• Title/Summary/Keyword: CT-guided

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Image Guided Brachytherapy in Cervix Cancer

  • 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
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    • 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.

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The Clinical Experience of Computed Tomographic-Guided Navigation System in C1-2 Spine Instrumentation Surgery

  • Kim, Sang-Uk;Roh, Byoung-Il;Kim, Seong-Joon;Kim, Sang-Don
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.330-333
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    • 2014
  • Objective : To identify the accuracy and efficiency of the computed tomographic (CT)-based navigation system on upper cervical instrumentation, particularly C1 lateral mass and C2 pedicle screw fixation compared to previous reports. Methods : Between May 2005 and March 2014, 25 patients underwent upper cervical instrumentation via a CT-based navigation system. Seven patients were excluded, while 18 patients were involved. There were 13 males and five females; resulting in four degenerative cervical diseases and 14 trauma cases. A CT-based navigation system and lateral fluoroscopy were used during the screw instrumentation procedure. Among the 58 screws inserted as C1-2 screws fixation, their precise positions were evaluated by postoperative CT scans and classified into three categories : in-pedicle, non-critical breach, and critical breach. Results : Postoperatively, the precise positions of the C1-2 screws fixation were 81.1% (47/58), and 8.6% (5/58) were of non-critical breach, while 10.3% (6/58) were of critical breach. Most (5/6, 83.3%) of the critical breaches and all of non-critical breaches were observed in the C2 pedicle screws and there was only one case of a critical breach among the C1 lateral mass screws. There were three complications (two vertebral artery occlusions and a deep wound infection), but no postoperative instrument-related neurological deteriorations were seen, even in the critical breach cases. Conclusion : Although CT-based navigation systems can result in a more precise procedure, there are still some problems at the upper cervical spine levels, where the anatomy is highly variable. Even though there were no catastrophic complications, more experience are needed for safer procedure.

Percutaneous Radiofrequency Therapy of Benign Bone Tumors in the Femoral Head (대퇴골두 부위에 발생한 양성 골 종양에 대한 경피적 고주파치료 (증례보고))

  • Seo, Jai-Gon;Kim, Eung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.84-92
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    • 2003
  • Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.

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Development of Respiratory Training System Using Individual Characteristic Guiding Waveform (환자고유의 호흡 패턴을 적용한 호흡 연습장치 개발 및 유용성 평가)

  • Kang, Seong-Hee;Yoon, Jai-Woong;Kim, Tae-Ho;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.1-7
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    • 2012
  • The purpose of this study was to develop the respiratory training system using individual characteristic guiding waveform to reduce the impact of respiratory motion that causes artifact in radiotherapy. In order to evaluate the improvement of respiratory regularity, 5 volunteers were included and their respiratory signals were acquired using the in-house developed belt-type sensor. Respiratory training system needs 10 free breathing cycles of each volunteer to make individual characteristic guiding waveform based on Fourier series and it guides patient's next breathing. For each volunteer, free breathing and guided breathing which uses individual characteristic guiding waveform were performed to acquire the respiratory cycles for 3 min. The root mean square error (RMSE) was computed to analyze improvement of respiratory regularity in period and displacement. It was found that respiratory regularity was improved by using respiratory training system. RMSE of guided breathing decreased up to 40% in displacement and 76% in period compared with free breathing. In conclusion, since the guiding waveform was easy to follow for the volunteers, the respiratory regularity was significantly improved by using in-house developed respiratory training system. So it would be helpful to improve accuracy and efficiency during 4D-RT, 4D-CT.

A Study on the Additional Radiation Exposure Dose of kV X-ray Based Image Guided Radiotherapy (kV X선 기반 영상유도방사선치료의 추가 피폭선량에 관한 연구)

  • Gha-Jung Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1157-1164
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    • 2023
  • This study measures the additional dose for each treatment area using kV X-ray based OBI (On-Board Imager) and CBCT (Cone-Beam CT), which have excellent spatial resolution and contrast, and evaluates the adequacy and stability of radiation management aspects of IGRT. The subjects of the experiment were examined with OBI and CBCT attached to a linear accelerator (Clinac IX), and ring-shaped Halcyon CBCT under imaging conditions for each treatment area, and the dose at the center was measured using an ion chamber. OBI single fraction dose was measured as 0.77 mGy in the head area, 3.04 mGy in the chest area, and 7.19 mGy in the pelvic area. The absorbed doses from the two devices, Clinac IX CBCT and Halcyon CBCT, were measured to be similar in the pelvic area, at 70.04 mGy and 70.45 mGy. and in chest CBCT, the Clinac IX absorbed dose (70.05 mGy) was higher than the Halcyon absorbed dose (21.01 mGy). The absorbed dose to the head area was also higher than that of Clinac IX (9.08 mGy) and Halcyon (5.44 mGy). In kV X-ray-based IGRT, additional radiation exposure due to photoelectric absorption may affect the overall volume of the treatment area, and caution is required.

The Effect of Silk Membrane Plus 3% 4-hexylresorcinol on Guided Bone Regeneration in a Rabbit Calvarial Defect Model

  • Seok, Hyun;Lee, Sang-Woon;Kim, Seong-Gon;Seo, Dong-Hyun;Kim, Han Sung;Kweon, Hae Yong;Jo, You-Young;Kang, Tae Yeon;Lee, Myung-Jin;Chae, Weon-Sik
    • International Journal of Industrial Entomology and Biomaterials
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    • v.27 no.1
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    • pp.209-217
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    • 2013
  • The objective of this study was to evaluate the bone regeneration capability of silk membrane plus 3% 4-hexylresorcinol (3% 4-HR plus SM) in a rabbit calvarial defect model. Twenty New Zealand white rabbits were used in this study. Bilateral round shaped defects were created in the parietal bone (diameter: 8.0 mm). And the defects were covered with (1) 3% 4-HR plus SM, (2) collagen membrane (CM), (3) no graft material. After surgery, the animals were sacrificed at 4 weeks and 8 weeks. Bone regeneration was analyzed in each section by micro-computerized tomography (${\mu}$-CT). And Hematoxylin and eosin stains were used for histological analysis. As measured by ${\mu}$-CT analysis 4 weeks after surgery, the average of new bone formation in animals treated with 3% 4-HR plus SM was greater than that of animals treated with CM. and the difference was statistically significant. And well organized lamella bones were observed in the histological view of the 3% 4-HR plus SM group. Therefore, more bone regeneration was seen in animals treated with 3% 4-HR plus SM than in those treated with CM or uncovered control.

Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

  • Hong, Goohyeon;Song, Junwhi;Lee, Kyung-Jong;Jeon, Kyeongman;Koh, Won-Jung;Suh, Gee Young;Chung, Man Pyo;Kim, Hojoong;Kwon, O Jung;Um, Sang-Won
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.177-180
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    • 2013
  • We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.

The First Pediatric Case of Intrathoracic Tuberculosis Lymphadenitis Diagnosed by Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (국내 소아에서 최초로 초음파기관지내시경-세침흡인술을 이용하여 진단된 흉곽 내 결핵 림프절염 증례)

  • Kim, Kwang Hoon;Lee, Kyung Jong;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.186-189
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    • 2013
  • Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) now provides an important alternative diagnostic modality in patients with intrathoracic tuberculosis lymphadenopathy. The procedure is well tolerated in the outpatient setting, provides access to the mediastinal and hilar lymph node locations commonly in tuberculosis and also allows bronchial washing to be performed at the same procedure. However, there is no report of EBUS-TBNA applied to children to diagnose tuberculosis. We report a case of EBUS-TBNA applied to children who had intrathoracic tuberculosis lymphadenopathy.

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Predictive model of fatigue crack detection in thick bridge steel structures with piezoelectric wafer active sensors

  • Gresil, M.;Yu, L.;Shen, Y.;Giurgiutiu, V.
    • Smart Structures and Systems
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    • v.12 no.2
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    • pp.97-119
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    • 2013
  • This paper presents numerical and experimental results on the use of guided waves for structural health monitoring (SHM) of crack growth during a fatigue test in a thick steel plate used for civil engineering application. Numerical simulation, analytical modeling, and experimental tests are used to prove that piezoelectric wafer active sensor (PWAS) can perform active SHM using guided wave pitch-catch method and passive SHM using acoustic emission (AE). AE simulation was performed with the multi-physic FEM (MP-FEM) approach. The MP-FEM approach permits that the output variables to be expressed directly in electric terms while the two-ways electromechanical conversion is done internally in the MP-FEM formulation. The AE event was simulated as a pulse of defined duration and amplitude. The electrical signal measured at a PWAS receiver was simulated. Experimental tests were performed with PWAS transducers acting as passive receivers of AE signals. An AE source was simulated using 0.5-mm pencil lead breaks. The PWAS transducers were able to pick up AE signal with good strength. Subsequently, PWAS transducers and traditional AE transducer were applied to a 12.7-mm CT specimen subjected to accelerated fatigue testing. Active sensing in pitch catch mode on the CT specimen was applied between the PWAS transducers pairs. Damage indexes were calculated and correlated with actual crack growth. The paper finishes with conclusions and suggestions for further work.

Description of a novel ultrasound guided peribulbar block in horses: a cadaveric study

  • Leigh, Hannah;Gozalo-Marcilla, Miguel;Esteve, Vicente;Bautista, Alvaro Jesus Gutierrez;Gimenez, Tamara Martin;Viscasillas, Jaime
    • Journal of Veterinary Science
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    • v.22 no.2
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    • pp.22.1-22.9
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    • 2021
  • Background: Standing surgery in horses combining intravenous sedatives, analgesics and local anaesthesia is becoming more popular. Ultrasound guided (USG) peribulbar nerve block (PB) has been described in dogs and humans for facial and ocular surgery, reducing the risk of complications versus retrobulbar nerve block (RB). Objective: To describe a technique for USG PB in horse cadavers. Methods: Landmarks and PB technique were described in two equine cadaver heads (Phase 1), with computed tomography (CT) imaging confirming contrast location and spread. In Phase 2, ten equine cadaver heads were randomised to two operators naive to the USG PB, with moderate experience with ultrasonography and conventional "blind" RB. Both techniques were demonstrated once. Subsequently, operators performed five USG PB and five RB each, unassisted. Contrast location and spread were evaluated by CT. Injection site success was defined for USG PB as extraconal contrast, and for RB intraconal contrast. Results: Success was 10/10 for USG PB and 0/10 for RB (p < 0.001). Of the RB injections, eight resulted in extraconal contrast and two in the masseter muscle (p = 0.47). Conclusions: The USG PB had a high injection site success rate compared with the RB technique; however, we cannot comment on clinical effect. The USG technique was easily learnt, and no potential complications were seen. The USG PB nerve block could have a wide application for use in horses for ocular surgeries (enucleations, eyelid, corneal, cataract surgeries, and ocular analgesia) due to reduced risk of iatrogenic damage. Further clinical studies are needed.