• Title/Summary/Keyword: CT-guided

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A Case with Unusual Manifestation of Multiple Amebic Liver Abscesses by Coinfection with Clonorchis Sinensis - Diagnosed by CT-guided Fine Needle Aspiration - (간흡충 감염에 의한 간내담도의 낭성변화와 동반된 아메바성 농양 - 세침흡인 세포학적 검사로 진단된 1례 -)

  • Kim, Sung-Sook;Kim, Jung-Ran;Lee, Hyeon-Kyeng;Lee, Sung-Hee;Han, Dong-Sun;Hong, Sung-Tae
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.176-180
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    • 1993
  • Clonorchiasis is common in Korea. The coinfection of amebic abscess with clonorchiasis is not rare in endemic areas. The coinfection may influence on its manifestations each other. We experienced a human case with unusal manifestation of amebic liver abscess associated with coinfection by Clonorchisis sinensis. The case was an 80-year-old female. She lived in Yongil-gun, Kyongsangbuk-do, Korea, She had multiple amebic abscess cavities in the liver, one of which subsided spontaneously and others newly appeared. She was diagnosed by CT guided aspiration of the cyst, which revealed trophozoites of ameba and eggs of C. sinensis. She was treated with praziquantel and metronidazale and was cured.

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Accuracy of 5-axis precision milling for guided surgical template (가이드 수술용 템플릿을 위한 5축 정밀가공공정의 정확성에 관한 연구)

  • Park, Ji-Man;Yi, Tae-Kyoung;Jung, Je-Kyo;Kim, Yong;Park, Eun-Jin;Han, Chong-Hyun;Koak, Jai-Young;Kim, Seong-Kyun;Heo, Seong-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.4
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    • pp.294-300
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    • 2010
  • Purpose: The template-guided implant surgery offers several advantages over the traditional approach. The purpose of this study was to evaluate the accuracy of coordinate synchronization procedure with 5-axis milling machine for surgical template fabrication by means of reverse engineering through universal CAD software. Materials and methods: The study was performed on ten edentulous models with imbedded gutta percha stoppings which were hidden under silicon gingival form. The platform for synchordination was formed on the bottom side of models and these casts were imaged in Cone beam CT. Vectors of stoppings were extracted and transferred to those of planned implant on virtual planning software. Depth of milling process was set to the level of one half of stoppings and the coordinate of the data was synchronized to the model image. Synchronization of milling coordinate was done by the conversion process for the platform for the synchordination located on the bottom of the model. The models were fixed on the synchordination plate of 5-axis milling machine and drilling was done as the planned vector and depth based on the synchronized data with twist drill of the same diameter as GP stopping. For the 3D rendering and image merging, the impression tray was set on the conbeam CT and pre- and post- CT acquiring was done with the model fixed on the impression body. The accuracy analysis was done with Solidworks (Dassault systems, Concord, USA) by measuring vector of stopping’s top and bottom centers of experimental model through merging and reverse engineering the planned and post-drilling CT image. Correlations among the parameters were tested by means of Pearson correlation coefficient and calculated with SPSS (release 14.0, SPSS Inc. Chicago, USA) ($\alpha$ = 0.05). Results: Due to the declination, GP remnant on upper half of stoppings was observed for every drilled bores. The deviation between planned image and drilled bore that was reverse engineered was 0.31 (0.15 - 0.42) mm at the entrance, 0.36 (0.24 - 0.51) mm at the apex, and angular deviation was 1.62 (0.54 - 2.27)$^{\circ}$. There was positive correlation between the deviation at the entrance and that at the apex (Pearson Correlation Coefficient = 0.904, P = .013). Conclusion: The coordinate synchronization 5-axis milling procedure has adequate accuracy for the production of the guided surgical template.

A Case of Cerebral Air Embolism that Occurred after CT-guided Transthoracic Needle Biopsy (CT 유도하 경피적 흉부 세침생검 후 발생한 뇌 공기 색전증 1례)

  • Yang, Doo Kyung;Lee, Soo-Keol;Suh, Sung Wan;Sohn, You Jeong;Kim, Kyoung Tae;Yoo, Jung Nam;Kim, Jong Kuk;Roh, Mee Sook;Choi, Pil Jo;Kim, Ki Nam;Lee, Ki-Nam;Son, Choon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.480-483
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    • 2004
  • CT-guided transthoracic needle biopsy is a common procedure for the evaluation of pulmonary and mediastinal lesions. The most frequent complications include pneumothorax, hemorrhage, and hemoptysis. Air embolism, and especially cerebral embolism, is a rare but potentially fatal complication after this procedure. Here, we report on a case of cerebral air embolism that occurred after CT-guided transthoracic needle biopsy for the peripheral lung mass.

Consideration of the Effect according to Variation of Material and Respiration in Cone-Beam CT (Cone-Beam CT에서 물질 및 호흡 변화가 영상에 미치는 영향에 대한 고찰)

  • Na, Jun-Young;Kim, Jung-Mi;Kim, Dae-Sup;Kang, Tae-Young;Baek, Geum-Mun;Kwon, Gyeong-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.15-21
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    • 2012
  • Purpose: Image Guided Radiation Therapy (IGRT) has been carried out using On-Board Imager system (OBI) in Asan Medical Center. For this reason, This study was to analyze and evaluate the impact on Cone-Beam CT according to variation of material and respiration. Materials and Methods: This study was to acquire and analyze Cone-Beam CT three times for two material: Cylider acryl (lung equvalent material, diameter 3 cm), Fiducial Marker (using clinic) under Motion Phantom able to adjust respiration pattern randomly was varying period, amplitude and baseline vis-a-vis reference respiration pattern. Results: First, According to a kind of material, when being showed 100% in the acryl and 120% in the Fiducial Marker under the condition of same movement of the motion phantom. Second, According to the respiratory alteration, when being showed 1.13 in the baseline shift 1.8 mm and 1.27 in the baseline shift 3.3 mm for acryl. when being showed 1.01 in 1 sec of period and 1.045 in 2.5 sec of period for acryl. When being showed 0.86 in 0.7 times the standard of amplitude and 1.43 in 1.7 times the standard of amplitude for acryl. when being showed 1.18 in the baseline shift 1.8 mm and 1.34 in the baseline shift 3.3 mm for Fiducial Marker. when being showed 1.0 in 1 sec of period and 1.0 in 2.5 sec of period for Fiducial Marker. When being showed 0.99 in 0.7 times the standard of amplitude and 1.66 in 1.7 times the standard of amplitude for Fiducial Marker. Conclusion: The effect of image size of CBCT was 20% in the case of Fiducial marker. The impact of changes in breathing pattern was minimum 13% - maximum 43% for Arcyl, min. 18% - max. 66% for Fiducial marker. This difference makes serious uncertainty. So, Must be stabilized breathing of patient before acquiring CBCT. also must be monitored breathing of patient in the middle of acquire. If you observe considerable change of breathing when acquiring CBCT. After Image Guided, must be need to check treatment site using fluoroscopy. If a change is too big, re-acquiring CBCT.

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The Effects of Tetracycline-loaded Silk Fibroin Membrane on Guided Bone Regeneration in a Rabbit Calvarial Defect Model (가토 두개골 결손부 모델에서 테트라사이클린 함유 실크 파이브로인 차폐막의 골유도 재생 효과)

  • Lee, Sang-Woon;Park, Yong-Tae;Kim, Seong-Gon;Kweon, HaeYong;Jo, You-Young;Lee, Heui Sam
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.293-298
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    • 2012
  • Purpose: The aim of this study was to evaluate the bone regeneration ability of 1% tetracycline (TC)-loaded silk fibroin membrane (SFM), in a rabbit calvarial defect model. Methods: Twenty New Zealand white rabbits were used for this study. Bilateral round defects were made on the rabbit parietal bone, using trephine bur with an 8 mm diameter. TC-loaded SFM or SFM was covered on the right parietal bone defect, and the left parietal bone defects were uncovered for the control. The animals were humanely sacrificed at 4 or 8 weeks postoperatively. A micro-computerized tomography (${\mu}$-CT) of each specimen was taken for analysis of bone regeneration. Hematoxylin and Eosin stain were done to observe histological findings. Results: From the ${\mu}$-CT results, regenerated bone volume ($mm^3$) of 1% TC-loaded SFM, SFM, and control were $7.80{\pm}5.87$, $8.79{\pm}3.44$, and $10.61{\pm}5.3$ at 4 weeks postoperatively, respectively (P>0.05). Regenerated bone volume ($mm^3$) of 1% TC-loaded SFM, SFM, and control were $36.56{\pm}8.50$, $25.86{\pm}8.17$, and $19.09{\pm}5.07$ at 8 weeks postoperatively, respectively (P<0.05). Conclusion: The 1% TC-loaded SFM showed more bone regeneration than the SFM and the uncovered control, in guided bone regeneration.

A Study on the Minimization of Spatial Error in 3-Demensional Neuronavigator (3차원 영상지원 뇌수술장비의 공간오차 최소화에 관한 연구)

  • 이동준;다영신;이정교
    • Progress in Medical Physics
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    • v.8 no.2
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    • pp.19-26
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    • 1997
  • 3-dimensional Neuronavigator, Viewing Wand(ISG Technologies, Toronto, Cannda) is the surgery aid equipment for real time image (CT or MRI) guided surgery. The assurance of spatial accuracy of this system is important for clinical application. In this study, we have designed the acrylic brain phantom and measured the spatial error with that phantom. The phantom has designed to have capability to simulate image guided surgery. The phantom has 22 vertical rods whose diameters are 5mm and each rods has different length. CT scans were performed by 2.0mm slice and reconstructed for 3-Dimensional analysis. End point of rods can be obtained using reconstructed 3- Dimensional images and they are compared to actual position data. Average deviation was less than 2mm for various situations. Spatial error of Viewing Wand is acceptable in the clinical points of view, while cosmetics of the software needs to be modified to more user friend. Better accuracy can be expected when we apply the mixed fiducial fit registration and surface fit registration method. And even better results can be obtained if registration points distributed even and symetric around the target.

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On-line Image Guided Radiation Therapy using Cone-Beam CT (CBCT) (콘빔CT (CBCT)를 이용한 온라인 영상유도방사선치료 (On-line Image Guided Radiation Therapy))

  • Bak, Jin-O;Jeong, Kyoung-Keun;Keum, Ki-Chang;Park, Suk-Won
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.294-299
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    • 2006
  • $\underline{Purpose}$: Using cone beam CT, we can compare the position of the patients at the simulation and the treatment. In on-line image guided radiation therapy, one can utilize this compared data and correct the patient position before treatments. Using cone beam CT, we investigated the errors induced by setting up the patients when use only the markings on the patients' skin. $\underline{Materials\;and\;Methods}$: We obtained the data of three patients that received radiation therapy at the Department of Radiation Oncology in Chung-Ang University during August 2006 and October 2006. Just as normal radiation therapy, patients were aligned on the treatment couch after the simulation and treatment planning. Patients were aligned with lasers according to the marking on the skin that were marked at the simulation time and then cone beam CTs were obtained. Cone beam CTs were fused and compared with simulation CTs and the displacement vectors were calculated. Treatment couches were adjusted according to the displacement vector before treatments. After the treatment, positions were verified with kV X-ray (OBI system). $\underline{Results}$: In the case of head and neck patients, the average sizes of the setup error vectors, given by the cone beam CT, were 0.19 cm for the patient A and 0.18 cm for the patient B. The standard deviations were 0.15 cm and 0.21 cm, each. On the other hand, in the case of the pelvis patient, the average and the standard deviation were 0.37 cm and 0.1 cm. $\underline{Conclusion}$: Through the on-line IGRT using cone beam CT, we could correct the setup errors that could occur in the conventional radiotherapy. The importance of the on-line IGRT should be emphasized in the case of 3D conformal therapy and intensity-modulated radiotherapy, which have complex target shapes and steep dose gradients.

The Investigation Image-guided Radiation Therapy of Bladder Cancer Patients (방광암 환자의 영상유도 방사선치료에 관한 고찰)

  • Bae, Seong-Soo;Bae, Sun-Myoung;Kim, Jin-San;Kang, Tae-Young;Back, Geum-Mun;Kwon, Kyung-Tae
    • The Journal of Korean Society for Radiation Therapy
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    • v.24 no.1
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    • pp.39-43
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    • 2012
  • Purpose: In hospital image-guided radiation therapy in patients with bladder cancer to enhance the reproducibility of the appropriate amount, depending on the patient's condition, and image-guided injection of saline system (On-Board Imager system, OBI, VARIAN, USA) three of the Cone-Beam CT dimensional matching (3D-3D matching) to be the treatment. In this study, the treatment of patients with bladder cancer at Cone-Beam CT image obtained through the analysis of the bones based matching and matching based on the bladder to learn about the differences, the bladder's volume change injected saline solution by looking at the bladder for the treatment of patients with a more appropriate image matching is to assess how the discussion. Materials and Methods: At our hospital from January 2009 to April 2010 admitted for radiation therapy patients, 7 patients with bladder cancer using a Folly catheter of residual urine in the bladder after removing the amount determined according to individual patient enough to inject saline CT-Sim was designed after the treatment plan. After that, using OBI before treatment to confirm position with Cone-Beam CT scan was physician in charge of matching was performed in all patients. CBCT images using a total of 45 bones, bladder, based on image matching and image matching based on the difference were analyzed. In addition, changes in bladder volume of Eclipse (version 8.0, VARIAN, USA) persuaded through. Results: Bones, one based image matching based on the bladder and re-matching the X axis is the difference between the average $3{\pm}2mm$, Y axis, $1.8{\pm}1.3mm$, Z-axis travel distance is $2.3{\pm}1.7mm$ and the overall $4.8{\pm}2.0mm$, respectively. The volume of the bladder compared to the baseline showed a difference of $4.03{\pm}3.97%$. Conclusion: Anatomical location and nature of the bladder due to internal movement of the bones, even after matching with the image of the bladder occurred in different locations. In addition, the volume of saline-filled bladder showed up the difference between the 4.03 percent, but matched in both images to be included in the planned volumes were able to confirm. Thus, after injection of saline into the bladder base by providing a more accurate image matching will be able to conduct therapy.

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Imaging Evaluation of Peritoneal Metastasis: Current and Promising Techniques

  • Chen Fu;Bangxing Zhang;Tiankang Guo;Junliang Li
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.86-102
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    • 2024
  • Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

Evaluate the Change of Body Shape and the Patient Alignment State During Image-Guided Volumetric Modulated Arc Therapy in Head and Neck Cancer Patients (두경부 환자의 VMAT 시 체형변화와 환자 정렬과의 상관관계 고찰)

  • Seo, Se Jeong;Kim, Tae Woo;Choi, Min Ho;Son, Jong Gi
    • The Journal of Korean Society for Radiation Therapy
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    • v.29 no.2
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    • pp.109-117
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    • 2017
  • Objectives: The purpose of this study was to evaluate the change of body shape and the patient alignment state during image-guided volumetric modulated arc therapy in head and neck cancer patients, Materials and Methods: We performed a image-guided volumetric modulated arc therapy plan for 89 patients with head and neck cancer who underwent curative radiotherapy. Ten of them were evaluated for set up error. The landmarks of the ramus, chin, posterior neck, and clavicle were specified using ARIA software (Offline review), and the positional difference was analyzed. Results: The re-CT simulation therapy was performed in 60 men with $17{\pm}4$ cycles of treatment. The weight loss rate was $-6.47{\pm}3.5%$. 29 women performed re-CT simulation at $17{\pm}5$ cycles As a result, weight loss rate was $-5.73{\pm}2.7%$. The distance from skin to C1, C3, and C5 was measured, and both clavicle levels were observed to measure the skin shrinkage changes. The skin shrinkage standard deviations were C1 (${\pm}0.44cm$), C3 (${\pm}0.83cm$), and C5 (${\pm}1.35cm$), which is about 1 mm shrinkage per 0.5 kg reduction. Skin shrinkage according to the number of treatments was 1 ~ 4 fractions (no change), 5 ~ 13 fractions (-2 mm), 14 ~ 22 fractions (-4 mm) and 23 ~ 30 fractions (-6 mm). Conclusion: When the body shape changes about 5 mm, the central dose starts to differ about 3 % or more. Therefore, the CT simulation treatment for the adaptive therapy should be additionally performed. In addition, it is necessary to actively study the CT simulation therapy method and set up method of the lower neck and to examine the use of a new immobilization device.

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