• Title/Summary/Keyword: CT complex

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Development and application of stent-based image guided navigation system for oral and maxillofacial surgery (구강외과 수술용 스텐트 기반 영상유도 수술 시스템의 개발)

  • Lee, Woo-Jin;Kim, Dae-Seung;Yi, Won-Jin;Lee, Sam-Sun;Choi, Soon-Chul;Heo, Min-Suk;Huh, Kyung-Hoe;Kim, Myung-Jin;Lee, Jee-Ho
    • Imaging Science in Dentistry
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    • v.39 no.3
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    • pp.149-156
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    • 2009
  • Purpose : The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. Materials and Methods : We devised a patient-specific stent for patient-to-image registration and navigation. Three-dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. Results : The accuracy over 8 anatomical landmarks showed an overall mean of $0.56{\pm}0.16\;mm$. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. Conclusion : The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

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Spatial reproducibility of complex fractionated atrial electrogram depending on the direction and configuration of bipolar electrodes: an in-silico modeling study

  • Song, Jun-Seop;Lee, Young-Seon;Hwang, Minki;Lee, Jung-Kee;Li, Changyong;Joung, Boyoung;Lee, Moon-Hyoung;Shim, Eun Bo;Pak, Hui-Nam
    • The Korean Journal of Physiology and Pharmacology
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    • v.20 no.5
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    • pp.507-514
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    • 2016
  • Although 3D-complex fractionated atrial electrogram (CFAE) mapping is useful in radiofrequency catheter ablation for persistent atrial fibrillation (AF), the directions and configuration of the bipolar electrodes may affect the electrogram. This study aimed to compare the spatial reproducibility of CFAE by changing the catheter orientations and electrode distance in an in -silico left atrium (LA). We conducted this study by importing the heart CT image of a patient with AF into a 3D-homogeneous human LA model. Electrogram morphology, CFAE-cycle lengths (CLs) were compared for 16 different orientations of a virtual bipolar conventional catheter (conv-cath: size 3.5 mm, inter-electrode distance 4.75 mm). Additionally, the spatial correlations of CFAE-CLs and the percentage of consistent sites with CFAE-CL<120 ms were analyzed. The results from the conv-cath were compared with that obtained using a mini catheter (mini-cath: size 1 mm, inter-electrode distance 2.5 mm). Depending on the catheter orientation, the electrogram morphology and CFAE-CLs varied (conv-cath: $11.5{\pm}0.7%$ variation, mini-cath: $7.1{\pm}1.2%$ variation), however the mini-cath produced less variation of CFAE-CL than conv-cath (p<0.001). There were moderate spatial correlations among CFAE-CL measured at 16 orientations (conv-cath: $r=0.3055{\pm}0.2194$ vs. mini-cath: $0.6074{\pm}0.0733$, p<0.001). Additionally, the ratio of consistent CFAE sites was higher for mini catheter than conventional one ($38.3{\pm}4.6%$ vs. $22.3{\pm}1.4%$, p<0.05). Electrograms and CFAE distribution are affected by catheter orientation and electrode configuration in the in-silico LA model. However, there was moderate spatial consistency of CFAE areas, and narrowly spaced bipolar catheters were less influenced by catheter direction than conventional catheters.

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity.modulated Radiation Therapy (세기조절방사선치료 시 콘빔CT (CBCT)를 이용한 환자자세 검증 및 보정평가)

  • Do, Gyeong-Min;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.83-88
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    • 2009
  • Purpose: Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. Materials and Methods: The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. Results: When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07o in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. Conclusion: By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and correct the change of position and target volume and treat more accurately, and could calculate and compare the errors. The results of this study show that CBCT was useful to deliver accurate treatment according to the treatment plan and to increase the reproducibility of repeated treatment, and satisfactory results were obtained. Accuracy enhanced through CBCT is highly required in IMRT, in which the shape of the target volume is complex and the change of dose distribution is radical. In addition, further research is required on the criteria for match focus by treatment site and treatment purpose.

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A Role of Trial Radiation Therapy in the Pineal Region Tumors (송과체부 종양에서 시험적 방사선치료의 역할)

  • Kim, Yeon-Shil;Ryu, Mi-Ryung;Chung, Su-Mi;Kim, Moon-Chan;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.100-107
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    • 2002
  • Purpose : The aim of this retrospective study was to assess the treatment results of 30 patients with pineal region tumors who were underwent radiation therapy under the diagnosis by either CT or MRI. There was no histological verification. We analyzed the prognostic factors that have a significant effect on the overall survival (OS) and disease free survival (DFS) rates. Materials and Methods : A total 30 patients with pineal region tumors were treated between March 1983 and August 1995. After a trial radiation therapy of $20\~30\;Gy/2\~3$ weeks, the patients were evaluated for their clinical response and radiological response by either CT or MRI and the final treatment direction was then decided. According to their response to the trial radiation therapy and the involved site, radiation treatment was given in various fields i.e., local, ventricle, whole brain and craniospinal field. The radiation dose ranged from 40.8 to 59.4 Gy (Median 50.4 Gy). The median follow up was 36.5 months $(4\~172\;months)$. Results : An improvement or stability in the clinical symptoms was observed in 28 patients $(93.3\%)$ after the trial RT. Nineteen patients $(63.3\%)$ showed a partial or complete response by CT or MRI. The two-year and five-year survival rates of the patients were $66.7\%$ and $55.1\%$, respectively. No significant difference in the survival rates according to the degree of the radiological response was abserved after the trial RT. The results of univariate analysis showed that age, the primary site, the performance status $(KPS\geq70)$, the degree of response after completing RT and the RT field were significant prognostic factors affecting the survival and disease free survival rates (p<0.05). Conclusion : The clinical and histological characteristics of pineal region tumors are quite complex and diverse. Therefore, it is difficult to predict the histological diagnosis and the possibility of radiocurability only with the initial response to RT. We think that the development of less invasive histological diagnostic techniques and tailored treatment to the histological type of each tumor are needed.

The consideration about exact set-up with stereotactic radiosurgery for lung cancer. (폐암 환자의 전신 정위적 방사선 수술시 정확한 SET UP에 대한 고찰)

  • Seo, Dong-Rin;Hong, Dong-Gi;Kwon, Kyung-Tea;Park, Kwang-Ho;Kim, Jung-Man
    • The Journal of Korean Society for Radiation Therapy
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    • v.16 no.2
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    • pp.1-8
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    • 2004
  • Purpose : What confirm a patient's set-up precisely is an important factor in stereotactic radiosurgery Especially, the tumor is moved by respiration in case of lung cancer. So it is difficult to confirm a exact location by L-gram or EPID. I will verify a exact patient's set-up about this sort of problem by verification system(exactrac 3.0) Materials and Methods : The patient that had lung cancer operated on stereotactic radiosurgery is composed of 6 people. The 5 patients use an ABC tool and 1 patient doesn't use it. I got such a patient's L-gram and EPID image by Body frame(elekta, sweden), compared Ant. image with Lat. one, and then confirmed a set-up. I fused DRR image of CT and X-ray image of Verification system(exactrac 3.0) 3 dimensional, analyzed the coordinate value(vertical, longitudinal, lateral), and then confirmed a difference of existing method. Results : In case of L-gram and EPID, we judge an exact of the patient's set-up subjectively, and on we could treat the patient with radiation. As a result of using Verification system(exactrac 3.0), coordinate value(vertical, longitudinal, lateral) of patient's set-up was comprised within 5mm. We could estimate a difference of the coordinate value visually and objectively. Consequently, Verification system(exactrac 3.0) was useful in judging an exact patient's set-up. Conclusion : In case of Verification system(exactrac 3.0), we can confirm an exact patient's set-up at any time whenever, However, there are several kinds of the demerit. First, it is a complex process of confirmation than the existing process. Second, thickness of CT scan slice is within 3mm. The last, X-ray image has to have shown itself clearly. If we solve this problem. stereotactic radiosurgery will be useful in treating patients why we can confirm an exact patient's positioning easily.

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Evaluation of Deterioration of Epoxy Primer for Steel Bridge Coating using Image Processing and Electrochemical Impedance Spectroscopy (화상처리 기법과 전기화학적 임피던스 분광법을 이용한 강교 도장용 에폭시 하도 도료의 열화 평가)

  • Lee, Chan Young;Lee, Sang Hun;Park, Jin Hwan
    • Corrosion Science and Technology
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    • v.8 no.2
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    • pp.53-61
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    • 2009
  • In this study, both evaluations by visual imaging for exterior view of coating and by EIS were executed for epoxy primer coated specimens deteriorated by accelerated test, and comparison and analysis were carried out for 2 evaluation methods. In the comparison between total damaged area ratio acquired by image processing method and deterioration point, higher deterioration points were appeared for rusted specimens than for non-rusted specimens. It is attributed that deterioration point per unit area ratio given for rust is higher than for peeling. In the comparison between total damaged area ratio and EIS result, impedance of coating was largely decreased as about TEX>$10^4{\Omega}{\cdot}cm^2$ or less when rust area ratio is more than about 0.1%, and blistering area ratio is more than about 3%. Charge transfer resistance ($R_{ct}$) and double layer capacitance ($C_{dl}$) values were appeared for all specimens except 2 ones, which shows that water is accumulated and steel substrate is corroded at coated film-steel interface. In the comparison between deterioration point and EIS result, more than 10 points as deterioration point were given for specimens of below $10^6{\Omega}{\cdot}cm^2$ of impedance at low frequency. For specimens deteriorated by NORSOK cyclic test, impedance was lowest of all, though deterioration point was not high. It is thought to be attributed that coating system and accelerated deterioration condition of cyclic tested specimens were different from those of main specimens. From the result, it is thought that coating resistance can be relatively more decreased than deterioration degree estimated from exterior view under more severe corrosion environment or in the present of more complex deterioration factors.

The Thermodynamics of the Formation of Pyridines-Iodine Charge Transfer Complexes (피리딘류와 요오드사이의 전하이동착물생성에 관한 열역학적 연구)

  • Oh Cheun Kwun;Jin Burm Kyong;Myong Kyun Kim
    • Journal of the Korean Chemical Society
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    • v.25 no.4
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    • pp.228-235
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    • 1981
  • Ultraviolet spectrophotometric investigation were carried out on the systems of pyridine, ${\beta}$-picoline and 3,5-lutidine with iodine in carbon tetrachloride. The results reveal the formation of one to one molecular complexes of the type, $C_5H_5N{\cdot}I_2$, ${\beta}-C_5H_4(CH_3)N{\cdot}I_2$ and 3,5-$C_5H_3(CH_3)_2N{\cdot}I_2$. The equrilibrium constants of complexes were obtained in consideration of that absorption maxima have the blue shift with the increasing temperatures according to the formation of the charge transfer complexes. The thermodynamic parameters, ${\Delta}H$, ${\Delta}G$ and ${\Delta}S$ for the formation of the charge transfer complexes were calculated from these values. These results indicated that the relative stabilities of the pyridine, ${\beta}$-picoline and 3,5-lutidine complexes with iodine increase in the order, pyridine < ${\beta}$-picoline < 3,5-lutidine. These results were supposed to be the influence resulted from increase of electron density by the positive inductive effect and the dipole moment of the steric hindrance effect. And this results were compared and discussed with polymethylbenzene-iodine CT-complexes.

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VR, AR Simulation and 3D Printing for Shoulder and Elbow Practice (VR, AR 시뮬레이션 및 3D Printing을 활용한 어깨와 팔꿈치 수술실습)

  • Lim, Wonbong;Moon, Young Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.175-179
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    • 2016
  • Recent advances in technology of medical image have made surgical simulation that is helpful to diagnosis, operation plan, or education. Improving and enhancing the medical imaging have led to the availability of high definition images and three-dimensional (3D) visualization, it allows a better understanding in the surgical and educational field. The Real human field of view is stereoscopic. Therefore, with just 2D images, stereoscopic reconstruction process through the surgeon's head, is necessary. To reduce these process, 3D images have been used. 3D images enhanced 3D visualization, it provides significantly shorter time for surgeon for judgment in complex situations. Based on 3D image data set, virtual medical simulations, such as virtual endoscopy, surgical planning, and real-time interaction, have become possible. This article describes principles and recent applications of newer imaging techniques and special attention is directed towards medical 3D reconstruction techniques. Recent advances in technology of CT, MR and other imaging modalities has resulted in exciting new solutions and possibilities of shoulder imaging. Especially, three-dimensional (3D) images derived from medical devices provides advanced information. This presentation describes the principles and potential applications of 3D imaging techniques, simulation and printing in shoulder and elbow practice.

Successful Renal Autotransplantation for the Treatment of Severe Renovascular Hypertension in a 14-year-old Boy (신 자가이식을 통한 14세 소년에서 발생한 심한 신성 고혈압의 성공적인 치료)

  • Ji, Min-Chul;Park, Se-Jin;Choi, Jae-Young;Ko, Young-Guk;Kim, Myoung-Soo;Kim, Ji-Hong;Shin, Jae-Il
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.223-229
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    • 2010
  • Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

AC impedance study on the interface between organic electrolyte and amorphous $WO_3$ thin film relating to the electrochemical intercalation of lithium (비정질 $WO_3$ 박막과 전해질 계면에서의 리튬 층간 반응의 교류 임피던스 해석)

  • Kim Byoung-Chul;Ju Jeh-Beck;Sohn Tae-Won
    • Journal of the Korean Electrochemical Society
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    • v.1 no.1
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    • pp.33-39
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    • 1998
  • To AC impedance study was performed in this study on the interfacial reaction between organic electrolyte and amorphous tungsten oxides thin film, cathodically coloring oxide, prepared by e-beam evaporation method in the 1 M $LiClO_4/PC$ organic solution. The electrochemical reactions at the interface were analyzed by the transient method and the complex impedance spectroscopy. The impedance spectrums showed that the electro-chemical intercalation of lithium cations was consisted of the following three steps; the first step, the charge transfer reaction of lithium cation at the interface between amorphous tungsten oxides thin film and the organic electrolyte, the second step, the adsorption of lithium atom on the surface of amorphous tungsten oxides thin film, and then the third step, the absorption and the diffusion of lithium atom into amorphous tungsten oxides thin layer. The bleaching and the coloring characteristics of amorphous tungsten oxides thin film were explained in terms of thermodynamic and kinetic variables, the simulated $R_{ct},\;C_{dl},\;D$ and $\sigma_{Li}$ by CNLS fitting method. Especially it was found that the limiting values of electrochromic reaction were the molar ratio of lithium, y=0.167 and the electrode potential, E=2.245 V (vs. Li).