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Evaluation of the Dose According to the Movement of Breath During Field-in-Field Technique Treatment of Breast Cancer Patients (유방암 환자의 Field-in-Field Technique 치료 시 호흡의 움직임에 따른 선량 평가)

  • Kwon, Kyung-Tae
    • Journal of radiological science and technology
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    • v.41 no.6
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    • pp.561-566
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    • 2018
  • Field-in-Field Technique is applied to the radiation therapy of breast cancer patients, and it is possible to compensate the difference in breast thickness and deliver uniform dose in the breast. However, there are several fields in the treatment field that result in a more complex dose delivery than a single field dose delivery. If the patient's respiration is irregular during the delivery of the dose by several fields and the change of respiration occurs, the dose distribution in the breast changes. Therefore, based on the computed tomography images of breast cancer patients, a human model was created by using a 3D printer (Builder Extreme 1000) to describe the volume in the same manner. A computerized tomography (CT) of the human body model was performed and a treatment plan of 260 cGy / fx was established using a 6-MV field-in-field technique using a computerized treatment planning system (Eclipse 13.6, Varian, USA). The distribution of the dose in the breast according to the change of the respiration was measured using a moving phantom at 0.1 cm, 0.3 cm, 0.5 cm amplitude, using a MOSOXIDE Silicon Field Effect Transistor (MOSFET, Best Medical, Canada) Were measured and compared. The distribution of dose in the breast according to the change of respiration showed similar value within ${\pm}2%$ in the movement up to 0.3 cm compared to the treatment plan. In this experiment, we found that the dose distribution in the breast due to the change of respiration when the change of respiration was increased was not much different from the treatment plan.

Evaluation of Scintillation Camera Applications of 3D Printing Phantom (3D 프린팅 팬텀의 섬광카메라 적용 평가)

  • Park, Hoon-Hee;Lee, Ju-young;Kim, Ji-Hyeon
    • Journal of radiological science and technology
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    • v.44 no.4
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    • pp.343-350
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    • 2021
  • 3D printing technology is an additive manufacturing technology produced through 3D scanning or modeling method. This technology can be produced in a short time without mold, which has recently been applied in earnest in various fields. In the medical field, 3D printing technology is used in various fields of radiology and radiation therapy, but related research is insufficient in the field of nuclear medicine. In this study, we compare the characteristics of traditional nuclear medicine phantom with 3D printing technology and evaluate its applicability in clinical trials. We manufactured the same size phantom of poly methyl meta acrylate(PMMA) and acrylonitrile butadiene styrene(ABS) based on the aluminum step wedge. We used BrightView XCT(Philips Health Care, Cleveland, USA) SPECT/CT. We acquired 60 min list mode for Aluminum, PMMA and ABS phantoms using Rectangular Flood Phantom (Biodex, New York, USA) 99mTcO4 3 mCi(111 MBq), 6 mCi (222MBq) and 57Co Flood phantom(adq, New Hampshire, USA). For the analysis of acquired images, the region of interest(ROI) were drawn and evaluated step by step for each phantom. Depending on the type of radioisotope and radiation dose, the counts of the ABS phantom was similar to that of the PMMA phantom. And as the step thickness increased, the counts decreased linearly. When comparing the linear attenuation coefficient of Aluminum, PMMA and ABS phantom, the linear attenuation coefficient of the aluminium phantom was higher than that of the others, and the PMMA and ABS phantom had similar the linear attenuation coefficient. Based on ABS phantom manufactured by 3D printing technology, as the thickness of the PMMA phantom increased, the counts and linear attenuation coefficient decreased linearly. It has been confirmed that ABS phantom is applicable in the clinical field of nuclear medicine. If the calibration factor is applied through further research, it is believed that practical application will be possible.

Application of Finite Element Analysis for Structural Stability Evaluation of Modern and Contemporary Sculptures: 'Eve 58-1' by Man Lin Choi

  • Kwon, Hee Hong;Shin, Jeong Ah;Cho, Nam Chul
    • Journal of Conservation Science
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    • v.38 no.4
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    • pp.277-288
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    • 2022
  • 'Eve 58-1', the subject of this study is a statue made of plaster and its structural stability was evaluated by utilizing the CAE program in order to prevent the risk of damage arising from impact and vibration that are generated during the packaging and transportation process given its material characteristics. CAE is an abbreviation for Computer Applied Engineering for realization by predicting changes at the time of application of virtual physical energy. It is applied by reflecting the physical property conditions and each boundary condition of plaster, and the digital images of the internal and external structure of the work were acquired through 3D scanning and CT analysis for interpretation by executing finite element modeling. When acceleration is applied to the work in the direction of its own weight, the left-right side and the front-rear side, it was possible to confirm a maximum displacement value of 15.24 mm in the head section of the front-rear side direction that has been tilted by approximately 27° from the Y-axis and the largest stress value of 12.46 MPa was at the left ankle section. The corresponding results confirmed that the left ankle section is the most vulnerable area and the section for which precautions need to be exercised and supplemented at the time of transporting the work by means of objective values.

Clinical Risk Evaluation Using Dose Verification Program of Brachytherapy for Cervical Cancer (자궁경부암 근접치료 시 선량 검증 프로그램을 통한 임상적 위험성 평가)

  • Dong‑Jin, Kang;Young‑Joo, Shin;Jin-Kyu, Kang;Jae‑Yong, Jung;Woo-jin, Lee;Tae-Seong, Baek;Boram, Lee
    • Journal of radiological science and technology
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    • v.45 no.6
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    • pp.553-560
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    • 2022
  • The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.

Evaluation of intracellular uptake of cyclic RGD peptides in integrin αvβ3-expressing tumor cells

  • Soyoung Lee;Young-Hwa Kim;In Ho Song;Ji Young Choi;Hyewon Youn;Byung Chul Lee;Sang Eun Kim
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.6 no.2
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    • pp.92-101
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    • 2020
  • The cyclic Arg-Gly-Asp (cRGD) peptide is well-known as a binding molecule to the integrin αvβ3 receptor which is highly expressed on activated endothelial cells and new blood vessels in tumors. Although numerous results have been reported by the usage of cRGD peptide-based ligands for cancer diagnosis and therapy, the distinct mechanisms, and functions of cRGD-integrin binding to cancer cells are still being investigated. In this study, we evaluated the internalization efficacy of different types of cRGD peptides (monomer, dimer and tetramer form) in integrin αvβ3 overexpressing cancer cells. Western blot and flow cytometric analysis showed U87MG expresses highly integrin αvβ3, whereas CT-26 does not show integrin αvβ3 expression. Cytotoxicity assay indicated that all cRGD peptides (0-200 µM) had at least 70-80% of viability in U87MG cells. Fluorescence images showed cRGD dimer peptides have the highest cellular internalization compare to cRGD monomer and cRGD tetramer peptides. Additionally, transmission electron microscope results clearly visualized the endocytic internalization of integrin αvβ3 receptors and correlated with confocal microscopic results. These results support the rationale for the use of cRGD dimer peptides for imaging, diagnosis, or therapy of integrin αvβ3-rich glioblastoma.

Evaluation of Clinical Risk according to Multi-Leaf Collimator Positioning Error in Spinal Radiosurgery (척추 방사선수술 시 다엽콜리메이터 위치 오차의 임상적 위험성 평가)

  • Dong‑Jin Kang;Geon Oh;Young‑Joo Shin;Jin-Kyu Kang;Jae-Yong Jung;Boram Lee
    • Journal of radiological science and technology
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    • v.46 no.6
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    • pp.527-533
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    • 2023
  • The purpose of this study is to evaluate the clinical risk of spinal radiosurgery by calculating the dose difference due to dose calculation algorithm and multi-leaf collimator positioning error. The images acquired by the CT simulator were recalculated by correcting the multi-leaf collimator position in the dose verification program created using MATLAB and applying stoichiometric calibration and Monte Carlo algorithm. With multi-leaf collimator positioning error, the clinical target volume (CTV) showed a dose difference of up to 13% in the dose delivered to the 95% volume, while the gross tumor volume (GTV) showed a dose difference of 9%. The average dose delivered to the total volume showed dose variation from -8.9% to 9% and -10.1% to 10.2% for GTV and CTV, respectively. The maximum dose delivered to the total volume of the spinal cord showed a dose difference from -14.2% to 19.6%, and the dose delivered to the 0.35 ㎤ volume showed a dose difference from -15.5% to 19.4%. In future research, automating the linkage between treatment planning systems and dose verification programs would be useful for spinal radiosurgery.

LI-RADS Version 2018 Treatment Response Algorithm: Diagnostic Performance after Transarterial Radioembolization for Hepatocellular Carcinoma

  • Jongjin Yoon;Sunyoung Lee;Jaeseung Shin;Seung-seob Kim;Gyoung Min Kim;Jong Yun Won
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1279-1288
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    • 2021
  • Objective: To assess the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 treatment response algorithm (TRA) for the evaluation of hepatocellular carcinoma (HCC) treated with transarterial radioembolization. Materials and Methods: This retrospective study included patients who underwent transarterial radioembolization for HCC followed by hepatic surgery between January 2011 and December 2019. The resected lesions were determined to have either complete (100%) or incomplete (< 100%) necrosis based on histopathology. Three radiologists independently reviewed the CT or MR images of pre- and post-treatment lesions and assigned categories based on the LI-RADS version 2018 and the TRA, respectively. Diagnostic performances of LI-RADS treatment response (LR-TR) viable and nonviable categories were assessed for each reader, using histopathology from hepatic surgeries as a reference standard. Inter-reader agreements were evaluated using Fleiss κ. Results: A total of 27 patients (mean age ± standard deviation, 55.9 ± 9.1 years; 24 male) with 34 lesions (15 with complete necrosis and 19 with incomplete necrosis on histopathology) were included. To predict complete necrosis, the LR-TR nonviable category had a sensitivity of 73.3-80.0% and a specificity of 78.9-89.5%. For predicting incomplete necrosis, the LR-TR viable category had a sensitivity of 73.7-79.0% and a specificity of 93.3-100%. Five (14.7%) of 34 treated lesions were categorized as LR-TR equivocal by consensus, with two of the five lesions demonstrating incomplete necrosis. Interreader agreement for the LR-TR category was 0.81 (95% confidence interval: 0.66-0.96). Conclusion: The LI-RADS version 2018 TRA can be used to predict the histopathologic viability of HCCs treated with transarterial radioembolization.

Noncontrast Computed Tomography-Based Radiomics Analysis in Discriminating Early Hematoma Expansion after Spontaneous Intracerebral Hemorrhage

  • Zuhua Song;Dajing Guo;Zhuoyue Tang;Huan Liu;Xin Li;Sha Luo;Xueying Yao;Wenlong Song;Junjie Song;Zhiming Zhou
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.415-424
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    • 2021
  • Objective: To determine whether noncontrast computed tomography (NCCT) models based on multivariable, radiomics features, and machine learning (ML) algorithms could further improve the discrimination of early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH). Materials and Methods: We retrospectively reviewed 261 patients with sICH who underwent initial NCCT within 6 hours of ictus and follow-up CT within 24 hours after initial NCCT, between April 2011 and March 2019. The clinical characteristics, imaging signs and radiomics features extracted from the initial NCCT images were used to construct models to discriminate early HE. A clinical-radiologic model was constructed using a multivariate logistic regression (LR) analysis. Radiomics models, a radiomics-radiologic model, and a combined model were constructed in the training cohort (n = 182) and independently verified in the validation cohort (n = 79). Receiver operating characteristic analysis and the area under the curve (AUC) were used to evaluate the discriminative power. Results: The AUC of the clinical-radiologic model for discriminating early HE was 0.766. The AUCs of the radiomics model for discriminating early HE built using the LR algorithm in the training and validation cohorts were 0.926 and 0.850, respectively. The AUCs of the radiomics-radiologic model in the training and validation cohorts were 0.946 and 0.867, respectively. The AUCs of the combined model in the training and validation cohorts were 0.960 and 0.867, respectively. Conclusion: NCCT models based on multivariable, radiomics features and ML algorithm could improve the discrimination of early HE. The combined model was the best recommended model to identify sICH patients at risk of early HE.

Percutaneous Thrombin Injection Based on Computational Fluid Dynamics of Femoral Artery Pseudoaneurysms

  • Hyoung-Ho Kim;Kyung-Wuk Kim;Changje Lee;Young Ho Choi;Min Uk Kim;Yasutaka Baba
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1834-1840
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    • 2021
  • Objective: To analyze the computational fluid dynamics (CFD) of femoral artery pseudoaneurysm (FAP), identify a suitable location and timing for percutaneous thrombin injection (PTI) based on this analysis, and report our clinical experience with the procedure. Materials and Methods: CFD can be used to analyze the hemodynamics of the human body. An analysis using CFD recommended that the suitable location of the needle tip for PTI is at the center of the aneurysm sac and the optimal timing for starting PTI is during the early inflow phase of blood into the sac. Since 2011, seven patients (three male and four female; median age, 60 years [range, 43-75 years]) with FAP were treated with PTI based on the devised suitable location and time. Prior to the procedure, color Doppler ultrasonography was performed to determine the location and timing of the thrombin injection. Results: The technical success rate of the PTI was 100%. The amount of thrombin used for the procedure ranged from 200 IU to 1000 IU (median, 500 IU). None of the patients experienced any symptoms or signs of embolic complications during the procedure. Follow-up CT images did not reveal any embolism in the lower extremities and showed complete thrombosis of the pseudoaneurysm. Conclusion: Based on our study of CFD, PTI administered centrally in the FAP during early inflow, as seen on color Doppler, can be an effective technique.

Evaluation of Zone 2 Thoracic Endovascular Aortic Repair Performed with and without Prophylactic Embolization of the Left Subclavian Artery in Patients with Traumatic Aortic Injury

  • Miju Bae;Chang Ho Jeon;Hoon Kwon;Jin Hyeok Kim;Seon Uoo Choi;Seunghwan Song
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.577-583
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    • 2021
  • Objective: To report the authors' experience in performing thoracic endovascular aortic repair (TEVAR) for zone 2 lesions after traumatic aortic injury (TAI). Materials and Methods: This retrospective review included 10 patients who underwent zone 2 TEVAR after identification of aortic isthmus injury by CT angiography (CTA) upon arrival at the emergency room of a regional trauma center from 2016 to 2019. Patients were classified into two groups: those who underwent left subclavian artery (LSA) embolization concurrently with the main TEVAR procedure, and those in whom LSA embolization was not performed during the main procedure, but was planned as a bailout treatment if type II endoleak was noted on follow-up CTA images. Pre-procedural and procedure-related factors and post-procedure prognosis were compared between the groups. Results: There were no differences in pre-procedural factors, occurrence of endoleaks, and post-procedure prognosis (including mortality) between patients in the two groups. The duration of the procedure was shorter in the non-LSA embolization group (61 minutes vs. 27 minutes, p = 0.012). During follow-up, type II endoleak did not occur in either group. Conclusion: Delaying preventative LSA embolization until stabilization of the patient would be desirable when performing zone 2 TEVAR for TAI, in the absence of endoleak on the completion aortography image taken after complete deployment of the stent graft.