• Journal of the Korean Society of Radiology
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• v.10 no.7
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• pp.503-510
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• 2016

Even though children are exposed to the same amount of radiation, their effective dose amount is higher than those of adults. Therefore, it is very important to reduce the amount of unnecessary radiation exposure because children have a higher radiosensitivity and a smaller body size than adults. In this study, the proposal to seek ways to reduce the amount of radiation is drawn by comparing and analyzing CT Dose Index(CTDI) on the pediatric head CT which was performed at the Busan regional hospitals, to the national diagnostic reference levels. For this, the pediatric head CT scan was conducted among the CT equipments that were installed in downtown Busan. From 2,043 children 10 years old or less who were referred to the pediatric head CT scan, targeting the 28 CT equipments in the 24 hospitals that transmit dose reports to PACS, were examined retrospectively. As a result, the average value of CTDIvol, computed tomography dose index (CTDI) of infant brain, across the hospital, was 31.18 mGy, with DLP of $444.73mGy{\cdot}cm$, which exceeded the diagnostic reference level. The lower the age, the more management is needed for radiation. However, the reality is that the CT examinations are being conducted with a dose that exceeds the reference level as the age of the aged is exceeded. For this purpose, the study seeks to determine the degree of doses of doses outside the diagnostic reference level and analyze the cause of the excess dose and devise measures to reduce the dose reduction.

• The Journal of the Korea Contents Association
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• v.15 no.6
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• pp.290-296
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• 2015

The purpose of this study was to derive the proposals and to suggest the exposure dose reduction scheme on pediatric head CT scan by analyzing and comparing CT dose index (CTDI) and the national diagnostic reference levels. From January 2014 to December, 231 children under 10years who were requested a pediatric head CT scan with head injury were examined. Research methods were to research and analyze the general characteristics kVp, mA test coverage $CTDI_{vol}$ and DLP referring to dose reports and electronic medical record (EMR). As a result, 7.4%(17 patients) of the total subjects in $CTDI_{vol}$ showed a national diagnostic reference levels exceeding. For DLP 41.6%(96 patients) in excess was relatively higher than $CTDI_{vol}$. DLP was exceeded more than about 60% that is higher than the CT dose index presented by Korea Food & Drug Administration. it is cause of high DLP that scan range increased more than about 30% wider than the standard test coverage presented in Health Insurance Review & Assessment Service. In conclusion, it is able to significantly lower the dose if it is complied with checking the baseline scan range of pediatric head CT scan and appropriately adjusting the protocol.

• Progress in Medical Physics
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• v.30 no.4
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• pp.160-166
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• 2019

This study examined the clinical use of two newly installed computed tomography (CT) simulators in the Department of Radiation Oncology. The accreditation procedure was performed by the Korean Institute for Accreditation of Medical Imaging. An Xi R/F dosimeter was used to measure the CT dose index for each plug of the CT dose index phantom. Image qualities such as the Hounsfield unit (HU) value of water, noise level, homogeneity, existence of artifacts, spatial resolution, contrast, and slice thickness were evaluated by scanning a CT performance phantom. All test items were evaluated as to whether they were within the required tolerance level. CT calibration curves-the relationship between CT number and relative electron density-were obtained for dose calculations in the treatment planning system. The positional accuracy of the lasers was also evaluated. The volume CT dose indices for the head phantom were 22.26 mGy and 23.70 mGy, and those for body phantom were 12.30 mGy and 12.99 mGy for the first and second CT simulators, respectively. HU accuracy, noise, and homogeneity for the first CT simulator were -0.2 HU, 4.9 HU, and 0.69 HU, respectively, while those for second CT simulator were 1.9 HU, 4.9 HU, and 0.70 HU, respectively. Five air-filled holes with a diameter of 1.00 mm were used for assessment of spatial resolution and a low contrast object with a diameter of 6.4 mm was clearly discernible by both CT scanners. Both CT simulators exhibited comparable performance and are acceptable for clinical use.

• Progress in Medical Physics
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• v.32 no.3
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• pp.59-69
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• 2021

Purpose: The relationship between computed tomography (CT) number and electron density (ED) has been investigated in previous studies. However, the role of these measures for guiding cancer treatment remains unclear. Methods: The CT number was plotted against ED for different imaging protocols. The CT number was imported into ED tables for the Pinnacle treatment planning system (TPS) and was used to determine the effect on dose calculations. Conversion tables for radiation dose calculations were generated and subsequently monitored using a dosimeter to determine the effect of different CT scanning protocols and treatment sites. These tables were used to retrospectively recalculate the radiation therapy plans for 41 patients after an incorrect scanning protocol was inadvertently used. The gamma index was further used to assess the dose distribution, percentage dose difference (DD), and distance-to-agreement (DTA). Results: For densities <1.1 g/cm³, the standard deviation of the CT number was ±0.6% and the greatest variation was noted for brain protocol conditions. For densities >1.1 g/cm³, the standard deviation of the CT number was ±21.2% and the greatest variation occurred for the tube voltage and head and neck (H&N) protocol conditions. These findings suggest that the factors most affecting the CT number are the tube voltage and treatment site (brain and H&N). Gamma index analyses for the 41 retrospective clinical cases, as well as brain metastases and H&N tumors, showed gamma passing rates >90% and <90% for the passing criterion of 2%/2 and 1%/1 mm, respectively. Conclusions: The CT protocol should be carefully decided for TPS. The correct protocol should be used for the corresponding TPS based on the treatment site because this especially affects the dose distribution for brain metastases and H&N tumor recognition. Such steps could help reduce systematic errors.

• The Journal of the Korea Contents Association
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• v.14 no.1
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• pp.356-363
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• 2014

Recently pediatric CT has been performed by reduced dose according to tube current modulation이라고, this fact has a possibility more reduce a dose because of strong affect depend on tube current modulation. Almost all MDCT snow show and allow storage of the volume CT dose index (CTDIvol), dose length product (DLP), and effective dose estimations on dose reports, which are essential to assess patient radiation exposure and risks. To decrease these radiation exposure risks, the principles of justification and optimization should be followed. justification means that the examination must be medically indicated and useful. Results is using tube current modulation이라고 tend to the lower kV, the lower effective dose. In case of use a low dose CT protocol, we found a relatively lower effective dose than using tube current modulation. Average effective dose of our studies(brain, chest, abdomen-pelvis) less than 47%, 13.8%, 25.7% of germany reference dose, and 55.7%, 10.2%, 43.6% of UK(United Kingdom) reference dose respectively. when performed examination for reduced dose, we must use tube current modulation and low dose CT protocol including body-weight based tube current adaption.

• The Journal of the Korea Contents Association
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• v.13 no.6
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• pp.331-338
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• 2013

CT for follow-up visits because of liver disease, body mass index (BMI) and kVp according to the change of the image quality and radiation dose to evaluate for changes. March 2010 to June 2011 at Pusan P University Hospital, abdominal CT scans a patient BMI (Body Mass Index. Less BMI) index was less than 25 in the treatment of subjects had a 48-person Noise and SNR at 100kVp abdominal image is lager than the 120kVp image. CTDI volume value at by the analysis of the radiation dose is 4.47mGy(100kVp) and 9.01mGy(120kVp). So CTDIvol in 100kVp is smaller than CTDIvol in 120kVp(decrease by 44.1%). And, effective dose is 7.1mSv(100kVp) and 12.51mSv(120kVp). So effective dose in 100kVp is smaller than effective dose in 120kVp(decrease by 43%). Evaluation of image quality is that Unacceptable 0 person, Suboptimal 0 person, Adequate 0 person, Good 1 person, Excellent 47 person. In case of repeatly patient, we examinate abdomianl CT scan by using low kVp and body mass index less than 25. We can has good quality image and benefit of low radiation dose.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.383-387
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• 2015

This study investigated the size specific dose estimates of difference localizer on pediatric CT image. Seventy one cases of pediatric abdomen-pelvic CT (M:F=36:35) were included in this study. Anterior-posterior and lateral diameters were measured in axial CT images. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for effective diameter to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. For the localizer of mid-slice SSDE was 107.63% higher than CTDIvol and that of xiphoid-process slices SSDE was higher than 92.91%. The maximum error of iliac crest slices, xiphoid process slices and femur head slices between mid-slices were 7.48%, 17.81% and 14.04%. In conclusion, despite the SSDE of difference localizer has large number of errors, SSDE should be regarded as the primary evaluation tool of the patient radiation in pediatric CT for evaluation.

• Journal of radiological science and technology
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• v.27 no.2
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• pp.21-27
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• 2004

This study was conducted to estimate absorbed radiation doses associated with CT examinations. We compared CT dose index between single detector CT and multi detector CT. To establish radiation dose criteria in CT examination in Korea, we measured radiation dose for CT examinations in Seoul and kyungki-do. The results obtained were as follows ; 1. Averaged CTDIW value per 100 mAs was $13.5{\pm}3.2\;mGy$, and ranged from 8.1 mGy to 19.1 mGy in head phantom, was $7.1{\pm}2.0\;mGy$, and ranged from 3.7 mGy to 10.9 mGy in body phantom. 2. CTDIW was 3.2 mGy(1.26 times) larger in multi detector CT than single detector CT in head phantom, and 2.1 mGy(1.34 times) larger in body phantom. 3. The dose was the highest in 4 channel multi detector CT, and followed 8 channel multi detector CT, 16 channel multi detector CT and single detector CT in head phantom. And the dose was the highest in 4 channel and 8 channel multi detector CT, and followed 16 channel multi detector CT and single detector CT in body phantom.

• Journal of the Korean Society of Radiology
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• v.11 no.6
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• pp.453-458
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• 2017

Computed Tomography (CT) provides information on the Diagnostic Reference Level Computed Tomography Dose Index (CTDI) and Dose Length Product (DLP) for accurate diagnosis of patients. However, it does not provide a dose change according to the table height for the diagnostic reference level provided by the CT equipment. The purpose of this study was to evaluate the image and dose according to the table height change using phantom (PMMA: Polymethyl Methacrylate) in order to find the optimal image and the minimum dose during computed tomography examination. When examining using a 32 cm PMMA phantom with the same thickness as the abdomen of an adult, there was little change in dose with table height. However, the noise evaluation of the image caused a high fluctuation of noise depending on the table height. and in the case of the 16 cm PMMA phantom, the change of the noise was small, but the dose change was about 30%. In conclusion, the location of the patient and the center of the detector are important during computed tomography (CT) examinations. In addition, table height setting is considered to be important for examinations with optimized image and minimum dose.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.9-17
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• 2017

Purpose: The tissue description and electron density indicated by the Computed Tomography(CT) number (also known as Hounsfield Unit) in radiotherapy are important in ensuring the accuracy of CT-based computerized radiotherapy planning. The internal metal implants, however, not only reduce the accuracy of CT number but also introduce uncertainty into tissue description, leading to development of many clinical algorithms for reducing metal artifacts. The purpose of this study was, therefore, to investigate the accuracy and the clinical applicability by analyzing date from SMART MAR (GE) used in our institution. Methode: and material: For assessment of images, the original images were obtained after forming ROIs with identical volumes by using CIRS ED phantom and inserting rods of six tissues and then non-SMART MAR and SMART MAR images were obtained and compared in terms of CT number and SD value. For determination of the difference in dose by the changes in CT number due to metal artifacts, the original images were obtained by forming PTV at two sites of CIRS ED phantom CT images with Computerized Treatment Planning (CTP system), the identical treatment plans were established for non-SMART MAR and SMART MAR images by obtaining unilateral and bilateral titanium insertion images, and mean doses, Homogeneity Index(HI), and Conformity Index(CI) for both PTVs were compared. The absorbed doses at both sites were measured by calculating the dose conversion constant (cCy/nC) from ylinder acrylic phantom, 0.125cc ionchamber, and electrometer and obtaining non-SMART MAR and SMART MAR images from images resulting from insertions of unilateral and bilateral titanium rods, and compared with point doses from CTP. Result: The results of image assessment showed that the CT number of SMART MAR images compared to those of non-SMART MAR images were more close to those of original images, and the SD decreased more in SMART compared to non-SMART ones. The results of dose determinations showed that the mean doses, HI and CI of non-SMART MAR images compared to those of SMART MAR images were more close to those of original images, however the differences did not reach statistical significance. The results of absorbed dose measurement showed that the difference between actual absorbed dose and point dose on CTP in absorbed dose were 2.69 and 3.63 % in non-SMRT MAR images, however decreased to 0.56 and 0.68 %, respectively in SMART MAR images. Conclusion: The application of SMART MAR in CT images from patients with metal implants improved quality of images, being demonstrated by improvement in accuracy of CT number and decrease in SD, therefore it is considered that this method is useful in dose calculation and forming contour between tumor and normal tissues.