• Title/Summary/Keyword: Cone-beam

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Is three-piece maxillary segmentation surgery a stable procedure?

  • Renata Mayumi Kato;Joao Roberto Goncalves;Jaqueline Ignacio;Larry Wolford;Patricia Bicalho de Mello;Julianna Parizotto;Jonas Bianchi
    • The korean journal of orthodontics
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    • v.54 no.2
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    • pp.128-135
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    • 2024
  • Objective: The number of three-piece maxillary osteotomies has increased over the years; however, the literature remains controversial. The objective of this study was to evaluate the skeletal stability of this surgical modality compared with that of one-piece maxillary osteotomy. Methods: This retrospective cohort study included 39 individuals who underwent Le Fort I maxillary osteotomies and were divided into two groups: group 1 (three pieces, n = 22) and group 2 (one piece, n = 17). Three cone-beam computed tomography scans from each patient (T1, pre-surgical; T2, post-surgical; and T3, follow-up) were used to evaluate the three-dimensional skeletal changes. Results: The differences within groups were statistically significant only for group 1 in terms of surgical changes (T2-T1) with a mean difference in the canine region of 3.09 mm and the posterior region of 3.08 mm. No significant differences in surgical stability were identified between or within the groups. The mean values of the differences between groups were 0.05 mm (posterior region) and -0.39 mm (canine region). Conclusions: Our findings suggest that one- and three-piece maxillary osteotomies result in similar post-surgical skeletal stability.

Anatomical Variations Encountered during Adrenal Venous Sampling: A Report of Three Case Series and Review of Literature (부신정맥채혈술 중 발견된 해부학적 변이들: 3건의 증례 보고 및 문헌 고찰)

  • Juyoung Pak;Hyoung Nam Lee;Myung Sub Kim;Hyerim Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.456-462
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    • 2024
  • Primary aldosteronism is a group of disorders in which the autonomous secretion of aldosterone is associated with hypertension and hypokalemia. It is crucial to determine the laterality of aldosterone hypersecretion because treatment options differ accordingly. Adrenal venous sampling (AVS) is considered the most reliable method for assessing the laterality of primary aldosteronism. This procedure is often technically challenging because of the small size and varied locations of the adrenal veins. A better understanding of anatomical variations and careful review of imaging studies would improve sampling success. This report presents three cases of anatomical variations encountered during AVS.

High Energy Electron Dosimetry by Alanine/ESR Spectroscopy (Alanine/ESR Spectroscopy에 의한 고에너지 전자선의 선량측정)

  • Chu, Sung-Sil
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.85-92
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    • 1989
  • Dosimerty based on electron spin resonance (ESR) analysis of radiation induced free radicals in amino acids is relevant to biological dosimetry applications. Alanine detectors are without walls and are tissue equivalent. Therefore, alanine ESR dosimetry looks promising for use in the therapy level. The dose range of the alanine/ESR dosimetry system can be extended down to 1 Gy. In water phantom the absorbed dose of electrons generated by a medical linear accelerator of different initial energies $(6\~21MeV)$ and therapeutic dose levels (1~60 Gy) was measured. Furthermore, depth dose measurements carried out with alanine dosimeters were compared with ionization chamber measurements. As the results, the measured absorbed doses for shallow depth of initial electron energies above 15 MeV were higher by$2\~5\%$ than those calculated by nominal energy $C_E$ factors. This seems to be caused by low energy scattered beams generated from the scattering foil and electron cones of beam projecting device in medical linear accelerator.

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Dosimetric Characteristics of Multileaf Collimator-based Intensity-modulated Arc Therapy for Stereotactic Radiosurgery (방사선수술 시 다엽 콜리메이터를 기초로 한 IMAT의 선량분포)

  • Yun, Sang-Mo;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.18 no.2
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    • pp.93-97
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    • 2007
  • This study was designed to evaluate radiosurgery technique using multiple noncoplanar arc therapy with intensity modulated fine MLC shaped photon beam. The stereotactic radiosurgery was performed with 6-MV X-ray beams from a Clinac 21EX LINAC (Varian, Palo Alto, CA, USA) with a MLC-120, which features a full $40{\times}40cm$ field and is the first MLC for general use that offers 0.5 cm resolution for high precision treatment of small and irregular fields. We used a single isocenter and five gantry-couch combinations with a set of intensity modulated arc therapy. We investigated dosimetric characteristics of 2 cm sized spherical target volume with film (X-OMAT V2 film, Kodak Inc, Rochester NY, USA) dosimetry within $25{\times}25cm$ acrylic phantom. A simulated single isocentric treatment using inversely Planned 3D radiotherapy planning system demonstrated the ability to conform the dose distribution to an spherical target volume. The 80% dose level was adequate to encompass the target volume in frontal, sagittal, and transverse planes, and the region between the 40% and 80% isodose lines was $4.0{\sim}4.5mm$ and comparable to the dose distribution of the Boston Arcs. We expect that our radiosurgery technique could be a treatment option for irregular-shaped large intracranial target.

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Fabrication of UV imprint stamp using diamond-like carbon coating technology (Diamond-like carbon 코팅기술을 사용한 UV-임프린트 스탬프 제작)

  • JEONG JUN-HO;KIM KI-DON;SIM YOUNG-SUK;CHOI DAE-GEUN;CHOI JUNHYUK;LEE EUNG-SUG;LIM TAE-WOO;PARK SANG-HU;YANG DONG-YOL;CHA NAM-GOO;PARK JIN-GOO
    • Proceedings of the Korean Society for Technology of Plasticity Conference
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    • 2005.10a
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    • pp.167-170
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    • 2005
  • The two-dimensional (2D) and three-dimensional (3D) diamond-like carbon (DLC) stamps for ultraviolet nanoimprint lithography (UV-NIL) were fabricated using two kinds of methods, which were a DLC coating process followed by the focused ion beam (FIB) lithography and the two-photon polymerization (TPP) patterning followed by nano-scale thick DLC coating. We fabricated 70 nm deep lines with a width of 100 nm and 70 nm deep lines with a width of 150 nm on 100 nm thick DLC layers coated on quartz substrates using the FIB lithography. 200 nm wide lines, 3D rings with a diameter of $1.35\;{\mu}m$ and a height of $1.97\;{\mu}m$, and a 3D cone with a bottom diameter of $2.88\;{\mu}m$ and a height of $1.97\;{\mu}m$ were successfully fabricated using the TPP patterning and DLC coating process. The wafers were successfully printed on an UV-NIL using the DLC stamp. We could see the excellent correlation between the dimensions of features of stamp and the corresponding imprinted features.

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Evaluation on Usefulness of Stereotactic Radio Surgery using $Fraxion^{(R)}$ System ($Fraxion^{(R)}$ System을 이용한 뇌 정위적 방사선 수술 유용성 평가)

  • Kim, Tae Won;Park, Kwang Woo;Ha, Jin Sook;Jeon, Mi Jin;Cho, Yoon Jin;Kim, Sei Joon;Kim, Jong Dae;Shin, Dong Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.345-354
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    • 2014
  • Purpose : We evaluated the usefulness of $Fraxion^{(R)}$ system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. Materials and Methods : 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while $Fraxion^{(R)}$ system was used for the other 3 patients (group2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. Results : The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when $Fraxion^{(R)}$ system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using $Fraxion^{(R)}$ system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when s-thermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using $Fraxion^{(R)}$ system showed only 1.9%. All percentage were calculated with respect to average value. Conclusion : Using $Fraxion^{(R)}$ system including mouthpiece, Fraxion frame, frontpiece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.

The assessment of dentoalveolar compensation in facial asymmetry individuals: integration of cone beam CT and laser scanned dental cast images (Cone beam CT 영상과 석고모형 레이저 스캔 영상의 결합을 이용한 안면비대칭자의 치성보상 평가)

  • Song, Hyo-Kyung;Son, Woo-Sung;Park, Soo-Byung;Kim, Seong-Sik;Kim, Yong-Il
    • The korean journal of orthodontics
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    • v.40 no.6
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    • pp.373-382
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    • 2010
  • Objective: The purpose of this study was to assess the dentoalveolar compensation in facial asymmetry individuals using an integration of a CBCT image and a laser scanned dental cast image. Methods: The subjects consisted of 30 adults with asymmetric mandibles and 20 adults with symmetric mandibles. The CBCT and laser scanned dental cast images were integrated with a registration technique. Canine and first molar position and angulation were assessed from reference coordinates. The differences between deviated and non-deviated sides were analyzed with the paired t-test. The differences shown according to menton deviation were also statistically analyzed using Pearson correlation analysis. Results: The experimental group showed deviated and non-deviated side differences (dev.-ndev.) in the position and angle of the canine and first molars. Menton deviation showed positive correlation with the deviation side (dev.-ndev.) for the maxillary and mandibular 1st molar angles, negative correlation with the deviation side for the vertical position of the maxillary 1st molars, transverse position of the mandibular canine, transverse position and vertical position of the mesio-lingual cusp of the mandibular 1st molars. Conclusions: The upper and lower canine and first molars of facial asymmetry individuals were compensated, so the transverse position, vertical position, and angle showed differences between the deviated/non-deviated sides.

The variability of tumor motion and respiration pattern in Stereotactic Body RadioTherapy(SBRT) for Lung cancer patients (RPM SystemTM을 이용한 호흡 관찰의 유용성 평가)

  • Park, hyun jun;Bae, sun myeong;Baek, Geum Mun;Kang, tae young;Seo, Dong Rin
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.17-25
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    • 2016
  • Purpose : The purpose of this study is to evaluate the variability of tumor motion and respiration pattern in lung cancer patients undergoing Stereotactic Body RadioTherapy(SBRT) by using On-Board imager (OBI) system and Real-time Position Management (RPM) System. Materials and Methods : This study population consisted of 60 lung cancer patient treated with stereotactic body radiotherapy (48 Gy / 4 fractions). Of these, 30 were treated with gating (group 1) and 30 without gating(group2): typically the patients whose tumors showed three-dimensional respiratory motion > 10 mm were selected for gating. 4-dimensional Computed Tomography (4DCT). Cone Beam CT (CBCT) and Fluoroscopy images were used to measure the tumor motion. RPM system was used to evaluate the variability of respiration pattern on SBRT for group1. Results : The mean difference of tumor motion among 4DCT, CBCT and Fluoroscopy images in the cranio-caudal direction was 2.3 mm in group 1, 2. The maximum difference was 12.5 mm in the group 1 and 8.5 mm in group 2. The number of treatment fractions that patient's respiration pattern was within Upper-Lower threshold on SBRT in group 2 was 31 fractions. A patient who exhibited the most unstable pattern exceeded 108 times in a fraction Conclusion : Although many patients in group 1 and 2 kept the reproducibility of tumor motion within 5 mm during their treatment, some patients exhibited variability of tumor motion in the CBCT and Fluoroscopy images. It was possible to improve the accuracy of dose delivery in SBRT without gating for lung cancer patient by using RPM system.

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Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images

  • Paek, Seung Jae;Yoo, Ji Yong;Lee, Jang Won;Park, Won-Jong;Chee, Young Deok;Choi, Moon Gi;Choi, Eun Joo;Kwon, Kyung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.38.1-38.10
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    • 2016
  • Background: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. Methods: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program $Ondemand^{TM}$. Paired and independent t tests were performed for statistical analysis. Results: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-$ChLt^{\circ}$) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-$ChLt^{\circ}$) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm ($^{\circ}$) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li ($^{\circ}$) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. Conclusions: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.

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.