• Title/Summary/Keyword: Dimensional analysis

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A Computed Tomography-Based Anatomic Comparison of Three Different Types of C7 Posterior Fixation Techniques : Pedicle, Intralaminar, and Lateral Mass Screws

  • Jang, Woo-Young;Kim, Il-Sup;Lee, Ho-Jin;Sung, Jae-Hoon;Lee, Sang-Won;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.166-172
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    • 2011
  • Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.

It Doesn't Taste the same from Someone Else's Plate: The Influence of Culture in Interpersonal Retail Service Evaluations (별인적반자적미도불일양(别人的盘子的味道不一样): 문화대인제령수복무평개적영향(文化对人际零售服务评价的影响))

  • Spielmann, Nathalie;Kim, Ju-Ran
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.164-172
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    • 2010
  • This study reviews the influence of culture in interpersonal servicescapes by examining the restaurant retail setting. Two cultures (Canada and France) are surveyed in order to better understand their retail expectations towards interpersonal servicescapes. Using Hofstede's (1991) cultural dimensions to explain some of the differences between Canadian and French restaurant patrons, this study demonstrates a potentially interesting research avenue in the field of cross-cultural interpersonal services marketing. It demonstrates that cultural dimensions do not operate independently but interdependently. Understanding this can help retailers better explain complex service interactions between countries that may appear similar in terms of various socio-demographic features. In this exploratory research, a measure via exploratory factor analysis was developed, one that encompasses both the physical and service aspects common to interpersonal servicescape by using personality traits. This measure was tested in order to better understand the service expectations between two cultures, Canada and France. Five dimensional structures were uncovered in both cultures but with different traits and groupings. The differences between the traits uncovered and the overall Canadian and French personality structures find some explanation using Hofstede's (1991) cultural dimensions. The results of this survey point to a possible explanation as to why when services are transferred between cultures, the perceptions of them can be different and sometimes even lead to service failure. There are clearly some cultural differences between the Canadian and French consumers and their overall expectations regarding their consumption experience. Reviewing the first factor of the French and Canadian personality structures shows that the individualist/collectivist differences are apparent between the Canadian and the French cultures. The second dimension also has quite a few traits in common, five, all of which have the personal treatment aspect of the restaurant experience that a service provider would be responsible for: polite, respectful, and dedicated. Notable is that the French dimension does not include the authenticity or the hospitable aspect of the experience but includes even more features that are inherent to the personal interaction, such as charming and courteous. The third dimension of the Canadian and French structures reflects completely different expectations. Whereas the French dimension centers around energy and enthusiasm, the Canadian version is more laid-back and relaxed. There is extroversion in the French dimension to introversion in the Canadian dimension. This could be explained by differences on the Uncertainty Avoidance dimension as outlined by Hofstede (1991). The fourth dimension seems to confirm previously outlined cultural differences. Whereas Canadians, being a bit lower on uncertainty avoidance and power distance, prefer an intimate and private experience, the French continue to expect extraversion and inclusive features to their experience. The fifth dimension is in the French personality structure a clear expression of the high power distance society, where the roles of the players in the restaurant experience are clearly defined and the rules of engagement preserved. This study demonstrates that different cultures clearly do relate to different expectations regarding interpersonal services. This is apparent in the dimensions that come up in both the French and the Canadian personality structures, not only in terms of how different they are but also in with which cultural dimensions these can be explained. For interpersonal servicescapes, the use of personality traits is interesting as it allows for both physical and service features to be accounted for. Furthermore, the social component inherent to interpersonal servicescapes surfaces in most of the dimensions of the service personality structures. The quality of social exchanges is extremely important, and this even more so in cross-cultural situations, where the expec tations regarding the service experience may vary. As demonstrated by this research and using Hofstede's (1991) paradigm, not all societies will have the same expectations pertaining to the interpersonal services. Furthermore, the traditions surrounding the type of service can also have an impact on the service evaluations and differ between countries and cultures. However, using personality traits may also allow for retailers to see which service traits are common to two or more cultures where they seek to be present, and focus on these in the offering. The findings demonstrate the importance of the individualist and collectivist dimension for interpersonal servicescapes. This difference between the French and the Canadian personality structure is apparent in the most dominant dimension as well as within others. The findings are a step in explaining how retailers can transfer and then measure interpersonal services across cultures.

Intensity Modulated Radiation Therapy Commissioning and Quality Assurance: Implementation of AAPM TG119 (세기조절방사선치료(IMRT)의 Commissioning 및 정도관리: AAPM TG119 적용)

  • Ahn, Woo-Sang;Cho, Byung-Chul
    • Progress in Medical Physics
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    • v.22 no.2
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    • pp.99-105
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    • 2011
  • The purpose of this study is to evaluate the accuracy of IMRT in our clinic from based on TG119 procedure and establish action level. Five IMRT test cases were described in TG119: multi-target, head&neck, prostate, and two C-shapes (easy&hard). There were used and delivered to water-equivalent solid phantom for IMRT. Absolute dose for points in target and OAR was measured by using an ion chamber (CC13, IBA). EBT2 film was utilized to compare the measured two-dimensional dose distribution with the calculated one by treatment planning system. All collected data were analyzed using the TG119 specifications to determine the confidence limit. The mean of relative error (%) between measured and calculated value was $1.2{\pm}1.1%$ and $1.2{\pm}0.7%$ for target and OAR, respectively. The resulting confidence limits were 3.4% and 2.6%. In EBT2 film dosimetry, the average percentage of points passing the gamma criteria (3%/3 mm) was $97.7{\pm}0.8%$. Confidence limit values determined by EBT2 film analysis was 3.9%. This study has focused on IMRT commissioning and quality assurance based on TG119 guideline. It is concluded that action level were ${\pm}4%$ and ${\pm}3%$ for target and OAR and 97% for film measurement, respectively. It is expected that TG119-based procedure can be used as reference to evaluate the accuracy of IMRT for each institution.

Accuracy of the healing abutment and impression coping combined system on implant impression (인상채득이 가능한 치유지대주를 이용한 임플란트 인상채득의 정확성)

  • Jeon, Kyoung-Bae;Lee, Du-Hyeong;Kim, Jung-Han;Hwang, Jun-Ho;Park, Hyun-We;Lee, Kyu-Bok
    • The Journal of Korean Academy of Prosthodontics
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    • v.53 no.2
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    • pp.105-110
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    • 2015
  • Purpose: The purpose of this study was to evaluate the 3 dimensional accuracy of impression taking on the newly developed healing abutment and impression coping combined system comparing conventional pick-up type impression. Materials and methods: For 10 patients who had a single missing tooth on molar area, dental implants (SuperLine; Dentium, Seoul, Korea) were placed and healing abutment (MyHealing; Raphabio Co., Seoul, Korea) abutments were connected. After 3 months, transfer type impression with MyHealing and pick-up type impression with impression coping were performed twice in the same patients, and master models were fabricated. Customized prosthetic abutments (Myplant; Raphabio Co., Seoul, Korea) were milled and connected to the master casts. Through a dental scanner (Scanner S600; Zirkonzahn, South Tyrol, Italy), the master casts were converted into virtual casts. The length and angulation differences between casts were measured using 3 dimentional analysis program (Geomagic Qualify 12; Geomagic, Morrisville, NC, USA). Statistical significance was calculated using Kruskal Wallis test and Mann-Whitney U test (${\alpha}$=.05). Results: The length differences between the two systems were 0.032 mm in sagittal plane, and 0.029 in coronal plane, and 0.023 mm in horizontal plane. The angulation differences were $0.755^{\circ}$ in sagittal plane, and $1.275^{\circ}$ in coronal plane, and $0.420^{\circ}$ in horizontal plane. Conclusion: The accuracy of newly developed healing abutment system is similar to that of conventional pick-up impression. The new system can reduces chair time by not using separate impression coping.

Color stability of three dimensional-printed denture teeth exposed to various colorants (다양한 색소에 대한 3D 프린팅 인공치의 색 안정성)

  • Koh, Eun-Sol;Cha, Hyun-Suk;Kim, Tae-Hyung;Ahn, Jin-Soo;Lee, Joo-Hee
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.1-6
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    • 2020
  • Purpose: This study evaluated color stability of Dentca 3D-printed denture teeth, in comparison to color stabilities of four conventional types of denture teeth, upon being immersed in various colorants. Materials and methods: Four types of conventional prefabricated denture teeth (Surpass, GC, Artic 6, Heraeus Kulzer, Premium 6, Heraeus Kulzer, Preference, Candulor), 3D-printed denture teeth (Dentca); and Z250 (Filtek Z250, 3M ESPE) were prepared for testing. The samples were immersed in erythrosine 3%, coffee, cola, and distilled water (DW) at 37℃. Color change (ΔE) was measured by spectrophotometer before immersion and at 7, 14, and 21 days after immersion. One-way analysis of variance was performed along with Tukey's honestly significant difference multiple comparisons test (P<.05). Results: No great difference was observed between the color change of Dentca denture teeth and that of conventional denture teeth in most cases (P>.05). The color change of Dentca denture teeth immersed in erythrosine 3% was greater than that of Surpass (ΔE = 0.67 ± 0.25) after 1 week; Artic 6 (ΔE = 1.44 ± 0.38) and Premium 6 (ΔE = 1.69 ± 0.35) after 2 weeks; and Surpass (ΔE = 1.79 ± 0.49), Artic 6 (ΔE = 2.07 ± 0.21), Premium 6 (ΔE = 2.03 ± 0.75), and Preference (ΔE = 2.01 ± 0.75) after 3 weeks (P<.05). Conclusion: A color change was observed in Dentca denture teeth when immersed in some colorants; however, the maximum value of ΔE for Dentca denture teeth was within the clinically acceptable range.

Verification of Non-Uniform Dose Distribution in Field-In-Field Technique for Breast Tangential Irradiation (유방암 절선조사 시 종속조사면 병합방법의 불균등한 선량분포 확인)

  • Park, Byung-Moon;Bae, Yong-Ki;Kang, Min-Young;Bang, Dong-Wan;Kim, Yon-Lae;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.277-282
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    • 2010
  • The study is to verify non-uniform dose distribution in Field-In-Field (FIF) technique using two-dimensional ionization chamber (MatriXX, Wellhofer Dosimetrie, Germany) for breast tangential irradiation. The MatriXX and an inverse planning system (Eclipse, ver 6.5, Varian, Palo Alto, USA) were used. Hybrid plans were made from the original twenty patients plans. To verify the non-uniform dose distribution in FIF technique, each portal prescribed doses (90 cGy) was delivered to the MatriXX. The measured doses on the MatriXX were compared to the planned doses. The quantitative analyses were done with a commercial analyzing tool (OmniPro IMRT, ver. 1.4, Wellhofer Dosimetrie, Germany). The delivered doses at the normalization points were different to average 1.6% between the calculated and the measured. In analysis of line profiles, there were some differences of 1.3-5.5% (Avg: 2.4%), 0.9-3.9% (Avg: 2.5%) in longitudinal and transverse planes respectively. For the gamma index (criteria: 3 mm, 3%) analyses, there were shown that 90.23-99.69% (avg: 95.11%, std: 2.81) for acceptable range ($\gamma$-index $\geq$ 1) through the twenty patients cases. In conclusion, through our study, we have confirmed the availability of the FIF technique by comparing the calculated with the measured using MatriXX. In the future, various clinical applications of the FIF techniques would be good trials for better treatment results.

Error Analysis of Delivered Dose Reconstruction Using Cone-beam CT and MLC Log Data (콘빔 CT 및 MLC 로그데이터를 이용한 전달 선량 재구성 시 오차 분석)

  • Cheong, Kwang-Ho;Park, So-Ah;Kang, Sei-Kwon;Hwang, Tae-Jin;Lee, Me-Yeon;Kim, Kyoung-Joo;Bae, Hoon-Sik;Oh, Do-Hoon
    • Progress in Medical Physics
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    • v.21 no.4
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    • pp.332-339
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    • 2010
  • We aimed to setup an adaptive radiation therapy platform using cone-beam CT (CBCT) and multileaf collimator (MLC) log data and also intended to analyze a trend of dose calculation errors during the procedure based on a phantom study. We took CT and CBCT images of Catphan-600 (The Phantom Laboratory, USA) phantom, and made a simple step-and-shoot intensity-modulated radiation therapy (IMRT) plan based on the CT. Original plan doses were recalculated based on the CT ($CT_{plan}$) and the CBCT ($CBCT_{plan}$). Delivered monitor unit weights and leaves-positions during beam delivery for each MLC segment were extracted from the MLC log data then we reconstructed delivered doses based on the CT ($CT_{recon}$) and CBCT ($CBCT_{recon}$) respectively using the extracted information. Dose calculation errors were evaluated by two-dimensional dose discrepancies ($CT_{plan}$ was the benchmark), gamma index and dose-volume histograms (DVHs). From the dose differences and DVHs, it was estimated that the delivered dose was slightly greater than the planned dose; however, it was insignificant. Gamma index result showed that dose calculation error on CBCT using planned or reconstructed data were relatively greater than CT based calculation. In addition, there were significant discrepancies on the edge of each beam while those were less than errors due to inconsistency of CT and CBCT. $CBCT_{recon}$ showed coupled effects of above two kinds of errors; however, total error was decreased even though overall uncertainty for the evaluation of delivered dose on the CBCT was increased. Therefore, it is necessary to evaluate dose calculation errors separately as a setup error, dose calculation error due to CBCT image quality and reconstructed dose error which is actually what we want to know.

PHOTOELASTIC ANALYSIS OF STRESS INDUCED BY FIXED PROSTHESES WITH RIGID OF NONRIGID CONNECTION BETWEEN NATURAL TOOTH AND OSSEOINTEGRATED IMPLANT (골육착성 보철 치료시 임플랜트와 자연 지대치와의 연결 방법에 따른 관탄성 응력 분석)

  • Kim, Young-Il;Chung, Chae-Heon;Cho, Kyu-Zong
    • The Journal of Korean Academy of Prosthodontics
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    • v.31 no.2
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    • pp.271-300
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    • 1993
  • The purpose of this study was to analyze the stress distribution at supporting bone according to the types of connection modality between implant and tooth in the superstrcture. This investigation evaluated the stress patterns in a photoelastic model produced by three different types of dental implants such as Branemark, Steri-Oss, IMZ and resin tooth using the techniques of quasi three dimensional photoelasticity. The teeth-supported bridge had a first molar pontic supported by second premolar and second molar as a control group. The implant and toothsupported bridge had a first molar pontic supported by second premolar and implant posterior retainer as an experimental group. Prostheses were mechanically connected to an adjacent second premolar by the rigid of nonrigid connection, Nonrigid connection used an attachment placed between the tooth-supported and fixture-supported component. The female(keyway) of attachment was placed on the distal end of the retainer supported by the tooth ; the male(Key) of attachment connected to the osseointegrated bridge was engaged into the keyway. All prostheses were casted in the same nonprecious alloy and were cemented and screwed on their respective abutments and implants. 16㎏ of vertical loads on central fossae of second premolar, first molar pontic, implant of second molar were applied respectively and 6.5㎏ of inclined load on middle buccal surface of first molar pontic was applied. The results were as follows : 1. Under the vertical load on the central fossa of first mloar pontic, the stress developed at the apex of tooth of implat was more uniformly distributed in the case of nonrigid connection than in the case of rigid connection. 2. Under the vertical load on the central fossa of first molar pontic, the stress developed around the cervical area of tooth of implant was larger in the case of rigid connection than in the case of nonrigid connection because the bending moment was more occured in the case of rigid connection than in the case of nonrigid connection. 3. Stress was more restricted to the loaded side of nonrigid connection than to that of rigid connection 4. Under the inclined load. The set screw loosening of implant was more easily occured in the case of nonrigid connection than in the case of rigid connection due to torque moment. 5. In the case of Branemark implant, the stress concentration in second premolar was larger and the stress developed around the cervical area of implant was lower than any other cases under the vertical load, because Branemark implant with the flexible gold screw was showed in incline toward second premolar by a bending moment. 6. The stress developed around the apex of tooth or implant was more uniformly distributed in the case of Steri-Oss implant with stiff screw than in the case of Branemark implant under the vertical load. But, the stress developed around the cervical area of the Steri-Oss implant was larger than that of any other implants because bending moment was occured by vertical migration of second premolar. 7. The stress distribution in the case of IMZ implant was similar to the case of natural teeth under small vertical load. But, the residual stress around the implant was showed to occurdue to deformation of IMC and sinking of screw under larger vertical load.

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Effect of Clothing cues and perceiver variables on Impression Formation of Female dressed in Korean Dress(Part I) - Focus on Clothing Cues - (의복단서, 지각자변인이 여자한복착용자의 인상형성에 미치는 영향(I) - 의복단서를 중심으로 -)

  • 박찬부
    • Journal of the Korean Society of Costume
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    • v.32
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    • pp.313-336
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    • 1997
  • Nineteen stimulus photograghs varied in hue and color scheme of one clothing style of Korean dress worn by a female were used to investigate the effect of color color scheme and structure on impression formation for Korean dress. Subjects were 77 male and 86 female undergraduate and graduate students. The stimuli c9onsisted of two sets(cool and warm) of four similar color schemes two sets (cool and warm in Chima color) of five contrasting color schemes and one extra stimulus triad 3 hue base. Structures were de-fined by color schemes of Kit.Korum toward the color schemes of Jokori and Chima. Stimu-lus photogragh selected from Korean dress fashion magazines was managed and varied in hues and color schemes to Kit Korum Jokori and Chima according to Korean Standard Color through scanning and Adobe photoshop 3.0 program and then pictured through slide printer(HR-6000). Each subject assessed 19 stimulus color photographs with incorporated 7 point semantic differential response scale. The data were analyzed by frequency mean factor analysis t-test ANOVA and Scheffe test. Results indicate impression ofrmations are af-fected by clothing cues. 1) Four factors emerged to account for dimensional structure of impressions of female features on Korean dress. These four factors were titled as(1) preference.evaluation (2) individuality.attention (3) youth and (4) friendshio. The preference.evaluation factor was the largest including eleven adjectives and accounting for 29.62% of the variances. 2) Almost every clothing cue(color, color scheme, structure) had some effects on im-pressions formed But the color of Chima did not form the effects on impression of prefer-ence.evaluation factor. The effect of related color scheme was the most influential clothing cue on impressions of preference.evalation factor and friendship factor whereas the ef-fect of contrasting color scheme was the most influential clothing cue on impressions of indi-viduality.attention factor and youth factor. The effect of cool color of Chima was the most influential clothing cue on impression of indi-viduality.attention factor whereas the effect of warm color of Chima was the most influen-tial clothing cue on impressions of youth factor and friendship factor. The effect of Jokori/Chima.Kit.Korum structure was the most influential clothing cue on impressions of pref-erence.evaluation factor and youth factor whereas the effect of Kit.Korum/Jokori.Chima structure was the most influential clothing cue on impressions of individuality.attention factor and friendship factor. 3) The interaction effects were appeared among clothing cues. Significant interaction effects between color schemes(similar and contrasting) and colors of Chima(cool and warm were appeared on impressions of prefer-ence.evaluation factor imdividuality.atten-tion factor and friendship factor, Significant interaction effects between color schemes (similar and contrasting) and structures (Jokori.Chima.Kit.Korum; Jokori.Kit.Koru-m/Chima;Jokori/Chima.Kit.Korum;Kit.Korum/Jokori.Chima) were appeared on impressions of preference.evaluation factor youth factor and friendship factor. Signifi-cant interaction effects between colors(cool and warm) and structures were appeared on impressions of individuality.attention factor youth factor and friendship factor. Sighifi-cant interaction effects between colors(cool and warm) and structures were appeared on impressions of individuality.attention factor youth factor and friendship factor. Significant interaction effects among clothing cues(color color schemes and structures) were appeared on all impression factors. The friendship factor was the most friquently affected impression factor by interaction effects among clothing cues. In summary the clothing was used as nonverbal cues in the effect on impression for-mation of female dressed in Korean dress. it concluded that color schemes worked as cen-tral traits and colors of Chima and structures worked as peripheral traits in the formation of impression of the female clothed in Korean dress. hence organizing our impressions with respect to the parts of the Korean dress in re-lation to the whole holistic perceptual pro-cess Gestalt approach was used and supported.

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Rotation Errors of Breast Cancer on 3D-CRT in TomoDirect (토모다이렉트 3D-CRT을 이용한 유방암 환자의 회전 오차)

  • Jung, Jae Hong;Cho, Kwang Hwan;Moon, Seong Kwon;Bae, Sun Hyun;Min, Chul Kee;Kim, Eun Seog;Yeo, Seung-Gu;Choi, Jin Ho;Jung, Joo-Yong;Choe, Bo Young;Suh, Tae Suk
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.6-11
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    • 2015
  • The purpose of this study was to analyze the rotational errors of roll, pitch, and yaw in the whole breast cancer treated by the three-dimensional radiation therapy (3D-CRT) using TomoDirect (TD). Twenty-patient previously treated with TD 3D-CRT was selected. We performed a retrospective clinical analysis based on 80 images of megavoltage computed tomography (MVCT) including the systematic and random variation with patient setup errors and treatment setup margin (mm). In addition, a rotational error (degree) for each patient was analyzed using the automatic image registration. The treatment margin of X, Y, and Z directions were 4.2 mm, 6.2 mm, and 6.4 mm, respectively. The mean value of the rotational error for roll, pitch, and yaw were $0.3^{\circ}$, $0.5^{\circ}$, $0.1^{\circ}$, and all of systematic and random error was within $1.0^{\circ}$. The errors of patient positioning with the Y and Z directions have generally been mainly higher than the X direction. The percentage in treatment fractions in less than $2^{\circ}$ at roll, pitch, and yaw are 95.1%, 98.8%, and 97.5%, respectively. However, the edge of upper and lower (i.e., bottom) based on the center of therapy region (point) will quite a possibility that it is expected to twist even longer as the length of treatment region. The patient-specific characters should be considered for the accuracy and reproducibility of treatment and it is necessary to confirm periodically the rotational errors, including patient repositioning and repeating MVCT scan.