• Archives of Reconstructive Microsurgery
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• 제21권1호
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• pp.8-13
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• 2012

Purpose: Purpose: The free deep inferior epigastric artery perforator (DIEP) flap is a popular option for autologous breast reconstruction. However, the anatomy of the deep inferior epigastric artery(DIEA) may vary from one individual to another. Unexpected vascular anomaly can confuse the surgeon and affects on the safety of the free DIEP flap. Materials and Methods: Thirty five consecutive patients who underwent free DIEP/TRAM flap for immediate breast reconstruction between Mar. 2010 and Oct. 2010 were enrolled in this study. Computed tomography angiography (CT angiography) of abdomen was evaluated part of our standard preoperative assessment: atypical patterns of DIEA/DIEP were evaluated by preoperative CT angiography and compared with intraoperative finding. Results: Atypical patterns of DIEA/DIEP which may affect preoperative planning were noted as the following: Circummusclar/subfascial DIEA (n=1), DIEA running underneath rectus muscle (n=8), septocutaneous perforator (n=3), peritoneo-cutaneous perforator (n=1), a large branch going into peritoneum (n=1), and very early division and muscle penetration of DIEA (n=1). Conclusion: Atypical DIEA/DIEP that might change the operation plan is not rare, so the individualized planning based on the preoperative CT angiography is recommended. Preoperative CT angiography could help to select reliable and easy-to-dissect perforator in free DIEP/TRAM breast reconstruction.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2008년도 춘계학술대회 논문집
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• pp.263-264
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• 2008

• Archives of Plastic Surgery
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• 제39권6호
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• pp.631-635
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• 2012

Background The evaluation of a breast after breast reconstruction depends on a surgeon's subjective criteria. We used computed tomography (CT) scans to obtain an objective evaluation of the postoperative results by measuring the breast volume of patients who had undergone breast reconstruction using pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. This research will help in the objective postoperative evaluation of reconstructed breasts, and also in the preoperative flap size designs. Methods A total of 27 patients underwent breast reconstruction using pedicled TRAM flaps after mastectomy from September 2007 to July 2010. Of these, 10 patients who were followed up and underwent CT scans 2 or more times during the follow-up period were included in this study. We evaluated the change in breast volume over time using CT scans, and the interval breast volume change between CT scans. Results All of the 10 patients' reconstructed breasts showed a volume decrease over time. The breast volume changes in the intervals between CT scans were as follows: 5.65% decrease between the first CT and second CT scan, 2.3% decrease between the second CT and third CT scan, (statistically significant) and 1.89% decrease between the third CT and forth CT scan. (not statistically significant). Conclusions This research shows the possibility of objectively evaluating the postoperative breast volume changes. The findings will be helpful in designing the size of TRAM flaps to use on defects after mastectomy. Based on these results, we should also closely observe the reconstructed breast volume for at least 2 years.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.461-463
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• 2002

Image quality and selection of optimized window for good quality reconstruction in coronary angiography using multi-detector row CT (MDCT) have not been studied by heart rate and its variation. Therefore, the effect of heart rate and its variation was systemically analyzed. Eighty-three patients were undergone contrast-enhanced coronary angiography using MDCT. In this study, sixty cases were enrolled. Two radiologists graded image quality as follows: 4, excellent; 3, good; 2, fair; l, bad. The starting points of the reconstruction window were chosen at seventy and forty percent of R wave interval. Optimized window was scored as 1 when 40% reconstruction was better quality than 70%, as 2 when 40% reconstruction is same as 70%, and as 3 when 70% reconstruction was better than 40%. Regression analysis was performed. The range of variation of beats per minute (BPM) was well correlated with image quality (r=-0.55, p=0.000), however correlation with optimized window percentage was not statistically significant (p=0.969). By contraries, median value of BPM was comparatively well correlated with optimized window grade (r=-0.24, p=0.086). Median value of BPM was not well correlated with image quality (r=0.l70, p=0.l97). Image quality is more affected by variation of heart rate (VHR) than by higher heart rate. Selection of optimized reconstruction window for good image quality is mainly affected by heart rate and there is a tendency that systolic phase reconstruction is better in image quality than diastolic reconstruction in higher heart rate.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2000년도 하계학술대회 논문집 D
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• pp.3207-3209
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• 2000

X-ray CT(Computed Tomography) has been a good modality for non-invasive diagnosis and recently, Conventional CT has been replaced rapidly with Spiral CT in recent. In X-ray CT, spiral scanning has various advantages such as better image quality, reduced scan time (in a single breath-hold), a lower x-ray dose. But, it requires very fast and high performance image processing system to reconstruct slice images from spiral scanning. This paper describes the fast image reconstruction techniques with filtered back projection from the viewpoints of fast algorithm as well as hardware implementation for real-time imaging.

• 한국방사선학회논문지
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• 제17권1호
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• pp.141-148
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• 2023

CT에서 대수적재구성기법은 잡음에 강점을 가지는 재구성기법으로 알려져 있다. 대수적재구성기법에서 반복 횟수는 계산 시간을 결정하는 중요한 인자 중의 하나이다. 그러나 반복 횟수에 대한 기준이 연구되어 있지만 수백 번 이상의 반복을 수행하게 되어 현실적으로 사용하기에는 무리가 있었다. 본 연구에서는 반복 횟수를 결정할 수 있는 현실적인 방법을 제시하였다. 반복 횟수에 따라 단면 영상의 품질이 천천히 개선된다는 것을 이용하였다. 반복 횟수를 절대치 평균 오차의 차이 𝜖 < 0.001 로 선택하였다. 잡음이 없는 경우는 Shepp-Logan 두부 팬텀을 이용하였고 잡음이 있는 경우는 Geant4를 이용하여 다양한 입사광자에 대해 360, 720, 1,440개의 투영을 얻었다. 정지 조건에서 10회 내외의 반복으로 우수한 단면 영상을 획득하였다. 수 백회 이상을 반복하는 최적 영상기반의 방법에 비해 현실적으로 적용 가능성이 높은 방법이 될 수 있을 것이다.

• 대한두개안면성형외과학회지
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• 제13권1호
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• pp.41-45
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• 2012

Purpose: Fibular osteocutaneous free flap is the procedure of choice for mandibular reconstruction. However, the anatomic consistency and the reliability of the skin paddle have been considered to be questionable and the utilization of the fibular osteocutaneous free flap can be challenging for the inexperienced surgeon. Preoperative computed tomography (CT) angiography can support revolutionary help with the operator design of the fibular osteocutaneous flap. The purpose of this article is to share the valuable experience of support with preoperative CT angiography. Methods: Three consecutive patients, who needed mandibular reconstruction, were treated with fibular osteocutaneous free flap. Each of the patients had undergone lower extremity CT angiography before the surgery. The CT angiographies were scrupulously investigated to calculate the locations and the tracts of the peroneal artery perforators. We compared the findings of the CT angiography with those of the real operation. Results: The information about the perforators was sufficiently matched with the findings of the operation. With the use of preoperative CT angiography, we were able to achieve confident performance during operation, shortening of operation time, and fine outcomes with a no flap failure. Conclusion: The CT angiography of lower extremity can provide reliable information of the perforators of the fibular osteocutaneous free flap.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2013년도 춘계학술대회 논문집
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• pp.367-368
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• 2013

• 한국의학물리학회지:의학물리
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• 제27권3호
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• pp.105-110
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• 2016

Sparse angular sampling has been studied recently owing to its potential to decrease the radiation exposure from computed tomography (CT). In this study, we investigated the analytic reconstruction algorithm in sparse angular sampling using the sinogram interpolation method for improving image quality and computation speed. A prototype of the spectral CT system, which has a 64-pixel Cadmium Zinc Telluride (CZT)-based photon-counting detector, was used. The source-to-detector distance and the source-to-center of rotation distance were 1,200 and 1,015 mm, respectively. Two energy bins (23~33 keV and 34~44 keV) were set to obtain two reconstruction images. We used a PMMA phantom with height and radius of 50.0 mm and 17.5 mm, respectively. The phantom contained iodine, gadolinium, calcification, and lipid. The Feld-kamp-Davis-Kress (FDK) with the sinogram interpolation method and Maximum Likelihood Expectation Maximization (MLEM) algorithm were used to reconstruct the images. We evaluated the signal-to-noise ratio (SNR) of the materials. The SNRs of iodine, calcification, and liquid lipid were increased by 167.03%, 157.93%, and 41.77%, respectively, with the 23~33 keV energy bin using the sinogram interpolation method. The SNRs of iodine, calcification, and liquid state lipid were also increased by 107.01%, 13.58%, and 27.39%, respectively, with the 34~44 keV energy bin using the sinogram interpolation method. Although the FDK algorithm with the sinogram interpolation did not produce better results than the MLEM algorithm, it did result in comparable image quality to that of the MLEM algorithm. We believe that the sinogram interpolation method can be applied in various reconstruction studies using the analytic reconstruction algorithm. Therefore, the sinogram interpolation method can improve the image quality in sparse-angular sampling and be applied to CT applications.

• 대한방사선기술학회지:방사선기술과학
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• 제25권2호
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• pp.39-45
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• 2002

흉부 종괴와 정상 조직의 CT밀도에 대해 재구성 연산방식에 따른 영향을 평가하기 위해 흉부 종괴가 있는 50명의 환자를 대상으로 연구를 시행하였다. CT영상은 연부, 표준, 골 그리고 선예의 4가지 재구성 연산법을 사용하여 평가하였다. 그 결과, 관심영역에 대한 폐종괴 밀도의 최대 차이는 평균 1HU 미만으로 나타났다. 또한 폐종괴의 조영증강의 최대 차이는 ROI 0.5, 3, $6cm^2$에서 각각 $0.1{\sim}3.2,\;0.1{\sim}2.8,\;0.0{\sim}2.1\;HU$로 나타났다. 흉부의 정상 조직에서 평균 밀도는 골 연산법에서 가장 높았으나, 4가지 재구성 연산법에 따라 의미 있는 차이는 없었다(P = 1.00).