• Imaging Science in Dentistry
• /
• 제44권1호
• /
• pp.1-6
• /
• 2014

Professionals performing radiographic examinations are responsible for maintaining optimal image quality for accurate diagnoses. These professionals must competently execute techniques such as film manipulation and processing to minimize patient exposure to radiation. Improper performance by the professional and/or patient may result in a radiographic image of unsatisfactory quality that can also lead to a misdiagnosis and the development of an inadequate treatment plan. Currently, the most commonly performed extraoral examination is panoramic radiography. The invention of panoramic radiography has resulted in improvements in image quality with decreased exposure to radiation and at a low cost. However, this technique requires careful, accurate positioning of the patient's teeth and surrounding maxillofacial bone structure within the focal trough. Therefore, we reviewed the literature for the most common types of positioning errors in panoramic radiography to suggest the correct techniques. We would also discuss how to determine if the most common positioning errors occurred in panoramic radiography, such as in the positioning of the patient's head, tongue, chin, or body.

• Progress in Medical Physics
• /
• 제24권4호
• /
• pp.290-294
• /
• 2013

Stereotactic Radiosurgery require high accuracy and precision of patient positioning and target localization. We evaluate the real time positioning accuracy of isocenter using optic guided patient positioning system, ExacTrac (BrainLab, Germany), during spinal radiosurgery procedure. The system is based on real time detect multiple body markers attached on the selected patient skin landmarks. And a custom designed patient positioning verification tool (PPVT) was used to check the patient alignment and correct the patient repositioning before radiosurgery. In this study, We investigate the selected 8 metastatic spinal tumor cases. All type of tumors commonly closed to thoracic spinal code. To evaluate the isocenter positioning, real time patient alignment and positioning monitoring was carried out for comparing the current 3-dimensional position of markers with those of an initial reference positions. For a selected patient case, we have check the isocenter positioning per every 20 millisecond for 45 seconds during spinal radiosurgery. In this study, real time average isocenter positioning translation were $0.07{\pm}0.17$ mm, $0.11{\pm}0.18$ mm, $0.13{\pm}0.26$ mm, and $0.20{\pm}0.37$ mm in the x (lateral), y (longitudinal), z (vertical) directions and mean spatial error, respectively. And body rotations were $0.14{\pm}0.07^{\circ}$, $0.11{\pm}0.07^{\circ}$, $0.03{\pm}0.04^{\circ}$ in longitudinal, lateral, table directions and mean body rotation $0.20{\pm}0.11^{\circ}$, respectively. In this study, the maximum mean deviation of real time isocenter positioning translation during spinal radiosurgery was acceptable accuracy clinically.

• Imaging Science in Dentistry
• /
• 제42권4호
• /
• pp.207-212
• /
• 2012

Purpose: This study was performed to determine the relative frequency of positioning errors, to identify those errors directly responsible for diagnostically inadequate images, and to assess the quality of panoramic radiographs in a sample of records collected from a dental college. Materials and Methods: This study consisted of 1,782 panoramic radiographs obtained from the Department of Oral and Maxillofacial Radiology. The positioning errors of the radiographs were assessed and categorized into nine groups: the chin tipped high, chin tipped low, a slumped position, the patient positioned forward, the patient positioned backward, failure to position the tongue against the palate, patient movement during exposure, the head tilted, and the head turned to one side. The quality of the radiographs was further judged as being 'excellent', 'diagnostically acceptable', or 'unacceptable'. Results: Out of 1,782 radiographs, 196 (11%) were error free and 1,586 (89%) were present with positioning errors. The most common error observed was the failure to position the tongue against the palate (55.7%) and the least commonly experienced error was patient movement during exposure (1.6%). Only 11% of the radiographs were excellent, 64.1% were diagnostically acceptable, and 24.9% were unacceptable. Conclusion: The positioning errors found on panoramic radiographs were relatively common in our study. The quality of panoramic radiographs could be improved by careful attention to patient positioning.

• Journal of radiological science and technology
• /
• 제45권3호
• /
• pp.249-254
• /
• 2022

The purpose of this study was to examine the importance of proper positioning in chest PA X-ray examination. As a study method, this author searched for and analyzed materials related to chest PA X-ray examination from theses and books that had been published previously to understand the importance of proper positioning in chest PA X-ray examination. Generally, one of the examinations frequently done in most of the hospitals is chest PA X-ray examination. Also, in any kinds of X-ray examination, proper positioning is the most fundamental and definite way to provide accurate information about the patient. Poor positioning in chest PA X-ray examination may jeopardize the diagnosis and treatment, increase social cost due to examination needed to be done additionally, and generate additional radiation exposure unnecessarily above all. In conclusion, it is expected that proper positioning in chest PA X-ray examination will exert positive effects such as the provision of accurate information about the patient, prevention of misdiagnosis, reduction in social cost, and lastly decrease in radiation exposure.

• Progress in Medical Physics
• /
• 제13권4호
• /
• pp.218-223
• /
• 2002

Stereotactic radiosurgery for intracranial lesion is well established since the Lars Leksell first introduced radiosurgery concept in 1951 Its use in the treatment of spinal lesion has been limited by the availability of effective immobilization devices. The first clinical experience of the spinal stereotactic radiosurgery technique was reported by Hamilton AJ. in 1995. Recently, Optic-guided patient positioning technique for extracranial stereotactic radiosurgery was developed and reported. This study is for assess the target positioning accuracy of the optic guided patient positioning system Exactrac (BrainLab., Inc, Germany). We have designed phantom for assess the accuracy of spinal stereotactic radiosurgery The infrared reflective body markers attached to the relatively immobile part of the body and a series of 2 mm CT images was taken. The image sets were transferred to the planning computer. During the radiosurgery treatment, we measure the real-time display showing the positioning values from Exactrac computer. And we compare the isocenter deviation from irradiated center point of the film which was mounted on the lesion site of the phantom and pin hole site of that film. The accuracy of the ExacTrac system in positioning a target point shows enough for the clinical applications.

• Health Policy and Management
• /
• 제5권2호
• /
• pp.127-154
• /
• 1995

The Korean hospital industry is rapidly changing along with the competition among hospitals. Until recently it was easy for hospitals to profit even without efficient management and competitive strategies. However, the increasingly intensive competition endanger their profits but also their survivals. Hospital managers have no choice but to seriously consider competitive management and marketing strategies to remain alive and prosper. This study introduces a useful methodology--perception map drawn using multidimensional scaling--for developing competitive strategies, and illustrates its application to developing a perception map of 9 Seoul-based general hospitals. We also suggest the concepts and examples of positioning strategies and patient satisfaction management system. One of the interesting findings is that the Samsung medical center which opened less than a year ago is ranked first in most aspects such as kindness, facilities, waiting time, and parking, and the second in clinical performance just after the Seoul National University Hospital.

• Proceedings of the Korean Society of Medical Physics Conference
• /
• 한국의학물리학회 2002년도 Proceedings
• /
• pp.206-207
• /
• 2002

The effective dose due to the X-Ray radiography in the patient positioning for the heavy ion radiotherapy was measured on three regions, chest, upper-abdomen and pelvis. All the radiographic systems and the conditions used in the measurements were same as the clinical trial being performed in National Institute of Radiological Sciences, Japan. The organ or tissue for measurements was selected by following ICRP60$^1$ and the effective dose was calculated from measured organ doses and the surface dose.

• Journal of radiological science and technology
• /
• 제46권4호
• /
• pp.287-294
• /
• 2023

This study was conducted to ultimately reduce unnecessary radiation exposure by emphasizing the need and importance of correct positioning by examining the positioning relationship of anatomical structures in the human body and changes in X-ray images according to changes in patient positioning during the left lateral chest X-ray examination. This study investigated and analyzed previously published papers and books on the left lateral chest X-ray examination to find out the importance of positioning in the left lateral chest X-ray examination. To find out the importance of correct positioning in the left lateral chest X-ray, we compared three images of incorrectly positioned right thorax and left thorax rotated forward and the lower median surface of the body leaning against the image receptor. In the left lateral chest examination, a distorted image was obtained in which the shape of the anatomical structure observed in the image was changed according to the presence or absence of rotation of the patient and the inclination of the median visual surface. X-ray images with the most accurate and large amount of information were obtained from X-ray images with the correct positioning performed during left lateral chest X-ray examination. Therefore, It is believed that the left lateral chest X-ray examination will have beneficial effects such as providing accurate medical information, preventing misdiagnosis, reducing social costs, and ultimately reducing radiation exposure.

• The Korean Journal of Rehabilitation Nursing
• /
• 제2권2호
• /
• pp.163-175
• /
• 1999

This study was done to identify the effectiveness of a proper positioning on musculoskeletal complication on patient with Stroke by using a quasi-experimental study. A total of 18 patients were selected as a subject from June 1st to October 31th 1998 who had been hospitalized at Intensive Care Units in K medical center. A experimental group consists of 8 patients who were given proper positioning every two hours. A control group consists of 10 patients who were given traditional positioning. The collected data were analyzed by SPSS windows including $X^2$-test (Fisher's exact method), Wilcoxon Rank Sum test and McNemar test. The result of this study was summerized as follows : 1) The experimental group with proper positioning has shown lower shoulder pain score, dorsiflexion contracture score, Shoulder subluxation score and higher Range of Motion and than the control group. 2) The experimental group with proper positioning has shown lower muscle pain score and edema score than the control group, but it was not statistically significant.Therefore, proper positioning could be applied as an independent nursing intervent ion for patients on Stroke in order to facilitate rehabilitation.

• Journal of Korean Neurosurgical Society
• /
• 제61권5호
• /
• pp.568-573
• /
• 2018

Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.