• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.15-24
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• 2013

Purpose: With the demand of SPECT/CT increasing, the interest in complex diagnostic information of CT is rising along with the expansion of various studies on potential performance value. But the study on reduction of exposure dose generated by CT is not being conducted enough. Therefore, in this study, the goal is to identify how much dose reduction exists when performing the extremity bone SPECT/CT using the flat-panel CT. Materials and Methods: The extremity bone SPECT/CT was performed with two equipments -BrightView XCT (Philips Healthcare, Cleveland, USA) and Brilliance 16 CT (Philips Healthcare, Cleveland, USA)-to identify the exposed dose and image quality resulted by changing scan parameter (mAs) applying for both equipment respectively. The noise value of image and spatial resolution were measured with AAPM CT phantom. Tube voltage (kVp) was fixed to 120 kVp, tube current (mAs) calculated at different mA (20, 30, 40, 50, 60, 70, 80) was applied to both equipments respectively. DLP (dose length product) were calculated at the same distance at respective mAs. Also, we acquired images and % contrast with NEMA IEC body phantom to confirm the effect on image. The output of statistics was analyzed by SPSS ver.18. Results: Regarding AAPM phantom, the noise decreased as the tube current (mAs) increased and flat-panel had less noise than Helical CT. This difference increased at lower dose exposure. As to the evaluation of spatial resolution, we can differentiate the space up to 0.75 mm with both equipments. With scan parameter (mA) growing, the value of DLP increased up to 54-216 mGy cm at flat-panel CT and up to 177-709 mGy cm at Helical CT. Regarding NEMA IEC body phantom, same sphere with varied parameter (mA) shows that similar results. Conclusion: There is no significant differences of image quality in both flat-panel and Helical CT when the scan parameter (mA) is changed respectively. Moreover, we can identify the reduction of exposure dose and confirm %contrast analysis value with maintaining image quality. Therefore, at the extremity bone SPECT/CT requiring high spital resolution without the wide ROI, the flat-panel CT is considered to be more useful and it expected to result in the similar image quality with lower exposure dose compared to Helical CT. Additionally, through this study, we expect to help the reduction of the unnecessary exposure dose.

• Archives of Plastic Surgery
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• v.48 no.3
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• pp.310-322
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• 2021

The incidence of extremity amputation is estimated at about 200,000 cases annually. Over 25% of patients suffer from terminal neuroma or phantom limb pain (TNPLP), resulting in pain, inability to wear a prosthetic device, and lost work. Once TNPLP develops, there is no definitive cure. Therefore, there has been an emerging focus on TNPLP prevention. We examined the current literature on TNPLP prevention in patients undergoing extremity amputation. A literature review was performed using Ovid Medline, Cochrane Collaboration Library, and Google Scholar to identify all original studies that addressed surgical prophylaxis against TNPLP. The search was conducted using both Medical Subject Headings and free-text using the terms "phantom limb pain," "amputation neuroma," and "surgical prevention of amputation neuroma." Fifteen studies met the inclusion criteria, including six prospective trials, two comprehensive literature reviews, four retrospective chart reviews, and three case series/technique reviews. Five techniques were identified, and each was incorporated into a targetbased classification system. A small but growing body of literature exists regarding the surgical prevention of TNPLP. Targeted muscle reinnervation (TMR), a form of physiologic target reassignment, has the greatest momentum in the academic surgical community, with multiple recent prospective studies demonstrating superior prevention of TNPLP. Neurorrhaphy and transposition with implantation are supported by less robust evidence, but merit future study as alternatives to TMR.

• Journal of Radiation Protection and Research
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• v.21 no.4
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• pp.263-271
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• 1996

The ANSI N13.32 recommends that a study of the angular response of a dosimeter be carried out once, although no pass/fail criterion is given for angular response. Gamma dose equivalent conversion and angular dependence factors were calculated by using MCNP code for the case of ANSI N13.32 extremity phantoms(finger and arm) at the depth of $7mg/cm^2$. Those extremity dosimeters were assumed to be irradiated from both monoenergitic photons and ISO X-ray narrow beams. These calculated gamma dose equivalent conversion and angular dependence factors were compared to B. Grosswendt's result calculated by using X-ray beams. The result showed that the dose equivalent conversion factors of this study agreed well with that of B. Grosswendt for all energies within 2% except 7% in the case of the low energies. In the case of angular dependence factors comparison, they agreed within 3%. It was shown that angular dependence factors of the finger phantom decreased as the horizontal angle of the phantom increased for the ISO X-ray beams less than 60keV. For the higher energy X-ray beams range they decreased slightly around 40 degree, but then increased from this energy to 90 degree.

• Journal of the Korean Society of Radiology
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• v.13 no.4
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• pp.613-621
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• 2019

The purpose of this study is to evaluate the effectiveness of supportive devices which are for minimizing the patient's movement during lower extremity angiography and to verify image quality of phantom by analyzing of Mask image, DSA image and Roadmap image into SNR and CNR. As a result of comparing SNR with CNR of mask image obtained by DSA technique using the phantom alone and phantom placed on the supportive devices, there was no significant difference between about 0~0.06 for SNR and about 0~0.003 for CNR. The study showed about 0.11~0.35 for SNR and 0.016~0.031 for CNR of DSA imaging by DSA technique about only water phantom of the blood vessel model and the water phantom placed on the device. Analyzing SNR and CNR of Roadmap technique about water phantom on the auxiliary device (hardboard paper, pomax, polycarbonate, acrylic) and water phantom alone, there was no significant difference between 0.02~0.05 for SNR and 0.002~0.004 for CNR. In conclusion, there was no significant difference on image quality by using supportive devices made by hardboard paper, pomax, polycarbonate or acryl regardless of whether using supportive devices or not. Supportive devices to minimize of the patient's movement may reduce the total amount of contrast, exam-time, radiation exposure and eliminate risk factors during angiogram. Supportive devices made by hardboard paper can be applied easily during angiogram due to advantages of reasonable price and simple processing. It is considered that will be useful to consider cost efficiency and types of materials and their properties in accordance with purpose and method of the study when the operator makes and uses supportive devices.

• Journal of radiological science and technology
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• v.33 no.4
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• pp.341-348
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• 2010

By accessing the current status of FPD system use in the hospitals located in Seoul and Gyeonggi Province as well as the entrance skin dose and the image quality evaluation realized by C-D Phantom, and the image assessment by the medical professionals regarding the radiography for the extremity, the following results were derived. 1. According to the evaluation made in the actual use of FPD system (12 machines), the grid ratio varied from 8:1 to 13:1, and 6 machines used the grid ratio with 12:1, realizing the largest number. Among the machines, there were 8 machines that allowed a removable grid while 3 machines did use a removable grid (25.0%). 2. When it came to the equipments used for the experiment, it showed that the amount of the entrance skin dose increased from 4.13 times up to 4.79 times with the grid use. 3. The difference in the entrance skin dose depending on the changes in the exposure condition(0.5times or 2.0times) was not significantly different regardless of the patients' thickness. 4. In terms of the image quality depending on C-D Phantom, the grid use was distinguished well. However, the images were well distinguishable as the exposure condition got increased. 5. In the clinical assessment, the grid use was less effective for the Hand PA, which was considered to shoot a thin body part. It was evaluated that the grid use was preferred for the Knee AP, which was shooting for a relatively thick body part. Nonetheless, 3 out of 5 people said that they would not use the grid if the entrance skin dose to reduced.

• Journal of Radiation Protection and Research
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• v.21 no.1
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• pp.41-50
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• 1996

In this study, the theoretical calculation of the air kerma-to-dose equivalent conversion factors was performed with a Monte Carlo N-Particle transport code for the two types of extremity phantom of the ANSI and the KAERI, respectively. Considering the distribution of absorbed dose due to the interaction of homogeneous Parallel broad beam of monoenergetic primary photons in the range between 15keV and 1.5MeV, the air kerma-to-dose equivalent conversion factors based on the kerma approximation were calculated. It is showed that all the theoretical conversion factors of the two types of the extremity phantom for the ANSI and the KAERI agree well with the experimental values of the ANSI N13.32 draft(1995) for each energy within 5.7%, maximum difference ratio, except for 13.6%, difference ratio in the case for the energy of less than 40keV. It is due to uncertainties of experiment occurred in the low X-ray energy range and geometry considered in the MCNP code.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.123-128
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• 2016

Phantom limb pain is a phenomenon in which patients experience pain in a part of the body that no longer exists. In several treatment modalities, spinal cord stimulation (SCS) has been introduced for the management of intractable post-amputation pain. A 46-year-old male patient complained of severe ankle and foot pain, following above-the-knee amputation surgery on the right side amputation surgery three years earlier. Despite undergoing treatment with multiple modalities for pain management involving numerous oral and intravenous medications, nerve blocks, and pulsed radiofrequency (RF) treatment, the effect duration was temporary and the decreases in the patient's pain score were not acceptable. Even the use of SCS did not provide completely satisfactory pain management. However, the trial lead positioning in the cauda equina was able to stimulate the site of the severe pain, and the patient's pain score was dramatically decreased. We report a case of successful pain management with spinal cauda equina stimulation following the failure of SCS in the treatment of intractable phantom limb pain.

• Journal of radiological science and technology
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• v.44 no.6
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• pp.663-669
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• 2021

The purpose of this study was to evaluate the usefulness of the rice bolus for upper-lower extremity radiation therapy by Tomotherapy. The computed tomography images were obtained for air, water, and rice bolus. The average and standard deviation of the Hounsfield unit (HU) were measured for image evaluation. The conformity index (CI) and homogeneity index (HI) were calculated for dose distribution of the planning target volume (PTV) which was treated by direct mode with gantry angle (90 and 270 angle). The point dose of a total of ten axial planes was measured to confirm the different regions. The mean of HU was -999.72 ± 0.72 at the air. The water and rice bolus were -0.13 ± 1.65 and -170 ± 27.2, respectively. The CI (HI) of PTV was 0.96 (1.36) at the air. 0.95 (1.04) at the water bolus, and 0.95 (1.04) at the rice bolus. The maximum dose for air was 136 cGy which is about 32% higher than 103 cGy for water and 104 cGy for rice bolus. There was a statistical difference for point dose between air and water including rice bolus (p=0.04), however, no statistical difference between water and rice bolus (p=0.579).The rice bolus phantom for extremities radiation therapy could be not only the optimized dose distribution but also the convenience and equipment safety at Tomotherapy. However, additional research will be necessary to more accurately verify the clinical usefulness of rice bolus phantom due to not enough examination.

• Journal of radiological science and technology
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• v.11 no.1
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• pp.3-16
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• 1988

Author has made an experiment on absolute speeds of 18 screenfilm combinations that have been on sale in Korea, with various beam qualities. At this time, the beam qualities were 60kVp with the ANSI extremity phantom, 80kVp with the ANSI chest phantom and 85kVp with 20 mm aluminium filter under scatter free condition. The obtained results were as follows; 1. When three independent measurements were performed, the percent standard deviations of mAs quantities of 1.0 + fog were decreased by the hardening of the beam quality, and the decreasing tendency was somewhat great in the blue systems. 2. Generally, the increasing tendency of absolute speeds was distinct by the hardening of the beam quality in the green systems. Conclusively, the green systems were more strongly dependent upon the beam quality rather than the blue systems. Therefore, the relative speed of green systems to blue systems were great under the same condition. 3. Differences in the green systems were kept almost constant even though the beam qualities were changed. 4. They were shown the mutual relationship of absolute speed and relative speed rather than independent.

• Journal of the Korean Society of Radiology
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• v.8 no.7
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• pp.409-415
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• 2014

In this study, radiation doses of major organs in various postures in lower extremity teleography were measured and compared to investigate the utility of the test methods. Ten adult males who underwent lower extremity teleography at a tube voltage of 73 kVp, tube current of 32 mAs, and SID of 180 cm. Using rando phantom, glass dosimeter was attached to the eye lens, thyroid gland, and genital gland to measure the radiation dose in each area 5 times in each anteroposterior posture and posteroanterior posture. The results were compared and analyzed through Paired T-test. The images from the anteroposterior posture and posteroanterior posture were evaluated through the blind test on a scale of 5. As a result, the posteroanterior method could reduce the dose than the anteroposterior posture method: less dose for the eye lens by 6%, thyroid gland by 6%, and genital gland by 26%. Since there was no significant difference in image evaluation, the posteroanterior posture is considered better than the anteroposterior posture in lower extremity teleography.