Hwang, Sun Boong;Kim, Ki Hwan;kim, il Hwan;Kim, Woong;Im, Hyeong Seo;Han, Su Chul;Kang, Jin Mook;Kim, Jinho
The Journal of Korean Society for Radiation Therapy
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v.27
no.1
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pp.1-11
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2015
Purpose : Evaluating absorbed dose related to 2D and 3D imaging confirmation devices Materials and Methods : According to the radiographic projection conditions, absorbed doses are measured that 3 glass dosimeters attached to the centers of 0', 90', 180' and 270' in the head, thorax and abdomen each with Rando phantom are used in field size $26.6{\times}20$, $15{\times}15$. In the same way, absorbed doses are measured for width 16cm and 10cm of CBCT each. OBI(version 1.5) system and calibrated glass dosimeters are used for the measurement. Results : AP projection for 2D imaging check, In $0^{\circ}$ degree absorbed doses measured in the head were $1.44{\pm}0.26mGy$ with the field size $26.6{\times}20$, $1.17{\pm}0.02mGy$ with the field size $15{\times}15$. With the same method, absorbed doses in the thorax were $3.08{\pm}0.86mGy$ to $0.57{\pm}0.02mGy$ by reducing field size. In the abdomen, absorbed dose were reduced $8.19{\pm}0.54mGy$ to $4.19{\pm}0.09mGy$. Finally according to the field size, absorbed doses has decreased by average 5~12%. With Lateral projection, absorbed doses showed average 5~8% decrease. CBCT for 3D imaging check, CBDI in the head were $4.39{\pm}0.11mGy$ to $3.99{\pm}0.13mGy$ by reducing the width 16cm to 10cm. In the same way in thorax the absorbed dose were reduced $34.88{\pm}0.93(10.48{\pm}0.09)mGy$ to $31.01{\pm}0.3(9.30{\pm}0.09)mGy$ and $35.99{\pm}1.86mGy$ to $32.27{\pm}1.35mGy$ in the abdomen. With variation of width 16cm and 10cm, they showed 8~11% decrease. Conclusion : By means of reducing 2D field size, absorbed dose were decreased average 5~12% in 3D width size 8~11%. So that it is necessary for radiation therapists to recognize systematical management for absorbed dose for Imaging confirmation. and also for frequent CBCT, it is considered whether or not prescribed dose for RT refer to imaging dose.
This study was evaluated high end research grade Near Infrared Reflectance Spectrophotometer (NIRS) to field grade multiple Near Infrared Reflectance Spectrophotometer (NIRS) for rapid analysis at fresh rice leaf at sight with 238 samples of fresh rice leaf during year 2012, collected Jeollabuk-do for evaluate accuracy and precision between instruments. Firstly collected and build database high end research grade NIRS using with 400 nm ~ 2500 nm during from year 2003 to year 2009, seven years collected fresh rice leaf database then trim and fit to field grade NIRS with 1200 nm ~ 2400 nm then build and create calibration, transfer calibration with special transfer algorithm. The result between instruments was 0.005% differences, rapidly analysis for chemical constituents, Total nitrogen in fresh rice leaf within 5 minutes at sight and the result equivalent with laboratory data. Nevertheless last during more than 8 years collected samples for build calibration was organic samples that make differentiate by local or yearly bases etc. This strongly suggest population evaluation technique needed and constantly update calibration and maintenance calibration to proper handling database accumulation and spread out by knowledgable control laboratory analysis and reflect calibration update such as powerful control center needed for long lasting usage of fresh rice leaf analysis with NIRS at sight. Especially the agriculture products such as rice will continuously changes that made easily find out the changes and update routinely, if not near future NIRS was worthless due to those changes. Many research related NIRS was shortly study not long term study that made not well using NIRS, so the system needed check simple and instantly using with local language supported signal methods global distance (GD) and neighbour distance (ND) algorithm. Finally the multiple popular field grades instruments should be the same results not only between research grade instruments but also between multiple field grade instruments that needed easily transfer calibration and maintenance between instruments via internet networking techniques.
Joo, Chan Seong;Park, Su Yeon;Kim, JongSik;Choi, Byeong Gi;Chung, Yoonsun;Park, Won
The Journal of Korean Society for Radiation Therapy
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v.27
no.2
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pp.175-181
/
2015
Purpose : To evaluate Contralateral Breast Doses with Supine and Prone Positions for tangential Irradiation techniques for left-sided breast Cancer Materials and Methods : We performed measurements for contralateral doses using Human Phantom at each other three plans (conventional technique, Field-in-Field, IMRT, with prescription of 50 Gy/25fx). For the measurement of contralateral doses we used Glass dosimeters on the 4 points of Human Phantom surface (0 mm, 10 mm, 30 mm, 50 mm). For the position check at every measurements, we had taken portal images using EPID and denoted the incident points on the human phantom for checking the constancy of incident points. Results : The contralateral doses in supine position showed a little higher doses than those in prone position. In the planning study, contralateral doses in the prone position increased mean doses of 1.2% to 1.8% at each positions while those in the supine positions showed mean dose decreases of 0.8% to 0.9%. The measurements using glass dosimeters resulted in dose increases (mean: 2.7%, maximum: 4% of the prescribed dose) in the prone position. In addition, the delivery techniques of Field-in-field and IMRT showed mean doses of 3% higher than conventional technique. Conclusion : We evaluated contralateral breast doses depending on different positions of supine and prone for tangential irradiations. For the phantom simulation of set-up variation effects on contralateral dose evaluation, although we used humanoid phantom for planning and measurements comparisons, it would be more or less worse set-up constancy in a real patient. Therefore, more careful selection of determination of patient set-up for the breast tangential irradiation, especially in the left-sided breast, should be considered for unwanted dose increases to left lung and heart. In conclusion, intensive patient monitoring and improved patient set-up verification efforts should be necessary for the application of prone position for tangential irradiation of left-sided breast cancer.
Lee, Soo Hyeung;Park, Soo Yeun;Choi, Ji Min;Park, Ju Young;Kim, Jong Suk
The Journal of Korean Society for Radiation Therapy
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v.26
no.2
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pp.337-343
/
2014
Purpose : The aim of this study is to evaluate unwanted scattered dose to ovary by scattering and leakage generated from treatment fields of Tomotherapy for childbearing woman with breast cancer. Materials and Methods : The radiation treatments plans for left breast cancer were established using Tomotherapy planning system (Tomotherapy, Inc, USA). They were generated by using helical and direct Tomotherapy methods for comparison. The CT images for the planning were scanned with 2.5 mm slice thickness using anthropomorphic phantom (Alderson-Rando phantom, The Phantom Laboratory, USA). The measurement points for the ovary dose were determined at the points laterally 30 cm apart from mid-point of treatment field of the pelvis. The measurements were repeated five times and averaged using glass dosimeters (1.5 mm diameter and 12 mm of length) equipped with low-energy correction filter. The measures dose values were also converted to Organ Equivalent Dose (OED) by the linear exponential dose-response model. Results : Scattered doses of ovary which were measured based on two methods of Tomo helical and Tomo direct showed average of $64.94{\pm}0.84mGy$ and $37.64{\pm}1.20mGy$ in left ovary part and average of $64.38{\pm}1.85mGy$ and $32.96{\pm}1.11mGy$ in right ovary part. This showed when executing Tomotherapy, measured scattered dose of Tomo Helical method which has relatively greater monitor units (MUs) and longer irradiation time are approximately 1.8 times higher than Tomo direct method. Conclusion : Scattered dose of left and right ovary of childbearing women is lower than ICRP recommended does which is not seriously worried level against the infertility and secondary cancer occurrence. However, as breast cancer occurrence ages become younger in the future and radiation therapy using high-precision image guidance equipment like Tomotherapy is developed, clinical follow-up studies about the ovary dose of childbearing women patients would be more required.
Purpose : To assess the clinical utility of turbo contrast-enhanced magnetic resonance angiography(CE MRA) in the evaluation of the aortic arch and its major branches and to compare the image quality of CE MRA among different coils used. Materials and Methods : Turbo three-phase dynamic CE MRA encompassing aortic arch and its major branches was prospectively performed after manual bolus IV injection of contrast material in 29 patients with suspected cerebrovascular diseases at 1.0T MR unit. the raw data were obtained with 3-D FISH sequence (TR 5.4ms, TE 2.3ms, flip angle 30, slab thickness 80nm, effective slice thickness 4.0mm, matrix size $100{\times}256$, FOV 280mm). Total data acquisition time was 4. to 60 seconds. We subjectively evaluated the imge quality with three-rating scheme : "good" for unequivocal normal finding, "fair" for relatively satisfactory quality to diagnose 'normal' despite intravascular low signal, and "poor" for equivocal diagnosis or non-visualization of the origin or segment of the vessels due to low signal or artifacts which needs catheter angiography. At the level of the carotid bifurcation, it was compared with conventional 2D-TOF MRA image. Overall image quality was also compared visually and quantitatively by measuring signal-to-noise ratios (SNRs) of the ascending aorta, the innominate artery and both common carotid arteries among the three different coils used(CP body array(n=12), CP neck array(n=9), and head-and-neck(n=8). Results : Demonstration of the aortic arch and its major branches was rated as "good" in 55% (16/29) and "fair" in 34%(10/29). At the level of the carotid bifurcation, image quality of turbo CE MRA was same as or better than conventional 2D-TOF MRA in 65% (17/26). Overall image quality and SNR were significantlygreater with CP body array coil than with CP neck array or head-and-neck coil. Conclusions : Turbo CE MRA can be used as a screening exam in the evaluation of the major branches of the aortic arch from their origin to the skull base. Overall imagequality appears to be better with CP body array coil than with CP neck array coil or head-and-neck coil.
Objectives : The aim of this study was to analyze the relationship between depressive symptoms and sociodemographic factors associated with geriatric depression and insomnia and to examine the effects of these factors on depression. Methods : The severities of insomnia and depression in elderly aged 60 and older lived in Gwangmyeong city were evaluated and the related sociodemographic factors were investigated. From April 20, 2016 to December 1, 2016, Gwangmyeong city Mental Health Sevices consignment by department of psychiatry of a university-affiliated general hospital conducted surveys and interviews for total 837 elderly peoples lived in Gwangmyeong city by visiting welfare center and wards located in the city. Structured interviews were conducted using Insomnia Severity Index(ISI) and Short form-Geriatric Depression Scale(S-GDS) to examine the relationship between sociodemographic factors and the severities of insomnia and depression. Results : There were significant differences in S-GDS mean scores and age(below 70 years old, 70s, 80s, above 90 years old), type of health care(health insurance, medical aid), type of residency(own, not own) and marital status(single, married, divorced or widowed).There was a significant difference in education level, especially between not educated(and/or) elementary graduates and college graduate(F=3.227, p=0.012). Also, there were significant differences in age, type of health care, type of residency, number of household on divided S-GDS score above and below 10 scores(p<0.05). Insomnia measured by ISI was not significantly associated with sociodemographic factors(p>0.05), but was significantly associated with depressive symptoms(p<0.05). These findings suggest more severe insomnia symptom indicated the higher probability of depression and elderly with depressive symptoms had more severe insomnia. Conclusions : Geriatric depression has significant relationships with age, type of health care, type of residency, marital status, education and number of households. In addition, insomnia which is main symptom of depression in elderly, has important role in predicting the severity and diagnosis of depression.
Kim, Heejin;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Ji, Young Hoon;Yi, Chul-Young;Kim, Kum Bae
Progress in Medical Physics
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v.24
no.2
/
pp.99-107
/
2013
The surgical resection was occurred mainly in liver metastasis before the development of radiation therapy techniques. Recently, Radiation therapy is increased gradually due to the development of radiation dose delivery techniques. 18F-FDG PET image showed better sensitivity and specificity in liver metastasis detection. This image modality is important in the radiation treatment with planning CT for tumor delineation. In this study, we applied automatic image segmentation methods on PET image of liver metastasis and examined the impact of image factors on these methods. We selected the patients who were received the radiation therapy and 18F-FDG PET/CT in Korea Cancer Center Hospital from 2009 to 2012. Then, three kinds of image segmentation methods had been applied; The relative threshold method, the Gradient method and the region growing method. Based on these results, we performed statistical analysis in two directions. 1. comparison of GTV and image segmentation results. 2. performance of regression analysis for relation between image factor affecting image segmentation techniques. The mean volume of GTV was $60.9{\pm}65.9$ cc and the $GTV_{40%}$ was $22.43{\pm}35.27$ cc, and the $GTV_{50%}$ was $10.11{\pm}17.92$ cc, the $GTV_{RG}$ was $32.89{\pm}36.8$4 cc, the $GTV_{GD}$ was $30.34{\pm}35.77$ cc, respectively. The most similar segmentation method with the GTV result was the region growing method. For the quantitative analysis of the image factors which influenced on the region growing method, we used the standardized coefficient ${\beta}$, factors affecting the region growing method show GTV, $TumorSUV_{MAX/MIN}$, $SUV_{max}$, TBR in order. The result of the region growing (automatic segmentation) method showed the most similar result with the CT based GTV and the region growing method was affected by image factors. If we define the tumor volume by the auto image segmentation method which reflect the PET image parameters, more accurate and consistent tumor contouring can be done. And we can irradiate the optimized radiation dose to the cancer, ultimately.
To investigate the factors which affecting the cognitive function and depression of the 65 or more age group, the authors surveyed for the subjects in the region of Taejon and nearby Taejon area. 729 studied subjects were tested for cognitive function with MMSE and depression with GDS. The main results were followings; In the studied subjects, the rate of normal cognitive function was 56.8%, the rate of mildly impaired was 24.1% and the rate of severe impairment was 19.1%. The cognitive function level was closely related to the depression score. As the age increased, the cognitive function was more impaired. Sexual difference was also existed in the cognitive function level and the depression score. After adjusting the effect of age, the variables such as sex, marital status, education level, past job, instrumental ability of daily living, regular physical exercise, frequencies of going out the house, chest discomfort, visual and auditory disturbance, and dizziness had the significant relationship with cognitive function impairment. Among these variables instrumental ADL, age, visual disturbance, and sex showed statistical significance in the logistic regression model. In the multiple stepwise regression, the variables which had significant relationship to depression score were education level, frequencies of going out house, current job and house work activity, regular physical exercise, instrumental ADL, self-rated health and nutritional status, dimness, visual disturbance, and chest pain. In conclusion, main characteristics which had close relationship to the cognitive function and depression symptoms in the studied subjects were physical function and self rated health status.
Purpose: To evaluate the availability of magnetic resonance (MRI voiding cystography for the diagnosis of vesicoureteral reflux (VUR) and to compare the sensitivity of MR voiding cystography (MRVC) with that of radiographic voiding cystourethrography (VCUG) in the detection of VUR. Material and Methods : MRVC was performed upon 20 children referred for investigation of VUR. Either coronal T1-weighted spin-echo or spoiled gradient-echo images were obtained before and after transurethral administration of a mixture of normal saline and gadopentetate dimeglumine, and immediately after voiding. The findings of MRVC were compared with those of VCUG performed within 6 months of MRVC. Results 1 VUR was detected in 23 ureterorenal units f16 VUR's by both methods, five VUR's by VCUG, and two VUR's by MRVC). The sensitivity of VCUG and MRVC in detecting VUR was 91.3% (21/23) and 78.3% (18/23), respectively. MRVC detected renal scarring in 15 out of 17 kidneys with scintigraphically detected renal scarring. Conclusion : Although MRVC is slightly less sensitive than VCUG in the detection of VUR, it can be used for the diagnosis of VUR and renal scarring simultaneouslyl and thus will reduce the radiation hazard.
The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.
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