• Title/Summary/Keyword: Patient-based

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An accuracy analysis of Cyberknife tumor tracking radiotherapy according to unpredictable change of respiration (예측 불가능한 호흡 변화에 따른 사이버나이프 종양 추적 방사선 치료의 정확도 분석)

  • Seo, jung min;Lee, chang yeol;Huh, hyun do;Kim, wan sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.2
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    • pp.157-166
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    • 2015
  • Purpose : Cyber-Knife tumor tracking system, based on the correlation relationship between the position of a tumor which moves in response to the real time respiratory cycle signal and respiration was obtained by the LED marker attached to the outside of the patient, the location of the tumor to predict in advance, the movement of the tumor in synchronization with the therapeutic device to track real-time tumor, is a system for treating. The purpose of this study, in the cyber knife tumor tracking radiation therapy, trying to evaluate the accuracy of tumor tracking radiation therapy system due to the change in the form of unpredictable sudden breathing due to cough and sleep. Materials and Methods : Breathing Log files that were used in the study, based on the Respiratory gating radiotherapy and Cyber-knife tracking radiosurgery breathing Log files of patients who received herein, measured using the Log files in the form of a Sinusoidal pattern and Sudden change pattern. it has been reconstituted as possible. Enter the reconstructed respiratory Log file cyber knife dynamic chest Phantom, so that it is possible to implement a motion due to respiration, add manufacturing the driving apparatus of the existing dynamic chest Phantom, Phantom the form of respiration we have developed a program that can be applied to. Movement of the phantom inside the target (Ball cube target) was driven by the displacement of three sizes of according to the size of the respiratory vertical (Superior-Inferior) direction to the 5 mm, 10 mm, 20 mm. Insert crosses two EBT3 films in phantom inside the target in response to changes in the target movement, the End-to-End (E2E) test provided in Cyber-Knife manufacturer depending on the form of the breathing five times each. It was determined by carrying. Accuracy of tumor tracking system is indicated by the target error by analyzing the inserted film, additional E2E test is analyzed by measuring the correlation error while being advanced. Results : If the target error is a sine curve breathing form, the size of the target of the movement is in response to the 5 mm, 10 mm, 20 mm, respectively, of the average $1.14{\pm}0.13mm$, $1.05{\pm}0.20mm$, with $2.37{\pm}0.17mm$, suddenly for it is variations in breathing, respective average $1.87{\pm}0.19mm$, $2.15{\pm}0.21mm$, and analyzed with $2.44{\pm}0.26mm$. If the correlation error can be defined by the length of the displacement vector in the target track is a sinusoidal breathing mode, the size of the target of the movement in response to 5 mm, 10 mm, 20 mm, respective average $0.84{\pm}0.01mm$, $0.70{\pm}0.13mm$, with $1.63{\pm}0.10mm$, if it is a variant of sudden breathing respective average $0.97{\pm}0.06mm$, $1.44{\pm}0.11mm$, and analyzed with $1.98{\pm}0.10mm$. The larger the correlation error values in both the both the respiratory form, the target error value is large. If the motion size of the target of the sine curve breathing form is greater than or equal to 20 mm, was measured at 1.5 mm or more is a recommendation value of both cyber knife manufacturer of both error value. Conclusion : There is a tendency that the correlation error value between about target error value magnitude of the target motion is large is increased, the error value becomes large in variation of rapid respiration than breathing the form of a sine curve. The more the shape of the breathing large movements regular shape of sine curves target accuracy of the tumor tracking system can be judged to be reduced. Using the algorithm of Cyber-Knife tumor tracking system, when there is a change in the sudden unpredictable respiratory due patient coughing during treatment enforcement is to stop the treatment, it is assumed to carry out the internal target validation process again, it is necessary to readjust the form of respiration. Patients under treatment is determined to be able to improve the treatment of accuracy to induce the observed form of regular breathing and put like to see the goggles monitor capable of the respiratory form of the person.

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Consideration on Shielding Effect Based on Apron Wearing During Low-dose I-131 Administration (저용량 I-131 투여시 Apron 착용여부에 따른 차폐효과에 대한 고찰)

  • Kim, Ilsu;Kim, Hosin;Ryu, Hyeonggi;Kang, Yeongjik;Park, Suyoung;Kim, Seungchan;Lee, Guiwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.32-36
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    • 2016
  • Purpose In nuclear medicine examination, $^{131}I$ is widely used in nuclear medicine examination such as diagnosis, treatment, and others of thyroid cancer and other diseases. $^{131}I$ conducts examination and treatment through emission of ${\gamma}$ ray and ${\beta}^-$ ray. Since $^{131}I$ (364 keV) contains more energy compared to $^{99m}Tc$ (140 keV) although it displays high integrated rate and enables quick discharge through kidney, the objective of this study lies in comparing the difference in exposure dose of $^{131}I$ before and after wearing apron when handling $^{131}I$ with focus on 3 elements of external exposure protection that are distance, time, and shield in order to reduce the exposure to technicians in comparison with $^{99m}Tc$ during the handling and administration process. When wearing apron (in general, Pb 0.5 mm), $^{99m}Tc$ presents shield of over 90% but shielding effect of $^{131}I$ is relatively low as it is of high energy and there may be even more exposure due to influence of scattered ray (secondary) and bremsstrahlung in case of high dose. However, there is no special report or guideline for low dose (74 MBq) high energy thus quantitative analysis on exposure dose of technicians will be conducted based on apron wearing during the handling of $^{131}I$. Materials and Methods With patients who visited Department of Nuclear Medicine of our hospital for low dose $^{131}I$ administration for thyroid cancer and diagnosis for 7 months from Jun 2014 to Dec 2014 as its subject, total 6 pieces of TLD was attached to interior and exterior of apron placed on thyroid, chest, and testicle from preparation to administration. Then, radiation exposure dose from $^{131}I$ examination to administration was measured. Total procedure time was set as within 5 min per person including 3 min of explanation, 1 min of distribution, and 1 min of administration. In regards to TLD location selection, chest at which exposure dose is generally measured and thyroid and testicle with high sensitivity were selected. For preparation, 74 MBq of $^{131}I$ shall be distributed with the use of $2m{\ell}$ syringe and then it shall be distributed after making it into dose of $2m{\ell}$ though dilution with normal saline. When distributing $^{131}I$ and administering it to the patient, $100m{\ell}$ of water shall be put into a cup, distributed $^{131}I$ shall be diluted, and then oral administration to patients shall be conducted with the distance of 1m from the patient. The process of withdrawing $2m{\ell}$ syringe and cup used for oral administration was conducted while wearing apron and TLD. Apron and TLD were stored at storage room without influence of radiation exposure and the exposure dose was measured with request to Seoul Radiology Services. Results With the result of monthly accumulated exposure dose of TLD worn inside and outside of apron placed on thyroid, chest, and testicle during low dose $^{131}I$ examination during the research period divided by number of people, statistics processing was conducted with Wilcoxon Signed Rank Test using SPSS Version. 12.0K. As a result, it was revealed that there was no significant difference since all of thyroid (p = 0.345), chest (p = 0.686), and testicle (p = 0.715) were presented to be p > 0.05. Also, when converting the change in total exposure dose during research period into percentage, it was revealed to be -23.5%, -8.3%, and 19.0% for thyroid, chest, and testicle respectively. Conclusion As a result of conducting Wilcoxon Signed Rank Test, it was revealed that there is no statistically significant difference (p > 0.05). Also, in case of calculating shielding rate with accumulate exposure dose during 7 months, it was revealed that there is irregular change in exposure dose for inside and outside of apron. Although the degree of change seems to be high when it is expressed in percentage, it cannot be considered a big change since the unit of accumulated exposure dose is in decimal points. Therefore, regardless of wearing apron during high energy low dose $^{131}I$ administration, placing certain distance and terminating the administration as soon as possible would be of great assistance in reducing the exposure dose. Although this study restricted $^{131}I$ administration time to be within 5 min per person and distance for oral administration to be 1m, there was a shortcoming to acquire accurate result as there was insufficient number of N for statistics and it could be processed only through non-parametric method. Also, exposure dose per person during lose dose $^{131}I$ administration was measured with accumulated exposure dose using TLD rather than through direct-reading exposure dose thus more accurate result could be acquired when measurement is conducted using electronic dosimeter and pocket dosimeter.

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Association between Kawasaki disease and acute respiratory viral infections (가와사끼병과 급성 호흡기 바이러스 감염증의 연관성에 관한 연구)

  • Cho, Eun Young;Eun, Byung Wook;Kim, Nam Hee;Lee, Jina;Choi, Eun Hwa;Lee, Hoan Jong;Choi, Jung Yun
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1241-1248
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    • 2009
  • Purpose:The etiology of Kawasaki disease (KD) is still unknown. Recently, an association between human coronavirus NL63 (HCoV-NL63) and KD was implicated. Hence, we attempted to determine the association between KD and acute respiratory viral infections. Methods:Nasopharyngeal aspirate samples were obtained from 54 patients diagnosed with KD at the Seoul National University (SNU) Children's Hospital and SNU-Bundang Hospital between October 2003 and September 2006. Viral diagnoses of 11 respiratory viruses were made using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR): respiratory syncytial virus (RSV), adenovirus, rhinovirus (RV), parainfluenza viruses (PIVs) 1 and 3, influenza viruses (IFVs) A and B, human metapneumovirus (HMPV), human bocavirus (HBoV), HCoV OC43/229E, and HCoV-NL63. Clinical data were reviewed retrospectively. Results:The median age was 32 months (6 months-10.4 years). Respiratory symptoms were observed in 37 patients (69%). The following respiratory viruses were identified in 12 patients (22%): RV (n=4), PIV-3 (n=2), HBoV (n=2), and adenovirus, RSV, PIV-1, IFV-A, and HCoV-NL63 (n=1). Co-infection with PIV-3 and RV was observed in one patient. Respiratory symptoms were observed in 7 (58.3%) and 30 (71.4%) patients of the virus-positive and virus-negative groups (P>0.05). Response rate to intravenous immunoglobulin administration was 67% (n=8) and 86% (n=36) in the virus- positive and virus-negative groups (P>0.05). Conclusion:Respiratory symptoms were commonly observed in KD patients but the association between respiratory viruses and KD were not found. Large multicenter-based investigations are required to confirm the association between acute respiratory viral infections and KD.

Effects of an intensive asthma education program on asthmatic children and their caregivers (천식 환아와 보호자를 대상으로 한 집중 교육 프로그램의 효과)

  • Seo, Kang Jin;Kim, Gun Ha;Yu, Byung Keun;Yeo, Yun Ku;Kim, Jong Hoon;Shim, Eu Ddeum;Yoon, Mi Ri;Yoo, Young;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.188-203
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    • 2008
  • Purpose : Asthma is one of the most common chronic childhood disease. Education of asthmatic children and their families about asthma and its management may improve disease control, reduce symptoms, and improve school performance. The aim of the study was to evaluate the effects of an intensive asthma education program in asthmatic children and their families on outcome measure of asthma management behavior scale, knowledge about asthma, self efficacy scale and quality of life. Methods : Fifteen asthmatic children and their families were invited the intensive asthma education program which including allergen avoidance, management of asthma, correct use of the inhalation devices and control of exercise-induced asthma (study group). Fifteen asthmatic children and their families those who did not participate this program were served as control group. Participants were asked to complete a written questionnaire before and 3-month after the program. Results : After completing the intensive education program, significant improvement of the childrens asthma management behavior scale (27.1 vs. 32.2, P=0.011), belief and knowledge about asthma (14.2 vs. 17.9, P<0.001), self efficacy (47.9 vs. 49.7, P=0.091) and quality of life (79.6 vs. 88.6, P<0.001) was noted in the study group by measuring questionnaires. There are increasing tendencies in parental asthma management behavior scale and knowledge about asthma. Conclusion : This intensive asthma education program is effective in improving asthma control, self efficacy and quality of life of asthmatic children. This should serve as a national model for family-based programs for asthmatic children and their families.

A RETROSPECTIVE MULTICENTER CLINICAL STUDY OF INSTALLED US II / SS II IMPLANTS AFTER MAXILLARY SINUS FLOOR ELEVATION (상악동저 거상술 후 Osstem Implant (US II / SS II)의 다기관 후향적 임상연구)

  • Kook, Min-Suk;Park, Hong-Ju;Kim, Su-Gwan;Kim, Young-Kyun;Cho, Yong-Seok;Choi, Gab-Lim;Oh, Young-Hak;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.3
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    • pp.341-349
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    • 2008
  • Purpose: The purpose of this study was to evaluate the $Osstem^{(R)}$ implants (US II/SS II implants) through the retrospective study for the clinical success rate during the installation of the $Osstem^{(R)}$ implants (US II/SS II implants) by using of the procedures of maxillary sinus floor elevation. Materials and methods: The current study was researched in the 6 medical institutions: Chonnam National University, Chosun University, Pusan DaeDong Hospital, Bundang Seoul National University Hospital, Ap-Seon Clinic, and All Clinic. Based on the total number of 116 patients whose treatment was the installation of the US II/SS II implants with the procedures of the maxillary sinus floor elevation, they were conferred on the dental records of the patients under the joint consultation of the 6 medical institutions. On the dental recording charts, there were included in as the following; the name of the institutions, gender, age, with or without smoking or drinking, with or without the generalized diseases, the height of the alveolar bone on the operational sites, elapsed edentulous state period, the state of the opposed or adjacent teeth, the methods of the maxillary sinus floor elevation, secondary time period for surgery, the lengths, types, and diameters of implants, with or without bone transplantation or the types of bone, postoperative current bone height, current adjacent soft tissue state of the implants, with or without the success of the installations of the implants. We have done our survey with the clinical and radiolographical examinations and dental questionaries. The success and survival rate of the implants was evaluated. Results 1. Total number of the patients with the installation of the US II implants were 62. The 252 numbers of US II implants were installed on the 89 maxillary sinuses. The patient's mean age was 54.1 years old and there were 36 men and 27 women. 2. Total number of patients with the installation of SS II implant were 57. The 165 numbers of SS II implants were planted on the 80 maxillary sinuses. Their mean age was 48.7 years old and there were 37 men and 20 women. 3. The follow-up period was 30.7 months(21-49 mon) on average. The vertical bone loss of installed implants after the procedures of the maxillary sinus elevation was 1.1 mm on average in SS II and 1.3 mm on average in US II. There existed no statistical significance on each group. The mean enlarged bone height after the maxillary sinus floor elevation was 8.2 mm. 4. For the procedures of the maxillary sinus elevation, the Lateral approach technique occupied 87.1%, which was the most used one. In addition, the most frequently used transplanted bone was autogenous bone only which was 72.7% during the maxillary sinus floor elevation. 5. The complication of maxillary sinus floor elevation were perforation of sinus membrane, disesthesia on doner site, exposure of cover screw and exposure of maxillar bone. 6. The survival rate of US II and SS II after maxillary sinus floor elevation was 99.2% and 95.8%, respectively. And the success rate of US II and SS II after maxillary sinus floor elevation was 97.6% and 89.7%, respectively. Conclusion : On the evaluation of the analysis of our study, both US II and SS II implants showed the excellent clinical results by use of the procedures of maxillary sinus floor elevation.

Analysis of Residual Solvents of [F-18]FDG Using Gas Chromatography (기체크로마토그래프법을 이용한 [F-18]FDG의 잔류용매 분석)

  • Kim, Dong-Il;Lee, Il-Jung;Kim, Shi-Hwal;Chi, Yong-Gi;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.26-29
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    • 2011
  • Purpose: The general test method of the Korean Pharmacopeia specifies the test method on the clauses of quality control after manufacturing. According to KFDA Guidance for Medicines, standards of residual solvents regulates the maximum permissible dose of acetonitrile as 400 ppm, ethanol as 5,000 ppm, and acetic acid as 5,000 ppm. This study aims at identifying the type of resiual solvents in the final [F-18]FDG vial of an automatic synthesizer and measure its residual quantity. Materials and Methods: The center carried out residual solvents test of [F-18]FDG injection using Agilent Technologies 7890A with a Flame Ionization Detector. The column of Agilent Technologies 7890A used in measuring of residual solvents was CP WAX column ($30m{\times}0.53mm{\times}1.0{\mu}m$) and analysis condition was split mode 1:1 at the initial temperature $70^{\circ}C$ which was increased $20^{\circ}C/minute$ after two minutes and maintained at the final $140^{\circ}C$ for two minutes. The analysis method was as following: Firstly, ethanol-acetonitrile-acetic acid mixture was classified into four types of concentration (250-25-250 ppm, 1,000-100-1,000 ppm, 3,000-300-3,000 ppm, and 6,000-600-6,000 ppm), and $1.0{\mu}L$ of each type of concentration was injected into gas chromatography followed by an analysis of its peak domain. Then, a calibration-curve by the external standard method was drawn based on the analysis result. Results: While ethanol and acetonitrile were detected in TRACERlab MX, FASTlab had additional acetic acid. The residual quantity of the ethanol-acetonitrile-acetic acid mixture evaluated using the calibration-curve was average 72 ppm ethanol, 54 ppm acetonitrile, and 1030 ppm acetic acid for FASTlab, whereas average 439 ppm ethanol and 79 ppm acetonitrile for TRACERlab MX. This indicated that both of them were within the maximum permissible dose. Conclusion: Solvent residues in the [F-18]FDG injection were all within maximum permissible doses and proper to be used to examine a patient. The result indicated that types and quantities of solvent resides of radioactive pharmaceuticals vary depending on the automatic synthesizer.

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Evaluation of Dose Change by Using the Deformable Image Registration (DIR) on the Intensity Modulated Radiation Therapy (IMRT) with Glottis Cancer (성문암 세기조절 방사선치료에서 변형영상정합을 이용한 선량변화 평가)

  • Kim, Woo Chul;Min, Chul Kee;Lee, Suk;Choi, Sang Hyoun;Cho, Kwang Hwan;Jung, Jae Hong;Kim, Eun Seog;Yeo, Seung-Gu;Kwon, Soo-Il;Lee, Kil-Dong
    • Progress in Medical Physics
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    • v.25 no.3
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    • pp.167-175
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    • 2014
  • The purpose of this study is to evaluate the variation of the dose which is delivered to the patients with glottis cancer under IMRT (intensity modulated radiation therapy) by using the 3D registration with CBCT (cone beam CT) images and the DIR (deformable image registration) techniques. The CBCT images which were obtained at a one-week interval were reconstructed by using B-spline algorithm in DIR system, and doses were recalculated based on the newly obtained CBCT images. The dose distributions to the tumor and the critical organs were compared with reference. For the change of volume depending on weight at 3 to 5 weeks, there was increased of 1.38~2.04 kg on average. For the body surface depending on weight, there was decreased of 2.1 mm. The dose with transmitted to the carotid since three weeks was increased compared be more than 8.76% planned, and the thyroid gland was decreased to 26.4%. For the physical evaluation factors of the tumor, PITV, TCI, rDHI, mDHI, and CN were decreased to 4.32%, 5.78%, 44.54%, 12.32%, and 7.11%, respectively. Moreover, $D_{max}$, $D_{mean}$, $V_{67.50}$, and $D_{95}$ for PTV were increased or decreased to 2.99%, 1.52%, 5.78%, and 11.94%, respectively. Although there was no change of volume depending on weight, the change of body types occurred, and IMRT with the narrow composure margin sensitively responded to such a changing. For the glottis IMRT, the patient's weight changes should be observed and recorded to evaluate the actual dose distribution by using the DIR techniques, and more the adaptive treatment planning during the treatment course is needed to deliver the accurate dose to the patients.

Evaluation of Etiological Factors for Injuries at Oral and Maxillofacial Area (구강악안면부 외상발생의 역학적 평가)

  • Bae, Sung-Suk;Hwang, Soon-Jung
    • Journal of dental hygiene science
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    • v.12 no.4
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    • pp.310-319
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    • 2012
  • In this study, 1,495 cases of computerized data collected as disease entities of oral and maxillofacial injuries among patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. It was found that the injury incidence in male was greater than in female (1.49:1), it occurred most frequently in the age of 7~14 years old (19.6%), and its most frequent cause was falling down (25.9%). Injuries occurred in other place including beach and open-air (24.7%) most frequently, often developed in anterior teeth (43.2%) and posterior teeth (43.1%), their incidence was relatively higher between 15:00~17:00 (10.4%) and 19:00~23:00 (7.1%) O'clock. In the relationship between causes of the injury and the diagnosis based on the international classification of disease), falling, fall, impingement, violence, traffic accident, sports and own making accident caused most frequently lip and oral open injuries (S01.5), open fracture of tooth (S02.51), close fracture of tooth (S02.50), close fracture of mandible (S02.60), close fracture of tooth (S02.50), respectively. From the above results, it is necessary to understand general characteristics of oral and maxillofacial injuries and to consider their trends for the establishment of systematic complement policies and for the performing safety training and public relations activities.

Exposure Assessments of Environmental Contaminants in Ansim Briquette Fuel Complex, Daegu(I) - Effect zone of environmental pneumoconiosis and fugitive dust - (대구 안심연료단지 환경오염물질 노출 평가(I) - 환경성 진폐증 및 비산먼지 영향권역 -)

  • Jung, Jong-Hyeon;Oh, In-Bo;Phee, Young-Gyu;Nam, Mi-Ran;Hwang, Mi-Kyoung;Bang, Jin-Hee;Jeon, Soo-Bin;Lee, Sang-sup;Yu, Seung-do;KimS, Byung-Seok;Yoo, Seok-Ju;Lee, Kwan;Lim, Hyun-Sul
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.25 no.3
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    • pp.366-379
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    • 2015
  • Objectives: The objective of this study is to assess airborne particulate matter(PM) pollution and its effect on health of residents living near Ansim Briquette Fuel Complex in Daegu metropolitan region. Methods: The California Puff(CALPUFF) dispersion model, version 5.8, which can estimate the dispersion direction and range of airborn $PM_{10}$ was used to determine the possible areas affected by $PM_{10}$ pollutants emitted from Ansim briquette fuel complex. The CALPUFF modeling with 200 m grid-cell resolution was performed based on $PM_{10}$ emissions estimated from the amount of coal consumption in the fuel complex for four months in 2012. The Weather Research and Forecasting(WRF) fields were processed using CALMET to produce CALPUFF-ready meteorological inputs. Also, the distance from Ansim Briquette Fuel Complex to the residence of each environmental pneumoconiosis patient was analyzed. In addition, the affecting region of the pollutants emitted from briquette factories in Ansim Briquette Fuel Complex was determined. Results: CALPUFF modeling results showed that the highest concentrations of $PM_{10}$ were found near around the fuel complex. The modeled $PM_{10}$ distributions were characterized by significant decreases in concentration with distance from the complex. Seasonally, the highest concentration of $45{\mu}g/m^3$ was calculated in October which was mostly due to the distinct variation of amount of emission. Additional modeling with the maximum $PM_{10}$ emission of about 88 tons per year in 1986 showed that the highest concentration in October was nearly increased by 8 times than the concentration modeled with emission of 2010. As a result of medical examination and interviews for the residents in Ansim Briquette Fuel Complex and its surroundings, 8 environmental pneumoconiosis patients were found. These patients do not have occupational exposure and history. These patients have lived 0.3~1.1 km area in Ansim Briquette Fuel Complex and its surroundings. Conclusions: Airborne particles emitted from Ansim Briquette Fuel Complex can contribute to significant increase in $PM_{10}$ concentration in residential areas near around the complex. Especially, the residents near fuel complex may exposed to the pollutants emitted from the factories in Ansim Briquette Fuel Complex.

Comparison of Exposure Dose by Using AEC Mode of Abdomen AP Study in Radiography (복부 전후 방향 검사의 자동노출제어 사용 시 선량 비교 연구)

  • Kim, Ki-Won;Kwon, Yong-Rak;Seo, Seong-Won;Kwon, Kyung-Tae;Oh, Joo-Young;Son, Soon-Yong;Son, Jin-Hyun;Min, Jung-Whan
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.205-211
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    • 2015
  • We evaluated the effectiveness of TL (Time Limit) method by comparing with NTL (Non-time limit) method when it is used for examinations for abdomen Anterior Posterior (AP) in this paper. The evaluation was conducted based on the comparison of dose, and of signal to noise ratio (SNR) and contrast to ratio (CNR) on both methods. The experiments were conducted with XGEO GC 80 (Samsung, Korea), Unfors ThinX RAD (Unfors, Sweden) and Rando Phantom (Alderson research laboratories, USA) and shielding material with the size of $5.5{\times}9{\times}0.1cm^3$. It was set to activate only two upper ionization chambers in automatic exposure control(AEC) mode and the tube-voltage was set to 80kVp. When the exposure time was limited, it is limited to 51 msec. The images both by NTL AEC method and TL AEC method were acquired when with and without attachment of shielding material on the upper ionization chambers. The images were evaluated by SNR and CNR which are the image evaluation methods using 'Image J'. The NTL AEC method showed increases in dose as much as 130.7% at maximum and 80% at minimum than other methods. The TL AEC method showed decreases in mAs and exposure dose than the NTL AEC method as much as 43.8% and 44.4% respectively. There were no significant differences in SNR or CNR for the experiments (($p{\geq}0.05$). Therefore, it is suggested that the TLAEC mode is more effective when examining patients who have high BMI index or a patient with a metallic substance in the body after surgery.