• Progress in Medical Physics
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• v.14 no.3
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• pp.151-160
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• 2003

The application of more complex radiotherapy techniques using multileaf collimation (MLC), such as 3D conformal radiation therapy and intensity-modulated radiation therapy (IMRT), has increased the significance of verifying leaf position and motion. Due to thier reliability and empirical robustness, quality assurance (QA) of MLC. However easy use and the ability to provide digital data of electronic portal imaging devices (EPIDs) have attracted attention to portal films as an alternatives to films for routine qualify assurance, despite concerns about their clinical feasibility, efficacy, and the cost to benefit ratio. In this study, we developed method for daily QA of MLC using electronic portal images (EPIs). EPID availability for routine QA was verified by comparing of the portal films, which were simultaneously obtained when radiation was delivered and known prescription input to MLC controller. Specially designed two-test patterns of dynamic MLC were applied for image acquisition. Quantitative off-line analysis using an edge detection algorithm enhanced the verification procedure as well as on-line qualitative visual assessment. In conclusion, the availability of EPI was enough for daily QA of MLC leaf position with the accuracy of portal films.

• Investigative Magnetic Resonance Imaging
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• v.17 no.2
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• pp.110-122
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• 2013

Purpose : To compare the image quality and ligament traceability in ankle images obtained using Volume Isotropic Turbo Spin Echo Acquisition (VISTA) MRI with and without fat suppression. Materials and Methods: The signal-to-noise ratios (SNRs) in images from a phantom and from the ankle of a volunteer were compared. Ten ankles from 10 non-symptomatic volunteers were imaged for comparisons of contrast ratio (CR) and ligament traceability. All examinations were performed using VISTA sequences with and without fat suppression on a 3T MRI scanner. The SNRs were obtained from images with subjects and without subjects (noise-only). Contrast ratios from images of the 10 ankles were acquired between fluid and tendon (F-T), F-cartilage (C), F-ligament (L), fat (f)-T, f-C and f-L. Two musculoskeletal radiologists independently scored the traceability of 7 ligaments, in sagittal, axial and coronal images respectively, based on a 4-point scale (1 as not traceable through 4 as clearly traceable). The Wilcoxon signed-rank test was used to compare the CR. Fisher's exact test and Pearson's chi-squared test were used to compare the ligament traceability. Results: The SNRs did not differ significantly between the two sequences except in bone marrow. VISTA SPAIR showed the higher CR only in F-T (p = 0.04), whereas VISTA showed higher CR in f-T (p = 0.005), f-C (p = 0.005) and f-L (p = 0.005). The calcaneofibular ligament traceability with VISTA was superior to that obtained with VISTA SPAIR (p < 0.05) in all planes. Conclusion: VISTA showed significant superiority to VISTA SPAIR in tracing CFL due to the superior CR between fat and ligament.

• Progress in Medical Physics
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• v.19 no.4
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• pp.256-262
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• 2008

To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean ($\pm$ standard deviation) age of 41 (${\pm}11.65$). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); $110{\times}110$ mm of VOI (view of interest); $15{\times}15{\times}15$ mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1~3) and 1~2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

• Progress in Medical Physics
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• v.18 no.3
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• pp.134-138
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• 2007

The current PET/CT system with high quality CT images not only increases diagnostic value by providing anatomic localization, but also shortens the acquisition time for attenuation correction than primary PET system. All commercially available PET/CT system uses the CT scan for attenuation correction instead of the transmission scan using radioactive source such as $^{137}Cs,\;^{68}Ge$. However the CT scan may substantially increase the patient dose. The purpose of this study was to evaluate quality of PET images reconstructed by CT attenuation map using various tube currents. in this study, images were acquired for 3D Hoffman brain phantom and cylindrical phantom using GE DSTe PET/CT system. The emission data were acquired for 10 min using phantoms after injecting 44.03 MBq of $^{18}F-FDG$. The CT images for attenuation map were acquired by changing tube current from 10 mA to 95 mA with fixed exposure time of 8 sec and fixed tube voltage of 140 kVp. The PET images were reconstructed using these CT attenuation maps. Image quality of CT images was evaluated by measuring SD (standard deviation) of cylindrical phantom which was filled with water and $^{18}F-FDG$ solution. The PET images were evaluated by measuring the activity ratio between gray matter and white matter in Hoffman phantom images. SDs of CT images decrease by increasing tube current. When PET images were reconstructed using CT attenuation maps with various tube currents, the activity ratios between gray matter and white matter of PET images were almost same. These results indicated that the quality of the PET images using low dose CT data were comparable to the PET images using general dose CT data. Therefore, the use of low dose CT is recommended than the use of general dose CT, when the diagnostic high quality CT is not required. Further studies may need to be performed for other system, since this study is limited to the GE DSTe system used in this study.

• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.173-178
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• 1999

Purpose : To evaluate the usefulness of functional MRI (fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. Materials and Methods : Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, $40^{\circ}$ flip angle, $240{\times}240{\;}FOV,{\;}64{\times}128$ matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. all patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. Results : On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one and of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. Conclusion : fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.153-165
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• 2017

Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.57-68
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• 2005

Purpose: The objective of this study was to assess attenuation correction algorithms with the $^{137}Cs$ point source for the brain positron omission tomography (PET) imaging process. Materials & Methods: Four different types of phantoms were used in this study for testing various types of the attenuation correction techniques. Transmission data of a $^{137}Cs$ point source were acquired after infusing the emission source into phantoms and then the emission data were subsequently acquired in 3D acquisition mode. Scatter corrections were performed with a background tail-fitting algorithm. Emission data were then reconstructed using iterative reconstruction method with a measured (MAC), elliptical (ELAC), segmented (SAC) and remapping (RAC) attenuation correction, respectively. Reconstructed images were then both qualitatively and quantitatively assessed. In addition, reconstructed images of a normal subject were assessed by nuclear medicine physicians. Subtracted images were also compared. Results: ELEC, SAC, and RAC provided a uniform phantom image with less noise for a cylindrical phantom. In contrast, a decrease in intensity at the central portion of the attenuation map was noticed at the result of the MAC. Reconstructed images of Jaszack and Hoffan phantoms presented better quality with RAC and SAC. The attenuation of a skull on images of the normal subject was clearly noticed and the attenuation correction without considering the attenuation of the skull resulted in artificial defects on images of the brain. Conclusion: the complicated and improved attenuation correction methods were needed to obtain the better accuracy of the quantitative brain PET images.