• The Journal of Korean Society for Radiation Therapy
• /
• v.11 no.1
• /
• pp.53-59
• /
• 1999

The aim of this study is to improve the accuracy of field placement and junction between adjacent fields and block shielding through the use of a computed tomography(CT) simulator and virtual simulation. The information was acquired by assessment of Alderson Rando phantom image using CT simulator (I.Q. Xtra - Picker), determination of each field by virtual fluoroscopy of voxel IQ workstation AcQsim and colored critical structures that were obtained by contouring in virtual simulation. And also using a coronal, sagittal and axial view can determine the field and adjacent field gap correctly without calculation during the procedure. With the treatment planning by using the Helax TMS 4.0, the dose in the junction among the adjacent fields and the spinal cord and cribriform plate of the critical structure was evaluated by the dose volume histogram. The pilot image of coronal and sagittal view took about 2minutes and 26minutes to get 100 images. Image translation to the virtual simulation workstation took about 6minutes. Contouring a critical structure such as cribriform plate, spinal cord using a virtual fluoroscopy were eligible to determine a correct field and shielding. The process took about 20 minutes. As the result of the Helax planning, the dose distribution in adjacent field junction was ideal, and the dose level shows almost 100 percentage in the dose volume histogram of the spinal cord and cribriform plate CT simulation can get a correct therapy area due to enhancement of critical structures such as spinal cord and cribriform plate. In addition, using a Spiral CT scanner can be saved a lot of time to plan a simulation therefore this function can reduce difficulties to keep the patient position without any movements to the patient, physician and radiotherapy technician.

• Journal of the Korea Computer Graphics Society
• /
• v.3 no.2
• /
• pp.27-34
• /
• 1997

3-D image modeling is in high demand for automated visual inspection and non-destructive testing. It also can be useful in biomedical research, medical therapy, surgery planning, and simulation of critical surgery (i.e. cranio-facial). Image processing and image analysis are used to enhance and classify medical volumetric data. Analyzing medical volumetric data is very difficult In this paper, we propose a new image modeling method based on tetrahedrization to improve the visualization of three-dimensional medical volumetric data. In this method, the trivariate piecewise linear interpolation is applied through the constructed tetrahedral domain. Also, visualization methods including iso-surface, color contouring, and slicing are discussed. This method can be useful to the correct and speedy analysis of medical volumetric data, because it doesn't have the ambiguity problem of Marching Cubes algorithm and achieves the data reduction. We expect to compensate the degradation of an accuracy by using an adaptive sub-division of tetrahedrization based on least squares fitting.

• The Journal of Korean Society for Radiation Therapy
• /
• v.28 no.1
• /
• pp.77-86
• /
• 2016

Purpose : When a radiation treatment, there is an attenuation by Carbon Fiber Couch. In this study, we tried to evaluate the usability of the Varian Standard Couch(VSC) by modeling with Treatment Planning System (TPS) Materials and Methods : VSC was scanned by CBCT(Cone Beam Computed Tomography) of the Linac(Clinac IX, VARIAN, USA), following the three conditions of VSC, Side Rail OutGrid(SROG), Side Rail InGrid(SRIG), Side Rail In OutSpine Down Bar(SRIOS). After scan, the data was transferred to TPS and modeled by contouring Side Rail, Side Bar Upper, Side Bar Lower, Spine Down Bar automatically. We scanned the Cheese Phantom(Middelton, USA) using Computed Tomography(Light Speed RT 16, GE, USA) and transfer the data to TPS, and apply VSC modeled previously with TPS to it. Dose was measured at the isocenter of Ion Chamber(A1SL, Standard imaging, USA) in Cheese Phantom using 4 and 10 MV radiation for every $5^{\circ}$ gantry angle in a different filed size($3{\times}3cm^2$, $10{\times}10cm^2$) without any change of MU(=100), and then we compared the calculated dose and measured dose. Also we included dose at the $127^{\circ}$ in SRIG to compare the attenuation by Side Bar Upper. Results : The density of VSC by CBCT in TPS was $0.9g/cm^3$, and in the case of Spine Down Bar, it was $0.7g/cm^3$. The radiation was attenuated by 17.49%, 16.49%, 8.54%, and 7.59% at the Side Rail, Side Bar Upper, Side Bar Lower, and Spine Down Bar. For the accuracy of modeling, calculated dose and measured dose were compared. The average error was 1.13% and the maximum error was 1.98% at the $170^{\circ}beam$ crossing the Spine Down Bar. Conclusion : To evaluate the usability for the VSC modeled by TPS, the maximum error was 1.98% as a result of compassion between calculated dose and measured dose. We found out that VSC modeling helped expect the dose, so we think that it will be helpful for the more accurate treatment.

• The Journal of Korean Society for Radiation Therapy
• /
• v.33
• /
• pp.25-33
• /
• 2021

Purpose : The purpose of this study is to evaluate the accuracy and usefulness of the Trigger mode for the Respiratory Gated Radiation Therapy (RGRT) Materials and methods : A QUASAR respiratory phantom that inserted a 3 mm fiducial marker (a gold marker) was used to estimate the accuracy of the Trigger mode. And the 20 bpm was used as reference respiration rate in this study. The marker that placed at the center of the phantom was contoured, and the lower threshold of a gating window was fixed at 2.0 mm using an OBI with Truebeam STx^TM. The upper threshold was measured every 0.5 mm from 1.0 mm to 3.0 mm. The respiration rates were changed every 10 bpm from 10 bpm to 60 bpm. We repeatedly measured five times to check the error rate of the trigger mode in the same condition. Result : The differences of a distance from a peak phase to upper threshold, 1.0 to 3.0 mm at a 20 bpm as a reference for 3 days in a row were 0.68±0.05 mm, 0.91±0.03 mm, 1.23±0.03 mm, 1.42±0.04 mm, and 1.66±0.06 mm, respectively. Measurement result of changes in respiratory rate compared to baseline respiratory rate in maximum absolute difference. The coefficient of determination (R2) to estimate the correlation between the respiration velocity and variation of absolute difference was on average 0.838, 0.887, 0.770, 0.850, and 0.906. The p-values of all the variables were below 0.05. Conclusion : Using Trigger mode during respiratory gated radiation therapy (RGRT), accuracy and usefulness of trigger mode at reference breathing rate were confirmed. However, inaccuracies depending on the rate of breathing it could be uncertain in case of respiration rate is faster than 20 bpm as a standard respiration rate compared to slower than 20 bpm. Consequently, when conducting a RGRT using the trigger mode, real time monitoring is required with well educated respiration.

• The KIPS Transactions:PartB
• /
• v.18B no.2
• /
• pp.57-66
• /
• 2011

To prevent cardiac diseases, quantifying cardiac function is important in routine clinical practice by analyzing blood volume and ejection fraction. These works have been manually performed and hence it requires computational costs and varies depending on the operator. In this paper, an automatic left ventricle segmentation algorithm is presented to segment left ventricle on cardiac magnetic resonance images. After coil sensitivity of MRI images is compensated, a K-mean clustering scheme is applied to segment blood area. A graph searching scheme is employed to correct the segmentation error from coil distortions and noises. Using cardiac MRI images from 38 subjects, the presented algorithm is performed to calculate blood volume and ejection fraction and compared with those of manual contouring by experts and GE MASS software. Based on the results, the presented algorithm achieves the average accuracy of 6.2mL${\pm}$5.6, 2.9mL${\pm}$3.0 and 2.1%${\pm}$1.5 in diastolic phase, systolic phase and ejection fraction, respectively. Moreover, the presented algorithm minimizes user intervention rates which was critical to automatize algorithms in previous researches.

• The Journal of Korean Society for Radiation Therapy
• /
• v.28 no.2
• /
• pp.161-169
• /
• 2016

Purpose : To quantify the inter-fractional variation in prostate displacement and their dosimetric effects for prostate cancer treatment. Materials and Methods : A total of 176 daily cone-beam CT (CBCT) sets acquired for 6 prostate cancer patients treated with volumetric-modulated arc therapy (VMAT) were retrospectively reviewed. For each patient, the planning CT (pCT) was registered to each daily CBCT by aligning the bony anatomy. The prostate, rectum, and bladder were delineated on daily CBCT, and the contours of these organs in the pCT were copied to the daily CBCT. The concordance of prostate displacement, deformation, and size variation between pCT and daily CBCT was evaluated using the Dice similarity coefficient (DSC). Results : The mean volume of prostate was 37.2 cm3 in the initial pCT, and the variation was around ${\pm}5%$ during the entire course of treatment for all patients. The mean DSC was 89.9%, ranging from 70% to 100% for prostate displacement. Although the volume change of bladder and rectum per treatment fraction did not show any correlation with the value of DSC (r=-0.084, p=0.268 and r=-0.162, p=0.032, respectively), a decrease in the DSC value was observed with increasing volume change of the bladder and rectum (r=-0.230,p=0.049 and r=-0.240,p=0.020, respectively). Conclusion : Consistency of the volume of the bladder and rectum cannot guarantee the accuracy of the treatment. Our results suggest that patient setup with the registration between the pCT and daily CBCT should be considered aligning soft tissue.

• The Journal of Korean Society for Radiation Therapy
• /
• v.31 no.1
• /
• pp.25-32
• /
• 2019

Purpose: The size, shape, and volume of prosthetic appliance depend on the metal artifacts resulting from dental implant during head and neck treatment with radiation. This reduced the accuracy of contouring targets and surrounding normal tissues in radiation treatment plan. Therefore, the purpose of this study is to obtain the images of metal representing the size of tooth through MVCT, SMART-MAR CT and KVCT, evaluate the volumes, apply them into the proton therapy plan, and analyze the difference of dose distribution. Materials and Methods : Metal A ($0.5{\times}0.5{\times}0.5cm$), Metal B ($1{\times}1{\times}1cm$), and Metal C ($1{\times}2{\times}1cm$) similar in size to inlay, crown, and bridge taking the treatments used at the dentist's into account were made with Cerrobend ($9.64g/cm^3$). Metal was placed into the In House Head & Neck Phantom and by using CT Simulator (Discovery CT 590RT, GE, USA) the images of KVCT and SMART-MAR were obtained with slice thickness 1.25 mm. The images of MVCT were obtained in the same way with $RADIXACT^{(R)}$ Series (Accuracy $Precision^{(R)}$, USA). The images of metal obtained through MVCT, SMART-MAR CT, and KVCT were compared in both size of axis X, Y, and Z and volume based on the Autocontour Thresholds Raw Values from the computerized treatment planning equipment Pinnacle (Ver 9.10, Philips, Palo Alto, USA). The proton treatment plan (Ray station 5.1, RaySearch, USA) was set by fusing the contour of metal B ($1{\times}1{\times}1cm$) obtained from the above experiment by each CT into KVCT in order to compare the difference of dose distribution. Result: Referencing the actual sizes, it was appeared: Metal A (MVCT: 1.0 times, SMART-MAR CT: 1.84 times, and KVCT: 1.92 times), Metal B (MVCT: 1.02 times, SMART-MAR CT: 1.47 times, and KVCT: 1.82 times), and Metal C (MVCT: 1.0 times, SMART-MAR CT: 1.46 times, and KVCT: 1.66 times). MVCT was measured most similarly to the actual metal volume. As a result of measurement by applying the volume of metal B into proton treatment plan, the dose of $D_{99%}$ volume was measured as: MVCT: 3094 CcGE, SMART-MAR CT: 2902 CcGE, and KVCT: 2880 CcGE, against the reference 3082 CcGE Conclusion: Overall volume and axes X and Z were most identical to the actual sizes in MVCT and axis Y, which is in the superior-Inferior direction, was regular in length without differences in CT. The best dose distribution was shown in MVCT having similar size, shape, and volume of metal when treating head and neck protons. Thus it is thought that it would be very useful if the contour of prosthetic appliance using MVCT is applied into KVCT for proton treatment plan.

• The Journal of Korean Society for Radiation Therapy
• /
• v.34
• /
• pp.61-72
• /
• 2022

Purpose: Conventional CBCT(Cone-beam Computed-tomography) caused an error in the target volume due to organ movement in the area affected by respiratory movement. The purpose of this paper is to evaluate the usefulness of accuracy and time spent using the Gated CBCT function, which reduces errors when performing RGRT(respiratory gated radiation therapy), and to examine the appropriateness of phase. Materials and methods: To evaluate the usefulness of Gated CBCT, the QUASAR^TM respiratory motion phantom was used in the Truebeam STx^TM. Using lead marker inserts, Gated CBCT was scaned 5 times for every 20~80% phase, 30~70% phase, and 40~60% phase to measure the blurring length of the lead marker, and the distance the lead marker moves from the top phase to the end of the phase was measured 5 times. Using Cedar Solid Tumor Inserts, 4DCT was scanned for every phase, 20-80%, 30-70%, and 40-60%, and the target volume was contoured and the length was measured five times in the axial direction (S-I direction). Result: In Gated CBCT scaned using lead marker inserts, the axial moving distance of the lead marker on average was measured to be 4.46cm in the full phase, 3.11cm in the 20-80% phase, 1.94cm in the 30-70% phase, 0.90cm in the 40-60% phase. In Fluoroscopy, the axial moving distance of the lead marker on average was 4.38cm and the distance on average from the top phase to the beam off phase was 3.342cm in the 20-80% phase, 3.342cm in the 30-70% phase, and 0.84cm in the 40-60% phase. Comparing the results, the difference in the full phase was 0.08cm, the 20~80% phase was 0.23cm, the 30~70% phase was 0.10cm, and the 40~60% phase was 0.07cm. The axial lengths of ITV(Internal Target Volume) and PTV(Planning Target Volume) contoured by 4DCT taken using cedar solid tumor inserts were measured to be 6.40cm and 7.40cm in the full phase, 4.96cm and 5.96cm in the 20~80% phase, 4.42cm and 5.42cm in the 30~70% phase, and 2.95cm and 3.95cm in the 40~60% phase. In the Gated CBCT, the axial lengths on average was measured to be 6.35 cm in the full phase, 5.25 cm in the 20-80% phase, 4.04 cm in the 30-70% phase, and 3.08 cm in the 40-60% phase. Comparing the results, it was confirmed that the error was within ±8.5% of ITV Conclusion: Conventional CBCT had a problem that errors occurred due to organ movement in areas affected by respiratory movement, but through this study, obtained an image similar to the target volume of the setting phase using Gated CBCT and verified its usefulness. However, as the setting phase decreases, the scan time was increases. Therefore, considering the scan time and the error in setting phase, It is recommended to apply it to patients with respiratory coordinated stereotactic radiation therapy using a wide phase of 30-70% or more.