• Journal of Periodontal and Implant Science
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• 제48권4호
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• pp.202-212
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• 2018

Purpose: Bone-to-implant contact (BIC) is difficult to measure on micro-computed tomography (CT) because of artifacts that hinder accurate differentiation of the bone and implant. This study presents an advanced algorithm for measuring BIC in micro-CT acquisitions using a spiral scanning technique, with improved differentiation of bone and implant materials. Methods: Five sandblasted, large-grit, acid-etched implants were used. Three implants were subjected to surface analysis, and 2 were inserted into a New Zealand white rabbit, with each tibia receiving 1 implant. The rabbit was sacrificed after 28 days. The en bloc specimens were subjected to spiral (SkyScan 1275, Bruker) and round (SkyScan 1172, SkyScan 1275) micro-CT scanning to evaluate differences in the images resulting from the different scanning techniques. The partial volume effect (PVE) was optimized as much as possible. BIC was measured with both round and spiral scanning on the SkyScan 1275, and the results were compared. Results: Compared with the round micro-CT scanning, the spiral scanning showed much clearer images. In addition, the PVE was optimized, which allowed accurate BIC measurements to be made. Round scanning on the SkyScan 1275 resulted in higher BIC measurements than spiral scanning on the same machine; however, the higher measurements on round scanning were confirmed to be false, and were found to be the result of artifacts in the void, rather than bone. Conclusions: The results of this study indicate that spiral scanning can reduce metal artifacts, thereby allowing clear differentiation of bone and implant. Moreover, the PVE, which is a factor that inevitably hinders accurate BIC measurements, was optimized through an advanced algorithm.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.89-94
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• 2010

Objective : To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian set-up. Methods : The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated. Results : There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG. Conclusion : USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.

• Korean Journal of Radiology
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• 제21권8호
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• pp.1018-1023
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• 2020

The coronavirus disease (COVID-19) outbreak has reached global pandemic status as announced by the World Health Organization, which currently recommends reverse transcription polymerase chain reaction (RT-PCR) as the standard diagnostic tool. However, although the RT-PCR test results may be found negative, there are cases that are found positive for COVID-19 pneumonia on computed tomography (CT) scan. CT is also useful in assessing the severity of COVID-19 pneumonia. When clinicians desire a CT scan of a patient with COVID-19 to monitor treatment response, a safe method for patient transport is necessary. To address the engagement of medical resources necessary to transport a patient with COVID-19, our institution has implemented the use of mobile CT. Therefore, we report two cases of COVID-19 pneumonia evaluated by using mobile cone-beam CT. Although mobile cone-beam CT had some limitations regarding its image quality such as scatter noise, motion and streak artifacts, and limited field of view compared with conventional multi-detector CT, both cases had acceptable image quality to establish the diagnosis of COVID-19 pneumonia. We report the usefulness of mobile cone-beam CT in patients with COVID-19 pneumonia.

• 한국방사선학회논문지
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• 제13권7호
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• pp.969-977
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• 2019

방사선 피폭감소를 위해 사용하는 비스무스 차폐체를 적용하여 CT스캔 시 차폐체에 의한 선속경화현상으로 화질이 감소되는 경우가 있다. 이에 G사의 듀얼 에너지 CT의 GSI모드 적용을 통해 화질저하 현상을 줄일 수 있는 에너지 영역대를 찾아보고, 가능성을 실험을 통해 알아보고자 하였다. 그 결과 비스무스 차폐 후 듀얼 에너지 CT 스캔 시 50 keV에서 118±10.6 HU, 50.1±14.6 HU로 화질저하 전 CT value와 가장 유사하였고(p>0.05), Image J의 Multi-point기능을 적용한 Pixel value에서도 50 keV에서 176.6±7.1, 138.3±1.1로 측정 되었다(p>0.05). CT검사 시 차폐체의 사용은 불가항력적으로 화질저하를 유발하지만 듀얼 에너지 CT의 GSI기능 적용으로 차폐체를 사용하고도 화질을 유지할 수 있다는 것을 실험을 통해 알 수 있었다. 향후 다양한 차폐체를 듀얼 에너지 CT를 이용, 평가 후 보안 한다면 CT검사의 최대 단점인 피폭 감소를 위한 방사선 차폐체 사용으로 발생한 화질저하라 단점을 극복할 수 있을 것으로 기대된다.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.437-442
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• 2001

Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.253-258
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• 2009

Bone scintigraphy using $^{99m}$Tc-labeled phosphate agents has long been the standard evaluation method for whole skeletal system. However, recent shortage of $^{99m}$Tc supply and advanced positron emission tomography (PET) technology evoked the attention to surrogate radiopharmaceuticals and imaging modalities for bone. Actually, fluorine-18 ($^{18}$F) was the first bone seeking radiotracer before the introduction of $^{99m}$Tc-labeled agents even though its clinical application failed to become pervasive anymore after the rapid spread of Anger type gamma camera systems in early 1970s. However, rapidly developed PET technology made us refocus on the usefulness of $^{18}$F as a PET tracer. Early study comparing $^{18}$F-Na PET scan and planar bone scintigraphy reported that PET has higher sensitivity and specificity in the diagnosis of metastatic bone lesions than planar bone scan. Subsequent reports comparing between PET and both planar and SPECT bone image also revealed better results of PET scan in similar study groups. Rapid clinical application of PET/CT also accumulated considerable amount of experiences in skeletal evaluation and this modality is known to have better diagnostic power than stand alone PET system as well as bone scan. Furthermore $^{18}$F-Na PET/CT revealed better or at least equal results in detection of primary and metastatic bone lesions compared with CT and MRI. Therefore, it is obvious that $^{18}$F-Na PET/CT has potential to become new imaging modality for practical skeletal evaluation so continuous and careful evaluation of this modality and radiopharmaceutical must be required.

• Advances in pediatric surgery
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• 제11권2호
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• pp.180-185
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• 2005

Superior mesenteric artery (SMA) syndrome is a rare disorder caused by extrinsic compression of the third portion of the duodenum by the SMA. The operative treatment of choice is bypassing the obstructed duodenal segment by duodenojejunostomy. We report one case of SMA syndrome treated by laparoscopic duodenojejunostomy and followed up by 3D-reconstructive CT scan. A fifteen-year-old boy with intermittent vomiting and weight loss was admitted. Ultrasonography showed narrowing of the distance between the SMA and aorta. Hypotonic duodenography showed dilatation of duodenal third portion and barium stasis. On 3Dreconstructive CT scan, the angle between SMA and aorta was $37^{\circ}$. The postoperative course was uneventful. Three months later, he had gained 3 kg of weight and the angle between SMA and aorta increased to $38-39^{\circ}$ on 3D reconstructive CT scan. Laparoscopic duodenojejunostomy for bypassing the obstructive duodenum in SMA syndrome is a feasible and safe method.

• Journal of Electrical Engineering and Technology
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• 제10권5호
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• pp.2197-2204
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• 2015

In recent years, medical image diagnosis has growing significant momentous in the medicinal field. Brain and lung image of patient are distorted with salt and pepper noise is caused by moving the head and chest during scanning process of patients. Reconstruction of these images is a most significant field of diagnostic evaluation and is produced clearly through techniques such as linear or non-linear filtering. However, restored images are produced with smaller amount of noise reduction in the presence of huge magnitude of salt and pepper noises. To eliminate the high density of salt and pepper noises from the reproduction of images, a new efficient fuzzy based median filtering algorithm with a moderate elapsed time is proposed in this paper. Reproduction image results show enhanced performance for the proposed algorithm over other available noise reduction filtering techniques in terms of peak signal -to -noise ratio (PSNR), mean square error (MSE), root mean square error (RMSE), mean absolute error (MAE), image enhancement factor (IMF) and structural similarity (SSIM) value when tested on different medical images like magnetic resonance imaging (MRI) and computer tomography (CT) scan brain image and CT scan lung image. The introduced algorithm is switching filter that recognize the noise pixels and then corrects them by using median filter with fuzzy two-sided π- membership function for extracting the local information.

• 핵의학기술
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• 제16권1호
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• pp.34-37
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• 2012

$^{18}F$-FDG 검사 시 한 bed 당 적정 스캔 시간을 정량 평가하기 위하여 Philips사 TF 64 PET/CT를 사용하였다. Phantom 실험과 환자를 대상으로 다양한 스캔 시간을 적용하며 평가를 하여 최적의 스캔 시간을 알고자 하였다. 20초 간격으로 총 5회의 서로 다른 bed 당 스캔 시간을 NEMA IEC body phantom과 환자들에게 적용하여 $^{18}F$-FDG 영상을 획득하였다. Phantom 실험의 경우 관심영역과 background의 방사능비를 8:1로 했다. 관심영역과 background 영역의 표준섭취계수(SUV)와 대조회복계수(CRC)가 계산되었다. 환자를 대상으로 한 연구에서는 평균$444{\pm}74$ MBq의 $^{18}F$-FDG가 환자에게 주사되었고 20명의 환자, 38개의 병소부위에서 표준섭취계수가 측정되었다. Background noise는 background 부분의 표준편차를 평균으로 나누어 계산되었다. Phantom 실험에서 두 그룹 (LT-60 [<60 sec]과 GT-60 [${\geq}60$ sec])을 비교한 결과 LT-60 그룹의 표준섭취계수(SUV)와 대조회복계수(CRC)가 (H1: 14.2 and 7.3, H2: 11.4 and 7.8, H3: 4.9 and 3.2), GT-60 그룹(H1: 8.9 and 2.8, H2: 8.2 and 5.0, H3: 2.0 and 1.6)에서 보다 높은 변이율을 보였다. 이는 한 bed 당 스캔시간이 60 sec 이상일 때 안정적인 표준섭취계수와 대조회복계수를 나타내는 것을 의미한다. 환자를 대상으로 한 연구에서 역시 표준섭취계수(SUV)와 대조회복계수(CRC)가 LT-60 그룹에서 높은 변이율을 보였다. PET/CT 영상에서 background noise는 bed 당 스캔시간이 증가함에 따라 감소하는 것으로 나타났다. 그리고 60 sec 이하 그룹에서는 높은 background noise로 인하여 높은 SUV와 CRC 변이율을 보였다. 따라서 PET/CT 영상의 질을 고려할 때 1 bed 당 스캔시간은 최소 60 sec 이상이어야 한다.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.116-120
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• 2008

Prostate cancer is the second leading cause of cancer death of men in western countries and the death related to this disease in Korea is also getting increased. Although anatomic imaging tools such as transrectal US or MRI have been playing a great role in detection of primary prostate lesion, the evaluation of regional lymph node or distant organ metastasis using these modalities is not successful. $^{18}F-FDG-PET$ scan is emerging diagnostic tool for various malignancies. Considering the usual characteristics of prostate cancer such as slow growing and osteoblastic metastasis, the application of FDG PET scan to this disease might be limited. However, in advanced prostate cancer refractory to chemotherapy, FDG PET scan show strong FDG uptake and SUV changes in serial PET scan can be a good indicator of treatment response. Although FDG PET can be useful only in limited cases of prostate cancer, its indication can be widened in future owing to rapid technical improvement and accumulated experiences in this field.