• Title/Summary/Keyword: CT dose reduction

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Low-Tube-Voltage CT Urography Using Low-Concentration-Iodine Contrast Media and Iterative Reconstruction: A Multi-Institutional Randomized Controlled Trial for Comparison with Conventional CT Urography

  • Kim, Sang Youn;Cho, Jeong Yeon;Lee, Joongyub;Hwang, Sung Il;Moon, Min Hoan;Lee, Eun Ju;Hong, Seong Sook;Kim, Chan Kyo;Kim, Kyeong Ah;Park, Sung Bin;Sung, Deuk Jae;Kim, Yongsoo;Kim, You Me;Jung, Sung Il;Rha, Sung Eun;Kim, Dong Won;Lee, Hyun;Shim, Youngsup;Hwang, Inpyeong;Woo, Sungmin;Choi, Hyuck Jae
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1119-1129
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    • 2018
  • Objective: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. Materials and Methods: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. Results: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose ($5.73{\pm}4.04$ vs. $8.43{\pm}4.38mSv$) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ${\geq}3$), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. Conclusion: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.

A Study on Signal Analysis of the Data Aquisition System for Photosensor (데이터 획득장치에 이용되는 포토센서에 대한 DAS의 신호분석연구)

  • Hwang, InHo;Yoo, Sun Kook
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.3
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    • pp.237-242
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    • 2016
  • The major advantage of slip-ring technology in Spiral CT is that it facilitates continuous rotation of the x-ray tube, so that volume data can be acquired from a patient quickly. Not only for such a fast scan, but also for the dose reduction purpose, high signal-to-noise ratio and fast data acquisition system is required. In this study, we have built a multi-channel photodetector and multi-channel data acquisition system for CT application. The detector module consisted of CdWO4 crystal and Si photodiode in 16 channels. For the performance test of the preamplifier stage, both the transimpedance and switched integrator types are optimized for the photodetector modules. Switched integrator showed better noise performance in the limited bandwidth which is suitable for the current CT application. The control sequence for data acquisition and 20 bit ADC is designed with VHDL(Very High Speed Integrated Circuit Hardware Description Language) and implemented on FPGA(Field Programmable Gate Array) chip. Our Si photodiode detector module coupled to CdWO4 crystal showed comparable signal with other commercially available photodiode for CT. Switched integrator type showed higher SNR but narrower bandwidth compared to transimpedance preamplifier. Digital hardware is designed by FPGA, so that the control signal could be redesigned without hardware alteration.

Small Bowel Sparing Effect of Small Bowel Displacement System in 3D-CRT and IMRT for Cervix Cancer (자궁경부암의 3D-CRT와 IMRT시 소장전위장치의 소장 선량에 대한 영향)

  • Kang, Min-Kyu;Huh, Seung-Jae;Han, Young-Yih;Park, Won;Ju, Sang-Gyu;Kim, Kyoung-Ju;Lee, Jeung-Eun;Park, Young-Je;Nam, Hee-Rim;Lim, Do-Hoon;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.130-137
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    • 2004
  • Purpose : In radiotherapy for cervix cancer, both 3-dimensioal radiotherapy (3D-CRT) and intensity-modulated radiation therapy (IMRT) could reduce the dose to the small bowel (SB), while the small bowel displacement system (SBDS) could reduce the SB volume in the pelvic cavity. To evaluate the effect of the SBDS on the dose to the SB in 3D-CRT and IMRT plans, 3D-CRT and IMRT plans, with or without SBDS, were compared. Materials and Methods : Ten consecutive uterine cervix cancer patients, receiving curative radiotherapy, were accrued. Ten pairs of computerized tomography (CT) scans were obtained in the prone position, with or without SBDS, which consisted of a Styrofoam compression device and an individualized custom-made abdominal immobilization device. Both 3D-CRT, using the 4-field box technique, and IMRT plans, with 7 portals of 15 MV X-ray, were generated for each CT image, and proscribed 50 Gy (25 fractions) to the isocenter. For the SB, the volume change due to the SBDS and the DVHs of the four different plans were analyzed using palled t-tests. Results : The SBDS significantly reduced the mean SB volume from 522 to 262 cm$^{3}$ (49.8$\%$ reduction). The SB volumes that received a dose of 10$\~$50 Gy were significantly reduced in 3D-CRT (65$\~$80$\%$ reduction) and IMRT plans (54$\~$67$\%$ reduction) using the SBDS. When the SB volumes that received 20$\~$50 Gy were compared between the 3D-CRT and IMRT plans, those of the IMRT without the SBDS were significantly less, by 6$\~$7$\%$, than those for the 3D-CRT without the SBDS, but the volume difference was less than 1$\%$ when using the SBDS. Conclusion : The SBDS reduced the radiation dose to the SB in both the 3D-CRT and IMRT plans, so could reduce the radiation injury of the SB.

Anti-tumor effect of Euphorbia hirta on Ehrlich's ascites carcinoma in mice

  • Kumarappan, CT;Sunderi, S Karpagam Kumara;Jaswanth, A;Lakshmi, S Mohana;Mandal, Subhash C
    • Advances in Traditional Medicine
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    • v.7 no.2
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    • pp.133-140
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    • 2007
  • Anti-tumor activity of Euphorbia hirta (50 mg/kg and 100 mg/kg) has been evaluated against Ehrlich's ascites carcinoma (EAC) in Swiss albino mice. Intraperitoneal (i.p) administration of Euphorbia hirta was effective in reducing solid tumor mass development induced by EAC cells. It exhibited significant anti-tumor activity in mice, when used at the dose of 100 mg/kg/day i.p., for 14days. The administration of Euphorbia hirta (100 mg/kg/day i.p.) resulted in an increase (P<0.001) of the life span (59.9%) of ascites tumor bearing mice as compared to the control group. After 14 days, on developed tumor masses, Euphorbia hirta administration brought about significant reduction in tumor volume and it reverse the changes in the hematological parameters, responding to tumor inoculation. The results are indicative of the anti-tumor activity of Euphorbia hirta against EAC induced tumor in a dose dependent manner.

A Study of a Non-commercial 3D Planning System, Plunc for Clinical Applicability (비 상업용 3차원 치료계획시스템인 Plunc의 임상적용 가능성에 대한 연구)

  • Cho, Byung-Chul;Oh, Do-Hoon;Bae, Hoon-Sik
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.71-79
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    • 1998
  • Purpose : The objective of this study is to introduce our installation of a non-commercial 3D Planning system, Plunc and confirm it's clinical applicability in various treatment situations. Materials and Methods : We obtained source codes of Plunc, offered by University of North Carolina and installed them on a Pentium Pro 200MHz (128MB RAM, Millenium VGA) with Linux operating system. To examine accuracy of dose distributions calculated by Plunc, we input beam data of 6MV Photon of our linear accelerator(Siemens MXE 6740) including tissue-maximum ratio, scatter-maximum ratio, attenuation coefficients and shapes of wedge filters. After then, we compared values of dose distributions(Percent depth dose; PDD, dose profiles with and without wedge filters, oblique incident beam, and dose distributions under air-gap) calculated by Plunc with measured values. Results : Plunc operated in almost real time except spending about 10 seconds in full volume dose distribution and dose-volume histogram(DVH) on the PC described above. As compared with measurements for irradiations of 90-cm 550 and 10-cm depth isocenter, the PDD curves calculated by Plunc did not exceed $1\%$ of inaccuracies except buildup region. For dose profiles with and without wedge filter, the calculated ones are accurate within $2\%$ except low-dose region outside irradiations where Plunc showed $5\%$ of dose reduction. For the oblique incident beam, it showed a good agreement except low dose region below $30\%$ of isocenter dose. In the case of dose distribution under air-gap, there was $5\%$ errors of the central-axis dose. Conclusion : By comparing photon dose calculations using the Plunc with measurements, we confirmed that Plunc showed acceptable accuracies about $2-5\%$ in typical treatment situations which was comparable to commercial planning systems using correction-based a1gorithms. Plunc does not have a function for electron beam planning up to the present. However, it is possible to implement electron dose calculation modules or more accurate photon dose calculation into the Plunc system. Plunc is shown to be useful to clear many limitations of 2D planning systems in clinics where a commercial 3D planning system is not available.

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Discrimination Energy Range Analysis of Contrast Agents and Calcification using by VNC Application of DECT (DECT의 VNC 적용으로 조영제와 석회화의 식별 에너지 영역 분석)

  • Hyeon-Ju Kim
    • Journal of the Korean Society of Radiology
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    • v.18 no.2
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    • pp.179-185
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    • 2024
  • By applying the various energy spectrum imaging functions of DECT, To quantitatively distinguish between contrast agent and calcification, changes in image quality are analyzed by comparing CNR and SNR. We investigated the level of dose reduction during two scans and one VNC scan. As a result, contrast agent and calcification were best distinguished in the 70 keV area, CNR and SNR were excellent, and scan dose was reduced by about 26.5%. Therefore, by applying DECT, meaningful results were obtained that could visually and quantitatively distinguish between the intravascular contrast agent and the shade of calcification. If clinical research is conducted in the future considering the patient's age, gender, and body type, quantitative analysis of calcification will be possible even with intravascular contrast agent flowing in, which will have a significant effect in reducing the patient's scan dose and the burden of multiple scans.

Adaptation of Deep Learning Image Reconstruction for Pediatric Head CT: A Focus on the Image Quality (소아용 두부 컴퓨터단층촬영에서 딥러닝 영상 재구성 적용: 영상 품질에 대한 고찰)

  • Nim Lee;Hyun-Hae Cho;So Mi Lee;Sun Kyoung You
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.240-252
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    • 2023
  • Purpose To assess the effect of deep learning image reconstruction (DLIR) for head CT in pediatric patients. Materials and Methods We collected 126 pediatric head CT images, which were reconstructed using filtered back projection, iterative reconstruction using adaptive statistical iterative reconstruction (ASiR)-V, and all three levels of DLIR (TrueFidelity; GE Healthcare). Each image set group was divided into four subgroups according to the patients' ages. Clinical and dose-related data were reviewed. Quantitative parameters, including the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), and qualitative parameters, including noise, gray matter-white matter (GM-WM) differentiation, sharpness, artifact, acceptability, and unfamiliar texture change were evaluated and compared. Results The SNR and CNR of each level in each age group increased among strength levels of DLIR. High-level DLIR showed a significantly improved SNR and CNR (p < 0.05). Sequential reduction of noise, improvement of GM-WM differentiation, and improvement of sharpness was noted among strength levels of DLIR. Those of high-level DLIR showed a similar value as that with ASiR-V. Artifact and acceptability did not show a significant difference among the adapted levels of DLIR. Conclusion Adaptation of high-level DLIR for the pediatric head CT can significantly reduce image noise. Modification is needed while processing artifacts.

Prognostic value of pretreatment 18F-FDG PET-CT in radiotherapy for patients with hepatocellular carcinoma

  • Jo, In Young;Son, Seok-Hyun;Kim, Myungsoo;Sung, Soo Yoon;Won, Yong Kyun;Kang, Hye Jin;Lee, So Jung;Chung, Yong-An;Oh, Jin Kyoung;Kay, Chul-Seung
    • Radiation Oncology Journal
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    • v.33 no.3
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    • pp.179-187
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    • 2015
  • Purpose: The purpose of this study was to investigate the predictable value of pretreatment $^{18}F$-fluorodeoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET-CT) in radiotherapy (RT) for patients with hepatocellular carcinoma (HCC) or portal vein tumor thrombosis (PVTT). Materials and Methods: We conducted a retrospective analysis of 36 stage I-IV HCC patients treated with RT. $^{18}F$-FDG PET-CT was performed before RT. Treatment target was determined HCC or PVTT lesions by treatment aim. They were irradiated at a median prescription dose of 50 Gy. The response was evaluated within 3 months after completion of RT using the Response Evaluation Criteria in Solid Tumors (RECIST). Response rate, overall survival (OS), and the pattern of failure (POF) were analyzed. Results: The response rate was 61.1%. The statistically significant prognostic factor affecting response in RT field was maximal standardized uptake value (maxSUV) only. The high SUV group (maxSUV ${\geq}5.1$) showed the better radiologic response than the low SUV group (maxSUV < 5.1). The median OS were 996.0 days in definitive group and 144.0 days in palliative group. Factors affecting OS were the %reduction of alpha-fetoprotein (AFP) level in the definitive group and Child-Pugh class in the palliative group. To predict the POF, maxSUV based on the cutoff value of 5.1 was the only significant factor in distant metastasis group. Conclusion: The results of this study suggest that the maxSUV of $^{18}F$-FDG PET-CT may be a prognostic factor for treatment outcome and the POF after RT. A %reduction of AFP level and Child-Pugh class could be used to predict OS in HCC.

Studies on the antimetastasis & antiangiogenesis effects of Gamisoamsan (가미소암산(加味消癌散)의 혈관신생(血管新生) 억제에 관한 항암효과 연구)

  • Yoon Sung-Chan;Ahn Seong-Hun;Kim Jin-Kyeoung;Mun Yeon-Ja;Chu Yeong-Guk;Jeong Gyu-Yong;Whoo Won-Hong
    • Herbal Formula Science
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    • v.10 no.2
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    • pp.113-126
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    • 2002
  • Soamsan is known as an anti-cancer remedy in the traditional Korean Medicine. To enhance the synergic effects of anti-cancer activity of Soamsan, this study reconstituted the original components of Soamsan with a slight modification and produced a novel herbal remedy, namely Gamisoamsan. Extracts of Gamisoamsan inhibited the growth of cultured CT-26 cells, mouse colon adenocarcinoma, in a dose-dependent manner $(1\;to\;50{\mu}g/ml)$, and $ID_{50}$ was estimated approximately $16.7{\mu}g/ml$. Using tumor-bearing mouse model, in which was produced by subcutaneous injection of CT-26 cells ($1{\times}10^5$cells). the effects of Gamisoamsan on tumor growth and host survival were examined by evaluating tumor volume and increase in life span. When Gamisoamsan extracts in variable doses of 100, 200 and 500mg/kg body weight per day were orally administered to tumor-bearing mice, following results were obtained: Improvement in the hematological parameters following Gamisoamsan treatment such as hemoglobin contents, red blood cells and white blood cells of the tumor-bearing mice have been observed. Gamisoamsan treatment also showed a prolongation of life span and a reduction of tumor volume in the CT-26 tumor hosts. The results of the present study suggest that Gamisoamsan extracts has a potential anti-tumor activity and may be an useful remedy to prevent and/or treat cancer.

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Comparison of dose-variation in skin due to Set-up error in case of radiation therapy for left breast using Volumetric Modulated Arc Therapy(VMAT) (좌측 유방에 대한 용적 변조 회전 방사선 치료 시 자세 오차로 인한 피부 선량)

  • Kwon, Yongjae;Park, Ryeunghwang;Kim, Seyoung;Jung, Dongmin;Baek, Jonggeol;Cho, Jeonghee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.55-62
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    • 2021
  • Purpose: This study aims to contribute to the reduction of complications of breast cancer radiation therapy by analyzing skin dose differences due to Set-up error. Materials and Method: Pseudo breast was produced using a 3D printer, applied to the phantom, and images were acquired through CT. Treatment plan was carried out that the PTV, which contains 95% of the prescription dose, could be more than 95% of the volume, so that Dmax did not exceed 107% of the prescription dose. The Set-up error was evaluated by applying ±1mm/±3mm/±5mm to the X-axis, Y-axis, and Z-axis. Results: The dose-variation in skin due to Set-up error was approximately 106% to 123% compared to prescription dose, and the highest dose in skin was 49.24 Gy at 5mm Set-up error in the lateral direction of the X-axis. More than 107% of the prescription dose was the widest at 6.87 cc in skin lateral. Conclusions: If a Set-up error occurs during left breast cancer VMAT, a great difference in skin dose was shown in the lateral direction of the X-axis. If more effort is made to align the X-axis of the breast treated during CBCT registration, the dose-variation of skin will be reduced.