• Title/Summary/Keyword: radiological emergency

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Evaluation of Applicability of Customized Bolus According to 3D Printer Material Characteristics (3D 프린터 소재 특성에 따른 맞춤형 볼루스의 적용성 평가)

  • Kyung-Tae Kwon;Hui-Min Jang;Myeong-Seong Yoon
    • Journal of the Korean Society of Radiology
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    • v.17 no.7
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    • pp.1091-1097
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    • 2023
  • Bolus is used in radiation therapy to prescribe an even dose to the tumor when the skin surface is inclined or has irregularities. At this time, the dose to the skin surface increases. Due to the patient's unique body structure and irregular skin, voids may occur between the bolus and the skin, which may reduce the accuracy of treatment. Therefore, in this study, the existing bolus and the self-produced bolus through 3D printing were applied to the nasal area, and the difference between the surface dose after treatment plan and the dose directly measured with an Optically Stimulated luminescence(OSL) dosimeter was compared to the existing bolus. The bolus rate was 97%, PLA 100.33%, ePETELA 75A 100.53%, and ePETELA 85A 100.36%. It was confirmed that there was little error in the measurement values and treatment plan values for each material. In addition, compared to when applying a conventional bolus, a difference of -3% to +0.5% for a 3D printed bolus can be confirmed, so a customized bolus produced through 3D printing can complement the shortcomings of the existing bolus. It is believed that there will be.

Consideration of Shoulder Joint's Image with the Changed Tube Angle of the Shoulder Oblique Projection in Supine Position (Supine 자세에서 Shoulder oblique촬영시 Tube angle 변화에 따른 Shoulder joint에 대한 고찰)

  • Seo, Jae-Hyun;Choi, Nam-Gil
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.109-114
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    • 2008
  • There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.

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MR T2 Map Technique: How to Assess Changes in Cartilage of Patients with Osteoarthritis of the Knee (MR T2 Map 기법을 이용한 슬관절염 환자의 연골 변화 평가)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.20 no.4
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    • pp.298-307
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    • 2009
  • By using the MR T2 map technique, this study intends, first, to measure the change of T2 values of cartilage between healthy people and patients with osteoarthritis and, second, to assess the form and the damage of cartilage in the knee-joint, through which this study would consider the utility of the T2 map technique. Thirty healthy people were selected based on their clinical history and current status and another thirty patients with osteoarthritis of the knee who were screened by simple X-ray from November 2007 to December 2008 were selected. Their T2 Spin Echo (SE hereafter) images for the cartilage of the knee joint were collected by using the T2 SE sequence, one of the multi-echo methods (TR: 1,000 ms; TE values: 6.5, 13, 19.5, 26, 32.5. 40, 45.5, 52). Based on these images, the changes in the signal intensity (SI hereafter) for each section of the cartilage of the knee joint were measured, which yielded average values of T2 through the Origin 7.0 Professional (Northampton, MA 01060 USA). With these T2s, the independent samples T-test was performed by SPSS Window version 12.0 to run the quantitative analysis and to test the statistical significance between the healthy group and the patient group. Closely looking at T2 values for each anterior and lateral articular cartilage of the sagittal plane and the coronal plane, in the sagittal plane, the average T2 of the femoral cartilage in the patient group with arthritis of the knee ($42.22{\pm}2.91$) was higher than the average T2 of the healthy group ($36.26{\pm}5.01$). Also, the average T2 of the tibial cartilage in the patient group ($43.83{\pm}1.43$) was higher than the average T2 in the healthy group ($36.45{\pm}3.15$). In the case of the coronal plane, the average T2 of the medial femoral cartilage in the patient group ($45.65{\pm}7.10$) was higher than the healthy group ($36.49{\pm}8.41$) and so did the average T2 of the anterior tibial cartilage (i.e., $44.46{\pm}3.44$ for the patient group vs. $37.61{\pm}1.97$ for the healthy group). As for the lateral femoral cartilage in the coronal plane, the patient group displayed the higher T2 ($43.41{\pm}4.99$) than the healthy group did ($37.64{\pm}4.02$) and this tendency was similar in the lateral tibial cartilage (i.e., $43.78{\pm}8.08$ for the patient group vs. $36.62{\pm}7.81$ for the healthy group). Along with the morphological MR imaging technique previously used, the T2 map technique seems to help patients with cartilage problems, in particular, those with the arthritis of the knee for early diagnosis by quantitatively analyzing the structural and functional changes of the cartilage.

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SNR and ADC Changes at Increasing b Values among Patients with Lumbar Vertebral Compression Fracture on 1.5T MR Diffusion Weighted Images (1.5T MR 기기를 이용한 확산강조영상에서 b Value의 증가에 따른 요추압박골절 환자의 신호대 잡음비와 현성 확산 계수의 변화)

  • Cho, Jae-Hwan;Park, Cheol-Soo;Lee, Sun-Yeob;Kim, Bo-Hui
    • Progress in Medical Physics
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    • v.21 no.1
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    • pp.52-59
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    • 2010
  • To examine among patients with vertebral compression fracture the extent to which signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values at the lumbar vertebral compression fracture site vary on diffusion-weighted MR images according to varying b values on the 1.5T MR device. Diffusion-weighted MR images of 30 patients with compression fracture due to chronic osteoporosis who underwent vertebral MRI from Jan. 2008 to Nov. 2009 were respectively obtained using a 1.5-T MR scanner with the b values increased from 400, 600, 800, 1,000 to $1,200\;s/mm^2$. For diffusion-weighted MR images with different b values, the signal-to-noise ratio (SNR) was assessed at three sites: the site of compression fracture of the lumbar vertebral body at L1 to L5, and both the upper and lower discs of the said fracture site, while for ADC map images with different b values, the SNR and ADC were respectively assessed at those three sites. As a quantitative analysis, diffusion-weighted MR images and ADC map images with b value of $400\;s/mm^2$ (the base b values) were respectively compared with the corresponding images with each different b value. As far as qualitative analysis is concerned, for both diffusion-weighted MR and ADC map images with b value of $400\;s/mm^2$, the extent to which signal intensity values obtained at the site of compression fracture of the lumbar vertebral body at L1 to L5 vary according to the increasing b values were examined. The quantitative analysis found that for both diffusion-weighted MR and ADC map images, as the b values increased, the SNR were relatively lowered at all the three sites, compared to the base b value. Also, it was found that as the b values increased, ADC valueswere relatively lowered at all the three sites on ADC map images. On the other hand, the qualitative analysis found that as the b values increased to more than $400\;s/mm^2$, the signal intensity gradually decreased at all the sites, while at the levels of more than $1,000\;s/mm^2$, severe image noises appeared at all of the three sites. In addition, higher signal intensity was found at the site of compression fracture of the lumbar vertebral body than at the discs. Findings showed that with the b value being increased, both the signal-to-noise ratio (SNR) and Apparent Diffusion Coefficient (ADC) values gradually decreased at all the sites of the lumbar vertebral compression fracture and both the upper and lower discs of the fracture site, suggesting that there is a possibility of a wider range of applications to assessment of various vertebral pathologies by utilizing multi b values in the diffusion-weighted MRI examination.

A Study on the Overall Economic Risks of a Hypothetical Severe Accident in Nuclear Power Plant Using the Delphi Method (델파이 기법을 이용한 원전사고의 종합적인 경제적 리스크 평가)

  • Jang, Han-Ki;Kim, Joo-Yeon;Lee, Jai-Ki
    • Journal of Radiation Protection and Research
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    • v.33 no.4
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    • pp.127-134
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    • 2008
  • Potential economic impact of a hypothetical severe accident at a nuclear power plant(Uljin units 3/4) was estimated by applying the Delphi method, which is based on the expert judgements and opinions, in the process of quantifying uncertain factors. For the purpose of this study, it is assumed that the radioactive plume directs the inland direction. Since the economic risk can be divided into direct costs and indirect effects and more uncertainties are involved in the latter, the direct costs were estimated first and the indirect effects were then estimated by applying a weighting factor to the direct cost. The Delphi method however subjects to risk of distortion or discrimination of variables because of the human behavior pattern. A mathematical approach based on the Bayesian inferences was employed for data processing to improve the Delphi results. For this task, a model for data processing was developed. One-dimensional Monte Carlo Analysis was applied to get a distribution of values of the weighting factor. The mean and median values of the weighting factor for the indirect effects appeared to be 2.59 and 2.08, respectively. These values are higher than the value suggested by OECD/NEA, 1.25. Some factors such as small territory and public attitude sensitive to radiation could affect the judgement of panel. Then the parameters of the model for estimating the direct costs were classified as U- and V-types, and two-dimensional Monte Carlo analysis was applied to quantify the overall economic risk. The resulting median of the overall economic risk was about 3.9% of the gross domestic products(GDP) of Korea in 2006. When the cost of electricity loss, the highest direct cost, was not taken into account, the overall economic risk was reduced to 2.2% of GDP. This assessment can be used as a reference for justifying the radiological emergency planning and preparedness.

Predictors on In-hospital Mortality Following In-hospital Diagnosis of Tuberculosis (결핵으로 입원한 환자의 병원내 사망과 관련된 인자)

  • Shin, Su Rin;Kim, Chang Hwan;Kim, Sung Eun;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung;Kim, Cheol Hong;Eom, Kwang Seok;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Gu;Jung, Ki Suck
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.3
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    • pp.233-238
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    • 2006
  • Study objectives: To determine the factors associated with mortality after an in-hospital diagnosis of tuberculosis in a region with low levels of HIV coinfection. Methods: From January 2003 to December 2004, all subjects who were > 15 years of age and had received a diagnosis of tuberculosis were registered. The clinical, radiological and laboratory aspects of the patients who died (n=27) were compared with those of an age and gender matched control population(n=54). Logistic regression analyses were carried out, which included age, gender, hospital admission source, initial site of admission, dyspnea, general weakness and initial laboratory data. Results: The mean age of the patients was $60{\pm}16$ years and male patients outnumbered female patients. Univariate analysis identified hemoglobin, blood urea nitrogen, albumin, cholesterol, aspartate aminotransferase (AST), C-reactive protein and the risk factors for tuberculosis to be significantly associated with mortality. Among the characteristics of disease presentation and treatment, emergency department admission, intensive care unit, disease severity, general weakness and dyspnea at the time of admission were associated with mortality. Multiple regression analysis revealed the initial management in the intensive care unit and lower serum albumin to be independently associated with mortality. Conclusion: The markers of disease chronicity and severity appear to be associated with in-hospital mortality. Identifying potentially reversible factors such as malnutrition and respiratory failure suggests specific intervention that might lead to an improvement in the patients' outcomes.

Feasibility of Reflecting Improvement of Tumor Hypoxia by Mild Hyperthermia in Experimental Mouse Tumors with $^18F-Fluoromisonidazole$ (저온온열치료에 의한 종양 내 저산소상태 개선효과를 $^18F$-Fluoromisonidazole의 섭취 변화를 이용한 평가)

  • Lee Sang-wook;Ryu Jin Sook;Oh Seung Joon;Im Ki Chun;Chen Gi Jeong;Lee So Ryung;Song Do Young;Im Soo Jeong;Moon Eun Sook;Kim Jong Hoon;Ahn Seung Do;Shin Seong Soo;Lee Kyeong Ryong
    • Radiation Oncology Journal
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    • v.22 no.4
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    • pp.288-297
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    • 2004
  • Puporse: The aims of this study were to evaluate the change of $[^18F]fluoromisonidazole$($[^18F]FMISO$) uptake in C3H mouse squamous cell carcinoma-VII (SCC-VII) treated with mild hyperthermia ($42^{circ}C$) and nicotinamide and to assess the biodistribution of the markers in normal tissues under similar conditions. Methods and Materials: $[^18F]FMISO$ was producedby our hospital. Female C3H mice with a C3H SCC-VII tumor grown on their extremities were used. Tumors were size matched. Non-anaesthetized, tumor-bearing mice underwent control or mild hyperthermia at $42^{circ}C$ for 60 min with nicotinamide (50 mg/kg i.p. injected) and were examined by gamma counter, autoradiography and animal PET scan 3 hours after tracer i.v. injected with breathing room air, The biodistribution of these agents were obtained at 3 h after $[^18F]FMISO$ injection. Blood, tumor, muscle, heart, lung, liver, kidney, brain, bone, spleen, and intestine were removed, counted for radioactivity and weighed. The tumor and liver were frozen and cut with a cryomicrotome into 10- um sections. The spatial distribution of radioactivity from the tissue sections was determined with digital autoradiography. Results: The mild hyperthermia with nicotinamide treatment had only slight effects on the biodistribution of either marker in normal tissues. We observed that the whole tumor radioactivity uptake ratios were higher in the control mice than in the mild hyperthermia with nicotinamide treated mice for $[^18F]FMISO$ ($1.56{\pm}1.03$ vs. $0.67{\pm}0.30$; p=0.063). In addition, autoradiography and animal PET scan demonstrated that the area and intensity of $[^18F]FMISO$ uptake was significantly decreased. Conclusion: Mild hyperthermla and nicotinamide significantly improved tumor hypoxia using $[^18F]FMISO$ and this uptake reflected tumor hypoxic status.

Evaluation of the Usefulness of the Transmittance of Metal Filaments Fabricated by 3D Printers in Radiation Therapy (방사선 치료에서 3D 프린터로 제작된 금속 필라멘트의 투과율에 관한 유용성 평가)

  • Kwon, Kyung-Tae;Jang, Hui-Min;Yoon, Myeong-Seong
    • Journal of the Korean Society of Radiology
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    • v.15 no.7
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    • pp.965-973
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    • 2021
  • Since radiation therapy is irradiated with high-energy X-rays in a variety of at least 20 Gy to 80 Gy, a high dose is administered to the local area where the tumor is located, and various side effects of some normal tissues are expected. Currently, in clinical practice, lead, a representative material, is used as an effort to shield normal tissues, but lead is classified as a heavy metal harmful to the human body, and a large amount of skin contact can cause poisoning. Therefore, this study intends to manufacture a measurement sheet that can compensate for the limitations of lead using the materials Tungsten, Brass, and Copper of the 3D printer of the FDM (Fused Deposition Modeling) method and to investigate the penetration performance. Tungsten mixed filament transmission measurement sheet size was 70 × 70 mm and thickness 1, 2, 4 mm using a 3D printer, and a linear accelerator (TrueBeam STx, S/N: 1187) was measured by irradiating 100 MU at SSD 100 cm and 5 cm in water using a water phantom, an ion chamber (FC-65G), and an elcetrometer (PTW UNIDOSE), and the permeability was evaluated. As a result of increasing the measurement sheet of each material by 1 mm, in the case of Tungsten sheet at 3.8 to 3.9 cm in 6 MV, the thickness of the lead shielding body was thinner than 6.5 cm, and in case of Tungsten sheet at 4.5 to 4.6 cm in 15 MV. The sheet was thinner than the existing lead shielding body thickness of 7 cm, and equivalent performance was confirmed. Through this study, the transmittance measurement sheet produced using Tungsten alloy filaments confirmed the possibility of transmission shielding in the high energy region. It has been confirmed that the usability as a substitute is also excellent. It is thought that it can be provided as basic data for the production of shielding agents with 3D printing technology in the future.

Analysis of dose reduction of surrounding patients in Portable X-ray (Portable X-ray 검사 시 주변 환자 피폭선량 감소 방안 연구)

  • Choe, Deayeon;Ko, Seongjin;Kang, Sesik;Kim, Changsoo;Kim, Junghoon;Kim, Donghyun;Choe, Seokyoon
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.113-120
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    • 2013
  • Nowadays, the medical system towards patients changes into the medical services. As the human rights are improved and the capitalism is enlarged, the rights and needs of patients are gradually increasing. Also, based on this change, several systems in hospitals are revised according to the convenience and needs of patients. Thus, the cases of mobile portable among examinations are getting augmented. Because the number of mobile portable examinations in patient's room, intensive care unit, operating room and recovery room increases, neighboring patients are unnecessarily exposed to radiation so that the examination is legally regulated. Hospitals have to specify that "In case that the examination is taken out of the operating room, emergency room or intensive care units, the portable medical X-ray protective blocks should be set" in accordance with the standards of radiation protective facility in diagnostic radiological system. Some keep this regulation well, but mostly they do not keep. In this study, we shielded around the Collimator where the radiation is detected and then checked the change of dose regarding that of angles in portable tube and collimator before and after shielding. Moreover, we tried to figure out the effects of shielding on dose according to the distance change between patients' beds. As a result, the neighboring areas around the collimator are affected by the shielding. After shielding, the radiation is blocked 20% more than doing nothing. When doing the portable examination, the exposure doses are increased $0^{\circ}C$, $90^{\circ}C$ and $45^{\circ}C$ in order. At the time when the angle is set, the change of doses around the collimator decline after shielding. In addition, the exposure doses related to the distance of beds are less at 1m than 0.5m. In consideration of the shielding effects, putting the beds as far as possible is the best way to block the radiation, which is close to 100%. Next thing is shielding the collimator and its effect is about 20%, and it is more or less 10% by controlling the angles. When taking the portable examination, it is better to keep the patients and guardians far enough away to reduce the exposure doses. However, in case that the bed is fixed and the patient cannot move, it is suggested to shield around the collimator. Furthermore, $90^{\circ}C$ of collimator and tube is recommended. If it is not possible, the examination should be taken at $0^{\circ}C$ and $45^{\circ}C$ is better to be disallowed. The radiation-related workers should be aware of above results, and apply them to themselves in practice. Also, it is recommended to carry out researches and try hard to figure out the ways of reducing the exposure doses and shielding the radiation effectively.