• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1477-1492
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• 2021

Purpose Dedicated breast CT is an emerging volumetric X-ray imaging modality for diagnosis that does not require any painful breast compression. To improve the detection rate of weakly enhanced lesions, an adaptive image rescaling (AIR) technique was proposed. Materials and Methods Two disks containing five identical holes and five holes of different diameters were scanned using 60/100 kVp to obtain single-energy CT (SECT), dual-energy CT (DECT), and AIR images. A piece of pork was also scanned as a subclinical trial. The image quality was evaluated using image contrast and contrast-to-noise ratio (CNR). The difference of imaging performances was confirmed using student's t test. Results Total mean image contrast of AIR (0.70) reached 74.5% of that of DECT (0.94) and was higher than that of SECT (0.22) by 318.2%. Total mean CNR of AIR (5.08) was 35.5% of that of SECT (14.30) and was higher than that of DECT (2.28) by 222.8%. A similar trend was observed in the subclinical study. Conclusion The results demonstrated superior image contrast of AIR over SECT, and its higher overall image quality compared to DECT with half the exposure. Therefore, AIR seems to have the potential to improve the detectability of lesions with dedicated breast CT.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.49-53
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• 2016

Purpose Recently, Cadmium-zinc-telluride (CZT) semiconductor myocardial SPECT (Single Photon Emission Computed Tomography) has been used myocardial scintigraphy. In this study, the performance of Semiconductor SPECT and conventional SPECT systems was compared by a comprehensive analysis of phantom SPECT images. Materials and Methods Methods: We evaluated the DSPECT CZT SEPCT (Spectrum-dynamic) and INFINA conventional (GE). Physical performance was compared on reconstructed SPECT images from a phantom. Results For count sensitivity on cardiac phantom images ($counts{\cdot}sec^{-1}{\cdot}MBq^{-1}$), DSPECT had a sensitivity of conventional SPECT. This classification was similar to that of myocardial counts normalized to injected activities from phantom images (respective mean values, $counts{\cdot}sec^{-1}{\cdot}MBq^{-1}$: 195.83 and 52.83). For central spatial resolution: DSPECT, 9.47mm; conventional SPECT, 16.90mm. For contrast-to-noise ratio on the phantom: DSPECT, 4.2; conventional SPECT, 3.6. Conclusion The performance of CZT cameras is dramatically higher than that of conventional SPECT. However, CZT cameras differ in that spatial resolution and contrast-to-noise ratio are better with conventional SPECT, whereas count sensitivity is markedly higher with the DSPECT.

• Radiation Oncology Journal
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• v.12 no.2
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• pp.151-158
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• 1994

Since Jan. 1992, authors have conducted a pilot study to treat malignant glioma with multiple daily fractionated(MDF) radiation therapy and this paper presents the outcome compared MDF to conventional factionated(CF) radiation therapy Between Sep. 1989 and Jan. 1993, forty three patients with high grade glioma of brain except brain stem glioma were treated: nineteen patients were treated with CF radiation therapy and 24 patients were treated with MDF radiation therapy. In CF radiation therapy, total dose was 6300cGy/35fx in 7 weeks, which 5040cGy was delivered to the initial target volume and 1260cGy to reduced target volume. And in MDF radiation therapy, total dose was 6400cGy/40fx in 4 weeks, which 3200cGy was delivered to the initial target volume as 160cGy 2 times daily 6hr apart. All patients had histologically confirmed anaplastic astrocytoma(AA) of glioblastoma multiforme (GBM) with stereotactic biopsy or craniotomy for subtotal or gross tumor resection. The range of follow-up was 7 months to 4 years with a median follow-up of 9 months. The Median survival from surgery was 9 months for all patients. The median survival was 9 months and 10 months for MDF group and CF group and 10 months and 9.5 months for glioblastoma multiforme and anaplastic astrocytoma, respectively. In 36 patients with follow-up CT scan or MRI scan, disease status was evaluated according to treatment groups, Four patients(GBM:3, AA:1) of 21 patients in MDF group, were alive with no evidence of disease, while none of patient was alive with no evidence of disease in CF group. The progression of disease had occurred in 20 patients, 11 patients and 9 patients in MDF group and CF group, respectively All of these patients showed in-field progression of disease, Four of 11 patients($27\%$) in MDF group showed the new leasion outside of the treatment field, while 5 of 9 patients($56\%$) in CF group. In our study the prognosis was not influenced by age, KPS, grade, extent of surgery and different fractional scheduled radiation therapy. Authors concluded that MDF regimen was well tolerated and shortened the treatment period from 7 weeks to 4 weeks without compromising results. We believe that further follow-up is needed to assess the role of MDF.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.98-103
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• 2014

Purpose: The effective half life of I-131 is useful to calculate radiation dose, period of hospitalization, and exposure dose of surrounding people from patient. However, it is difficult to measure. This study estimates the effective half life in whole body and thyroid in using of value of residual radioactivity obtained from the early and delay images of Dual time I-131 whole body scan. Also, the correlations between the effective half life and serum creatinine, GFR, and administration dose were investigated in this study. Materials and Methods: The targets were 50 patients administration high dose of I-131 from February to August in 2013, having normal range of serum creatinine and over $30{\mu}IU/mL$ of TSH levels. After administration radioactive I-131, the early scan in the 3rd day and the delay scan in the 5-6th days were performed. To measure the residual radioactivity in the whole body and thyroid, ROI was set and then background radioactivity was corrected to estimate. The effective half life was estimated by calculating the ratio of measured values between the early and delay images. To compare the effective half lives of the whole body and thyroid, it was analyzed by Independent t-test, and each correlation of the effective half life, GFR, serum creatinine, and the dose of administration were analyzed by calculating the pearson's correlation coefficient. All of the analysis were determined to be statistically significant when P<0.05. Results: The effective half life of the whole body was $17.06{\pm}5.50$ hours and of the thyroid was $17.22{\pm}5.41$ hours. The two effective half life did not show significant difference (P=0.887). As the value of GFR was increased, the effective half life of whole body (r=-0.407, P=0.003) and of thyroid (r=-0.473, P=0.001) were significantly decreased; as the value of serum creatinine was increased, the effective half life of whole body (r=0.309, P=0.029) and of thyroid (r=0.371, P=0.008) were significantly increased. In the administration dose, effective half life did not have correlations. Conclusion: The effective half life of I-131 of patients treated for their thyroids were estimated only by using the images of Dual time I-131 whole body scan. Also, the correlations with the effective life, GFR, and serum creatinine were examined. This study might be utilized for a study on optimization for the period of hospitalization of patients treated by high dose of I-131 and on evaluation for internal absorbed dose of MIRD schema in application of the effective half life.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.64-68
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• 2019

Purpose In the preparation process for N-13 Ammonia injections, there were radioactive medicines adsorbed on filters remarkably. Hereby, we have compared the adsorption rate and quality test on Millex GS filter and Satorious Minisart filter, both representatively hydrophilic sterilizing filters, also evaluated which filter is more accommodative for N-13 Ammonia injection. Materials and Methods The filters used for sterilization of N-13 Ammonia injections were Millex GS filter($0.22{\mu}m$) mand Satorious Minisart filter ($0.2{\mu}m$), which are generally used to strain aqueous solutions. After the N-13 Ammonia passes through each sterilization filter, the adsorption rate of the filter (n=10) is determined by measuring not only the radioactivity through the filter also the amount of radioactivity remaining in it using a Dose Calibrator. The N-13 Ammonia injections after each filter is tested by the quality control test to conform to the Samsung Medical Center standard. Results The ratio of radioactivity passed through Millex GS indicated $29.0{\pm}17.6%$. Satorious Minisart filters output was $80.9{\pm}3.2%$, respectively. Each ratio of radioactivity adsorbed on the sterile filter was $71.0{\pm}17.6%$ for Millex GS and $19.1{\pm}3.2%$ for the Satorious Minisart filters, respectively. Furthermore, on the ratio of filtered radioactivity, Using Satorious Minisart filter showed about 2.8 times higher than using Millex GS filter. The quality testing of N-13 Ammonia injections through each filter met the Samsung Medical Center standard. Conclusion The Millex GS filter is composed of cellulose acetate and cellulose nitrate, whereas the Satorious Minisart filter if composed only of cellulose acetate. Therefore, the presence of cellulose nitrate in the membrane seems to have made differences. Therefore, the use of Satorious Minisart filter in the preparation of N-13 Ammonia injection solution minimized the loss of radioactive medicines due to filter adsorption, thereby improving the synthesis yield.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.627-635
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• 2017

Brachytherapy is generally performed in conjunction with external radiation therapy, and the treatment course is very complicated, which can lead to radiation accidents. In order to solve this problem, we designed the process map by applying the failure mode and effects analysis (FMEA) method to the Brachytherapy and scored the risk priority number (RPN) for each treatment course based on this process map. The process map consisted of five steps, Patient consulting", "Brachytherapy simulation", "CT simulation", "Brachytherapy treatment planning" and "Treatment". In order to calculate the RPN, doctor, medical physicist, dose planners, therapist, and nurse participated in the study and evaluated occurrence, severity, and lack of detectability at each detail step. Overall, the process map is preceded by a patient identification procedure at each treatment stage, which can be mistaken for another patient, and a different treatment plan may be established to cause a radiation accident. As a result of evaluating the RPN for the detailed steps based on the process map, overall "Patient consulting" and "Brachytherapy treatment planning" step were evaluated as high risk. The nurses showed a tendency to be different from each other, and the nurses had a risk of 55 points or more for all the procedures except "Treatment", and the "Brachytherapy simulation" step was the highest with 88.8 points. Since the treatment stage differs somewhat for each medical institution performing radiotherapy, it is thought that the risk management should be performed intensively by preparing the process map for each institution and calculating the risk RPN.

• Progress in Medical Physics
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• v.11 no.2
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• pp.123-130
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• 2000

The performance of an electrometer directly affects on the accuracy and precision in radiation dosimetry. This study is to list of the quality control for maintaining performance and to perform evaluation tests of an electrometer. Performance tests selected include proper polarizing voltages, warm-up and equalization time, leakages, long-term stability, linearity, and effect of ambient conditions. An electrometer connected with a rigid stem ionization chamber was evaluated with a Strontium-90 check device. Bias voltage was measured directly on the input socket. Equalization time is the time required for reaching threshold of charged state after the power is on or the bias voltage is changed. Pre- and post-signal leakages are defined as the accumulation of signal with no exposure and after exposure, respectively. Over three months period, the electrometer's long-term stability was measured by comparison of the temperature-pressure corrected readings. Linearity was expressed as the deviation of readings from multiple short exposures from one continuous exposure. Effect of ambient conditions was expressed as the zero drift of the electrometer over 17-34$^{\circ}C$ temperature ranges. For two nominal values, 300 and 500 volts, measured voltages were lower by 2.5 and 5.8%, respectively. The warm-up time, 20 minutes, was longer than the lamp time by 9 minutes and the equalization time was less than 1 minute. Without exposure, the zero-drift was 0.002 scale-unit in 15 minutes and the leakage after 10 minutes exposure was minimal. The IQ-4 was stable over 99.4% for three-month periods. Deviation from the linearity was 0.9% for measurement scale, 0.000-9.991. Over 17-34$^{\circ}C$ temperature range, the zero-drift was minimal, less than 0.2%. For a clinically-used electrometer, a list for the basic peformance evaluations is proposed. By running this program, the measurement error using an electrometer can be reduced and in turn the improvement in accuracy and precision of radiation dosimetry can be achieved.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.71-75
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• 2013

Purpose: Currently, decrement revision using LDCT is used in PET/CT. But cold artifacts are often found in decrement revision image by mismatch between LDCT image and Emission image near diaphragm due to patient's respiration. This research studied reduction of cold artifact by patient's respiration using CTAC Shift among revision methods. Materials and Methods: From March to September in 2012, 30 patients who had cold artifacts by respiration were targeted using PET/CT Discovery 600 (GE Healthcare, MI, USA) equipment. Patients with cold artifacts were additionally scan in diaphragm area, and the image shown cold artifacts at whole body test were revised using CTAC Shift. Cold artifacts including image, additional scan image and CTAC Shift revision image were evaluated as 1~5 points with naked eye by one nuclear medicine expert, 4 radiotechnologists with over 5 year experience. Also, standard uptake value of 3 images was compared using paired t-test. Results: Additional scan image and CTAC Shift revision image received relatively higher score in naked eye evaluation than cold artifacts including image. The additional scan image and CTAC Shift revision image had high correlation as the results of ANOVA test of standard uptake value and did not show significant difference. Conclusion: When cold artifacts are appeared by patient's respiration at PET/CT, it causes not only patient inconvenience but troubles in test schedule due to extra radiation exposure and time consumption by additional scan. But if CTAC Shift revision image can be acquired with out additional scan, it is considered to be helped in exact diagnosis without unnecessary extra radiation exposure and additional scan.

• Progress in Medical Physics
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• v.11 no.2
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• pp.157-165
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• 2000

Purpose: For estimation of yields of l)NA damages induced by radiation and enhanced by oxygen, a mathematical model was used and tested. Materials and Methods: Reactions of the products of water radiolysis were modeled as an ordinary time dependant equations. These reactions include formation of radicals, DNA damage, damage repair, restitution, and damage fixation by oxygen and H-radical. Several rate constants were obtained from literature while others were calculated by fitting an experimental data. Sensitivity studies were performed changing the chemical rate constant at a constant oxygen number density and varying the oxygen concentration. The effects of oxygen concentration as well as the damage fixation mechanism by oxygen were investigated. Oxygen enhancement ratio(OER) was calculated to compare the simulated data with experimental data. Results: Sensitivity studies with oxygen showed that DNA survival was a function of both oxygen concentration and the magnitude of chemical rate constants. There were no change in survival fraction as a function of dose while the oxygen concentration change from 0 to 1.0 x 10$^{7}$ . When the oxygen concentration change from 1.0 $\times$ 107 to 1.0 $\times$ 101o, there was significant decrease in cell survival. The OER values obtained from the simulation study were 2.32 at 10% cell survival level and 1.9 at 45% cell survival level. Conclusion: Sensitivity studies with oxygen demonstrated that the experimental data were reproduced with the effects being enhanced for the cases where the oxygen rate constants are largest and the oxygen concentration is increased. OER values obtained from the simulation study showed good agreement for a low level of cell survival. This indicated that the use of the semi-empirical model could predict the effect of oxygen in cell killing.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.889-896
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• 2023

Changes in the energy spectrum were analyzed using ^99mTc as a point source and a scattering phantom, and the shielding effect of the lead apron according to the changed gamma ray energy was evaluated. In the gamma ray energy spectrum of the scattering phantom, the photo peak area decreased and the compton scattering area increased compared to the point source. The coefficients for each energy range according to the change in the shape of the gamma ray source showed a reduction rate of up to 66.1 % at a distance of 20 cm compared to the coefficient of the point source, and in the compton scattering area, the coefficient of the scattering phantom was 122.2 % at a distance of up to 40 cm compared to the coefficient of the point source. In the difference in shielding rate according to the distance between the source and the scattering phantom using a gamma camera, the photo peak area showed similar results, but in the Compton scattering area, the shielding rate of the scattering phantom at a distance of 20 cm increased by 29.2 % compared to the shielding rate of the point source. As the distance increased, the difference in shielding rate decreased. In measuring the shielding rate of the lead apron using a radiation dosimeter, the difference in the shielding rate of the scattering phantom was up to 15.3 %, and as the distance increased, the difference in the shielding rate between the two sources decreased. The shielding rate of the lead apron of the scattering phantom is higher than that of the point source, and the effectiveness of the lead apron increases as the distance to the source increases. As a result, wearing a lead apron when directly confronting a patient who has injected radioactive pharmaceuticals is expected to be helpful in reducing radiation exposure.