• Journal of the Korean Society of Radiology
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• v.15 no.7
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• pp.943-948
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• 2021

The purpose of this study was to investigate changes in surface dose due to increased scattering of gamma rays from patients injected with ^99mTc and ¹⁸F, which are radioactive isotopes, in close contact with materials with high atomic number such as the walls of the stable room. Prepare ^99mTc and ¹⁸F by injecting 20 and 10 mCi respectively into the NEMA phantom, and then measuring the surface dose for 60 minutes by positioning the phantom at a height of 1 m above the surface, at a distance of 0, 5 and 10 cm from the wall, and at the same location as the phantom facing the wall. Each experiment was repeated five times for reproducibility of the experiment and one way analysis of variability (ANOVA) was performed for significance testing and Tukey was used as a post-test. The study found that surface doses of 220.268, 287.121, 243.957, and 226.272 mGy were measured at ^99mTc, respectively, in the case of empty space and in the case of 0, 5 and 10 cm, while those of ¹⁸F were measured at 637.111, 724.469, 657.107, and 640.365 mGy, respectively. In order to reduce changes in surface dose depending on the patient's location while waiting, it is necessary to keep the distance from the ground or the wall where the patient is closely adhered to, or install an air mattress, etc., to prevent the scattered lines as much as possible, considering the scattered lines due to the wall etc. in future setup of the patient waiting room and safety room, and in addition to the examination, the external skin width may be reduced.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.125-131
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• 2005

Purpose : For stereotactic radiosurgery (SRS) of a tumor in the region whose movement due to respiration is significant, like Lung lower lobe, the gated therapy, which delivers radiation dose to the selected respiratory phases when tumor motion is small, was performed using the Respiratory gating system and its clinical effectiveness was evaluated. Materials and Methods : For two SRS patients with a tumor in Lung lower lobe, a marker block (infrared reflector) was attached on the abdomen. While patient' respiratory cycle was monitored with Real-time Position Management (RPM, Varian, USA), 4D CT was performed (10 phases per a cycle). Phases in which tumor motion did not change rapidly were decided as treatment phases. The treatment volume was contoured on the CT images for selected treatment phases using maximum intensity projection (MIP) method. In order to verify setup reproducibility and positional variation, 4D CT was repeated. Results : Gross tumor volume (GTV) showed maximum movement in superior-inferior direction. For patient #1, motion of GTV was reduced to 2.6 mm in treatment phases ($30{\sim}60%$), while that was 9.4 mm in full phases ($0{\sim}90%$) and for patient #2, it was reduced to 2.3 mm in treatment phases ($30{\sim}70%$), while it was 11.7 mm in full phases ($0{\sim}90%$). When comparing two sets of CT images, setup errors in all the directions were within 3 mm. Conclusion : Since tumor motion was reduced less than 5 mm, the Respiratory gating system for SRS of Lung lower lobe is useful.

• Progress in Medical Physics
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• v.22 no.3
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• pp.107-116
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• 2011

Respiratory gated radiation therapy and stereotactic body radiation therapy require identical tumor motions during each treatment with the motion detected in treatment planning CT. Therefore, this study developed a tumor motion monitoring and analysis system during the treatments employing RPM data, gated setup OBI images and a data analysis software. A respiratory training and guiding program which improves the regularity of breathing was used to patients. The breathing signal was obtained by RPM and the recorded data in the 4D console was read after treatment. The setup OBI images obtained gated at 0% and 50% of breathing phases were used to detect the tumor motion range in crenio-caudal direction. By matching the RPM data recorded at the OBI imaging time, a factor which converts the RPM motion to the tumor motion was computed. RPM data was entered to the institute developed data analysis software and the maximum, minimum, average of the breathing motion as well as the standard deviation of motion amplitude and period was computed. The computed result is exported in an excel file. The conversion factor was applied to the analyzed data to estimate the tumor motion. The accuracy of the developed method was tested by using a moving phantom, and the efficacy was evaluated for 10 stereotactic body radiation therapy patients. For the sine wave motion of the phantom with 4 sec of period and 2 cm of peak-to-peak amplitude, the measurement was slightly larger (4.052 sec) and the amplitude was smaller (1.952 cm). For patient treatment, one patient was evaluated not to qualified to SBRT due to the usability of the breathing, and in one patient case, the treatment was changed to respiratory gated treatment due the larger motion range of the tumor than treatment planed motion. The developed method and data analysis program was useful to estimate the tumor motion during treatment.

• Progress in Medical Physics
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• v.17 no.1
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• pp.24-31
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• 2006

Automated analysis software was developed to measure the magnitude of the intrafractional and interfractional errors during breast radiation treatments. Error analysis results are important for determining suitable planning target volumes (PTV) prior to Implementing breast-conserving 3-D conformal radiation treatment (CRT). The electrical portal imaging device (EPID) used for this study was a Portal Vision LC250 liquid-filled ionization detector (fast frame-averaging mode, 1.4 frames per second, 256X256 pixels). Twelve patients were imaged for a minimum of 7 treatment days. During each treatment day, an average of 8 to 9 images per field were acquired (dose rate of 400 MU/minute). We developed automated image analysis software to quantitatively analyze 2,931 images (encompassing 720 measurements). Standard deviations ($\sigma$) of intrafractional (breathing motion) and intefractional (setup uncertainty) errors were calculated. The PTV margin to include the clinical target volume (CTV) with 95% confidence level was calculated as $2\;(1.96\;{\sigma})$. To compensate for intra-fractional error (mainly due to breathing motion) the required PTV margin ranged from 2 mm to 4 mm. However, PTV margins compensating for intefractional error ranged from 7 mm to 31 mm. The total average error observed for 12 patients was 17 mm. The intefractional setup error ranged from 2 to 15 times larger than intrafractional errors associated with breathing motion. Prior to 3-D conformal radiation treatment or IMRT breast treatment, the magnitude of setup errors must be measured and properly incorporated into the PTV. To reduce large PTVs for breast IMRT or 3-D CRT, an image-guided system would be extremely valuable, if not required. EPID systems should incorporate automated analysis software as described in this report to process and take advantage of the large numbers of EPID images available for error analysis which will help Individual clinics arrive at an appropriate PTV for their practice. Such systems can also provide valuable patient monitoring information with minimal effort.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Progress in Medical Physics
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• v.30 no.4
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• pp.112-119
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• 2019

Purpose: The advantages of ocular proton therapy are that it spares the optic nerve and delivers the minimal dose to normal surrounding tissues. In this study, it developed a solid eye phantom that enabled us to perform quality assurance (QA) to verify the dose and beam range for passive single scattering proton therapy using a single phantom. For this purpose, a new solid eye phantom with a polymethyl-methacrylate (PMMA) wedge was developed using film dosimetry and an ionization chamber. Methods: The typical beam shape used for eye treatment is approximately 3 cm in diameter and the beam range is below 5 cm. Since proton therapy has a problem with beam range uncertainty due to differences in the stopping power of normal tissue, bone, air, etc, the beam range should be confirmed before treatment. A film can be placed on the slope of the phantom to evaluate the Spread-out Bragg Peak based on the water equivalent thickness value of PMMA on the film. In addition, an ionization chamber (Pin-point, PTW 31014) can be inserted into a hole in the phantom to measure the absolute dose. Results: The eye phantom was used for independent patient-specific QA. The differences in the output and beam range between the measurement and the planned treatment were less than 1.5% and 0.1 cm, respectively. Conclusions: An eye phantom was developed and the performance was successfully validated. The phantom can be employed to verify the output and beam range for ocular proton therapy.

• The korean journal of orthodontics
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• v.24 no.4 s.47
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• pp.759-772
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• 1994

Orthodontists have experienced the treatment of cases with three lower incisors. Occasionally a lower incisor was either congenitally missing or so seriously damaged by injury or disease that its removal presented the best prospect for the patient. Sometimes the intentional extraction of a lower incisor is needed to produce enhanced functional and esthetic results with minimal orthodontic manipulation. Such cases have unfavorable anterior tooth size discrepancies and present difficulties in achieving good occlusal results. However such difficulties can be overcome by the sensible diagnosis and treatment plan. Three different cases are presented and the conclusions are listed. 1. It is important for orthodontist who tries to treat three lower incisor cases to measure and calculate accurately the degree of deviation of tooth size and morphology and the anterior tooth size ratio. 2. A diagnostic setup model should be made to determine whether the incisor extraction is appropriate and space closure is needed or not. It is the best way to be sure that the occlusal results, including overbite and overjet, will be acceptable and how far the degree of midline deviation is. It also shows the amount of interproximal reduction to achieve an acceptable occlusal result. 3. The class I relationship between the upper canine and the lower one must be obtained to establish the canine rise during eccentric movement by the concept of mutually protective occlusion. It also helps to maintain the stable occlusal result.

• Journal of the Korean Society of Radiology
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• v.5 no.6
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• pp.421-426
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• 2011

This research was accomplished to assess dose effects on image quality at computed radiography (CR). The ultimate target of the research was finding optimized exposure that provides necessary image quality for the clinical chest diagnosis. Modulation transfer function (MTF), normalized noise power spectrum (NNPS), and Noise equivalent quanta (NEQ) corresponding to the different doses were measured for the assessment of image quality. The preparation of "edge test device" used in MTF measurement and experimental geometry setup were followed by the recommendations of International Electrotechnical Commission (IEC). The experimental results show the necessary image quality can be achieved even at a half of the automatic exposure control (AEC) setting dose for chest diagnosis. It means that the patient exposure can be reduced dramatically by using optimized dose.

• The Journal of The Korea Institute of Intelligent Transport Systems
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• v.9 no.6
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• pp.151-158
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• 2010

In line with the requirement of appropriate protocol support for such mission-critical wireless sensor network (WSN) applications as patient monitoring, we investigate the framework for designing medium access control (MAC) schemes. The data traffic in medical systems comes with inherent traffic heterogeneity as well as strict requirement of reliability according to the varied extents of devise-wise criticality in separate cases. This implies that the quality-of-Service (QoS) issues are very distinctly delicate requiring specialized consideration. Besides, there are features in such systems that can be exploited during the design of a MAC scheme. In a monitoring or routine surveillance application, there are degrees of regularity or predictability in traffic as coordinated from a node of central control. The coordinator thus takes on the role of marshaling the resources in a neighborhood of nodes deployed mostly for upstream traffic; in a collision-free scheme, it schedules the time slots for each superframe based on the QoS specifications. In this preliminary study, we identify the key artifacts of such a MAC scheme. We also present basic performance issues like the impact of superframe length on delay incurred, energy efficiency achieved in the network operation as obtained in a typical simulation setup based on this framework.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.411-414
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• 1997

This paper describes the design guideline, methodology and general specification of the developed 12 channel interpretive electrocardiograph. The developed 12 channel electrocardiograph consists of main module, patient module, DSP module, interface module, power/battery module, TFT color LCD and thermal recorder. The control panel of the system has full keyboard, rotate/push button, function key and unctional indicators. The graphic user interface program conveniently allows user to record, setup, store, manage ECGs. A variety of system configurations give it ability to make user favorable environment. This system also has a resting adult's ECG analysis program. The developed system and program will be continusely evolved using a database of clinically correlated ECGs.