례: 증례보고 및 5년 추적관찰)

  • Shin, Mi-sun;Paek, Janghyun
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.3
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    • pp.312-320
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    • 2019
  • One of the fastest growing segments of implant dentistry is the utilization of computed tomography (CT) scan data and treatment planning software in conjunction with guided surgery for implant reconstruction cases. Computer assisted planning systems and associated surgical templates have established a predictable, esthetic, functional technique for placing and restoring implants. Especially, a philosophy of restoratively driven implant placement has been generally adopted. Recently, a variety of commercial dental fields have released their scanning and fabricating protocols and methods for restorations. This process is still being investigated and developed for the most precise and predictable outcome. This case report describes a female patient who wanted dental implants in fully edentulous areas. Restoratively driven implant placements were performed with surgical guide and the patient was fully satisfied with the clinical results, and at 5-year post restorative follow-up assessment, both implant and prosthesis were proved clinical success.