• Maxillofacial Plastic and Reconstructive Surgery
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• v.42
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• pp.24.1-24.7
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• 2020

Background: In daily practice, three-dimensional patient-specific jawbone models (3D models) are a useful tool in surgical planning and simulation, resident training, patient education, and communication between the physicians in charge. The progressive improvements of the hardware and software have made it easy to obtain 3D models. Recently, in the field of oral and maxillofacial surgery, there are many reports on the benefits of 3D models. We introduced a desktop 3D printer in our department, and after a prolonged struggle, we successfully constructed an environment for the "in-house" fabrication of the previously outsourced 3D models that were initially outsourced. Through various efforts, it is now possible to supply inexpensive 3D models stably, and thus ensure safety and precision in surgeries. We report the cases in which inexpensive 3D models were used for orthodontic surgical simulation and discuss the surgical outcomes. Review: We explained the specific CT scanning considerations for 3D printing, 3D printing failures, and how to deal with them. We also used 3D models fabricated in our system to determine the contribution to the surgery. Based on the surgical outcomes of the two operators, we compared the operating time and the amount of bleeding for 25 patients who underwent surgery using a 3D model in preoperative simulations and 20 patients without using a 3D model. There was a statistically significant difference in the operating time between the two groups. Conclusions: In this article, we present, with surgical examples, our in-house practice of 3D simulation at low costs, the reality of 3D model fabrication, problems to be resolved, and some future prospects.

• The Journal of the Korea institute of electronic communication sciences
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• v.8 no.1
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• pp.191-197
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• 2013

Conventional CT and MRI scans produce cross-section slices of body that are viewed sequentially by radiologists who must imagine or extrapolate from these views what the 3 dimensional anatomy should be. By using sophisticated algorithm and high performance computing, these cross-sections may be rendered as direct 3D representations of human anatomy. The 2D medical image analysis forced to use time-consuming, subjective, error-prone manual techniques, such as slice tracing and region painting, for extracting regions of interest. To overcome the drawbacks of 2D medical image analysis, combining with medical image processing, 3D visualization is essential for extracting anatomical structures and making measurements. We used the gray-level thresholding, region growing, contour following, deformable model to segment human organ and used the feature vectors from texture analysis to detect harmful cancer. We used the perspective projection and marching cube algorithm to render the surface from volumetric MR and CT image data. The 3D visualization of human anatomy and segmented human organ provides valuable benefits for radiation treatment planning, surgical planning, surgery simulation, image guided surgery and interventional imaging applications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.4
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• pp.321-329
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• 2001

To establish systematic diagnosis and treatment planning of dentofacial deformity patient including facial asymmetry or hemifacial microsomia patient, comprehensive analysis of three dimensional structure of the craniofacial skeleton is needed. Even though three dimensional CT has been developed, landmark identification of the CT is still questionable. In recent, a method for correcting cephalic malpositioning that enables accurate superimposition of the landmarks in different stages without using any additional equipment was developed. It became possible to compare the three-dimensional positional change of the maxillomandible without invasive procedure. Based on the principle of the method, a new program was developed for the purpose of diagnosis and treatment planning of dentofacial deformity patient via three dimensional visualization and structural analysis. This program enables us to perform following menu. First, visualization of three dimensional structure of the craniofacial skeleton with wire frame model which was made from the landmarks observed on both lateral and frontal cephalogram. Second, establishment of midsagittal plane of the face three dimensionally, with the concept of "the plane of the best-fit". Third, examination of the degree of deviation and direction of deformity of structure to the reference plane for the purpose of establishing surgical planning. Fourth, simulation of expected postoperative result by various image operation such as mirroring, overlapping.

• Progress in Medical Physics
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• v.23 no.4
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• pp.234-238
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• 2012

A tumor on the eyelid is often treated using a high-energy electron beam, with a metallic eye shield inserted between the eyelid and the eyeball to preserve the patient's sight. Pretreatment quality assurance of the inner eyelid dose on the metallic shield requires a very small dosimetry tool. For enhanced accuracy, a flexible device fitting the curved interface between the eyelid and the shield is also required. The radiochromic film is the best candidate for this device. To measure the doses along the curved interface and small area, a 3-mm-wide strip of EBT2 film was inserted between the phantom eyelid and the shield. After irradiation with 6 MeV electron beams, the film was evaluated for the dose profile. An acrylic eye shield of the same size as the real eye shield was machined, and CT images free from metal artifacts were obtained. Monte Carlo simulation was performed on the CT images, taking into account eye shield material, such as tungsten, aluminum, and steel. The film-based interface dose distribution agreed with the MC calculation within 2.1%. In the small (millimeter scale) and curved region, radiochromic film dosimetry promises a satisfactory result with easy handling.

• Radiation Oncology Journal
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• v.16 no.1
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• pp.63-69
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• 1998

Purpose : This study is to evaluate the efficacy of small bowel displacement system(SBDS) in post-operative pelvic radiation therapy(RT) of rectal cancer patients by measurement of small bowel volume included in the radiation fields receiving therapeutic dose. Materials and Method : Ten consecutive new rectal cancer patients referred to the department of Radiation Oncology of Samsung Medical Center in May of 1997 were included in this study. All patients were asked to drink $Castrographin^(R)$ before simulation and were laid prone for conventional simulation and CT scans with and without SBDS. The volume of opacified small bowel on CT scans, which was to be included in the radiation fields receiving therapeutic dose, was measured using Picture archiving and communication system (PACS). Results : The average small bowel volumes with and without SBDS were 176.0ml(5.2-415.6ml) and 185.1ml(54.5-434.2ml), respectively The changes of small bowel volume with SBDS compared to those without SBDS were more than $10\%$ decrease in three, less than 10% decrease in two, less than $10\%$ increase in three, and more than $10\%$ increase in two patients. Conclusion : No significant advantage of using SBDS in post-operative pelvic RT for rectal cancer patients has been shown by small bowel volume measurement using CT scan considering additional effort and time needed for simulation and treatment setup.

• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.7-12
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• 2014

Purpose Surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these surgeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable reationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. Method Author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Results The method was allowed to evaluate inter-dacryon distance, inter-centroid distance, movement of the medial orbital wall, movement of the lateral orbital wall, alteration of thickness of the lateral periorbital fat as indicator of movement of the orbital wall and orbit in the patient with congenital periorbital anomaly and postoperative periorbital surgery. The goal of surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these sugeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable relationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. In this report, author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Conclusion The method suggested is objective and accurate method in measurement of the orbital contents. It takes time and is not easy to do, however, this kind of measurement for fine structures will be more easily available in near future.

• Journal of the Korean Institute of Telematics and Electronics C
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• v.35C no.11
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• pp.21-30
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• 1998

In this paper, a digital current control system using a FPGA(Field Programmable Gate Array) was implemented, and the system was applied to an induction motor widely used as an industrial driving machine. The FPGA designed by VHDL(VHSIC Hardware Description Language) consists of a PWM(Pulse Width Modulation) generation block, a PWM protection block, a speed measuring block, a watch dog timer block, an interrupt control block, a decoder logic block, a wait control block and digital input and output blocks respectively. Dedicated clock inputs on the FPGA were used for high-speed execution, and an up-down counter and a latch block were designed in parallel, in order that the triangle wave could be operated at 40 MHz clock. When triangle wave is compared with many registers respectively, gate delay occurs from excessive fan-outs. To reduce the delay, two triangle wave registers were implemented in parallel. Amplitude and frequency of the triangle wave, and dead time of PWM could be changed by software. This FPGA was synthesized by pASIC 2SpDE and Synplify-Lite synthesis tool of Quick Logic company. The final simulation for worst cases was successfully performed under a Verilog HDL simulation environment. And the FPGA programmed for an 84 pin PLCC package was applied to digital current control system for 3-phase induction motor. The digital current control system of the 3 phase induction motor was configured using the DSP(TMS320C31-40 MHz), FPGA, A/D converter and Hall CT etc., and experimental results showed the effectiveness of the digital current control system.

• Journal of Radiation Protection and Research
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• v.27 no.3
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• pp.155-164
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• 2002

Methodology to evaluate the effective doses to adults undergoing various diagnostic x-ray examinations were established by Monte Carlo simulation of the x-ray examinations. Anthropomorphic mathematical phantoms, the MIRD5 male phantom and the ORNL female phantom, were used as the target body and x-ray spectra were produced by the x-ray spectrum generation code SPEC78. The computational procedure was validated by comparing the resulting doses to the results of NRPB studies for the same diagnostic procedures. The effective doses as well as the organ doses due to chest, abdomen, head and spine examinations were calculated for x-rays incident from AP, PA, LLAT and RLAT directions. For instance, the effective doses from the most common procedures, chest PA and abdomen AP, were 0.029 mSv and 0.44 mSv, respectively. The fact that the effective dose from PA chest x-ray is far lower than the traditional value of 0.3 mSv(or 30 mrem), which results partly from the advances of technology in diagnostic radiology and partly from the differences in the dose concept employed, emphasizes necessities of intensive assessment of the patient doses in wide ranges of medical exposures. The methodology and tools established in this study can easily be applied to dose assessments for other radiology procedures; dose from CT examinations, dose to the fetus due to examinations of pregnant women, dose from pediatric radiology.

• Progress in Medical Physics
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• v.24 no.4
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• pp.303-314
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• 2013

Image quality of computed tomography (CT) is very vulnerable to metal artifacts. Recently, the thickness and background normalization techniques have been introduced. Since they provide flat sinograms, it is easy to determine metal traces and a simple linear interpolation would be enough to describe the missing data in sinograms. In this study, we have developed a theory describing two normalization methods and compared two methods with respect to various sizes and numbers of metal inserts by using simple numerical simulations. The developed theory showed that the background normalization provide flatter sinograms than the thickness normalization, which was validated with the simulation results. Numerical simulation results with respect to various sizes and numbers of metal inserts showed that the background normalization was better than the thickness normalization for metal artifact corrections. Although the residual artifacts still existed, we have showed that the background normalization without the segmentation procedure was better than the thickness normalization for metal artifact corrections. Since the background normalization without the segmentation procedure is simple and it does not require any users' intervention, it can be readily installed in conventional CT systems.

• Progress in Medical Physics
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• v.23 no.3
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• pp.145-153
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• 2012

In this study, we quantify the residual motion artifact in 4D-CT scan using the dynamic lung phantom which could simulate respiratory target motion and suggest a simple one-dimension theoretical model to explain and characterize the source of motion artifacts in 4DCT scanning. We set-up regular 1D sine motion and adjusted three level of amplitude (10, 20, 30 mm) with fixed period (4s). The 4DCT scans are acquired in helical mode and phase information provided by the belt type respiratory monitoring system. The images were sorted into ten phase bins ranging from 0% to 90%. The reconstructed images were subsequently imported into the Treatment Planning System (CorePLAN, SC&J) for target delineation using a fixed contour window and dimensions of the three targets are measured along the direction of motion. Target dimension of each phase image have same changing trend. The error is minimum at 50% phase in all case (10, 20, 30 mm) and we found that ${\Delta}S$ (target dimension change) of 10, 20 and 30 mm amplitude were 0 (0%), 0.1 (5%), 0.1 (5%) cm respectively compare to the static image of target diameter (2 cm). while the error is maximum at 30% and 80% phase ${\Delta}S$ of 10, 20 and 30 mm amplitude were 0.2 (10%), 0.7 (35%), 0.9 (45%) cm respectively. Based on these result, we try to analysis the residual motion artifact in 4D-CT scan using a simple one-dimension theoretical model and also we developed a simulation program. Our results explain the effect of residual motion on each phase target displacement and also shown that residual motion artifact was affected that the target velocity at each phase. In this study, we focus on provides a more intuitive understanding about the residual motion artifact and try to explain the relationship motion parameters of the scanner, treatment couch and tumor. In conclusion, our results could help to decide the appropriate reconstruction phase and CT parameters which reduce the residual motion artifact in 4DCT.