Purpose: We evaluated whether it was necessary to perform whole body acquisition of $^{18}F$-FDG PET/CT including whole skull and lower extremity (LE) distal to mid-thigh (MT) in patients with multiple myeloma (MM). Materials and Methods: Thirty patients underwent 45 whole body $^{18}F$-FDG PET/CT scans including skull and LE distal to MT. PET scans were divided by 2 subgroups according to the presence of abnormal focal $^{18}F$-FDG uptake in skull or LE distal to MT. Clinical characteristics including age, sex, and stages were compared between the 2 subgroups. Results: Of total 45 whole body PET/CT scans, focally increased abnormal FDG uptake in the skull or LE distal to MT suggesting myeloma involvement was found in 22 scans (48.9%) of 14 patients (46.7%). Skull lesions were more frequently observed than LE lesions distal to MT on PET (86.4% vs. 40.9%, p<0.005). There were no significant differences in age, sex, initial Durie/Salmon stage, and tumor burden at the time of PET scan suggested by serum hemoglobin level, serum calcium level, serum and urine paraprotein level, and serum creatinine level between the two subgroups. The presence of the skull or LE distal MT lesions on PET did not affect on the Durie/Salmon plus stage except only 1 case (1/22, 4.5%, p>0.05). Conclusion: Abnormal lesions in the skull or LE distal to MT on $^{18}F$-FDG PET/CT did not affect significantly on the tumor burden and Durie/Salmon plus stage of MM. Therefore, torso PET acquisition including head may be sufficient for evaluating patients with MM.
Seismic reflection surveying is one of the most widely used and effective techniques for coal seam structure delineation and risk mitigation for underground longwall mining. However, the ability of the method can be compromised by the presence of volcanic cover. This problem arises within parts of the Bowen and Sydney Basins of Australia and seismic surveying can be unsuccessful. As a consequence, such areas are less attractive for coal mining. Techniques to improve the success of seismic surveying over basalt flows are needed. In this paper, we use elastic wave-equation-based forward modelling techniques to investigate the effects and characteristics of seismic wave propagation under different settings involving changes in basalt properties, its thickness, lateral extent, relative position to the shot position and various forms of inhomogeneity. The modelling results suggests that: 1) basalts with high impedance contrasts and multiple flows generate strong multiples and weak reflectors; 2) thin basalts have less effect than thick basalts; 3) partial basalt cover has less effect than full basalt cover; 4) low frequency seismic waves (especially at large offsets) have better penetration through the basalt than high frequency waves; and 5) the deeper the coal seams are below basalts of limited extent, the less influence the basalts will have on the wave propagation. In addition to providing insights into the issues that arise when seismic surveying under basalts, these observations suggest that careful management of seismic noise and the acquisition of long-offset seismic data with low-frequency geophones have the potential to improve the seismic results.
Thirty three members of the Korean Association of Pediatric Surgeons were surveyed to determine the clinical manifestations and current management of infantile hypertrophic pyloric stenosis (IHPS). The members completed a registration form and a questionnaire that indicated their treatment preferences for patients treated during 1996. The response rate was 84.8 %, and 23 institutions participated. Three hundred and sixty-three cases of IHPS were analysed. The male to female ratio was 5.15: 1. The presenting symptoms were nonbilious vomiting in 363 cases(100 %), palpable mass in the upper abdomen in 200 cases (55.1 %) and visible peristaltic waves in 67 cases(18.5 %). Fluid therapy was done in 161 cases(44.4 %) for preoperative preparation. Twenty patients(5.5 %) were premature. There were 27 low birth weight babies(7.7 %). The onset of symptoms ranged from 1 to 14 weeks of age with a peak occurrence at 2 to 4 weeks of age. Two hundred and thirty-six cases(66.6 %) presented within 4 weeks of age. There was one set of male twins and a family history of twins. The modes of feedings were: breast feeding; 69 cases(24.5 %), formula feeding; 176 cases(62.4 %) and mixed feeding; 37 cases(13.1 %). The preferred diagnostic modalities were ultrasonography (US) 229 cases(63.1 %), UGI series 27 cases(7.4%) and US and UGI series combined 86 cases(23.7 %). Only 21 cases(5.8 %) were operated on without imaging study, ie. with positive physical finding. Perforation of the mucosa during pyloromytomy occurred in 5 cases. All were treated successfully with primary closure. Persistent vomiting over 2 weeks after operation were reported in 5 cases. Three wound infections, one aspiration pneumonia and one postoperative bleeding were reported. There was no mortality in 363 cases.
Purpose : To compare the enhancement pattern of normal facial nerves on 3D-FLAIR and 3D-T1-FFE-F) sequences at 3.0 T MR units. Materials and Methods: We assessed 20 consecutive subjects without a history of facial nerve abnormalities who underwent temporal bone MRI with contrast enhancement between January 2008 and March 2009. Two neuroradiologists independently reviewed pre-/post-enhanced 3D-T1-FFE-FS and 3D-FLAIR images respectively with 2-week interval to assess the enhancement of normal facial nerves divided into five anatomical segments. The degree of enhancement in each segment was graded as none, mild or strong, and the results of 3D-FLAIR and 3D-T1-FFE-FS image sets were compared. Results: On 3D-FLAIR images, one of the two reviewers observed mild enhancement of the genu segment in two (10%) subjects. On 3D-T1-FFE-FS images, at least one segment of the facial nerve was enhanced in 13 (65%) subjects. At least one reviewer found that 17 of the 100 segments showed enhancement on 3D-T1-FFE-FS images, with the mastoid segment being the most commonly enhanced. Interobserver agreement on 3D-T1-FFE-FS images was good for enhancement of the normal facial nerve (${\kappa}$= 0.589). Conclusion: In contrast to 3D-T1-FFE-FS, normal facial nerve segments rarely showed enhancement on 3D-FLAIR images.
An, Jae-Seok;Hong, Sung-Tack;Kang, Se-Hun;Won, Woo-Jae
The Korean Journal of Nuclear Medicine Technology
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v.15
no.2
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pp.72-75
/
2011
Purpose: The HSV1-tk reporter gene system is the most widely used system because of its advantage is that it is possible to monitor directly without the introduction of a separate reporter gene in case of HSV1-tk suicide gene therapy. This study was performed to automate 9-(4-[$^{18}F$] Fluoro-3-hydroxymethylbutyl) guanine ([$^{18}F$] FHBG) that are widely used as substrate for the HSV1-tk reporter gene in living organisms with positron emission tomography (PET) and find the optimized conditions of synthesis. Materials and Methods: Fully automated synthesis of [$^{18}F$] FHBG was performed using Explora-RN (CTI, USA) module. We have changed of reaction time (3, 5, 10 min) and temperature (110, 120, $130^{\circ}C$) for the optimized conditions of synthesis. Also we experimented to find the optimal concentration of precursor (5, 7, 10 mg). Results: [$^{18}F$] FHBG was purified by HPLC system and collected at around 10-12 min. Synthesis using Explora-RN module showed a $32.0{\pm}1.2%$ yield of radiochemical (decay corrected), the purity was greater than 98%. And the entire synthesis time was less than 48 min. Temperature of the highest synthesis yield was $130^{\circ}C$, reaction time was 5 minutes and concentration of precursor was 10 mg (recommended volume in manual) (n=36). In contrast to radiochemical yield of precursor 10 mg ($32{\pm}1.2%$), yield of 5 and 7 mg precursor was unstable. Conclusion: Automation of [$^{18}F$] FHBG synthesis at Explora-RN module has been completed. In addition, we were able to obtain optimized reaction time, temperature and concentration of precursor. Therefore this study would be provided more rapid synthesis and higher radiochemical yield.
We investigated the relative errors of satellite-observed Surface Skin Temperature (SST) data caused by sea ice in the northern hemispheric ocean ($30-90^{\circ}N$) during April 16-24, 2003-2014 by intercomparing MODerate Resolution Imaging Spectroradiometer (MODIS) Ice Surface Temperature (IST) data with two types of Atmospheric Infrared Sounder (AIRS) SST data including one with the AIRS/Advanced Microwave Sounding Unit-A (AMSU) and the other with 'AIRS only'. The MODIS temperatures, compared to the AIRS/AMSU, were systematically up to ~1.6 K high near the sea ice boundaries but up to ~2 K low in the sea ice regions. The main reason of the difference of skin temperatures is that the MODIS algorithm used infrared channels for the sea ice detection (i.e., surface classification), while microwave channels were additionally utilized in the AIRS/AMSU. The 'AIRS only' algorithm has been developed from NASA's Goddard Space Flight Center (NASA/GSFC) to prepare for the degradation of AMSU-A by revising part of the AIRS/AMSU algorithm. The SST of 'AIRS only' compared to AIRS/AMSU showed a bias of 0.13 K with RMSE of 0.55 K over the $30-90^{\circ}N$ region. The difference between AIRS/AMSU and 'AIRS only' was larger over the sea ice boundary than in other regions because the 'AIRS only' algorithm utilized the GCM temperature product (NOAA Global Forecast System) over seasonally-varying frozen oceans instead of the AMSU microwave data. Three kinds of the skin temperatures consistently showed significant warming trends ($0.23-0.28Kyr^{-1}$) in the latitude band of $70-80^{\circ}N$. The systematic disagreement among the skin temperatures could affect the discrepancies of their trends in the same direction of either warming or cooling.
Yeo, Inhwan;Xu, Qianyi;Chen, Yan;Jung, Jae Won;Kim, Jong Oh
Progress in Medical Physics
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v.25
no.3
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pp.139-142
/
2014
The purpose of this study was to develop a system of clinical application of reconstructed dose that includes dose reconstruction, reconstructed dose registration between fractions of treatment, and dose-volume-histogram generation and to demonstrate the system on a deformable prostate phantom. To achieve this purpose, a deformable prostate phantom was embedded into a 20 cm-deep and 40 cm-wide water phantom. The phantom was CT scanned and the anatomical models of prostate, seminal vesicles, and rectum were contoured. A coplanar 4-field intensity modulated radiation therapy (IMRT) plan was used for this study. Organ deformation was simulated by inserting a "transrectal" balloon containing 20 ml of water. A new CT scan was obtained and the deformed structures were contoured. Dose responses in phantoms and electronic portal imaging device (EPID) were calculated by using the XVMC Monte Carlo code. The IMRT plan was delivered to the two phantoms and integrated EPID images were respectively acquired. Dose reconstruction was performed on these images using the calculated responses. The deformed phantom was registered to the original phantom using an in-house developed software based on the Demons algorithm. The transfer matrix for each voxel was obtained and used to correlate the two sets of the reconstructed dose to generate a cumulative reconstructed dose on the original phantom. Forwardly calculated planning dose in the original phantom was compared to the cumulative reconstructed dose from EPID in the original phantom. The prescribed 200 cGy isodose lines showed little difference with respect to the "prostate" and "seminal vesicles", but appreciable difference (3%) was observed at the dose level greater than 210 cGy. In the rectum, the reconstructed dose showed lower volume coverage by a few percent than the plan dose in the dose range of 150 to 200 cGy. Through this study, the system of clinical application of reconstructed dose was successfully developed and demonstrated. The organ deformation simulated in this study resulted in small but observable dose changes in the target and critical structure.
In gated radiation therapy (gRT), due to residual motion, beam delivery is intended to irradiate not only the true extent of disease, but also neighboring normal tissues. It is desired that the delivery covers the true extent (i.e. clinical target volume or CTV) as a minimum, although target moves under dose delivery. The objectives of our study are to validate if the intended dose is surely delivered to the true target in gRT and to quantitatively understand the trend of dose delivery on it and neighboring normal tissues when gating window (GW), motion amplitude (MA), and CTV size changes. To fulfill the objectives, experimental and computational studies have been designed and performed. A custom-made phantom with rectangle- and pyramid-shaped targets (CTVs) on a moving platform was scanned for four-dimensional imaging. Various GWs were selected and image integration was performed to generate targets (internal target volume or ITV) for planning that included the CTVs and internal margins (IM). The planning was done conventionally for the rectangle target and IMRT optimization was done for the pyramid target. Dose evaluation was then performed on a diode array aligned perpendicularly to the gated beams through measurements and computational modeling of dose delivery under motion. This study has quantitatively demonstrated and analytically interpreted the impact of residual motion including penumbral broadening for both targets, perturbed but secured dose coverage on the CTV, and significant doses delivered in the neighboring normal tissues. Dose volume histogram analyses also demonstrated and interpreted the trend of dose coverage: for ITV, it increased as GW or MA decreased or CTV size increased; for IM, it increased as GW or MA decreased; for the neighboring normal tissue, opposite trend to that of IM was observed. This study has provided a clear understanding on the impact of the residual motion and proved that if breathing is reproducible gRT is secure despite discontinuous delivery and target motion. The procedures and computational model can be used for commissioning, routine quality assurance, and patient-specific validation of gRT. More work needs to be done for patient-specific dose reconstruction on CT images.
Park, Su Yeon;Oh, Dongryul;Park, Hee Chul;Kim, Jin Sung;Kim, Jong Sik;Shin, Eun Hyuk;Kim, Hye Young;Jung, Sang Hoon;Han, Youngyih
Progress in Medical Physics
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v.25
no.3
/
pp.176-184
/
2014
In this study, we compared dose distributions from simultaneously integrated boost (SIB) method versus the RTOG 0631 protocol for spine radiosurgery. Spine radiosurgery plans were performed in five patients with localized spinal metastases from hepatocellular carcinoma. The computed tomography (CT) and T1- and T2-weighted magnetic resonance imaging (MRI) were fused for delineating of GTV and spinal cord. In SIB plan, the clinical target volume (CTV1) was included the whole compartments of the involved spine, while RTOG 0631 protocol defines the CTV2 as the involved vertebral body and both left and right pedicles. The CTV2 includes transverse process and posterior element according to the extent of GTV. The doses were prescribed 18 Gy to GTV and 10 Gy to CTV1 in SIB plan, while the prescription of RTOG 0631 protocol was applied 18 Gy to CTV2. The results of dose-volume histogram (DVH) showed that there were competitive in target coverage, while the doses of spinal cord and other normal organs were lower in SIB method than in RTOG 0631 protocol. The 85% irradiated volume of VB in RTOG 0631 protocol was similar to that in the SIB plan. However, the dose to normal organs in RTOG 0631 had a tendency to higher than that in SIB plan. The SIB plan might be an alternative method in case of predictive serious complications of surrounded normal organs. In conclusion, although both approaches of SIB or RTOG 0631 showed competitive planning results, tumor control probability (TCP) and normal tissue complication probability (NTCP) through diverse clinical researches should be analyzed in the future.
Purpose: To design applied anamorphic lens that focal length ratio is 3:1 optical system to improve detecting distance. Methods: We defined a boundary condition as $50^{\circ}{\sim}60^{\circ}$ for viewing angle, horizontal direction 36mm, vertical direction 12 mm for focal length, f-number 4, $15{\mu}m{\times}15{\mu}m$ for pixel size and limit resolution 25% in 33l p/mm. Si, ZnS and ZnSe as a materials were used and 4.8 ${\mu}m$, 4.2 ${\mu}m$, 3.7 ${\mu}m$ as a wavelength were set. optical performance with detection distance, narcissus and athermalization in designed camera were analyzed. Results: F-number 4, y direction 12 mm and x direction 36 mm for focal length of the thermal optical system were satisfied. Total length of the system was 76 mm so that an overall volume of the system was reduced. Astigmatism and spherical aberration was within ${\pm}$0.10 which was less than 2 pixel size. Distortion was within 10% so there was no matter to use as a thermal optical camera. MTF performance for the system was over 25% from 33l p/mm to full field so it was satisfied with the boundary condition. Designed optical system was able to detect up to 2.9 km and reduce a diffused image by decreasing a narcissus value from all surfaces except the 4th surface. From sensitivity analysis, MTF resolution was increased on changing temperature with the 5th lens which was assumed as compensation. Conclusions: Designed optical system which used anamorphic lens was satisfied with boundary condition. an increasing resolution with temperature, longer detecting distance and decreasing of narcissus were verified.
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