• KIPS Transactions on Computer and Communication Systems
• /
• v.11 no.9
• /
• pp.317-322
• /
• 2022

The rapid development of information technology is also bringing about many changes in the medical environment. In particular, it is leading the rapid change of medical image information systems using big data and artificial intelligence (AI). The prescription delivery system (OCS), which consists of an electronic medical record (EMR) and a medical image storage and transmission system (PACS), has rapidly changed the medical environment from analog to digital. When combined with multiple solutions, PACS represents a new direction for advancement in security, interoperability, efficiency and automation. Among them, the combination with artificial intelligence (AI) using big data that can improve the quality of images is actively progressing. In particular, AI PACS, a system that can assist in reading medical images using deep learning technology, was developed in cooperation with universities and industries and is being used in hospitals. As such, in line with the rapid changes in the medical image information system in the medical environment, structural changes in the medical market and changes in medical policies to cope with them are also necessary. On the other hand, medical image information is based on a digital medical image transmission device (DICOM) format method, and is divided into a tomographic volume image, a volume image, and a cross-sectional image, a two-dimensional image, according to a generation method. In addition, recently, many medical institutions are rushing to introduce the next-generation integrated medical information system by promoting smart hospital services. The next-generation integrated medical information system is built as a solution that integrates EMR, electronic consent, big data, AI, precision medicine, and interworking with external institutions. It aims to realize research. Korea's medical image information system is at a world-class level thanks to advanced IT technology and government policies. In particular, the PACS solution is the only field exporting medical information technology to the world. In this study, along with the analysis of the medical image information system using big data, the current trend was grasped based on the historical background of the introduction of the medical image information system in Korea, and the future development direction was predicted. In the future, based on DICOM big data accumulated over 20 years, we plan to conduct research that can increase the image read rate by using AI and deep learning algorithms.

• Radiation Oncology Journal
• /
• v.28 no.3
• /
• pp.166-176
• /
• 2010

Purpose: To determine the appropriate prostate planning target volume (PTV) margins for 3-dimensitional (3D) conformal radiotherapy (CRT) and intensity-modulated radiation therapy (IMRT) patients treated with an endorectal balloon (ERB) under our institutional treatment condition. Materials and Methods: Patients were treated in the supine position. An ERB was inserted into the rectum with 70 cc air prior to planning a CT scan and then each treatment fraction. Electronic portal images (EPIs) and digital reconstructed radiographs (DRR) of planning CT images were used to evaluate inter-fractional patient's setup and ERB errors. To register both image sets, we developed an in-house program written in visual $C^{++}$. A new method to determine prostate PTV margins with an ERB was developed by using the common method. Results: The mean value of patient setup errors was within 1 mm in all directions. The ERB inter-fractional errors in the superior-inferior (SI) and anterior-posterior (AP) directions were larger than in the left-right (LR) direction. The calculated 1D symmetric PTV margins were 3.0 mm, 8.2 mm, and 8.5 mm for 3D CRT and 4.1 mm, 7.9 mm, and 10.3 mm for IMRT in LR, SI, and AP, respectively according to the new method including ERB random errors. Conclusion: The ERB random error contributes to the deformation of the prostate, which affects the original treatment planning. Thus, a new PTV margin method includes dose blurring effects of ERB. The correction of ERB systematic error is a prerequisite since the new method only accounts for ERB random error.

• Journal of radiological science and technology
• /
• v.33 no.1
• /
• pp.19-24
• /
• 2010

The aim of this study was to evaluate the change of bone mineral density according to distal radius rotation and the correlations of the lowest BMD measured by DXA at the lumba versus distal radius. The eleven males were projected distal radius by DR X-ray and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 21 males. The healthy 11 and 21 volunteers without any history of operations, anomalies, or trauma were enrolled. The experiment was performed by two methods. First, The DR X-ray was measured distal radius of 11 males in pronation and supination with three, six and nine degrees, including a neutral position. The ROI was measured by the m-view program on the PACS monitor. Second, The DXA was measured distal radius of 21 males in pronation and supination with five and ten degrees, including a neutral position to evaluate the changes of BMD according to the rotation. A correlation of the BMD in the distal radius with BMD that lumbar spine was performed, along with analysis of the data by SPSS 12.0v. The mean rotation angle of the distal radius about eleven males DR X-ray measured $7^{\circ}$ of pronation (82%, n = 9), $6^{\circ}$ of supination and $0^{\circ}$ of neutral of (9%, n = 1), The total average rotation angle in 11 male was $5.1^{\circ}$ of pronation. The rotation angle of the distal radius about twenty one males on DXA measured $7.2^{\circ}$ of pronation (43%, n = 9), $7^{\circ}$ of supination (24%, n = 5), and $0^{\circ}$ of neutral (33%, n = 7), The total average rotation angle in 21 people was $4.1^{\circ}$ of pronation. The correlation of the analysis of lumba and distal radius were r = 3.0, p = 0.18. consequently, The correlation was not significance. Because BMD of lumba was not coverd for BMD of the distal radius, with a neutral position, Pronation is needed for BMD in the distal radius with the rotation angle measuring at the lowest BMD. the rotation angle about five degrees of pronation of the distal radius is recommended.

• Journal of the Korean Society of Radiology
• /
• v.6 no.1
• /
• pp.73-77
• /
• 2012

Recently, Interest to the photoconductor, which is used to flat form X-ray detector such as a-Se, $HgI_2$, PbO, CdTe, $PbI_2$ etc. is increasing. In this study, the film layer by using the photoconductive material with particle sedimentation was fabricated and evaluated. The quantization efficiency of the continuous X-ray with the 70 kVp energy bandwidth was analyzed by using the Monte Carlo simulation. With the results, the thickness of film with 64 % quantization efficiency was 180 ${\mu}m$ which is similar to the efficiency of 500 ${\mu}m$ a-Se film. And $HIg_2$ film has the high quantization efficiency of 74 % on 240 ${\mu}m$ thickness. The electrical characteristics of the 239 ${\mu}m$ $Hgl_2$ films produced by particle sedimentation were shown as very low dark current(under 10 $pA/mm^2$), and high sensitivity(19.8 mC/mR-sec) with 1 $V/{\mu}m$ input voltage. The SNR, which is influence to the contrast of X-ray image, was shown highly as 3,125 in low driving voltage on 0.8 $V/{\mu}m$. With the results of this study, the development of the low-cost, high-performance image detector with film could be possible by replacing the film produced by particle sedimentation instead to a-Se detector.

• Radiation Oncology Journal
• /
• v.18 no.4
• /
• pp.345-354
• /
• 2000

Purpose : Conventional radiation therapy Portal images gives low contrast images. The purpose of this study was to enhance image contrast of a linacgram by developing a low-cost image processing method. Materials and Methods : Chest linacgram was obtained by irradiating humanoid Phantom and scanned using Diagnostic-Pro scanner for image processing. Several types of scan method were used in scanning. These include optical density scan, histogram equalized scan, linear histogram based scan, linear histogram independent scan, linear optical density scan, logarithmic scan, and power square root scan. The histogram distribution of the scanned images were plotted and the ranges of the gray scale were compared among various scan types. The scanned images were then transformed to the gray window by pallette fitting method and the contrast of the reprocessed portal images were evaluated for image improvement. Portal images of patients were also taken at various anatomic sites and the images were processed by Gray Scale Expansion (GSE) method. The patient images were analyzed to examine the feasibility of using the GSE technique in clinic. Results :The histogram distribution showed that minimum and maximum gray scale ranges of 3192 and 21940 were obtained when the image was scanned using logarithmic method and square root method, respectively. Out of 256 gray scale, only 7 to 30$\%$ of the steps were used. After expanding the gray scale to full range, contrast of the portal images were improved. Experiment peformed with patient image showed that improved identification of organs were achieved by GSE in portal images of knee joint, head and neck, lung, and pelvis. Conclusion :Phantom study demonstrated that the GSE technique improved image contrast of a linacgram. This indicates that the decrease in image quality resulting from the dual exposure, could be improved by expanding the gray scale. As a result, the improved technique will make it possible to compare the digitally reconstructed radiographs (DRR) and simulation image for evaluating the patient positioning error.

• The Journal of Korean Society for Radiation Therapy
• /
• v.21 no.1
• /
• pp.33-39
• /
• 2009

Purpose: The aim of this study is to compare patient's body posture and its position at the time of simulation with one at the treatment room using On-board Imaging (OBI) and CT (CBCT). The detected offsets are compared with position errors of Rando Phantom that are practically applied. After that, Rando Phantom's position is selected by moving couch based on detected deviations. In addition, the errors between real measured values of Rando Phantom position and theoretical ones is compared. And we will evaluate target position's accuracy of KV X-ray imaging's 2D and CBCT's 3D one. Materials and Methods: Using the Rando Phantom (Alderson Research Laboratories Inc. Stanford. CT, USA) which simulated human body's internal structure, we will set up Rando Phantom on the treatment couch after implementing simulation and RTP according to the same ways as the real radioactive treatment. We tested Rando Phantom that are assumed to have accurate position with different 3 methods. We measured setup errors on the axis of X, Y and Z, and got mean standard deviation errors by repeating tests 10 times on each tests. Results: The difference between mean detection error and standard deviation are as follows; lateral 0.4+/-0.3 mm, longitudinal 0.6+/-0.5 mm, vertical 0.4+/-0.2 mm which all within 0~10 mm. The couch shift variable after positioning that are comparable to residual errors are 0.3+/-0.1, 0.5+/-0.1, and 0.3+/-0.1 mm. The mean detection errors by longitudinal shift between 20~40 mm are 0.4+/-0.3 in lateral, 0.6+/-0.5 in longitudinal, 0.5+/-0.3 in vertical direction. The detection errors are all within range of 0.3~0.5 mm. Residual errors are within 0.2~0.5 mm. Each values are mean values based on 3 tests. Conclusion: Phantom is based on treatment couch shift and error within the average 5mm can be gained by the diminution detected by image registration based on OBI and CBCT. Therefore, the selection of target position which depends on OBI and CBCT could be considered as useful.

• Journal of radiological science and technology
• /
• v.32 no.3
• /
• pp.335-341
• /
• 2009

Purpose : The medical imaging issuance is changed from conventional film method to Digital Compact Disk solution because of development on IT technology. However other medical record department's are undergoing identification check through and through whereas medical imaging department cannot afford to do that. So, we examine present applicant's recognition of private intelligence safeguard, and medical imaging issuance condition by CD & DVD medium toward various medical facility and then perform comparative analysis associated with domestic and foreign law & recommendation, lastly suggest standard for medical imaging issuance and process relate with internal environment. Materials and methods : First, we surveyed issuance process & required documents when situation of medical image issuance in the metropolitan medical facility by wire telephone between 2008.6.1$\sim$2008.7.1. in accordance with the medical law Article 21$\sim$clause 2, suggested standard through applicant's required documents occasionally - (1) in the event of oneself $\rightarrow$ verifying identification, (2) in the event of family $\rightarrow$ verifying applicant identification & family relations document (health insurance card, attested copy, and so on), (3) third person or representative $\rightarrow$ verifying applicant identification & letter of attorney & certificate of one's seal impression. Second, also checked required documents of applicant in accordance with upper standard when situation of medical image issuance in Kyung-hee university medical center during 3 month 2008.5.1$\sim$2008.7.31. Third, developed a work process by triangular position of issuance procedure for situation when verifying required documents & management of unpreparedness. Result : Look all over the our manufactured output in the hospital - satisfy the all conditions $\rightarrow$ 4 place(12%), possibly request everyone $\rightarrow$ 4 place(12%), and apply in the clinic section $\rightarrow$ 9 place(27%) that does not medical imaging issuance office, so we don't know about required documents condition. and look into whether meet or not the applicant's required documents on upper 3month survey - satisfy the all conditions $\rightarrow$ 629 case(49%), prepare a one part $\rightarrow$ 416 case(33%), insufficiency of all document $\rightarrow$ 226case(18%). On the authority of upper research result, we are establishing the service model mapping for objective reception when image export situation through triangular position of issuance procedure and reduce of friction with patient and promote the patient convenience. Conclusion : The PACS is classified under medical machinery that mean indicates about higher importance of medical information therefore medical information administrator's who already received professional education & mind, are performer about issuance process only and also have to provide under ID checking process exhaustively.

• Progress in Medical Physics
• /
• v.23 no.3
• /
• pp.154-161
• /
• 2012

Digital Radiography (DR) has rapidly developed in megavoltage X-ray imaging (MVI). Thus, a very simple and general quality assurance (QA) method is required. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE) for MVI using general QA method and computed radiography (CR) device. We used tungsten edge block with $19{\times}10{\times}1cm^3$ thickness and 6MV energy. For detector, CR-IP (image plate), CR-IP-lead, the CR-IP-back (lanex TM fast back screen), CR-IP-front (lanex TM fast front screen) were used and pre-sampling MTF was calculated. The MTF of CR-IP-front showed the highest value with 1.10 lp/mm although the CR-IP showed the only 0.70 lp/mm. The best NPS was observed in CR-IP front screen. According to the increase in spatial frequency, our results showed that DQE was approximately 1.0 cycles/mm. The present study demonstrates that the QA method with our home-made edge block can be used to evaluate MTF, NPS and DQE for MVI.

• The Journal of Korean Society for Radiation Therapy
• /
• v.20 no.1
• /
• pp.25-29
• /
• 2008

Purpose: To monitor the changes of location of prostate gland using DIPS and to examine the adjustment and proton beam therapy depending on the movement of prostate gland in proton beam therapy for prostate gland in which a fiducial gold marker was inserted. Materials and Methods: This study was conducted in ten patients with prostate cancer who received proton beam therapy since April of 2008. To monitor the change of prostate location, three fiducial gold markers were inserted prior to the treatment. To minimize the movement of prostate gland, patients were recommended to urinate prior to the treatment, to intake a certain amount of water and to concomitantly undergo rectal balloon. In these patients, the set-up position was identical to that for a CT-simulation. The PA (posterior-anterior) and lateral images were obtained using both DIPS (digital image positioning system) and a plain radiography, and they were compared between the two imaging modalities. Thus, the changes of the location of fiducial gold marker were assessed based on three coordinates (x, y, z) and then adjusted. This was followed by proton beam therapy. Results: Images which were taken using a plain radiography were compared with those which were taken using DIPS. In ten patients, according to a reference bony marker, the mean changes of the location of fiducial gold marker based on an iso-center were X-axis: $\pm$0.116 cm, Y-axis: $\pm$0.19 cm and Z-axis: $\pm$0.176 cm. These ten patients showed a difference in the changes of location of prostate gland and it ranged between RT: 0.04 cm and RT: 0.24 cm on the X-axis; between Inf: 0.03 cm and Sup: 0.42 cm on the Y-axis; and Post: 0.05 cm and Ant: 0.35 cm on the Z-axis. Conclusion: To minimize the movement of prostate gland, as the pre-treatment prior to the treatment. In all the patients, however, three fiducial gold markers showed a daily variation which were inserted in the prostate gland. Based on the above data, Thus, the requirement of gold marker matching system depending on the daily variation in the proton beam therapy for which more accurate establishment of target was confirmed. It is assumed that an accurate effect of proton beam therapy would be enhanced by adjusting the target-center depending on the location change of prostate gland using DIPS which was used in the current study.

• Journal of the Korean Society of Radiology
• /
• v.12 no.1
• /
• pp.23-30
• /
• 2018

To evaluate the effect of patient size on effective dose and image quality for Digital Chest Tomosynthesis(DTS) using additional 0.3 mm copper filtration. Eighty artificial nodules were placed in the thorax phantom("Lungman," Kyoto Kagaku, Japan), and Digital Chest Tomosynthesis(DTS) images of the phantom were acquired both with and without added 0.3 mm Cu filtration. To simulate patients of three sizes: small, average size and oversize, one or two 20-mm-thick layer of PMMA(polymethyl methacrylatek) blocks were placed on the phantom. The Effective dose was calculated using Monte Carlo simulations. Two evaluations of image quality methods have been employed. Three readers counted the number of nodules detected in the lung, and the measured contrast-to-noise ratios(CNRs) were used. Data were analyzed statistically. The ED reduced $26{\mu}Sv$ in a phantom, $33{\mu}Sv$ in one 20-mm-thick layer of PMMA block placed on the phantom, and $48{\mu}Sv$ in two 20-mm-thick layer of PMMA blocks placed on the phantom. The Effective dose(ED) differences between DTS with and without filtration were significant(p<0.05). In particular, when we used two 20-mm-thick layer of PMMA blocks placed on the phantom, the ED was significantly reduced by 36% compared with those without additional filtration. Nodule detection sensitivities were not different between with and without added filtration. Differences of CNRs were statistically insignificant(p>0.05). Use of additional filtration allows a considerable dose reduction during Digital Chest Tomosynthesis(DTS) without loss of image quality. In particular, additional filtration showed outstanding result for effective dose reduction on two 20-mm-thick layer of PMMA blocks placed on the phantom. It applies to overweight patients.