• Progress in Medical Physics
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• v.24 no.1
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• pp.48-53
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• 2013

Monte Carlo method has been known as the most accurate method for calculating absorbed dose in the human body, and an anthropomorphic phantom has been mainly used as a method of simulating internal organs for using such a calculation method. However, various efforts are made to extract data on several internal organs in the human body directly from CT DICOM files in recent Monte Carlo calculation using Geant4 code and to use by converting them into the geometry necessary for simulation. Such a function makes it possible to calculate the internal absorbed dose accurately while duplicating the actual human anatomical structure. Thus, this study calculated the absorbed dose in the human body by using Geant4 associating with DICOM files, and aimed to confirm the usefulness by compare the result with the measured dose using a Gafchromic EBT2 film. This study compared the dose calculated using simulation and the measured dose in beam central axis using the EBT2 film. The results showed that the range of difference was an average of 3.75% except for a build-up region, in which the dose rapidly changed from skin surface to the depth of maximum dose. In addition, this study made it easy to confirm the target absorbed dose by internal organ and organ through the output of the calculated value of dose by CT slice and the dose value of each voxel in each slice. Thus, the method that outputs dose value by slice and voxel through the use of CT DICOM, which is actual image data of human body, instead of the anthropomorphic phantom enables accurate dose calculations of various regions. Therefore, it is considered that it will be useful for dose calculation of radiotherapy planning system in the future. Moreover, it is applicable for currently-used several energy ranges in current use, so it is considered that it will be effectively used in order to check the radiation absorbed dose in the human body.

• Journal of the Korean Society of Radiology
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• v.13 no.5
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• pp.801-809
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• 2019

Existing Gamma Knife Radiosurgery(GKRS) for large lesions is often conducted in stages with volume or dose partitions. Often in case of volume division the target used to be divided into sub-volumes which are irradiated under the determined prescription dose in multi-sessions separated by a day or two, 3~6 months. For the entire course of treatment, treatment informations of the previous stages needs to be reflected to subsequent sessions on the newly mounted stereotactic frame through coordinate transformation between sessions. However, it is practically difficult to implement the previous dose distributions with existing Gamma Knife system except in the same stereotactic space. The treatment area is expanding because it is possible to perform the multistage treatment using the latest Gamma Knife Platform(GKP). The purpose of this study is to introduce the image-coregistration based on the stereotactic spaces and the strategy of multistage GKRS such as the determination of prescription dose at each stage using new GKP. Usually in image-coregistration either surgically-embedded fiducials or internal anatomical landmarks are used to determine the transformation relationship. Author compared the accuracy of coordinate transformation between multi-sessions using four or six anatomical landmarks as an example using internal anatomical landmarks. Transformation matrix between two stereotactic spaces was determined using PseudoInverse or Singular Value Decomposition to minimize the discrepancy between measured and calculated coordinates. To evaluate the transformation accuracy, the difference between measured and transformed coordinates, i.e., ${\Delta}r$, was calculated using 10 landmarks. Four or six points among 10 landmarks were used to determine the coordinate transformation, and the rest were used to evaluate the approaching method. Each of the values of ${\Delta}r$ in two approaching methods ranged from 0.6 mm to 2.4 mm, from 0.17 mm to 0.57 mm. In addition, a method of determining the prescription dose to give the same effect as the treatment of the total lesion once in case of lesion splitting was suggested. The strategy of multistage treatment in the same stereotactic space is to design the treatment for the whole lesion first, and the whole treatment design shots are divided into shots of each stage treatment to construct shots of each stage and determine the appropriate prescription dose at each stage. In conclusion, author confirmed the accuracy of prescribing dose determination as a multistage treatment strategy and found that using as many internal landmarks as possible than using small landmarks to determine coordinate transformation between multi-sessions yielded better results. In the future, the proposed multistage treatment strategy will be a great contributor to the frameless fractionated treatment of several Gamma Knife Centers.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.45-52
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• 2024

In this study, an AI-based algorithm was developed to prevent image quality deterioration and reading errors due to patient movement in PET/CT examinations that use radioisotopes in medical institutions to test cancer and other diseases. Using the Mothion Free software developed using, we checked the degree of correction of movement due to breathing, evaluated its usefulness, and conducted a study for clinical application. The experimental method was to use an RPM Phantom to inject the radioisotope 18F-FDG into a vacuum vial and a sphere of a NEMA IEC body Phantom of different sizes, and to produce images by directing the movement of the radioisotope into a moving lesion during respiration. The vacuum vial had different degrees of movement at different positions, and the spheres of the NEMA IEC body Phantom of different sizes produced different sizes of lesions. Through the acquired images, the lesion volume, maximum SUV, and average SUV were each measured to quantitatively evaluate the degree of motion correction by Motion Free. The average SUV of vacuum vial A, with a large degree of movement, was reduced by 23.36 %, and the error rate of vacuum vial B, with a small degree of movement, was reduced by 29.3 %. The average SUV error rate at the sphere 37mm and 22mm of the NEMA IEC body Phantom was reduced by 29.3 % and 26.51 %, respectively. The average error rate of the four measurements from which the error rate was calculated decreased by 30.03 %, indicating a more accurate average SUV value. In this study, only two-dimensional movements could be produced, so in order to obtain more accurate data, a Phantom that can embody the actual breathing movement of the human body was used, and if the diversity of the range of movement was configured, a more accurate evaluation of usability could be made.

• Journal of Gastric Cancer
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• v.9 no.2
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• pp.51-56
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• 2009

Purpose: Peritoneal recurrence has been reported to be the most common form of recurrence of gastric cancer. Peritoneal recurrence can generally be suggested by several types of image studies and also if there is evidence of ascites or Bloomer's rectal shelf. It can be confirmed by explorative laparotomy, but diagnostic laparoscopy is a good alternative method and laparoscopic surgery has also been widely used. We reviewed and analyzed the ability of diagnostic laparoscopy to detect peritoneal recurrence or carcinomatosis, and especially for gastric cancer. Materials and Methods: We performed a retrospective review the 45 gastric cancer patients who were operated via diagnostic laparoscopy between 2004. 2. and 2009. 3. We analyzed the perioperative clinical characteristics and the accuracy of the diagnostic methods. Results: The study groups included 14 patients who had confirmed gastric cancer, but they suspected to have carcinomatosis, and 31 patients who had previously underwent gastric resection, but they suspected to have recurrence. The mean operation time was $44.1\pm26.9$ minutes and the mean postoperative hospital stay was $2.7\pm2.8$ days. There was one case of operation-related complication and no postoperative mortality occurred. The sensitivities for detecting peritoneal recurrence or carcinomatosis were 92.1% for diagnostic laparoscopy, 29.7% for detecting ascites and rectal shelf on the physical examination, 86.5% for abdominal computed tomography, 69.2% for PET CT and 18.8% for CEA. Conclusion: Diagnostic laparoscopy does not require a long operation time or a long hospital stay, and it showed a low complication rate in our study. It has high sensitivity for detecting peritoneal recurrence of gastric cancer. It can be an alternative diagnostic confirmative method and it is useful for deciding on further treatment.

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.25-39
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• 2002

The purpose of this study is to develop and evaluate a web-based instruction Program(WBI) to help nurses improving their knowledge and skill of cardiopulmonary resuscitation. Using the model of web-based instruction(WBI) program designed by Rhu(1999), this study was carried out during February-April 2002 in five different steps; analysis, design, data collection and reconstruction, programming and publishing, and evaluation. The results of the study were as follows; 1) The goal of this program was focused on improving accuracy of knowledge and skills of cardiopulmonary resuscitation. The program texts consists of the concepts and importances of cardiopulmonary resuscitation(CPR), basic life support(BLS), advanced cardiac life support(ACLS), treatment of CPR, nursing care after CPR treatment. And in the file making step, photographs, drawings and image files were collected and edited by web-editor(Namo), scanner and Adobe photoshop program. Then, the files were modified and posted on the web by file transfer protocol(FTP). Finally, the program was demonstrated and once again revised by the result, and then completed. 2) For the evaluation of the program, 36 nurses who in K university hospital located in D city, and related questionnaire were distributed to them as well. Higher scores were given by the nurses in its learning contents with $4.2{\pm}.67$, and in its structuring and interaction of the program with $4.0{\pm}.79$, and also in its satisfactory of the program with $4.2{\pm}.58$ respectively. In conclusion, if the contents of this WBI educational program upgrade further based upon analysis and applying of the results the program evaluation, it is considered as an effective tool to implement for continuing education as life-long educational system for nurse.

• Progress in Medical Physics
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• v.18 no.3
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• pp.134-138
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• 2007

The current PET/CT system with high quality CT images not only increases diagnostic value by providing anatomic localization, but also shortens the acquisition time for attenuation correction than primary PET system. All commercially available PET/CT system uses the CT scan for attenuation correction instead of the transmission scan using radioactive source such as $^{137}Cs,\;^{68}Ge$. However the CT scan may substantially increase the patient dose. The purpose of this study was to evaluate quality of PET images reconstructed by CT attenuation map using various tube currents. in this study, images were acquired for 3D Hoffman brain phantom and cylindrical phantom using GE DSTe PET/CT system. The emission data were acquired for 10 min using phantoms after injecting 44.03 MBq of $^{18}F-FDG$. The CT images for attenuation map were acquired by changing tube current from 10 mA to 95 mA with fixed exposure time of 8 sec and fixed tube voltage of 140 kVp. The PET images were reconstructed using these CT attenuation maps. Image quality of CT images was evaluated by measuring SD (standard deviation) of cylindrical phantom which was filled with water and $^{18}F-FDG$ solution. The PET images were evaluated by measuring the activity ratio between gray matter and white matter in Hoffman phantom images. SDs of CT images decrease by increasing tube current. When PET images were reconstructed using CT attenuation maps with various tube currents, the activity ratios between gray matter and white matter of PET images were almost same. These results indicated that the quality of the PET images using low dose CT data were comparable to the PET images using general dose CT data. Therefore, the use of low dose CT is recommended than the use of general dose CT, when the diagnostic high quality CT is not required. Further studies may need to be performed for other system, since this study is limited to the GE DSTe system used in this study.

• Journal of radiological science and technology
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• v.34 no.3
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• pp.203-208
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• 2011

In this study, we investigated factors for affecting pneumothorax in percutaneous needle aspiration biopsy of lung lesions. This research were conducted at University Hospital in Daejeon from August 2007 to May 2008. Total 104 patients between the ages of 25~85 who had focal lung lesions were grouped in terms of the tumor location, tumor size, depth of lesion, gender, age, biopsy time, and the number of biopsies. Then, their correlations with pneumothorax were studied. The incidence of pneumothorax according to the positions showed 27.3% in the right lower lobe, 24.3% in the right upper lobe, 15% in the left lower lobe and 12% in the left upper, respectively. In addition, the incidence by lesion size showed 24.0% in 0~2.0 cm, 18.2% in 2.1~4.0 cm, above 20.0% in 4.1 cm respectively. The probabilities of pneumothorax was 6.7% at 0 cm depth of lesion, 24.2% at 0.1~2.0 cm and greater than 26.8% at 2.1 cm. By gender differences, we found that probability of incidence of pneumothrax is 21.7% for male and 17.1% for female. According to age, pneumothorax occurred in 25% in the group of less than 40-years-old, 11.7% in 41~50 years, 14.3% in 51~60 years, 24.1% in 61~70 years old and 24.1% in over 70 years. According to the time of biopsy, the incidence of pneumothorax was 3.8% from 0 to 10.0 minutes, 18.9% from 10.1 to 20.0 minutes and 40% more than 21 minutes.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.109-114
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• 2008

There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

• Progress in Medical Physics
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• v.21 no.1
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• pp.70-77
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• 2010

This study tested how S/N (Signal to Noise Ratio) ratios and ADC (apparent diffusion coefficient) values vary with different T-scores in a group of patients with osteoporosis. Based on DEXA (Dual Energy X-ray Absorptiometry) T-scores for L1.L4 for two groups of subjects consisting of 30 healthy people without osteoporosis and 30 patients who came for treatment of waist (lumbar or low back) pain and were suspected to have osteoporosis as judged from the simple X-ray findings, this study classified every spine into two groups of osteoporosis and osteopenia. Signal intensity measurements were made in the four regions of L1 to L4 on diffusion-weighted MR images obtained using 1.5T MR scanner, while ADC measurements were obtained from ADC map images. As an approach for quantitative analysis, the comparison of the variances in S/N ratios and ADC values for varying T-scores in the selected regions of interest was carried out based on averaged T-scores, S/N ratios, and ADC values. Also, the variances in S/N ratios and ADC values for each of the groups of osteoporosis and osteopenia, which were classified into by T-scores, were compared. For qualitative analysis, a careful naked eye examination of signal intensity differences in the area of L4 was made on T1-weighted sagittal images for each of the healthy (normal), osteopenia, and osteoporosis groups. In the qualitative analysis, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the S/N ratios on diffusion-weighted MR images also decreased, with the greatest decrease in the S/N ratio found in the osteoporosis group. Additionally, among the three groups, the lowest S/N ratio was found in the osteoporosis group. With respect to ADC map, it was found that for both the osteopenia group and the osteoporosis group, as T-scores deceased, the ADC values on diffusion-weighted MR images also decreased, with the greatest decrease in the ADC values found in the osteoporosis group. Additionally, among the three groups, the lowest ADC value was found in the osteoporosis group. On the other hand, in the qualitative analysis, the osteoporosis group showed the highest signal intensity. Additionally, among the three groups, the lowest signal intensity was found in the healthy (normal) group. It was found that as osteoporosis progressed, S/N ratio and ADC decreased, whereas signal intensity increased on T1-weighted images. Also, in diagnosing osteoporosis, MRI tests turned out to be (more) effective.

• Progress in Medical Physics
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• v.19 no.4
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• pp.256-262
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• 2008

To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.