• Title/Summary/Keyword: a motion system

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Prediction of Salvaged Myocardium in Patients with Acute Myocardial Infarction after Primary Percutaneous Coronary Angioplasty using early Thallium-201 Redistribution Myocardial Perfusion Imaging (급성심근경색증의 일차적 관동맥성형술 후 조기 Tl-201 재분포영상을 이용한 구조심근 예측)

  • Choi, Joon-Young;Yang, You-Jung;Choi, Seung-Jin;Yeo, Jeong-Seok;Park, Seong-Wook;Song, Jae-Kwan;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.219-228
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    • 2003
  • Purpose: The amount of salvaged myocardium is an important prognostic factor in patients with acute myocardial infarction (MI). We investigated if early Tl-201 SPECT imaging could be used to predict the salvaged myocardium and functional recovery in acute MI after primary PTCA. Materials and Methods: In 36 patients with first acute MI treated with primary PTCA, serial echocardiography and Tl-201 SPECT imaging ($5.8{\pm}2.1$ days after PTDA) were performed. Regional wall motion and perfusion were quantified with on 16-segment myocardial model with 5-point and 4-point scaling system, respectively. Results: Wall motion was improved in 78 of the 212 dyssynergic segments on 1 month follow-up echocardiography and 97 on 7 months follow-up echocardiography, which were proved to be salvaged myocardium. The areas under receiver operating characteristic curves of Tl-201 perfusion score for detecting salvaged myocardial segments were 0.79 for 1 month follow-up and 0.83 for 7 months follow-up. The sensitivity and specificity of Tl-201 redistribution images with optimum cutoff of 40% of peak thallium activity for detecting salvaged myocardium were 84.6% and 55.2% for 1 month follow-up, and 87.6% and 64.3% for 7 months follow-up, respectively. There was a linear relationship between the percentage of peak thallium activity on early redistribution imaging and the likelihood of segmental functional improvement 7 months after reperfusion. Conclusion: Tl-201 myocardial perfusion SPECT imaging performed early within 10 days after reperfusion can be used to predict the salvaged myocardium and functional recovery with high sensitivity during the 7 months following primary PTCA in patients with acute MI.

The Effect of Glide Path on Canal Centering Ability in Reciprocating File System (Reciprocating 파일 시스템에서 Glide Path가 근관만곡도 유지에 미치는 영향)

  • Zang, Ki-Choul;Kim, Jin-Woo;Cho, Kyung-Mo;Park, Se-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.3
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    • pp.245-252
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    • 2012
  • The purpose of this study was to evaluate the influence of glide path on canal centering ratio after instrumentation with different single file systems; WaveOne and Reciproc. Reciproc R25 (VDW), WaveOne Primary (Dentsply Maillefer) and PathFile #13, 16, 19 (Dentsply Maillefer) were used in this study. In no glide path groups, Reciproc files and WaveOne files used for canal preparation without glide path. In glide path groups, the PathFile were used before canal preparation. Methylene blue dye was introduced into the canal to obtain a clear pre-instrumentation image. Pre-instrumentation images and post-instrumentation images were scanned using Epson Perfection V700 Photo scanner (Epson, Nagano, Japan). Transparencies of post-instrumentation images were changed and superimposed on pre-instrumentation images using Adobe Photoshop CS 3 (Adobe Systems Incorporated, San Jose, CA, USA). The centering ratio was calculated for each instrumented canal using the following formula: CR=|X1-X2|/Y. It was statistically analyzed using two-way ANOVA at 95% confidential level. The centering ratio in glide path groups were significant less than it in no glide path groups at 3, 4, 5 and 6 mm level. Except 1 and 6 mm level, WaveOne groups had significant less centering ration than Reciproc groups. At 6 mm level, there was no significant difference between WaveOne and Reciproc. In the limitation of this study, creation of a previous glide path before reciprocating motion instrumentation in curved canal appears to be appropriate and WaveOne system can be used for preparation of curved canal without severe aberrations.

A Study on the Development of High Sensitivity Collision Simulation with Digital Twin (디지털 트윈을 적용한 고감도 충돌 시뮬레이션 개발을 위한 연구)

  • Ki, Jae-Sug;Hwang, Kyo-Chan;Choi, Ju-Ho
    • Journal of the Society of Disaster Information
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    • v.16 no.4
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    • pp.813-823
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    • 2020
  • Purpose: In order to maximize the stability and productivity of the work through simulation prior to high-risk facilities and high-cost work such as dismantling the facilities inside the reactor, we intend to use digital twin technology that can be closely controlled by simulating the specifications of the actual control equipment. Motion control errors, which can be caused by the time gap between precision control equipment and simulation in applying digital twin technology, can cause hazards such as collisions between hazardous facilities and control equipment. In order to eliminate and control these situations, prior research is needed. Method: Unity 3D is currently the most popular engine used to develop simulations. However, there are control errors that can be caused by time correction within Unity 3D engines. The error is expected in many environments and may vary depending on the development environment, such as system specifications. To demonstrate this, we develop crash simulations using Unity 3D engines, which conduct collision experiments under various conditions, organize and analyze the resulting results, and derive tolerances for precision control equipment based on them. Result: In experiments with collision experiment simulation, the time correction in 1/1000 seconds of an engine internal function call results in a unit-hour distance error in the movement control of the collision objects and the distance error is proportional to the velocity of the collision. Conclusion: Remote decomposition simulators using digital twin technology are considered to require limitations of the speed of movement according to the required precision of the precision control devices in the hardware and software environment and manual control. In addition, the size of modeling data such as system development environment, hardware specifications and simulations imitated control equipment and facilities must also be taken into account, available and acceptable errors of operational control equipment and the speed required of work.

Patients with brain metastases the usefulness of contrast-enhanced FLAIR images after delay (뇌전이 환자의 조영 증강 후 지연 FLAIR 영상의 유용성)

  • Byun, Jae-Hu;Park, Myung-Hwan;Lee, Jin-Wan
    • Korean Journal of Digital Imaging in Medicine
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    • v.16 no.1
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    • pp.13-19
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    • 2014
  • Purpose: FLAIR image is beneficial for the diagnosis of various bran diseases including ischemic CVS, brain tumors and infections. However the border between the legion of brain metastasis and surrounding edema may not be clear. Therefore, this study aims to investigate the practical benefits of delayed imaging by comparing the image from a patient with brain metastasis before a contrast enhancement and the image 10 minutes after a contrast enhancement. Materials and methods: Of the 92 people who underwent MRI brain metastases in suspected patients 13 people in three patients there is no video to target the 37 people confirmed cases, and motion artifacts brain metastases in our hospital June-December 2013, 18 people measurement position except for the three incorrect patient (male: 11 people, female: 7 people, average age: 60 years) in the target, test equipment, 3.0T MR System (ACHIEVA Release, Philips, I was 8ChannelSENSE Head Coil use Best, and the Netherlands). TR 11000 ms, TE 125 ms, TI2800 ms, Slice Thickness 5 mm, gap 5 mm, is a Slice number 21, the parameters of the 3D FFE, T2 FLAIR variable that was used to test, TR 8.1 ms, TE 3.7 ms, Slice number 240 I set to. The experiment was conducted by acquiring the FLAIR prior to contrast enhancement (heretofore referred to as Pre FLAIR), and acquiring the 3D FFE CE five minutes after the contrast enhancement, and recomposing the images in an axial plane of S/T 3mm, G 0mm (heretofore referred to as MPR TRA CE). Using the FLAIR 10 minutes after the contrast enhancement (heretofore referred to as Post FLAIR) and Pi-View, a retrospective study was conducted. Using MRIcro on the image of a patient confirmed for his diagnosis, the images before and after the contrast media, as well as the CNR and SNR of the MPR TRA CE images of the lesion and the site absent of lesion were compared and analyzed using a one-way analysis of variance. Results: CNR for Pre FLAIR and Post FLAIR were 34.35 and 60.13, respectively, with MPR TRA CE at 23.77 showing no significant difference (p<0.050). Post-experiment analysis shows a difference between Pre FLAIR and Post FLAIR in terms of CNR (p<0.050), but no difference in CNR between Post FLAIR and MPR TRA CE (p>0.050), indicating that the contrast media had an effect only on Pre FLAIR and Post FLAIR. The SNR for the normal site Pre FLAIR was 106.43, and for the lesion site 140.79. Post FLAIR for the normal site was 107.79, and for the lesion site 167.91. MPR TRA CE for the normal site was 140.23 and for the lesion site 183.19, showing significant difference (p<0.050), and post-experiment analysis shows that there was a difference in SNR only on the lesion sites for Pre FLAIR and Post FLAIR (p<0.050). There was no difference in SNR between the normal site and lesion site for Post FLAIR and MPR TRA CE, indicating no effect from the contrast media (p>0.050). Conclusions: This experiment shows that Post FLAIR has a higher contrast than Pre FLAIR, and a higher SNR for lesions, It was not not statistically significant and MPR TRA CE but CNR came out high. Inspection of post-contrast which is used in a high magnetic field is frequently used images of 3D T1 but, since the signal of the contrast medium and the blood flow is included, this method can be diagnostic accuracy is reduced, it is believed that when used in combination with Post FLAIR, and that can provide video information added to the diagnosis of brain metastases.

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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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Usefulness of Acoustic Noise Reduction in Brain MRI Using Quiet-T2 (뇌 자기공명영상에서 Quiet-T2 기법을 이용한 소음감소의 유용성)

  • Lee, SeJy;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.51-57
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    • 2016
  • Acoustic noise during magnetic resonance imaging (MRI) is the main source for patient discomfort. we report our preliminary experience with this technique in neuroimaging with regard to subjective and objective noise levels and image quality. 60 patients(29 males, 31 females, average age of 60.1) underwent routine brain MRI with 3.0 Tesla (MAGNETOM Tim Trio; Siemens, Germany) system and 12-channel head coil. Q-$T_2$ and $T_2$ sequence were performed. Measurement of sound pressure levels (SPL) and heart rate on Q-$T_2$ and $T_2$ was performed respectively. Quantitative analysis was carried out by measuring the SNR, CNR, and SIR values of Q-$T_2$, $T_2$ and a statistical analysis was performed using independent sample T-test. Qualitative analysis was evaluated by the eyes for the overall quality image of Q-$T_2$ and $T_2$. A 5-point evaluation scale was used, including excellent(5), good(4), fair(3), poor(2), and unacceptable(1). The average noise and peak noise decreased by $15dB_A$ and $10dB_A$ on $T_2$ and Q-$T_2$ test. Also, the average value of heartbeat rate was lower in Q-$T_2$ for 120 seconds in each test, but there was no statistical significance. The quantitative analysis showed that there was no significant difference between CNR and SIR, and there was a significant difference (p<0.05) as SNR had a lower average value on Q-$T_2$. According to the qualitative analysis, the overall quality image of 59 case $T_2$ and Q-$T_2$ was evaluated as excellent at 5 points, and 1 case was evaluated as good at 4 points due to a motion artifact. Q-$T_2$ is a promising technique for acoustic noise reduction and improved patient comfort.

A Real-Time Head Tracking Algorithm Using Mean-Shift Color Convergence and Shape Based Refinement (Mean-Shift의 색 수렴성과 모양 기반의 재조정을 이용한 실시간 머리 추적 알고리즘)

  • Jeong Dong-Gil;Kang Dong-Goo;Yang Yu Kyung;Ra Jong Beom
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.42 no.6
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    • pp.1-8
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    • 2005
  • In this paper, we propose a two-stage head tracking algorithm adequate for real-time active camera system having pan-tilt-zoom functions. In the color convergence stage, we first assume that the shape of a head is an ellipse and its model color histogram is acquired in advance. Then, the min-shift method is applied to roughly estimate a target position by examining the histogram similarity of the model and a candidate ellipse. To reflect the temporal change of object color and enhance the reliability of mean-shift based tracking, the target histogram obtained in the previous frame is considered to update the model histogram. In the updating process, to alleviate error-accumulation due to outliers in the target ellipse of the previous frame, the target histogram in the previous frame is obtained within an ellipse adaptively shrunken on the basis of the model histogram. In addition, to enhance tracking reliability further, we set the initial position closer to the true position by compensating the global motion, which is rapidly estimated on the basis of two 1-D projection datasets. In the subsequent stage, we refine the position and size of the ellipse obtained in the first stage by using shape information. Here, we define a robust shape-similarity function based on the gradient direction. Extensive experimental results proved that the proposed algorithm performs head hacking well, even when a person moves fast, the head size changes drastically, or the background has many clusters and distracting colors. Also, the propose algorithm can perform tracking with the processing speed of about 30 fps on a standard PC.

Efficacy and Safety of Miniscalpel Acupuncture in Knee Degenerative Osteoarthritis Patients: A Study Protocol for a Randomized Controlled Pilot Trial (퇴행성 슬관절염 환자에 대한 도침요법의 효능 및 안전성 연구: 임상예비연구)

  • Jun, Seungah;Park, Mu Seob;Oh, Se Jung;Lee, Jung Hee;Gong, Han Mi;Choi, Seong Hun;Hwangbo, Min;Lee, Hyun-Jong;Kim, Jae Soo
    • Korean Journal of Acupuncture
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    • v.33 no.2
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    • pp.67-74
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    • 2016
  • Objectives : The Knee degenerative osteoarthritis patients are not satisfied with the conventional therapies of KDOA, which results in the use of alternative therapies. The miniscalpel acupuncture is effective in treating chronic soft tissue, releasing contractures. However, there is little scientific evidence supporting the use of miniscalpel acupuncture in knee degenerative osteoarthritis. This study was designed to obtain basic data for a further large-scale trial as well as provide information about the feasibility of miniscalpel acupuncture in knee degenerative osteoarthritis patients. Methods : We describe the protocol for a randomized controlled pilot clinical trial of 5 weeks duration. Twenty patients will be recruited and randomly allocated to two treatment groups: miniscalpel acupuncture treatment(experimental group); and acupuncture and electro-acupuncture treatment(control group). Miniscalpel acupuncture will be performed once with a 1-week interval for 3 weeks. Electro-acupuncture will be administered twice per week for a period of 3 weeks. The primary outcomes will be measured by visual analogue scale and range of motion. The secondary outcomes will be short-form McGill Pain Questionnaire and Western Ontario and McMaster Universities Osteoarthritis Index. Both primary and secondary outcomes will be measured at baseline and at 1, 2, 3 and 5 weeks(i.e. 2 weeks after treatment completion). Conclusions : This pilot study will provide a basic foundation for a future large-scale trial as well as information about the feasibility of miniscalpel acupuncture in knee degenerative osteoarthritis.

Assessment for the Utility of Treatment Plan QA System according to Dosimetric Leaf Gap in Multileaf Collimator (다엽콜리메이터의 선량학적엽간격에 따른 치료계획 정도관리시스템의 효용성 평가)

  • Lee, Soon Sung;Choi, Sang Hyoun;Min, Chul Kee;Kim, Woo Chul;Ji, Young Hoon;Park, Seungwoo;Jung, Haijo;Kim, Mi-Sook;Yoo, Hyung Jun;Kim, Kum Bae
    • Progress in Medical Physics
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    • v.26 no.3
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    • pp.168-177
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    • 2015
  • For evaluating the treatment planning accurately, the quality assurance for treatment planning is recommended when patients were treated with IMRT which is complex and delicate. To realize this purpose, treatment plan quality assurance software can be used to verify the delivered dose accurately before and after of treatment. The purpose of this study is to evaluate the accuracy of treatment plan quality assurance software for each IMRT plan according to MLC DLG (dosimetric leaf gap). Novalis Tx with a built-in HD120 MLC was used in this study to acquire the MLC dynalog file be imported in MobiusFx. To establish IMRT plan, Eclipse RTP system was used and target and organ structures (multi-target, mock prostate, mock head/neck, C-shape case) were contoured in I'mRT phantom. To verify the difference of dose distribution according to DLG, MLC dynalog files were imported to MobiusFx software and changed the DLG (0.5, 0.7, 1.0, 1.3, 1.6 mm) values in MobiusFx. For evaluation dose, dose distribution was evaluated by using 3D gamma index for the gamma criteria 3% and distance to agreement 3 mm, and the point dose was acquired by using the CC13 ionization chamber in isocenter of I'mRT phantom. In the result for point dose, the mock head/neck and multi-target had difference about 4% and 3% in DLG 0.5 and 0.7 mm respectively, and the other DLGs had difference less than 3%. The gamma index passing-rate of mock head/neck were below 81% for PTV and cord, and multi-target were below 30% for center and superior target in DLGs 0.5, 0.7 mm, however, inferior target of multi-target case and parotid of mock head/neck case had 100.0% passing rate in all DLGs. The point dose of mock prostate showed difference below 3.0% in all DLGs, however, the passing rate of PTV were below 95% in 0.5, 0.7 mm DLGs, and the other DLGs were above 98%. The rectum and bladder had 100.0% passing rate in all DLGs. As the difference of point dose in C-shape were 3~9% except for 1.3 mm DLG, the passing rate of PTV in 1.0 1.3 mm were 96.7, 93.0% respectively. However, passing rate of the other DLGs were below 86% and core was 100.0% passing rate in all DLGs. In this study, we verified that the accuracy of treatment planning QA system can be affected by DLG values. For precise quality assurance for treatment technique using the MLC motion like IMRT and VMAT, we should use appropriate DLG value in linear accelerator and RTP system.

Evaluation of difference in respiratory phase between amplitude- and phase-based four-dimensional computed tomography (위상 기반 사차원전산화단층촬영과 진폭 기반 사차원전산화단층촬영 영상에서의 위상차 평가)

  • Lee, So Hyang;Park, Soo Yeon;Kim, Jong Sik;Choi, Byung Ki;Park, Hee Chul;Jung, Sang Hoon
    • The Journal of Korean Society for Radiation Therapy
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    • v.27 no.1
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    • pp.73-78
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    • 2015
  • Purpose : Under the assumption of change to the amplitude based sorting, the study will use four dimensional computed tomography imaging (4DCT) arrayed using the phase based sorting to analyze the respiratory phase difference. Materials and Methods : The study analyzed the 4DCT (4-dimensional computed tomography) images of 10 liver cancer patients that were treated with respiratory gated radiotherapy from 2015 February to March. Using RPM respiratory gating (RPM 1.7.5, Varian, USA) equipment, imaging according to respiratory cycle of phase based sorting was acquired and using a treatment planning system (Pinnacle 9.2, Philips, USA) the acquired imaging according to respiratory cycle was used to measure the abdominal movement value by respiratory cycle. The measuring point was the point where the center point of the Marker Block and the body surface met in the 50% phase image and here the coordinate values Lateral, Vertical, Longitudinal (X, Y, Z) were set as reference points, and on the X, Z plane identical to the reference point, using the identical method the Y axis coordinate value of each 0%, 30%, 40%, 50%, 60%, 80% phase images were acquired to quantitatively measure the variation of distance to the Y axis. The abdominal movement value according to respiration was applied to the theoretical model that the value decreases linearly from maximum inhalation to maximum exhalation to divide the variation of my value to predict as amplitude value by respiratory cycle and conversely the variation in amplitude was recalculated with the phase variation deviation value to analyze. Results : The deviation value between expected value and actual location was the largest in the 30% phase with 0.24 cm, and standard deviation was also the largest in 30% phase with 0.13 cm. The effective value of the deviation value derived from the average of the deviation squared value of each patient appeared as minimum 0.7 cm, maximum 0.18 cm, average 0.12 cm, and standard deviation 0.4 cm. Also by dividing the actual movement distance value with the peak expiration value then converting it into %Phase, the deviation value with actual phase 16.5% in 30% phase, 10.0% and 40% phase, 10.0% and 60% phase, 15.4% and 80% phase, and overall average about 13%, and arraying based on amplitude, phase shift occurred and further it was from peak expiration the chance of deviation occurrence was increasingly measured. Conclusion : Based on the results of the study there were differences between value acquired based on theoretical model and actual value. Therefore in respiratory gated radiotherapy using external surrogates, there needs to be establishment of respiration gated radiation system that avoids the combination of two Sorting methods considering that there will be occurrence of treatment and corresponding clinical differences due to the phase difference that occur due to the Amplitude based Phase Sorting.

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