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Verification of Gated Radiation Therapy: Dosimetric Impact of Residual Motion (여닫이형 방사선 치료의 검증: 잔여 움직임의 선량적 영향)

  • Yeo, Inhwan;Jung, Jae Won
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.128-138
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    • 2014
  • In gated radiation therapy (gRT), due to residual motion, beam delivery is intended to irradiate not only the true extent of disease, but also neighboring normal tissues. It is desired that the delivery covers the true extent (i.e. clinical target volume or CTV) as a minimum, although target moves under dose delivery. The objectives of our study are to validate if the intended dose is surely delivered to the true target in gRT and to quantitatively understand the trend of dose delivery on it and neighboring normal tissues when gating window (GW), motion amplitude (MA), and CTV size changes. To fulfill the objectives, experimental and computational studies have been designed and performed. A custom-made phantom with rectangle- and pyramid-shaped targets (CTVs) on a moving platform was scanned for four-dimensional imaging. Various GWs were selected and image integration was performed to generate targets (internal target volume or ITV) for planning that included the CTVs and internal margins (IM). The planning was done conventionally for the rectangle target and IMRT optimization was done for the pyramid target. Dose evaluation was then performed on a diode array aligned perpendicularly to the gated beams through measurements and computational modeling of dose delivery under motion. This study has quantitatively demonstrated and analytically interpreted the impact of residual motion including penumbral broadening for both targets, perturbed but secured dose coverage on the CTV, and significant doses delivered in the neighboring normal tissues. Dose volume histogram analyses also demonstrated and interpreted the trend of dose coverage: for ITV, it increased as GW or MA decreased or CTV size increased; for IM, it increased as GW or MA decreased; for the neighboring normal tissue, opposite trend to that of IM was observed. This study has provided a clear understanding on the impact of the residual motion and proved that if breathing is reproducible gRT is secure despite discontinuous delivery and target motion. The procedures and computational model can be used for commissioning, routine quality assurance, and patient-specific validation of gRT. More work needs to be done for patient-specific dose reconstruction on CT images.

In Vitro imaging of MRI and Ultrasound for Colorectal Carcinoma (직결장암 조직의 자기공명영상과 초음파 소견에 대한 비교 연구)

  • Lee, Hwang Kyu;Jee, Keum Nahn;Hong, Sujin;Koh, Jae Hyang
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.133-143
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    • 2013
  • Purpose : To evaluate and compare the accuracy of magnetic resonance imaging (MRI) and ultrasound (US) for detection and estimation of invasion depth of colorectal carcinoma (CRC) by correlation with histopathologic findings in vitro, and to find out the best MR pulse sequence for accurate delineation of tumor from surrounding normal tissue. Materials and Methods: Resected specimens of CRC from 45 patients were examined about tumor detectability and invasion depth of US using high frequency (5-17 MHz) linear transducer in a tube filled with normal saline and MRI in a 8-channel quadrate head coil. The institutional review board approved this study and informed consent was waived. MRI with seven pulse sequences of in- and out-of-phases gradient echo T1 weighted images, fast spin echo T2 weighted image and its fat suppression image, fast imaging employing steady-state acquisition (FIESTA) and its fat suppression image, and diffusion weighted image (DWI) were performed. In each case, both imaging findings of MRI and US were evaluated independently for detection and estimation of invasion depth of tumor by consensus of two radiologists and were compared about diagnostic accuracy according to the histopathologic findings as reference standard. Seven MR pulse sequences were evaluated on the point of accurate delineation of tumor from surrounding normal tissue in each specimen. Results: In specimens of CRC, both imaging modalities of MRI (91.1%) and US (86.7%) showed relatively high diagnostic accuracy to detect tumor and evaluate invasion depth of tumor. In early CRC, diagnostic accuracy of US was 87.5% and that of MRI was 75.0%. There was no statistically significant difference between two imaging modalities (p > 0.05). The best pulse sequence among seven MR sequences for accurate delineation of tumor from surrounding normal tissue in each specimen of CRC was fast spin echo T2 weighted image. Conclusion: MRI and US show relatively high diagnostic accuracy to detect tumor and evaluate invasion depth of resected specimen of CRC. The most excellent pulse sequence of MRI for accurate delineation of tumor from surrounding normal tissue in CRC is fast spin echo T2 weighted image.

Preoperative Prediction of Ductal Carcinoma in situ Underestimation of the Breast using Dynamic Contrast Enhanced and Diffusion-weighted Imaging (역동적 유방 자기공명 영상 및 확산 강조영상을 이용한 관상피내암종 저평가 수술전 예측)

  • Park, Mina;Kim, Eun-Kyung;Kim, Min Jung;Moon, Hee Jung
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Objective: To investigate roles of dynamic contrast enhanced magnetic resonance (DCE MR) and diffusion-weighted (DW) imaging in preoperative prediction of underestimation of ductal carcinoma in situ (DCIS) ${\geq}2cm$ on US guided core needle biopsy. Materials and Methods: Twenty two patients with DCIS on US-guided 14 gauge core needle biopsy were included. Patients were divided into a group with and without DCIS underestimation based on histopathology. MR images including DCE and DW imaging were obtained with a 3.0-T MR. The lesion type (mass or non-mass), enhancement pattern, peak enhancement, and apparent diffusion coefficient (ADC) values of proven malignant masses were generated using software of CADstream and compared between two groups using Fisher's exact test and Mann Whitney test. Results: Eight patients were in the group with underestimation and 14 patients were in the group without underestimation. The lesion type and enhancement pattern were not different between two groups (P values = 1.000 and 0.613, respectively). The median peak enhancement of lesions with underestimation was 159.5%, higher than 133.5% of those without underestimation, but not significant (P value = 0.413). The median ADC value of lesions with underestimation was $1.26{\times}10^{-3}mm^2/sec$, substantially lower than $1.35{\times}10^{-3}mm^2/sec$ of those without underestimation (P value = 0.094). Conclusion: ADC values had the potential to preoperatively predict DCIS underestimation on US-guided core needle biopsy, although a large prospective series study should be conducted to confirm these results.

MORPHOLOGIC STUDY FOR SAGITTAL SPLIT RAMUS OSTEOTOMY USING 3-D IMAGE IN MANDIBULAR PROGNATHISM (하악전돌자에서 3차원영상을 이용한 하악지시상분할골절단술과 관련된 하악골의 해부학적 연구)

  • Park, Chung-Ryoul;Kook, Min-Suk;Park, Hong-Ju;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.350-359
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    • 2005
  • Sagittal split ramus osteotomy(SSRO) has been commonly performed in the mandibular prognathism. The previous studies of the mandibular anatomy for SSRO have mostly been used in dry skull without consideration of age, sex or jaw relationship of patients. This study was performed to evaluate the location of mandibular canal and the anatomy of ramus, such as the location of mandibular lingula and the ramal bone marrow, which were associated with SSRO procedures, in the patients with mandibular prognathism and normal young adults by using computerized tomographs(CT) and 3D images. The young adults at their twenties, who were considered to complete their skeletal growth, and seen in the Department of Orthodontics and Oral and Maxillofacial Surgery in Chonnam National University Hospital between March 2000 and May 2003, were selected. This study was performed in 30 patients (15men, 15women) who were diagnosed as skeletal class I normal relationship, and another 30 patients (15men, 15women) who were diagnosed as skeletal class III relationship upon clinical examination and lateral cephalometric radiographs. The patients were divided into 2 groups : Class I group, the patients who had skeletal class Ⅰ normal relationship(n=30, 15men, 15women), and Class III group, the patients who had skeletal class III relationship(n=30, 15men, 15women). Facial CT was taken in all patients, and pure 3D mandibular model was constructed by V-works version 4.0. The occlusal plane was designed by three points, such as the mesiobuccal cusp of both mandibular 1st molar and the incisal edge of the right mandibular central incisor, and used as a reference plane. Distances between the tip of mandibular lingula and the occlusal plane, the sigmoid notch, the anterior and the posterior borders of ramus were measured. The height of ramal bone marrow from the occlusal plane and the distance between mid-point of mandibular canal and the buccal or lingual cortex of the mandible in the 1st and 2nd molars were measured by V-works version 4.0. Distance(Li-OP) between the occlusal plane and the tip of mandibular lingula of Class III Group was longer than that of Class I Group in men(p<0.01), but there was no significant difference in women between both groups. Distance(Li-SN) between the sigmoid notch and the tip of mandibular ligula of Class III group was longer than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(Li-RA) between the anterior border of ramus and the tip of mandibular lingula of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Distance(Li-RP) between the posterior border of ramus and the tip of mandibular lingula of Class III Group was slightly shorter than that of Class I Group in men(p<0.05), but there was no significant difference in women between both groups. Distance(RA-RP) between the anterior and the posterior borders of ramus of Class III Group was shorter than that of Class I Group in men and women(p<0.01). Longer the distance(SN-AN) between the sigmoid notch and the antegonial notch was, longer the vertical ramal length above occlusal plane, higher the location of mandibular lingula, and shorter the antero-posterior ramal length were observed(p<0.01). Height of ramal bone marrow of Class III Group was higher than that of Class I Group in men and women(p<0.01). Distance between mandibular canal and buccal cortex of Class III Group in 1st and 2nd lower molars was shorter than that of Class I Group in men and women (p<0.05 in 1st lower molar in men, p<0.01 in others). These results indicate that there are some anatomical differences between the normal occlusal patients and the mandibular prognathic patients, such as the anterior-posterior length of ramus, the height of ramal bone marrow, and the location of mandibular canal.

Control of Chlorinated Volatile Pollutants at Indoor Air Levels Using Polymer-based Photocatalyst, Composite

  • Kim, Byeong-Chan;Kim, Hye-Jin;Kim, Ji-Eun;Park, Eun-Ju;Noh, Ji-Sun;Kang, Hyun-Jung;Shin, Seung-Ho;Jo, Wan-Kuen
    • Clean Technology
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    • v.19 no.2
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    • pp.105-112
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    • 2013
  • In this study, polyaniline (PANI)-based $TiO_2$ (PANI-$TiO_2$) composites calcined at different temperatures were prepared and their applications for control of trichloroethylene (TCE) and tetrachloroethylene (TTCE) at indoor air levels were investigated. For these target compounds, the photocatalytic control efficiencies of PANI-$TiO_2$ composites did not exhibit any trend with varying calcination temperatures (CTs). Rather, the average control efficiencies of PANI-$TiO_2$ composites over 3-h photocatalytic process increased from 61 to 72% and from 21 to 39% for TCE and TTCE, respectively, as the CT increased from 350 to $450^{\circ}C$. However, for both the target compounds, the average control efficiencies of PANI-$TiO_2$ composites decreased gradually as the CT increased further to 550 and $650^{\circ}C$. These results were ascribed to contents of anatase crystal phase and specific surface area of different particle sizes in the PANI-$TiO_2$ composites, which were demonstrated by the X-ray diffraction and scanning electron microscopy images, respectively. At the lowest input concentration (IC, 0.1 ppm), average control efficiencies of TCE and TTCE were 72 and 39%, respectively, whereas at the highest IC (1.0 ppm) they were 52 and 18%, respectively. As stream flow rate increased from 0.1 to 1.0 L $min^{-1}$, the average control efficiencies of TCE and TTCE decreased from ca. 100 to 47% and ca. 100 to 18%, respectively. In addition, the average control efficiencies of TCE and TTCE decreased from ca. 100 to 23% and ca. 100 to 8%, respectively as the relative humidity increased from 20 to 95%. Overall, these findings indicated that as-prepared PANI-$TiO_2$ composites could be used efficiently for control of chlorinated compounds at indoor air levels;if operational conditions were optimized.

Optimizations of 3D MRI Techniques in Brain by Evaluating SENSE Factors (삼차원 자기공명영상법의 뇌 구조 영상을 위한 최적화 연구: 센스인자 변화에 따른 신호변화 평가)

  • Park, Myung-Hwan;Lee, Jin-Wan;Lee, Kang-Won;Ryu, Chang-Woo;Jahng, Geon-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.161-170
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    • 2009
  • Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.

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Clinical Significance of MRI Findings During Medical Treatment for Tuberculous Spondylitis (척추염 환자의 약물치료기간 중 추적 검사한 MRI소견 변화의 임상적 중요성)

  • Kim, Dae-Jung;Chung, Tae-Sub;Suh, Sang-Hyun;Kim, Keun-Su;Cho, Yong-Eun;Yoon, Young-Sul;Kim, Sam-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.146-151
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    • 2009
  • Purpose : To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. Materials and Methods : Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. Results : The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. Conclusion : During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.

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(Image Analysis of Electrophoresis Gels by using Region Growing with Multiple Peaks) (다중 피크의 영역 성장 기법에 의한 전기영동 젤의 영상 분석)

  • 김영원;전병환
    • Journal of KIISE:Software and Applications
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    • v.30 no.5_6
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    • pp.444-453
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    • 2003
  • Recently, a great interest of bio-technology(BT) is concentrated and the image analysis technique for electrophoresis gels is highly requested to analyze genetic information or to look for some new bio-activation materials. For this purpose, the location and quantity of each band in a lane should be measured. In most of existing techniques, the approach of peak searching in a profile of a lane is used. But this peak is improper as the representative of a band, because its location does not correspond to that of the brightest pixel or the center of gravity. Also, it is improper to measure band quantity in most of these approaches because various enhancement processes are commonly applied to original images to extract peaks easily. In this paper, we adopt an approach to measure accumulated brightness as a band quantity in each band region, which Is extracted by not using any process of changing relative brightness, and the gravity center of the region is calculated as a band location. Actually, we first extract lanes with an entropy-based threshold calculated on a gel-image histogram. And then, three other methods are proposed and applied to extract bands. In the MER method, peaks and valleys are searched on a vertical search line by which each lane is bisected. And the minimum enclosing rectangle of each band is set between successive two valleys. On the other hand, in the RG-1 method, each band is extracted by using region growing with a peak as a seed, separating overlapped neighbor bands. In the RG-2 method, peaks and valleys are searched on two vertical lines by which each lane is trisected, and the left and right peaks nay be paired up if they seem to belong to the same band, and then each band region is grown up with a peak or both peaks if exist. To compare above three methods, we have measured the location and amount of bands. As a result, the average errors in band location of MER, RG-1, and RG-2 were 6%, 3%, and 1%, respectively, when the lane length is normalized to a unit value. And the average errors in band amount were 8%, 5%, and 2%, respectively, when the sum of band amount is normalized to a unit value. In conclusion, RG-2 was shown to be more reliable in the accuracy of measuring the location and amount of bands.

New Fast Block-Matching Motion Estimation using Temporal and Spatial Correlation of Motion Vectors (움직임 벡터의 시공간 상관성을 이용한 새로운 고속 블럭 정합 움직임 추정 방식)

  • 남재열;서재수;곽진석;이명호;송근원
    • Journal of Broadcast Engineering
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    • v.5 no.2
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    • pp.247-259
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    • 2000
  • This paper introduces a new technique that reduces the search times and Improves the accuracy of motion estimation using high temporal and spatial correlation of motion vector. Instead of using the fixed first search Point of previously proposed search algorithms, the proposed method finds more accurate first search point as to compensating searching area using high temporal and spatial correlation of motion vector. Therefore, the main idea of proposed method is to find first search point to improve the performance of motion estimation and reduce the search times. The proposed method utilizes the direction of the same coordinate block of the previous frame compared with a block of the current frame to use temporal correlation and the direction of the adjacent blocks of the current frame to use spatial correlation. Based on these directions, we compute the first search point. We search the motion vector in the middle of computed first search point with two fixed search patterns. Using that idea, an efficient adaptive predicted direction search algorithm (APDSA) for block matching motion estimation is proposed. In the experimental results show that the PSNR values are improved up to the 3.6dB as depend on the Image sequences and advanced about 1.7dB on an average. The results of the comparison show that the performance of the proposed APDSA algorithm is better than those of other fast search algorithms whether the image sequence contains fast or slow motion, and is similar to the performance of the FS (Full Search) algorithm. Simulation results also show that the performance of the APDSA scheme gives better subjective picture quality than the other fast search algorithms and is closer to that of the FS algorithm.

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Changes of lip morphology following mandibular setback surgery using 3D cone-beam computed tomography images

  • Paek, Seung Jae;Yoo, Ji Yong;Lee, Jang Won;Park, Won-Jong;Chee, Young Deok;Choi, Moon Gi;Choi, Eun Joo;Kwon, Kyung-Hwan
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.38.1-38.10
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    • 2016
  • Background: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. Methods: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program $Ondemand^{TM}$. Paired and independent t tests were performed for statistical analysis. Results: Landmarks in the mouth corner (cheilion, Ch) moved backward and downward (p < .005, p < .01). However, cheilion width was not statistically significantly changed. Landmark in labrale superius (Ls) was not altered significantly. Upper lip prominence angle (ChRt-Ls-$ChLt^{\circ}$) became acute. Landmarks in stomion (Stm), labrale inferius (Li) moved backward (p < .005, p < .001). Lower lip prominence angle (ChRt-Li-$ChLt^{\circ}$) became obtuse (p < .001). Height of the upper and lower lips was not altered significantly. Length of the upper lip vermilion was increased (p =< 0.01), and length of the lower lip vermilion was decreased (p < .05). Lip area on frontal view was not statistically significantly changed, but the upper lip area on lateral view was increased and change of the lower lip area decreased (p > .05, p < .005). On lateral view, upper lip prominent point (UP) moved downward and stomion moved backward and upward and the angle of Ls-UP-Stm ($^{\circ}$) was decreased. Lower lip prominent point (LP) moved backward and downward, and the angle of Stm-LP-Li ($^{\circ}$) was increased. Li moved backward. Finally, landmarks in the lower incisor tip (L1) moved backward and upward, but stomion moved downward. After surgery, lower incisor tip (L1) was positioned more superiorly than stomion (p < .05). There were significant associations between horizontal soft tissue and corresponding hard tissue. The posterior movement of L1 was related to statistically significantly about backward and downward movement of cheilion. Conclusions: The lip morphology of patients with dento-skeletal class III malocclusion shows a significant improvement after orthognathic surgery. Three-dimensional lip morphology changes in class III patients after MSS exhibited that cheilion moved backward and downward, upper lip projection angle became acute, lower lip projection angle became obtuse, change of upper lip area on lateral view was increased, change of lower lip area decreased, and morphology of lower lip was protruding. L1 was concerned with the lip tissue change in statistically significant way.