• Title/Summary/Keyword: body-image

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Comparative Analysis of Absorption Doses between Exposed and Unexposed Area on Major Organs During CT Scan (전산화 단층촬영시 주선속내 외의 주요장기 흡수선량 비교분석)

  • 사정호;서태석;최보영;정규회
    • Progress in Medical Physics
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    • v.11 no.1
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    • pp.59-71
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    • 2000
  • It is possible to obtain a fast CT scan during breath holding with spiral technique. But the risk of radiation is increased due to detailed and repeated scans. However, the limitation of X-ray doses is not fully specified on CT, yet. Therefore, the purpose of the present study is to define the limitation of X-ray doses on CT The CT unit was somatom plus 4. Alderson Rando phantom, Solenoid water phantom, TLD, and reader were used. For determining adequate position and size of organs, the measurement of distance(${\pm}$2mm) from the midline of vertebral body was performed in 40 women(20~40 years). On the brain scan for 8:8(8mm slice thickness, 8mm/sec movement velocity of the table) and 10:10(10mm slice thickness, 10mm/sec movement velocity of the table) methods, the absorption doses of exposed area of the 10:10 were slightly higher than those of 8:8. The doses of unexposed uterus were negligible on the brain scan for both 8:8 and 10:10. On the chest scan for 8:8, 8:10(8mm slice thickness, 10mm/sec movement velocity of the table), 10:10, 10:12(10mm slice thickness, 12mm/sec movement velocity of the table) and 10:15(10mm slice thickness, 15mm/sec movement velocity of the table) methods, 8:8 method of the absorption doses of exposure area was the most highest and 10:15 method was the most lowest. The absorption doses of 8:10 method was relatively lower than those of the other methods. In conclusion, the 8:10 method is the most suitable to give a low radiation burden to patient without distorting image quality.

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Imaging Neuroreceptors in the Living Human Brain

  • Wagner Jr Henry N.;Dannals Robert F.;Frost J. James;Wong Dean F.;Ravert Hayden T.;Wilson Alan A.;Links Jonathan M.;Burns H. Donald;Kuhar Michael J.;Snyder Solomon H.
    • The Korean Journal of Nuclear Medicine
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    • v.18 no.2
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    • pp.17-23
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    • 1984
  • For nearly a century it has been known that chemical activity accompanies mental activity, but only recently has it been possible to begin to examine its exact nature. Positron-emitting radioactive tracers have made it possible to study the chemistry of the human mind in health and disease, using chiefly cyclotron-produced radionuclides, carbon-11, fluorine-18 and oxygen-15. It is now well established that measurable increases in regional cerebral blood flow, glucose and oxygen metabolism accompany the mental functions of perception, cognition, emotion and motion. On May 25, 1983 the first imaging of a neuroreceptor in the human brain was accomplished with carbon-11 methyl spiperone, a ligand that binds preferentially to dopamine-2 receptors, 80% of which are located in the caudate nucleus and putamen. Quantitative imaging of serotonin-2, opiate, benzodiazapine and muscarinic cholinergic receptors has subsequently been accomplished. In studies of normal men and women, it has been found that dopamine and serotonin receptor activity decreases dramatically with age, such a decrease being more pronounced in men than in women and greater in the case of dopamine receptors than serotonin-2 receptors. Preliminary studies in patients with neuropsychiatric disorders suggests that dopamine-2 receptor activity is diminished in the caudate nucleus of patients with Huntington's disease. Positron tomography permits quantitative assay of picomolar quantities of neuro-receptors within the living human brain. Studies of patients with Parkinson's disease, Alzheimer's disease, depression, anxiety, schizophrenia, acute and chronic pain states and drug addiction are now in progress. The growth of any scientific field is based on a paradigm or set of ideas that the community of scientists accepts. The unifying principle of nuclear medicine is the tracer principle applied to the study of human disease. Nineteen hundred and sixty-three was a landmark year in which technetium-99m and the Anger camera combined to move the field from its latent stage into a second stage characterized by exponential growth within the framework of the paradigm. The third stage, characterized by gradually declining growth, began in 1973. Faced with competing advances, such as computed tomography and ultrasonography, proponents and participants in the field of nuclear medicine began to search for greener pastures or to pursue narrow sub-specialties. Research became characterized by refinements of existing techniques. In 1983 nuclear medicine experienced what could be a profound change. A new paradigm was born when it was demonstrated that, despite their extremely low chemical concentrations, in the picomolar range, it was possible to image and quantify the distribution of receptors in the human body. Thus, nuclear medicine was able to move beyond physiology into biochemistry and pharmacology. Fundamental to the science of pharmacology is the concept that many drugs and endogenous substances, such as neurotransmitters, react with specific macromolecules that mediate their pharmacologic actions. Such receptors are usually identified in the study of excised tissues, cells or cell membranes, or in autoradiographic studies in animals. The first imaging and quantification of a neuroreceptor in a living human being was performed on May 25, 1983 and reported in the September 23, 1983 issue of SCIENCE. The study involved the development and use of carbon-11 N-methyl spiperone (NMSP), a drug with a high affinity for dopamine receptors. Since then, studies of dopamine and serotonin receptors have been carried out in over 100 normal persons or patients with various neuropsychiatric disorders. Exactly one year later, the first imaging of opitate receptors in a living human being was performed [1].

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Biodistribution of Iodine-131-Iodomisonidazole and Imaging of Tumor Hypoxia in Mice bearing CT-26 Adenocarcinoma (CT-26 선암을 접종한 마우스에서 Iodine-131-Iodomisonidazole의 생체분포 및 종양저산소증의 영상화)

  • Kim, Hye-Won;Kim, Chang-Guhn;Yoon, Kwon-Ha;Kim, Hyun-Jeong;Juhng Seon-Kwan;Roh, Byung-Suk;Yang, David J.;Kim, E.Edmund;Lee, Hyun-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.289-297
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    • 1999
  • Purpose: Misonidazole is a radiosensitizer that binds in hypoxic cells. The purpose of this study was to find out the feasibility of I-131-Iodomisonidazole (IMISO) for imaging of tumor hypoxia. Materials and Methods: Tosyl precursor was dissolved in acetonitrile and I-131-NaI was added to synthesize IMISO. Balb/c mice inoculated with CT-26 adenocarcinoma were injected with IMISO. Mice were sacrificed at 1, 2, 4, 24 hr and % of injected dose per gram of tissue (%ID/g) was determined. For scintigraphy and MRI, mouse bearing CT-26 adenocarcinoma was administered with IMISO and imaging was performed 4 hr after. Then, mouse body was fixed and microtomized slice was placed on radiographic film for autoradiography Results: %ID/g of tumor was 1.64 (1h), 0.98 (2h), 0.85 (4h) and 0.20 (24h), respectively. At 24h, %ID/g of tumor was higher than that of all other tissues except thyroid. Tumor to muscle ratio increased with time and tumor to blood ratio also increased with time and reached 1.53 at 24 hr. On autoradiogram, tumor was well visualized as an increased activity in central hypoxic area of the tumor which corresponds to the area of high signal intensity on T2-weighted MR image. On scintigraphy, tumor uptake was visualized. Conclusion: This results suggest that IMISO may have a potential for tumor hypoxia imaging in mouse model. However, further study is needed to improve it's localization in tumor tissue and to achieve acceptable images of tumor hypoxia.

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The Relationship between Thymic Size and Vesicoureteral Reflux in Infants with Febrile Urinary Tract Infection (발열성 요로감염 영아에서 방광요관역류와 연관된 흉선의 크기)

  • Jung, Seong-Kwan;Park, Kyu-Hee;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.215-221
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    • 2009
  • Purpose : Thymus is a lymphoproliferative organ that changes size in various physiological states in addition to some pathological conditions. Thymus is susceptible to involution, and shows a dramatic response to severe stress. Thymic measurements may be helpful in various diseases. UTI (urinary tract infection) is most common bacterial infection in infants and VUR (vesicoureteral reflux) is a common abnormality associated with UTI. In our study, the size of thymus was compared on the premise that a greater stress is exerted on the body when UTI is accompanied by VUR, than when occurs on its own. Methods : Thymic size was measured on standard chest anteroposterior radiographs and expressed as the ratio between the transverse diameter of the cardiothymic image at the level of the carina and that of the thorax (CT/T). The medical records of 99 febrile urinary tract infection infants without other genitourinary anomalies except VUR were reviewed retrospectively. Results : Among 99 patients with febrile UTIs, 25 were febrile UTI without VUR and 74 with VUR. For the UTI with VUR group, there was a significant decrease in the thymic size compared to the those without VUR group ($0.382{\pm}0.048$ vs $0.439{\pm}0.079$, P<0.05). However, there were no differences in the duration of fever and WBC, CRP between the UTI with VUR and UTI without VUR. In addition, there were no differences in the cardiothymic/thoracic ratios between renal defects and renal scars in febrile UTI patients. Conclusion : The results of this study show that the shirinkage of thymus was more frequently found in the UTI patients with VUR. Therefore, awareness of the risks associated with thymic size is important for the appropriate work up and management of UTI patients.

Analysis of Serum proteom before and after Intravenous Injection of wild ginseng herbal acupuncture (자연산 산삼 증류약침의 혈맥주입 전.후 혈장의 Proteom 분석)

  • Kang, Tae-Sik;Lee, Sun-Gu;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.7 no.3
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    • pp.5-25
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    • 2004
  • Objectives : To observe changes in the serum proteins before and after intravenous injection of wild ginseng herbal acupuncture. Methods : Blood was collected before and after the administration of wild ginseng herbal acupuncture and only the serum was centrifuged. Then differences in the spots on the scanned image after running 2-Dimensionl electrophoresis were located and conducted mass analysis and protein identification. Results : Following results were obtained from the comparative analysis of serum proteins before and after the administration of wild ginseng herbal acupuncture. 1. 28 spots were identified before and after the administration. 2. In confirming manifestation degree, spots with more than two-times increase were 204, 803, 1505, 2205, 3105, 7104, 9001 spots, with more than one-time increase were 1101, 1302, 2013, 3009, 3010, 4002, 4009, 6706, 7103, 8006, 8101, and spots with decrease were 205, 801, 3205, 5202, 6105. 3. After conducting protein identification, proteins 205, 804, 1302, 4009, 6105, 6106 are unidentified yet, and 1101 is unnamed protein. Protein 204 is identified as complement receptor CR2-C3d, 801 as YAP1 protein, 803 as antitrypsin polymer, 1505 as PRO0684, 2013 and 3010 as proapolipoprotein, 2205 as USP48, 2403 as vitamin D binding protein, 3009 as complement component 4A preprotein, 3105 as immunoglobulin lambda chain, 3205 as transthyretin, 4002 as Ras-related protein Ral-A, 4204 as beta actin, 5202 and 7104 as apolipoprotein L1, 6704 as alpha 2 macroglobulin precursor, 7103 as complement component 3 precursor, 8006 as testis-specific protein Y, 8101 as Transferrin, 9001 as(Alpha-Oxy, Beta-(C112g)deoxy) T-State Human Hemoglobin, and 9003 as human hemoglobin. 4. Immune protein CR2-C3d, which acts against microbes and pathogenic organisms, and Antitrypsin(803), which is secreted with inflammatory response in the lungs, were increased by more than 200% after the administration of herbal acupuncture. 5. Immunoglobulin lambda chain(3105), Alpha-Oxy, Beta-(C112g)deoxy T-State Human Hemoglobin(9001), and human hemoglobin(9003) were increased by more than two-times after the administration of herbal acupuncture. 6. Proapolipoprotein(2013, 3010) and apolipoprotein(7104), key components of the HDL-cholesterol which plays an important role in preventing arteriosclerosis, were increased after the administration of herbal acupuncture. 7. Vitamin D binding protein(DBP, 2403), protecting the lung at the time of inflammatory response, was increased after the administration of herbal acupuncture. 8. Transthyretin(TTR, 3205), which is the main protein causing familial aimyloid polyneuropathy(FAP), was decreased after the administration of herbal acupuncture. 9. Ras-related protein Ral-A(4002) that controls phospholipid metabolism, cytoskeletal formation, and membrane traffic, was increased after the administration of herbal acupuncture. 10. Testis-specific protein Y(8006), which takes part in determination of the gender, was increased by more than two-times after the administration of herbal acupuncture. 11. Transferrin(8101), T-State Human Hemoblobin(9001), and Human Hemoblobin(9003) which balances the iron level in the body, were increased after the administration of herbal acupuncture. Conousion : Above results support the notion that intravenous injection of cultivated wild ginseng herbal acupuncture induce changes in serum proteins and this research can be a pioneer work in finding biomarkers.

Experiences of the First 130 Patients in Gangnam Severance Hospital (강남세브란스병원 토모테라피를 이용한 치료환자의 130예 통계분석 및 경험)

  • Ha, Jin-Sook;Jeon, Mi-Jin;Kim, Sei-Joon;Kim, Jong-Dae;Shin, Dong-Bong
    • The Journal of Korean Society for Radiation Therapy
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    • v.20 no.1
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    • pp.45-53
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    • 2008
  • Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

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Comparison of Life Style, School Achievement and Snaking Behaviors among Underweight and Overweight Adolescents (일부 저체중과 과체중 청소년의 생활습관, 학업성취도 및 간식섭취행동의 비교)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of Nutrition and Health
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    • v.44 no.2
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    • pp.131-139
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    • 2011
  • The purpose of this study was to obtain information related to life style characteristics, school achievement and snacking behaviors among underweight and overweight adolescents in Ulsan area. The survey was carried out by self-questionnaires with 464 adolescents (333 underweight and 131 overweight). The results were as follows: Average BMI of the subjects was $19.81{\pm}3.10\;kg/m^2$ which was normal range, but average BMI of underweight and overweight were $16.90{\pm}1.19\;kg/m^2$ and $25.38{\pm}2.16\;kg/m^2$ respectively. The 49.5% of underweight and 94.7% of overweight students have correct perception about their body image. In the sleeping time, 58.9% of underweight and 66.4% of overweight students go to bed after PM 12 o'clock. In the regularity of eating breakfast, 68.5% of underweight and 67.9% of overweight students skipping breakfast at least 5 times per week. 32.6% of the subjects had snack once or more a day. Underweight students had more frequently ate snack than overweight students. The criteria of choosing snack were taste (77.4%), nutrition (9.3%), and price (6.3%). Food as snack they frequently had fruits, milk & milk products, cookies in order. Underweight students had more dodkboki & sundae, candy & chocolate and cake & bread than overweight students, although overweight students had more milk & yogurt than underweight students. The group who had a higher school record, they significantly had more fruits, milk & milk products (p < 0.01) and had not less nutritious foods (p < 0.001). This study may provide basic information on weight status, sleeping and snacking behaviors of adolescents. Therefore they should have nutrition education program to improve their life style and snacking patterns for underweight and overweight adolescents toward healthy weight.

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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A Study on Soviet Constructive Fashion in 1920s (1920년대 소비에트 구성주의 패션에 관한 연구)

  • 조윤경;금기숙
    • Journal of the Korean Society of Costume
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    • v.36
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    • pp.183-203
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    • 1998
  • The wave of Avant-garde swept away all in the unique social background so called 'October Revolution' and the early 1900 Russian society which was able to absorb and accept anything. The Russian avant-garde has been affected by the Cubism and the Futurism those had peculiarly appeared in the early twentieth century, spreaded out to three spheres: the Suprematism, the Rayonism and the Constructivism. The Russian Constructivism has appeared in this background, concretely and ideally ex-pressed the ideology of the revolution into the artistic form and made an huge influence to the whole Russian society. The Constructivist like Tatlin, naum Gabo, Pevaner, Rodchenko, Stepanova, Popova and Exter gave great effect on the Soviet Constructive fashion design in 1920's after the Revolution. The Soviet costume in 1920s hold in common the characteristicss of the Constructive graphic as it is, geometrical and abstractive form, energetic and motility. In fashion design, these graphic qualities have been showed as the application of geometrical form and architectural image, physical distortion and transformation. And in textile design, the simple, dynamical presentation has been appeared. We can classify the Soviet costume at this time into three occasions. The first term is from late 1910 th mid 1920, and it is altered from folk costume design to modern one. With Lamanova as the first on the list, using the folk mitif, the Constructive expression of simple form has been gradually revealed in design. Designers like Makarova, Pribylskaia and Mukhina produced the plane, simple chemise style with the decoration of the Russian traditional motif. From early to late 1920 is the second term, and it is at the pick of the most active processing of the Constructive design. Not only at the costume in daily life but also at the theatrical costume and textile, the con-structive design has been represented all avail-able fields. Many Constructivists including Stepanova, Popova, Exter and Rodchenko took part in the textile design and costume design so as to evlvo their aesthetic concept. The third term is from late 1920 to early 1930. The socialistic realism has dominated over the whole culture and art, the revolutionary dynamic motif has been presented also in textile design. The formative features of Soviet Constructive fashion design are; silhouette, from, motif, color and fabric. The first, the silhouette : a straight rectangular silhouetted has been expressed through the whole period and a volumed one with distorted human body shape has introduced in the theatrical costume design. The second, the form: many lengthened rectangular forms have been made at beginnings, but to the middle period, geometrical, architectural forms have been more showed and there are energy and movement in design. At the last period, only a partial feature-division has been seen. The third, the motif; no pattern or ethnic motif has been partly used at beginnings, a figure like circle, tri-angle has gradually appeared in textile design. At latter period, a real-existent motif like an airplane has been represented with graphing and simplicity. The fourth, the color ; because of insufficient dyeing, neutral color like black or grey color has been mainly covered, but after middle term, a primary color or pastel tone has been seen, contrast of the fabric; without much development of textile industry after the Revolution, thick and durable fabrics have been the main stream, but as time had going to the last period, fabrics such as linen, cotton, velvet and silk have been varously choesn. At the theatrical costume, new materials like plastics and metals that were able to accentuate the form. The pursuit of popularity, simplicity and functionalism that the basic concept of Constructive fashion is one of the "beauty" which has been searching in modern fashion. And now we can appreciate how innovative and epochal this Soviet Constructive fashion movement was.ement was.

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Availability and Reproducibility Evaluation of High-dose-rate Intraluminal Brachytherapy for Unresectable Recurrent Cholangiocarcinoma (재발한 간담도암 환자에서 시행 한 high-dose-rate intraluminal brachytherapy의 유용성 및 재현성 평가)

  • Park, Ju-Kyeong;Lee, Seung-Hun;Cha, Seok-Yong;Kim, Yang-Su;Lee, Sun-Young
    • Journal of the Korean Society of Radiology
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    • v.6 no.2
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    • pp.151-157
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    • 2012
  • General treatment for cholangiocarcinoma is complete surgical resection. However recurrence is common in those patients. In most of cases the purpose of the treatment for patients with recurrent is palliative. Therefore we adopt intraluminal catheter to treat a recurrent patient with high-dose-rate intraluminal brachytherapy. This study aims to evaluate the treatment procedure and set-up reproducibility of intraluminal brachytherapy in the recurrent patient. Study patient was diagnosed at rcT1N0M0 and undergone intraluminal brachytherapy after Arrow Sheath insertion. 3 Gy was delivered in every fraction with a total dose of 30 Gy. We planned dose normalization at distal, proximal and central axis point of narrowed bile duct far from 1 cm. To evaluate set-up reproducibility, we measured distance between distal, proximal treatment target volume point and anterior surface of the thoracic vertebral body respectively for five times before every treatment with dummy seed insertion. Mean distance between distal, proximal treatment target volume point and anterior surface of 10th and 11th thoracic vertebral bodies is 0.5 cm, 6.1 cm and standard deviation is 0.06, 0.08 respectively. In addition, set-up reproducibility was maintained significantly. The patient has been alive with no evidence of disease recurrence for more than a year and has not yet reported severe complications. In conclusion, high-dose-rate intraluminal brachytherapy for unresectable recurrence of cholangiocarcinoma maintains high set-up reproducibility without severe side effects.