• Journal of radiological science and technology
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• v.31 no.3
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• pp.217-222
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• 2008

Radiation dose to radiologists working at three hospitals in Seoul was investigated from Jan 1, 2006 to Dec. 31, 2006. The results are as follows. First, radiation dose to radiologists at a cardiac angiography room was measured as 1.41mSv, the highest while radiation dose to radiologists at a department of radiation oncology was measured as 0.64 mSv, the lowest. Second, radiation dose proves to be in direct proportion to the number of X-ray treatment. Third, as for the radiation dose in X-ray treatments, radiologists in cardiac angiography room are exposed to the largest amount of radiation while radiologists in diagnostic radiology department are exposed to the smallest amount of radiation. Last, radiation dose at a cardiac angiography room is the largest and is followed by nuclear medicine, diagnostic radiology, and radiation oncology departments in order. According to ICRP, exposure less than 20mSv per year is highly recommended while radiation dose is allowed as long as it is ranged less than 50mSv per year or 100mSv within a 5-year period. Taking into account the results, radiation exposure does not do any harm to radiologists at any related departments in Korean hospitals because the dose per year is less than 1.60mSv.

• Journal of the Korean Society of Radiology
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• v.12 no.5
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• pp.669-675
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• 2018

This study aimed to investigate the difference of X-ray exposure by comparing and analyzing entrance surface dose and absorbed dose according to the frame change in coronary angiography using an X-ray machine. Moreover, appropriate frame selection measures for examination, including the effect of frame change on the image quality, were sought by measuring and analyzing the SNR and CNR of the image through image J. The study was conducted on 30 patients (19 males and 11 females) who underwent CAG at this hospital from June 2017 to October 2017. In regard to the patients, their age range was 49-82 years (mean of $65{\pm}9$ years), body weight was 45-91 kg (mean of $67{\pm}8.9kg$), height was 150-179cm (mean of $165.1{\pm}8.9kg$), and BMI was 19.5-30.5(mean of $24.5{\pm}2.9$). For the entrance surface dose and absorbed dose, air kerma value and DAP were obtained and analyzed retrospectively. The SNR and CNR were measured and analyzed through imageJ, and the result values were derived by applying the values to the formula. As for the statistical analyses, the correlations between the entrance surface dose and absorbed dose, and between the SNR and CNR were analyzed by using the SPSS statistical program. The relationship between the entrance surface dose and absorbed dose was not statistically significant for both 10 f/s and 15 f/s (p>0.05). In terms of the relationship between the SNR and CNR, the SNR ($3.374{\pm}2.1297$) and CNR ($0.234{\pm}0.2249$) in 10 f/s were $1.43{\pm}0.4861$ and $0.132{\pm}0.0555$ lower, respectively, than the SNR ($4.929{\pm}2.8532$) and CNR ($0.391{\pm}0.3025$) in 15 f/s, which were not statistically significant (p>0.05). In the correlation analysis, statistically significant results were obtained among the BMI, air kerma, and DAP; between air kerma and DAP; and between SNR and CNR (p<0.001, p<0.001). In conclusion, there was no significant difference between the entrance surface dose and absorbed dose even when the images were taken by changing the frame from 10 f/s to 15 f/s at the time of the coronary angiography. SNR and CNR increased at 15 f/s than at 10 f/s, but they were not statistically significant. Therefore, this study suggests that the concern of the patient and practitioner regarding image quality degradation, as well as the problem of X-ray exposure caused by imaging at 10 f/s and 15 f/s, may be reduced.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.427-434
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• 2022

Atrial fibrillation treatment includes 3D RFCA and Cryo-balloon ablation. Both procedures have in common that they enter after understanding the structure of the heart using angiography equipment. Therefore, there is a disadvantage that the effect of exposure according to the procedure time can be a threat to both the patient and the operator, so this study aims to confirm the relationship between the total ablation time and the effect of radiation exposure. We used follow-up data (retrospective) from 41 patients who underwent coronary angiography and arrhythmia at the same time from March 2019 to July 2022. The range for total ablation time was based on the recorded data from the start to the end of the total ablation. The end point of 3D RFCA was when the ablation was completed for 4 pulmonary veins, and in the case of Cryo-balloon ablation, the data that succeeded in electrical insulation were included. As a result of analyzing the total ablation time, the time taken for Cryo-balloon ablation was 1037.29±103.66 s, which was 2448.61 s faster than 3D RFCA using 3485.9±405.71 s, and was statistically significant. (p<0.05) As a result of analyzing the total fluoroscopy time, the exposure time for 3D RFCA was 2573.75±239.08 s, which was less by 1717.15 s than the exposure time for Cryo-balloon ablation, 4290.9±420.42 s, and was statistically significant. In the case of total area dose product, 3D RFCA was 59.04±13.1 uGy/m², which was lower than Cryo-balloon ablation 980.6±658.07 uGy/m² by 921.56 uGy/m², which was statistically significant. As the insulation time of the Cryo-balloon ablation is shorter than that of the 3D RFCA, the method using the Cryo-balloon ablation is considered to be effective when the patient's condition is not good and a quick procedure is required. However, in patients with permanent Atrial fibrillation, there is a high probability of structural changes in the heart, so it is considered that 3D RFCA is better than Cryo-balloon ablation, which is difficult to manipulate.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.597-602
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• 2020

The study was conducted to improve the efficiency of the test and to reduce the exposure dose of patients and operators by analyzing the difference in the moving speed of Lipiodol according to the temperature during lymphography. The device for injecting Lipiodol at a constant pressure was self-made, and after inserting Lipiodol into the Connecting Tube, the moving speed of the contrast agent was photographed at temperatures of 26℃, 36℃, and 46℃ using a heat transfer device. Lipiodol movement time from the Support Catheter to 20cm was measured and analyzed, and statistical significance was confirmed. In the 46℃ environment, the average moving time was 11 seconds, at 36℃ the average was 13 seconds, and at 26℃ the average was 17 seconds. Lipiodol showed a significant difference in moving time with increasing temperature (p<.001), and it was confirmed that the higher the temperature, the faster the moving speed. In the case of lymphangiography, when heated to a certain temperature (46 degrees) rather than injecting Lipiodol at room temperature, the injection speed can be increased and the speed of movement in the lymphatic vessel can be improved.

• The Journal of the Korea Contents Association
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• v.11 no.1
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• pp.236-244
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• 2011

Recently, the number of interventional procedures has increased dramatically as an alternative of invasive surgical procedure. The need for the quality control program of the angiographic units has also increased, because of concerns about the increased patient dose and the importance of image quality of angiographic units for the successful procedures. The purpose of this study was to propose an optimal guideline for the quality control program of the angiographic units. We reviewed domestic and international standards about medical imaging system and we evaluated the quality of 61 angiographic units in Korea with the use of NEMA 21 phantom. According to the results of our study, we propose a guideline for the quality control program of the angiographic units. Quality control program includes tube voltage test, tube current test, HVL test, image-field geometry test, spatial resolution test, low-contrast iodine detectability test, wire resolution test, phantom entrance dose test. Proposed reference levels are as follows: PAE < $\pm$ 10% in tube voltage test, PAE < $\pm$ 15% in tube current test, minimum 2.3 mmAl at 80 kVp in HVL test, minimum 'acceptable' level at image-field geometry test, 0.8 lp/mm for detector size of 34-40cm, 1.0 lp/mm for detector size of 28-33cm, 1.2 lp/mm for detector size of 22-27cm in spatial resolution test, minimum 200mg/cc in low contrast iodine detectability test, phantom entrance dose should be under 10R/min, 0.012 inch wire should be seen at static wire resolution test, and 0.022 inch wire should be seen at moving wire resolution test.

• Journal of the Korean Society of Radiology
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• v.5 no.5
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• pp.303-308
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• 2011

Background/Aims : The increasing use of diagnostic and therapeutic interventional radiology calls for greater consideration of radiation exposure risk to radiologist and radiological technician, and emphasizes the proper system of radiation protection. This study was designed to assess the effect of a protective grass shield. Methods : A protective grass was following data depth, 0.8 cm; width, 100 cm; length, 100 cm, lead equivalent, 1.6 mmPb. The protective shield was located between the patient and the radiologist. Thirty patients (13 male and 17 female) undergoing interventional radiology between September 2010 and December 2010 were selected for this study. The dose of radiation exposure was recorded with or without the protective grass shield at the level of the head, chest, and pelvis. The measurement was made at 50 cm and 150 cm from the radiation source. Results : The mean patient age was 69 years. The mean patient height and weight was $159.7{\pm}6.7$ cm and $60.3{\pm}5.9$ kg, respectively. The mean body mass index (BMI) was $20.5{\pm}3.0$ kg/m2. radiologists received $1530.2{\pm}550.0$ mR/hr without the protective lead shield. At the same distance, radiation exposure was significantly reduced to $50.3{\pm}85.2$ mR/hr with the protective lead shield (p-value<0.0001). The radiation exposure to radiologist and radiological technician was significantly reduced by the use of a protective lead shield (p value <0.0001). The amount of radiation exposure during interventional radiology was related to the patient' BMI (r=0.749, p=0.001). Conclusions : This protective shield grass is effective in protecting radiologist and radiological technician from radiation exposure.

• Korean Journal of Digital Imaging in Medicine
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• v.15 no.2
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• pp.13-18
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• 2013

Purpose : Fluoroscopy equipment, depending on the type of changes that occur in the patient's position ESD and study the patient's scatter ray of ESD Practitioners considered a comparative analysis was to evaluate the correct dose. Materials and Methods : HITACHI four overtube type TU-8000 Flat Detector and Under tube C-Arm Philips' Multi Diagnost Eleva with Flat Detector type were measured by. Each devices is a measure of the patient's esd randophantom position in tabel unfors Xi multi funtion then fixed to the abdomen fluoroscopy and 10 seconds, spot was measured three times, practitioners of the incident surface dose by considering the patient's scatter ray of the table for each device in the average human stomach 21cm thickness acrylic phantom ($25cm{\times}25cm$) Place the practitioner position after position randophantom unfors Xi multi funtion in the thyroid and stomach 1 minute by a fixed one-time fluoroscopy and measured. Results : 10 seconds and the patient perspective of the c-arm ESD 1.2 times smaller on the AP and oblique measurements were measured in the 6-13 times smaller. spot positions to changes in the measured three times on the AP of the abdomen, ESD is 18 times smaller c-arm measurements and the oblique measurement was 19-30 times smaller. And 1 minute at practitioners fluoroscopy esd in the thyroid 2.12 times the c-arm, chest 1.75 times less the dose was measured. On the AP, depending on the device, but the lack of dose difference oblique positions of the two devices depending on changes in the area due to changes in both the AP than on the dose increased, the difference in dose between the two devices, the maximum difference was approximately 27 times. Conclusion : Fluoroscopic equipment at the time of inspection in accordance with changes in dose according to the patient and the patient's positions changes, because the area of the scatter ray considering the change of dose measurements be made, and study of the equipment according to the characteristics of the efficiency and the exposure of the patient and practitioner is considered smooth study equipment manufacturers that can be done is to build the system and think that is also important. Various fluoroscopy when you check future changes in many factors of change in dose for the equipment in the laboratory system by considering the scatter ray radiation shielding for the management to take advantage of reckless undertube have been utilized as more exposure Reduction activities can help is considered as the direction.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.309-316
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• 2007

Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)

• Radiation Oncology Journal
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• v.10 no.2
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• pp.171-180
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• 1992

The precise role of radiotherapy for low grade gliomas including the optimal radiation dose and timing of treatment remains unclear. The information given by a retrosepctive analysis may be useful in the design of prospective randomized studies looking at radiation dose and time of surgical and radiotherapeutic treatment. The records of 56 patients (M:F = 29:27) with histologically verified cerebral low grade gliomas (47 cases of grade 1 or 2 astrocytomas and 9 oligodendrogliomas) diagnosed between 1979 and 1989 were retrospectively reviewed. The extent of surgical tumor removal was gross total or radical subtotal in 38 patients ($68\%$) and partial or biopsy only in the remaining 18 patients ($32\%$). Postooperative radiation therapy was given to 36 patients ($64\%$) of the total 56 patients with minimum dose of 5000 cGy (range=1250 to 7220 cGy). The 5-and 10-year survival rates for the total 56 patients were $44\%$ and $32\%$ respectively with a median survival of 4.1 years. According to the histologic grade the 5- and 10-year survivals were $52\%$ and $35\%$ for the 24 patients respectively with grade I astrocytomas compared to $20\%$ and $10\%$ for the 23 patients with grade II astrocytomas. Survival of oligodendroglioma patients was greater than those with astrocytoma ($65\%$ vs $36\%$ at 5 years), and the difference was also remarkable in the long term period of follow up ($54\%$ vs $23\%$ at 10 years). Those who received high-dose radiation therapy ($\geq$5400 cGy) had significant better survival than those who received low-dose radiation (< 5400cGy) or surgery alone (p<0.05). The 5- and 10-year survival rates were, respectively $59\%$ and $46\%$ for the 23 patients receiving high-dose radiation, $36\%$ and $24\%$ for the 13 patients receiving low-dose radiation, and $35\%$ and $26\%$ for the 20 patients with surgery alone. Survival rates by the extent of surgical resection were similar at 5 years ($46\%$ vs $41\%$), but long term survival was quite different (p<0.01) between total/subtotal resection and partial resection/biopsy ($41\%$ and $12\%$, resepctively). Previously published studies have identified important prognostic factors in these tumor: age, extent of surgery, grade, performance status, and duration of symptoms. But in our cases statistical analysis revealed that grade I histology (p<0.025) and young age (p<0.001) were the most significant good prognostic variables.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.1
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• pp.49-56
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• 2017

Purpose: To evaluate the accuracy of the Iterative Metal Artifact Reduction (IMAR) algorithm in correcting CT (computed tomography) images distorted due to a metal artifact and to evaluate the usefulness when proton therapy plan was plan using the images on which IMAR algorithm was applied. Materials and Methods: We used a CT simulator to capture the images when metal was not inserted in the CIRS model 062 Phantom and when metal was inserted in it and Artifact occurred. We compared the differences in the CT numbers from the images without metal, with a metal artifact, and with IMAR algorithm by setting ROI 1 and ROI 2 at the same position in the phantom. In addition, CT numbers of the tissue equivalents located near the metal were compared. For the evaluation of Rando Phantom, CT was taken by inserting a titanium rod into the spinal region of the Rando phantom modelling a patient who underwent spinal implant surgery. In addition, the same proton therapy plan was established for each image, and the differences in Range at three sites were compared. Results: In the evaluation of CIRS Phantom, the CT numbers were -6.5 HU at ROI 1 and -10.5 HU at ROI 2 in the absence of metal. In the presence of metal, Fe, Ti, and W were -148.1, -45.1 and -151.7 HU at ROI 1, respectively, and when the IMAR algorithm was applied, it increased to -0.9, -2.0, -1.9 HU. In the presence of metal, they were 171.8, 63.9 and 177.0 HU at ROI 2 and after the application of IMAR algorithm they decreased to 10.0 6,7 and 8.1 HU. The CT numbers of the tissue equivalents were corrected close to the original CT numbers except those in the lung located farthest. In the evaluation of the Rando Phantom, the mean CT numbers were 9.9, -202.8, and 35.1 HU at ROI 1, and 9.0, 107.1, and 29 HU at ROI 2 in the absence, presence of metal, and in the application of IMAR algorithm. The difference between the absence of metal and the range of proton beam in the therapy was reduced on the average by 0.26 cm at point 1, 0.20 cm at point 2, and 0.12 cm at point 3 when the IMAR algorithm was applied. Conclusion: By applying the IMAR algorithm, the CT numbers were corrected close to the original ones obtained in the absence of metal. In the beam profile of the proton therapy, the difference in Range after applying the IMAR algorithm was reduced by 0.01 to 3.6 mm. There were slight differences as compared to the images absence of metal but it was thought that the application of the IMAR algorithm could result in less error compared with the conventional therapy.