• Title/Summary/Keyword: Cone Beam

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Evaluation of Setup Usefulness of CBCT using Rando Phantom (인체 팬텀(Rando Phantom)을 이용한 CBCT의 Setup 유용성 평가)

  • Jang, Eun-Sung
    • The Journal of the Korea Contents Association
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    • v.11 no.7
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    • pp.234-238
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    • 2011
  • This paper will evaluate the usefulness of 3D target of CBCT by comparing human body's posture and position when simulated treatment is being carried out as well as human phantom posture and position using CBCT which is applying OBI. From the Rando Phantom which is located in the datum point moved in parallel and rotationary direction using CBCT. Then the mean and standard deviation difference on images location difference that are acquired were compared with real the Rando Phantom' moved distance. To make a plan of simulated treatment with the same procedure of real radiation therapy, we are going to setup the Rando Phantom. With an assumption that the position is set in accurate place, we measured the setup errors accroding to the change of the translation and rotation. Tests are repeated 10 times to get the standard deviation of the error values. The variability in couch shift after positioning equivalent to average residual error showed lateral $0.2{\pm}0.2$mm, longitudinal $0.4{\pm}0.3$mm, vertical $-0.4{\pm}0.1$mm. The average rotation erroes target localization after simulated $0.4{\pm}0.2$ mm, $0.3{\pm}0.3$ mm, and $0.3{\pm}0.4$ mm. The detection error by rotation is $0{\sim}0.6^{\circ}$ CBCT 3D/3D matching using the Rando Phantom minimized the errors by realizing accurate matching during simulated treatment and patient caring.

Quantitative Evaluation of Patient Positioning Error Using CBCT 3D Gamma Density Analysis in Radiotherapy

  • Lee, Soon Sung;Min, Chul Kee;Cho, Gyu Suk;Han, Soorim;Kim, Kum Bae;Jung, Haijo;Choi, Sang Hyoun
    • Progress in Medical Physics
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    • v.28 no.4
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    • pp.149-155
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    • 2017
  • Radiotherapy patients should maintain their treatment position as patient setup is very important for accurate treatment. In this study, we evaluated patient setup error quantitatively according to Cone-Beam Computed Tomography (CBCT) Gamma Density Analysis using Mobius CBCT. The adjusted setup error to the $QUASAR^{TM}$ phantom was moved artificially in the superior and lateral direction, and then we acquired the CBCT image according to the phantom setup error. To analyze the treatment setup error quantitatively, we compared values suggested in the CBCT system with the Mobius CBCT. This allowed us to evaluate the setup error using CBCT Gamma Density Analysis by comparing the planning CT with the CBCT. In addition, we acquired the 3D-gamma density passing rate according to the gamma density criteria and phantom setup error. When the movement was adjusted to only the phantom body or 3 cm diameter target inserted in the phantom, the CBCT system had a difference of approximately 1 mm, while Mobius CBCT had a difference of under 0.5 mm compared to the real setup error. When the phantom body and target moved 20 mm in the Mobius CBCT, there are 17.9 mm and 13.5 mm differences in the lateral and superior directions, respectively. The CBCT gamma density passing rate was reduced according to the increase in setup error, and the gamma density criteria of 0.1 g/cc/3 mm has 10% lower passing rate than the other density criteria. Mobius CBCT had a 2 mm setup error compared with the actual setup error. However, the difference was greater than 10 mm when the phantom body moved 20 mm with the target. Therefore, we should pay close attention when the patient's anatomy changes.

Implementation of KV Cone Beam CT for Image Guided Radiation Therapy (영상유도 방사선치료에서의 KV 콘빔CT 이용)

  • Yoo, Young-Seung;Lee, Hwa-Jung;Kim, Dae-Young;Yu, Ri
    • The Journal of Korean Society for Radiation Therapy
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    • v.19 no.1
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    • pp.43-49
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    • 2007
  • Purpose: The aim of this study was the clinical implementation of IGRT using KV CBCT for setup correction in radiation therapy. Materials and Methods: We selected 9 patients (3 patient for each region; head, body, pelvis)and acquired 135 CBCT images with CLINAC iX (Varian medical system, USA). During the scan, the required time was measured. We analyzed the result in 3 direction; vertical, longitudinal, lateral. Results: The mean setup errors at the couch position of vertical, lateral, and longitudinal direction were 0.07, 0.12, and 0.1 cm in the head region, 0.3, 0.26, and 0.22 cm in the body region, 0.21, 0.18, and 0.15 cm in the pelvis region respectively. The mean time required for CBCT was $6{\sim}7$ minute. Conclusion: The CBCT on the LINAC provides the capacity for soft tissue imaging in the treatment position and real time monitoring during treatment delivery. With presented workflow, the setup correction within reasonable time for more accurate radiation therapy is possible. And it's image can be very useful for adaptive radiation therapy(ART) in the future with improved image quality.

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Comparative Analysis of Surgical Outcomes of C1-2 Fusion Spine Surgery between Intraoperative Computed Tomography Image Based Navigation-Guided Operation and Fluoroscopy-Guided Operation

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.237-247
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    • 2020
  • Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

Whole pelvic intensity-modulated radiotherapy for high-risk prostate cancer: a preliminary report

  • Joo, Ji Hyeon;Kim, Yeon Joo;Kim, Young Seok;Choi, Eun Kyung;Kim, Jong Hoon;Lee, Sang-Wook;Song, Si Yeol;Yoon, Sang Min;Kim, Su Ssan;Park, Jin-Hong;Jeong, Yuri;Ahn, Hanjong;Kim, Choung-Soo;Lee, Jae-Lyun;Ahn, Seung Do
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.199-205
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    • 2013
  • Purpose: To assess the clinical efficacy and toxicity of whole pelvic intensity-modulated radiotherapy (WP-IMRT) for high-risk prostate cancer. Materials and Methods: Patients with high-risk prostate cancer treated between 2008 and 2013 were reviewed. The study included patients who had undergone WP-IMRT with image guidance using electronic portal imaging devices and/or cone-beam computed tomography. The endorectal balloon was used in 93% of patients. Patients received either 46 Gy to the whole pelvis plus a boost of up to 76 Gy to the prostate in 2 Gy daily fractions, or 44 Gy to the whole pelvis plus a boost of up to 72.6 Gy to the prostate in 2.2 Gy fractions. Results: The study cohort included 70 patients, of whom 55 (78%) had a Gleason score of 8 to 10 and 50 (71%) had a prostate-specific antigen level > 20 ng/mL. The androgen deprivation therapy was combined in 62 patients. The biochemical failure-free survival rate was 86.7% at 2 years. Acute any grade gastrointestinal (GI) and genitourinary (GU) toxicity rates were 47% and 73%, respectively. The actuarial rate of late grade 2 or worse toxicity at 2 years was 12.9% for GI, and 5.7% for GU with no late grade 4 toxicity. Conclusion: WP-IMRT was well tolerated with no severe acute or late toxicities, resulting in at least similar biochemical control to that of the historic control group with a small field. The long-term efficacy and toxicity will be assessed in the future, and a prospective randomized trial is needed to verify these findings.

Accuracy assessment of implant placement using a stereolithographic surgical guide made with digital scan (디지털 스캔을 이용하여 제작된 임플란트 수술가이드의 정확도)

  • Jeong, Seung-Mi;Fang, Jeong-Whan;Hwang, Chan-Hyeon;Kang, Se-Ha;Choi, Byung-Ho;Fang, Yiqin;Jeon, Hyongtae;An, Sunghun
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.111-119
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    • 2015
  • Purpose: The objective of this study was to evaluate the accuracy of a stereolithographic surgical guide that was made with information from intraoral digital impressions and cone beam CT (CBCT). Materials and methods: Six sets of resin maxilla and mandible models with missing teeth were used in this study. Intraoral digital impressions were made. The virtual models provided by these intraoral digital impressions and by the CBCT scan images of the resin models were used to create a surgical guide. Implant surgery was performed on the resin models using the surgical guide. After implant placement, the models were subjected to another CBCT scan to compare the planned and actual implant positions. Deviations in position, depth and axis between the planned and actual positions were measured for each implant. Results: The mean deviation of the insertion point and angulation were 0.28 mm and $0.26^{\circ}$, apex point were 0.11 mm and 0.14 mm respectively. The implants were situated at a mean of 0.44 mm coronal to the planned vertical position. Conclusion: This study demonstrates that stereolithographic surgical guides created without the use of impressions and stone models show promising accuracy in implant placement.

Influence of the Alveolar Cleft Type on Preoperative Estimation Using 3D CT Assessment for Alveolar Cleft

  • Choi, Hang Suk;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.477-482
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    • 2012
  • Background The bone graft for the alveolar cleft has been accepted as one of the essential treatments for cleft lip patients. Precise preoperative measurement of the architecture and size of the bone defect in alveolar cleft has been considered helpful for increasing the success rate of bone grafting because those features may vary with the cleft type. Recently, some studies have reported on the usefulness of three-dimensional (3D) computed tomography (CT) assessment of alveolar bone defect; however, no study on the possible implication of the cleft type on the difference between the presumed and actual value has been conducted yet. We aimed to evaluate the clinical predictability of such measurement using 3D CT assessment according to the cleft type. Methods The study consisted of 47 pediatric patients. The subjects were divided according to the cleft type. CT was performed before the graft operation and assessed using image analysis software. The statistical significance of the difference between the preoperative estimation and intraoperative measurement was analyzed. Results The difference between the preoperative and intraoperative values were $-0.1{\pm}0.3cm^3$ (P=0.084). There was no significant intergroup difference, but the groups with a cleft palate showed a significant difference of $-0.2{\pm}0.3cm^3$ (P<0.05). Conclusions Assessment of the alveolar cleft volume using 3D CT scan data and image analysis software can help in selecting the optimal graft procedure and extracting the correct volume of cancellous bone for grafting. Considering the cleft type, it would be helpful to extract an additional volume of $0.2cm^3$ in the presence of a cleft palate.

Gaussian Noise Reduction Method using Adaptive Total Variation : Application to Cone-Beam Computed Tomography Dental Image (적응형 총변이 기법을 이용한 가우시안 잡음 제거 방법: CBCT 치과 영상에 적용)

  • Kim, Joong-Hyuk;Kim, Jung-Chae;Kim, Kee-Deog;Yoo, Sun-K.
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.49 no.1
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    • pp.29-38
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    • 2012
  • The noise generated in the process of obtaining the medical image acts as the element obstructing the image interpretation and diagnosis. To restore the true image from the image polluted from the noise, the total variation optimization algorithm was proposed by the R.O. F (L.Rudin, S Osher, E. Fatemi). This method removes the noise by fitting the balance of the regularity and fidelity. However, the blurring phenomenon of the border area generated in the process of performing the iterative operation cannot be avoided. In this paper, we propose the adaptive total variation method by mapping the control parameter to the proposed transfer function for minimizing boundary error. The proposed transfer function is determined by the noise variance and the local property of the image. The proposed method was applied to 464 tooth images. To evaluate proposed method performance, PSNR which is a indicator of signal and noise's signal power ratio was used. The experimental results show that the proposed method has better performance than other methods.

A dose monitoring system for dental radiography

  • Lee, Chena;Lee, Sam-Sun;Kim, Jo-Eun;Symkhampha, Khanthaly;Lee, Woo-Jin;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Yeom, Heon-Young
    • Imaging Science in Dentistry
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    • v.46 no.2
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    • pp.103-108
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    • 2016
  • Purpose: The current study investigates the feasibility of a platform for a nationwide dose monitoring system for dental radiography. The essential elements for an unerring system are also assessed. Materials and Methods: An intraoral radiographic machine with 14 X-ray generators and five sensors, 45 panoramic radiographic machines, and 23 cone-beam computed tomography (CBCT) models used in Korean dental clinics were surveyed to investigate the type of dose report. A main server for storing the dose data from each radiographic machine was prepared. The dose report transfer pathways from the radiographic machine to the main sever were constructed. An effective dose calculation method was created based on the machine specifications and the exposure parameters of three intraoral radiographic machines, five panoramic radiographic machines, and four CBCTs. A viewing system was developed for both dentists and patients to view the calculated effective dose. Each procedure and the main server were integrated into one system. Results: The dose data from each type of radiographic machine was successfully transferred to the main server and converted into an effective dose. The effective dose stored in the main server is automatically connected to a viewing program for dentist and patient access. Conclusion: A patient radiation dose monitoring system is feasible for dental clinics. Future research in cooperation with clinicians, industry, and radiologists is needed to ensure format convertibility for an efficient dose monitoring system to monitor unexpected radiation dose.

Evaluation of the mechanical properties and clinical efficacy of biphasic calcium phosphate-added collagen membrane in ridge preservation

  • Lee, Jung-Tae;Lee, Yoonsub;Lee, Dajung;Choi, Yusang;Park, Jinyoung;Kim, Sungtae
    • Journal of Periodontal and Implant Science
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    • v.50 no.4
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    • pp.238-250
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    • 2020
  • Purpose: This study aimed to evaluate the biocompatibility and the mechanical properties of ultraviolet (UV) cross-linked and biphasic calcium phosphate (BCP)-added collagen membranes and to compare the clinical results of ridge preservation to those obtained using chemically cross-linked collagen membranes. Methods: The study comprised an in vitro test and a clinical trial for membrane evaluation. BCP-added collagen membranes with UV cross-linking were prepared. In the in vitro test, scanning electron microscopy, a collagenase assay, and a tensile strength test were performed. The clinical trial involved 14 patients undergoing a ridge preservation procedure. All participants were randomly divided into the test group, which received UV cross-linked membranes (n=7), and the control group, which received chemically cross-linked membranes (n=7). BCP bone substitutes were used for both the test group and the control group. Cone-beam computed tomography (CBCT) scans were performed and alginate impressions were taken 1 week and 3 months after surgery. The casts were scanned via an optical scanner to measure the volumetric changes. The results were analyzed using the nonparametric Mann-Whitney U test. Results: The fastest degradation rate was found in the collagen membranes without the addition of BCP. The highest enzyme resistance and the highest tensile strength were found when the collagen-to-BCP ratio was 1:1. There was no significant difference in dimensional changes in the 3-dimensional modeling or CBCT scans between the test and control groups in the clinical trial (P>0.05). Conclusions: The addition of BCP and UV cross-linking improved the biocompatibility and the mechanical strength of the membranes. Within the limits of the clinical trial, the sites grafted using BCP in combination with UV cross-linked and BCP-added collagen membranes (test group) did not show any statistically significant difference in terms of dimensional change compared with the control group.