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Fractionated Stereotactic Radiation Therapy for Intracranial Benign Tumor : Preliminary Results of Clinical Application (양성 뇌종양의 분할정위 방사선치료 : 임상적 응용의 예비적 결과)

  • Kim Dae Yong;Ahn Yong Chan;Huh Seung Jae;Choi Dong Rak;Nam Jong Hyun;Lee Jung Il;Park Kwan;Nam Do-Hyun;Kim Moon Kyung
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.185-194
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    • 1998
  • Purpose : With the development of stereotactic immobilization systems capable of reliable serial repositioning, fractionated stereotactic radiation therapy (FSRT) offers the Potential for an improved treatment outcome by excellent dose delivery, and dose distribution characteristics with the favorable radiobiological properties of fractionated irradiation. We describe our initial experience using FSRT for the treatment of intracranial benign tumor. Materials and Methods : Between August 1995 and December 1996. 15 patients(7 males and 8 females aged 6-70 years) were treated with FSRT. The patients had the following diagnosis pituitary adenoma(10) including one patient who previously had received radiotherapy, craniopharyngioma (2), acoustic neurinoma (1), meningioma (2). Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2Gy was irradiated at 90% to 100% isodose surface of the isocenter The collimator sizes ranged from 26mm to 70mm. Results : In all patients except one follow-up lost, disease was well-controlled. Acute complication was negligible and no patient experienced cranial nerve neuropathies and radiation necrosis. In overall patient setup with scalp measurements, reproducibility was found to have mean of $1.1{\pm}0.6mm$ from the baseline reading. Conclusion : Relocatable stereotactic system for FSRT is highly reproducible and comfortable. Although the follow-up period was relatively short. FSRT is considered to be a safe and effective radiation technique as the treatment of intracranial tumor. But the fractionation schedule(fraction size, overall treatment time and total dose) still remains to be solved by further clinical trials.

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GafChromic Film Dosimetry for Stereotactic Radiosurgery with a Linear Accelerator (선형가속기를 이용한 정위방사선 치료 시 GafChromic Film을 이용한 선량측정)

  • Han Seung Hee;Cho Byung Chul;Park Suk Won;Oh Do Hoon;Park Hee Chul;Bae Hoon Sik
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.167-173
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    • 2003
  • Purpose: The purpose of this study was to evaluate whether a GafChromic film applied to stereotactic radiosurgery with a linear accelerator could provide information on the value for acceptance testing and quality control on the absolute dose and relative dose measurements and/or calculation of treatment planning system. Materials and methods: A spherical acrylic phantom, simulating a patient's head, was constructed from three points. The absolute and relative dose distributions could be measured by inserting a GafChromic film into the phantom. We tested the use of a calibrated GafChromic film (MD-55-2, Nuclear Associate, USA) for measuring the optical density. These measurements were achieved by irradiating the films with a dose of 0-112 Gy employing 6 MV photon. To verify the accuracy of the prescribed dose delivery to a target isocenter using a five arc beams (irradiated in 3 Gy per one beam) setup, calculated by the Linapel planning system the absolute dose and relative dose distribution using a GafChromic film were measured. All the irradiated films were digitized with a Lumiscan 75 laser digitizer and processed with the RIT113 film dosimetry system. Results: We verified the linearity of the Optical Density of a MD-55-2 GafChromic film, and measured the depth dose profile of the beam. The absolute dose delivered to the target was close to the prescribed dose of Linapel within an accuracy for the GafChromic film dosimetry (of $\pm$3$\%$), with a measurement uncertainty of $\pm$1 mm for the 50$\~$90$\%$ isodose lines. Conclusion: Our results have shown that the absolute dose and relative dose distribution curves obtained from a GafChromic film can provide information on the value for acceptance. To conclude the GafChromic flim is a convenient and useful dosimetry tool for linac based radiosurgery.

Determination of Grades and Design Strengths of Machine Graded Lumber in Korea (국내 기계등급구조재의 등급구분체계 및 기준설계값 결정방법 연구)

  • Hong, Jung-Pyo;Lee, Jun-Jae;Park, Moon-Jae;Yeo, Hwanmyeong;Pang, Sung-Jun;Kim, Chul-Ki;Oh, Jung-Kwon
    • Journal of the Korean Wood Science and Technology
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    • v.43 no.4
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    • pp.446-455
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    • 2015
  • Based on comparative studies on standards and grading procedures of machine graded lumber in Korea and other countries, this study proposed a procedure of determining the grade classification and design strengths of domestic machine graded lumber. Differences between machine stress rated lumber and E-rated laminations were detailed in order to clarify the need for the procedure improvement. To this improvement the use of average MOE requirement for grading was introduced instead of the fixed minimum MOE requirement which is currently used in the Korean standards. It was found that the fixed minimum MOE requirement method was easier for an inspector to grade but, less efficient as a strength predictor than the average MOE requirement method. The advantage of average MOE requirement method is statistically MOR-MOE regression-based MOR prediction and highly efficient in quality control though it requires a computer-aided operation system in an initial setup. A major weakness of the current Korean grading system was found that different strength characteristics depending on wood species were not reflected on the grade classification and the tabulated allowable design stress. The proposed procedures were developed taking advantages of respective merits of both methods and based on MOR-MOE regression analysis. Through this procedure, the grades of machine stress rated lumber should be revised to become interchangeable with E-rated lamination, which would be beneficial to the cost competitiveness of domestic machine graded lumber and glued laminated timber industry.

A Suvey on Satisfaction Measurement of Automatic Milking System in Domestic Dairy Farm (자동착유시스템 설치농가의 설치 후 만족도에 관한 실태조사)

  • Ki, Kwang-Seok;Kim, Jong-Hyeong;Jeong, Young-Hun;Kim, Yun-Ho;Park, Sung-Jai;Kim, Sang-Bum;Lee, Wang-Shik;Lee, Hyun-June;Cho, Won-Mo;Baek, Kwang-Soo;Kim, Hyeon-Shup;Kwon, Eung-Gi;Kim, Wan-Young;Jeo, Joon-Mo
    • Journal of Animal Environmental Science
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    • v.17 no.1
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    • pp.39-48
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    • 2011
  • The present survey was conducted to provide basic information on automatic milking system (AMS) in relation to purchase motive, milk yield and quality, customer satisfaction, difficulties of operation and customer suggestions, etc. Purchase motives of AMS were insufficient labor (44%), planning of dairy experience farm (25%), better performance of high yield cows (19%) and others (6%), respectively. Average cow performance after using AMS was 30.9l/d for milk yield, 3.9% for milk fat, 9,100/ml for bacterial counts. Sixty-eight percentage of respondents were very positive in response to AMS use for their successors but 18% were negative. The AMS operators were owner (44%), successor (44%), wife (6%) and company worker (6%), respectively. The most difficulty (31%) in using AMS was operating the system and complicated program manual. The rate of response to system error and breakdown was 25%. The reasons for culling cow after using AMS were mastitis (28%), reproduction failure (19%), incorrect teat placement (12%), metabolic disease (7%) and others (14%), respectively. Fifty-six percentages of the respondents made AMS maintenance contract and 44% did not. Average annual cost of the maintenance contract was 6,580,000 won. Average score for AMS satisfaction measurement (1 to 5 range) was 3.2 with decrease of labor cost 3.7, company A/S 3.6, increase of milk yield 3.2 and decrease of somatic cell count 2.8, respectively. Suggestions for the higher efficiency in using AMS were selecting cows with correct udder shape and teat placement, proper environment, capital and land, and attitude for continuous observation. Systematic consulting was highly required for AMS companies followed by low cost for AMS setup and systematization of A/S.

The error analysis of field size variation in pelvis region by using immobilization device (고정기구의 사용이 골반부위 방사선조사영역의 변화에 미치는 오차분석)

  • Kim, Ki-Hwan;Kang, No-Hyun;Bim, Dong-Wuk;Kim, Jun-Sang;Jang, Ji-Young;Kim, Yong-Eun;Kim, Jae-Sung;Cho, Moon-June
    • Journal of Radiation Protection and Research
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    • v.25 no.1
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    • pp.31-36
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    • 2000
  • In radiotherapy, it may happen to radiate surrounding normal tissue because of inconsistent field size by changing patient position during treatment. We are going to analyze errors reduced by using immobilization device with Electonic portal imaging device(EPID) in this study. We had treated the twenty-one patients in pelvic region with 10 MV X-ray from Aug. 1998 to Aug. 1999 at Chungnam National University Hospital. All patients were treated at supine position during treatment. They were separated to two groups, 11 patients without device and 10 patients with immobilization device. We used styrofoam for immobilization device and measured the errors of anterior direction for x, y axis and lateral direction for z, y axis from simulation film to EPID image using matching technique. For no immobilization device group, the mean deviation values of x axis and y axis are 0.19 mm. 0.48 mm, respectively and the standard deviations of systematic deviation are 2.38 mm, 2.19 mm, respectively and of random deviation for x axis and y axis are 1.92 mm. 1.29 mm, respectively. The mean deviation values of z axis and y axis are -3.61 mm. 2.07 mm, respectively and the standard deviations of systematic deviation are 3.20 mm, 2.29 mm, respectively and of random deviation for z axis and y axis are 2.73 mm. 1.62 mm, respectively. For immobilization device group, the mean deviation values of x axis and y axis are 0.71 mm. -1.07 mm, respectively and the standard deviations of systematic deviation are 1.80 mm, 2.26 mm, respectively and of random deviation for x axis and y axis are 1.56 mm. 1.27 mm, respectively. The mean deviation values of z axis and y axis are -1.76 mm. 1.08 mm, respectively and the standard deviations of systematic deviation are 1.87 mm, 2.83 mm, respectively and of random deviation for x axis and y axis are 1.68 mm, 1.65 mm, respectively. Because of reducing random and systematic error using immobilization device, we had obtained good reproducibility of patient setup during treatment so that we recommend the use of immobilization device in pelvic region of radiation treatment.

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3-D Conformal Radiotherapy for CNS Using CT Simulation (입체조준장치를 이용한 중추신경계의 방사선 입체조형치료 계획)

  • 추성실;조광환;이창걸
    • Progress in Medical Physics
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    • v.14 no.2
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    • pp.90-98
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    • 2003
  • Purpose : A new virtual simulation technique for craniospinal irradiation (CSI) that uses a CT-simulator was developed to improve the accuracy of field and shielding placement as well as patient positioning. Materials and Methods : A CT simulator (CT-SIM) and a 3-D conformal radiation treatment planning system (3D-CRT) were used to develop CSI. The head and neck were immobilized with a thermoplastic mask while the rest of the body was immobilized with a Vac-Loc. A volumetric image was then obtained with the CT simulator. In order to improve the reproducibility of the setup, datum lines and points were marked on the head and body. Virtual fluoroscopy was performed with the removal of visual obstacles, such as the treatment table or immobilization devices. After virtual simulation, the treatment isocenters of each field were marked on the body and on the immobilization devices at the conventional simulation room. Each treatment fields was confirmed by comparing the fluoroscopy images with the digitally reconstructed radiography (DRR) and digitally composited radiography (DCR) images from virtual simulation. Port verification films from the first treatment were also compared with the DRR/DCR images for geometric verification. Results : We successfully performed virtual simulations on 11 CSI patients by CT-SIM. It took less than 20 minutes to affix the immobilization devices and to obtain the volumetric images of the entire body. In the absence of the patient, virtual simulation of all fields took 20 min. The DRRs were in agreement with simulation films to within 5 mm. This not only reducee inconveniences to the patients, but also eliminated position-shift variables attendant during the long conventional simulation process. In addition, by obtaining CT volumetric image, critical organs, such as the eyes and the spinal cord, were better defined, and the accuracy of the port designs and shielding was improved. Differences between the DRRs and the portal films were less than 3 m in the vertebral contour. Conclusion : Our analysis showed that CT simulation of craniospinal fields was accurate. In addition, CT simulation reduced the duration of the patient's immobility. During the planning process. This technique can improve accuracy in field placement and shielding by using three-dimensional CT-aided localization of critical and target structures. Overall, it has improved staff efficiency and resource utilization by standard protocol for craniospinal irradiation.

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The Prototype and Structure of the Water Supply and Drainage System of the Wolji Pond During the Unified Silla Period (통일신라시대 월지(月池) 입·출수 체계의 원형과 구조)

  • Kim, Hyung-suk;Sim, Woo-kyung
    • Korean Journal of Heritage: History & Science
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    • v.52 no.4
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    • pp.124-141
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    • 2019
  • This research explored the relationship between the water quality issue of Wolji Pond (Anapji Pond) with the maintenance of the channel flow circulation system. The water supply and drainage system closely related to the circulation system of pond has been reviewed, rather than the existing water supply and drainage system that has been analyzed in previous studies. As a result of reviewing the water supply system, it has been learned that the water supply system on the southeastern shore of Wolji Pond, being the current water supply hole, has been connected to the east side garden facility (landscaping stone, curved waterway, storage facility of water) between the north and south fence and the waterway. This separate facility group seems to have been a subject of the investigation of the eastern side of Wolji Pond, with the landscaping stones having been identified in the 1920's survey drawings. The water supply facility on the southeastern shore, being the suspected water supply hole, seems to have some connection with the granite waterway remaining on the building site of Imhaejeon (臨海殿) on the southern side of Wolji Pond. It is inferred that it provides clean water, seeing that the slope towards the southwestern shore of Wolji Pond becomes lower, the landscaping stones have been placed in the filter area, and it is present in the 1920's survey drawings and the water supply hole survey drawing of 1975. The water drainage facility on the northern shore is composed of five stages. The functions of the wooden waterway and the rectangular stone water catchment facility seem not to be only for the water drainage of Wolji Pond. In light of the points that there are wood plugs in the wooden waterway and that there is a water catchment facility in the final stage, it is judged that the water of Balcheon Stream (撥川) may be charged in reverse according to this setup. Namely, the water could enter and exit in either direction in the water drainage facility on the northern shore It also seems that the supply to the wooden waterway could be opened and shut through the water catchment facility of rectangular stone group as well. The water drainage facility on the western shore is very similar to the water drainage facility on the northern shore, so it is difficult to avoid the belief that it existed during the Silla Dynasty, or it has been produced by imitating the water drainage facility on the northern shore at some future point in time. It seems to have functioned as the water drainage facility for the supply of agricultural water during the Joseon Dynasty. The water supply and drainage facilities in Wolji Pond have been understood as a systematized distribution network that has been intertwined organically with the facility of Donggung Palace, which was the center of the Silla capital. Water has been supplied to each facility group, including Wolji Pond, through this structure; it includes the drainage system connecting to the Namcheon River (南川) through the Balcheon Stream, which was an important canal of the capital center.

Impact of the Planning CT Scan Time on the Reflection of the Lung Tumor Motion (전산화단층촬영 주사시간(Scan Time)이 폐종양운동의 재현성에 미치는 영향 분석)

  • Kim Su Ssan;Ha Sung Whan;Choi Eun Kyung;Yi Byong Yong
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.55-63
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    • 2004
  • Purpose : To evaluate the reflection of tumor motion according to the planning CT scan time. Material and Methods : A model of N-shape, which moved aiong the longitudinal axis during the ventilation caused by a mechanical ventilator, was produced. The model was scanned by planning CT, while setting the relative CT scan time (T: CT scan time/ventilatory period) to 0.33, 0.50, 0.67, 0.75, 1.00, 1.337, and 1.537. In addition, three patients with non-small cell lung cancer who received stereotactic radiosurgery In the Department of Radiation Oncology, Asan Medical Center from 03/19/2002 to 05/21/2002 were scanned. Slow (10 Premier, Picker, scan time 2.0 seconds per slice) and fast CT scans (Lightspeed, GE Medical Systems, with a scan time of 0.8 second per slice) were peformed for each patient. The magnitude of reflected movement of the N-shaped model was evaluated by measuring the transverse length, which reflected the movement of the declined bar of the model at each slice. For patients' scans, all CT data sets were registered using a stereotactic body frame scale with the gross tumor volumes delineated in one CT image set. The volume and three-dimensional diameter of the gross tumor volume were measured and analyzed between the slow and fast CT scans. Results : The reflection degree of longitudinal movement of the model increased in proportion to the relative CT scan times below 1.00 7, but remained constant above 1.00 T Assuming the mean value of scanned transverse lengths with CT scan time 1.00 T to be $100\%$, CT scans with scan times of 0.33, 0.50, 0.57, and 0.75 T missed the tumor motion by 30, 27, 20, and $7.0\%$ respectively, Slow (scan time 2.0 sec) and Fast (scan time 0.8 sec) CT scans of three patients with longitudinal movement of 3, 5, and 10 mm measured by fluoroscopy revealed the increases in the diameter along the longitudinal axis Increased by 6.3, 17, and $23\%$ in the slow CT scans. Conculsion : As the relative CT scan time increased, the reflection of the respiratory tumor movement on planning CT also Increased, but remained constant with relative CT scan times above 1.00 T When setting the planning CT scan time above one respiration period (>1.00 T), only the set-up margin is needed to delineate the planning target volume. Therefore, therapeutic ratio can be increased by reducing the radiation dose delivered to normal lung tissue.

Treatment Margin Assessment using Mega-Voltage Computed Tomography of a Tomotherapy Unit in the Radiotherapy of a Liver Tumor (간종양 방사선치료 시 토모테라피 메가볼트 CT를 이용한 치료 여백 평가)

  • You, Sei-Hwan;Seong, Jin-Sil;Lee, Ik-Jae;Koom, Woong-Sub;Jeon, Byeong-Chul
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.280-288
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    • 2008
  • Purpose: To identify the inter-fractional shift pattern and to assess an adequate treatment margin in the radiotherapy of a liver tumor using mega-voltage computed tomography (MVCT) of a tomotherapy unit. Materials and Methods: Twenty-six patients were treated for liver tumors by tomotherapy from April 2006 to August 2007. The MVCT images of each patient were analyzed from the $1^{st}$ to the $10^{th}$ fraction for the assessment of the daily liver shift by four groups based on Couinard's proposal. Daily setup errors were corrected by bony landmarks as a prerequisite. Subsequently, the anterior-, posterior-, right-, and left shifts of the liver edges were measured by maximum linear discrepancies between the kilo-voltage computed tomography (KVCT) image and MVCT image. All data were set in the 2-dimensional right angle coordinate system of the transverse section of each patient's body. Results: The liver boundary shift had different patterns for each group. In group II (segment 2, 3, and 4), the anterior mean shift was $2.80{\pm}1.73\;mm$ outwards, while the left mean shift was $2.23{\pm}1.37\;mm$ inwards. In group IV (segment 7 and 8), the anterior-, posterior-, right-, and left mean shifts were $0.15{\pm}3.93\;mm$ inwards, $3.15{\pm}6.58\;mm$ inwards, $0.60{\pm}3.58\;mm$ inwards, and $4.50{\pm}5.35\;mm$ inwards, respectively. The reduced volume in group II after MVCT reassessment might be a consequence of stomach toxicity. Conclusion: Inter-fractional liver shifts of each group based on Couinard's proposal were somewhat systematic despite certain variations observed in each patient. The geometrical deformation of the liver by respiratory movement can cause shrinkage in the left margins of liver. We recommend a more sophisticated approach in free-breathing mode when irradiating the left lobe of liver in order to avoid stomach toxicity.

Evaluation of Target Position's Accuracy in 2D-3D Matching using Rando Phantom (인체팬톰을 이용한 2D-3D 정합시 타켓위치의 정확성 평가)

  • Jang, Eun-Sung;Kang, Soo-Man;Lee, Chul-Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.1
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    • pp.33-39
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    • 2009
  • Purpose: The aim of this study is to compare patient's body posture and its position at the time of simulation with one at the treatment room using On-board Imaging (OBI) and CT (CBCT). The detected offsets are compared with position errors of Rando Phantom that are practically applied. After that, Rando Phantom's position is selected by moving couch based on detected deviations. In addition, the errors between real measured values of Rando Phantom position and theoretical ones is compared. And we will evaluate target position's accuracy of KV X-ray imaging's 2D and CBCT's 3D one. Materials and Methods: Using the Rando Phantom (Alderson Research Laboratories Inc. Stanford. CT, USA) which simulated human body's internal structure, we will set up Rando Phantom on the treatment couch after implementing simulation and RTP according to the same ways as the real radioactive treatment. We tested Rando Phantom that are assumed to have accurate position with different 3 methods. We measured setup errors on the axis of X, Y and Z, and got mean standard deviation errors by repeating tests 10 times on each tests. Results: The difference between mean detection error and standard deviation are as follows; lateral 0.4+/-0.3 mm, longitudinal 0.6+/-0.5 mm, vertical 0.4+/-0.2 mm which all within 0~10 mm. The couch shift variable after positioning that are comparable to residual errors are 0.3+/-0.1, 0.5+/-0.1, and 0.3+/-0.1 mm. The mean detection errors by longitudinal shift between 20~40 mm are 0.4+/-0.3 in lateral, 0.6+/-0.5 in longitudinal, 0.5+/-0.3 in vertical direction. The detection errors are all within range of 0.3~0.5 mm. Residual errors are within 0.2~0.5 mm. Each values are mean values based on 3 tests. Conclusion: Phantom is based on treatment couch shift and error within the average 5mm can be gained by the diminution detected by image registration based on OBI and CBCT. Therefore, the selection of target position which depends on OBI and CBCT could be considered as useful.

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