• Clinical and Experimental Pediatrics
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• v.45 no.4
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• pp.519-523
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• 2002

Purpose : We aimed to evaluate the abnormalities of chest radiographs including atelectasis in children who were admitted with bronchial asthma. Methods : We retrospectively analyzed the 357 chest radiographs and the clinical and laboratory features of the 144 children with asthma, who were admitted at Daejoen St. Mary's Hospital from April 1994 to May 1998. Results : Clinical and laboratory characteristics were as follows : male to female ratio, 2.1 : 1; mean age, 4.8 years of age; mean numbers of admission, 2.5; mean hospitalization, 5.0 days; mean IgE, 387 IU/mL; mean eosinophil count, $362/mm^3$. In the abnormal findings of the 357 radiographs, there were 314 cases(88.0%) of hyperinflation, pulmonary infiltration 35.0%, atelectasis 5.3% and pneumomediastinum 0.3%. All(19) cases of atelectasis were observed in the right lung field with mostly segmental and lobular distribution, except one with lobar involvement. Atelectasis was predominant in males and those under 2 years of age. There was a tendency that the right upper lung was more involved under two years while the right lower lung was more involved over seven years of age. Conclusion : Radiographs of children admitted to hospital with bronchial asthma showed abnormal findings including pneumonia or atelectasis(5.3%). These abnormal findings can help to determine other therapeutic modalities in addition to asthma treatment.

• Progress in Medical Physics
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• v.19 no.3
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• pp.143-149
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• 2008

The aim of this study is to suggest the method for image enhancement of digital chest radiograph and evaluate clinically the quality of the resultant image. A nonlinear iterative filter was developed in order to reduce quantum noise preserving edge. Dynamic range was adjusted and adaptive image enhancement was performed based on the property of anatomic region and the degree of compatibility with neighboring pixels. The lung fields were enhanced appropriately to visualize effectively vascular tissue, bronchus and lung tissue with the desired mediastinum enhancement. Clinic evaluation was performed by three radiologists with at least 8 years experience. The anatomic regions of 11 in PA and 9 in Lateral were observed carefully in each 100 radiographs according to ITU (International Telecommunication Union) recommendation 500 protocol. The result showed the mean 3.4 between good and adequate. This means that the clinical utility of the image quality is enough. In this study, image enhancement was carried out considering image display device and human perceptual system to prevent the loss of useful anatomic information. In order to increase the diagnostic accuracy in digital radiograph, the continuous study on image enhancement is needed.

• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.43-47
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• 2010

We report a case of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule (SPN). A 35-year-old male was admitted due to a SPN in the right upper lobe which was detected on the chest radiography being examed due to recurrent cough for 1 year. The computed tomography (CT) revealed a spiculated nodule containing air-bronchogram, which was suspicious of malignancy. We performed transbronchial biopsy and the pathology showed granulomatous inflammation with caseous necrosis. Under the presumptive diagnosis of pulmonary tuberculosis, we started anti-tuberculous medication including isoniazid, rifampin, ethambutol, and pyrazinamide. In one month, however, the sputum culture was positive for Mycobacterium intracellulare. The follow-up chest CT showed slight aggravation of the previous lesions. Under the final diagnosis of Mycobacterium intracellulare pulmonary infection presenting as a solitary pulmonary nodule, we changed the regimen to rifampin, ethambutol, and clarithromycin. The follow-up chest CT after the completion of treatment, revealed resolution of the previous lesions.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.305-314
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• 2011

The purpose of this study was to compare the findings on the chest low-dose CT (LDCT) images between the negative and positive groups for pneumoconiosis in the group exposed to inorganic dust. From May 30, 2007 to August 31, 2008, total 328 subjects were examined by a LDCT. LDCT images were read by a chest radiologist who has much experience for reading of pneumoconiosis. All subjects were classified into two groups based on digital images after consensus reading of two radiologists according to the ILO 2000 guidelines; negative group (87, 26.5%) without pneumoconiosis and positive group (241, 73.5%). Statistical analysis was performed using a SPSS 14.0. There were significant differences in age (60.9 vs. 65.0, p<0.001), and in dust expose duration (17.0 vs. 19.2, p=0.024) between two groups, but no significant difference in smoking (p=0.784). Of the 328 subjects, 13 diagnosis were extracted from 245 subjects (74.7%). Coronary artery calcification (CAC) was significantly higher in positive group than that in negative group (36.9% vs. 25.3%, p=0.049). Honeycombing showed higher frequency in positive group than in negative group (6.2% vs. 1.2%, p=0.079). Pneumoconiosis findings caused by inorganic dusts exposure showed the significant relation with CAC on LDCT images. Future studies need to prove that pneumoconiosis finding is independent risk factor for CAC using a coronary artery angiography.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.248-250
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• 2002

A 56 year-old man complaining of dry cough, dyspnea, chest pain, fever, and chills was admitted to the emergency room. The patient had a history of esophagectomy and esophagogastrostomy and subsequent radiotherapy because of an esophageal cancer. After the emergency echocardiography revealed a small amount of pericardial effusion and pneumopericardium. Upper GI contrast study showed a fistulous tract between the stomach and the pericardium, and an emergency operation was done under the diagnosis of gastropericardial fistula. The patient expired postoperative seven days later. Gastropericardial fistula caused by a peptic ulcer perforation after the esophagectomy and esophagogastrostomy operation is a very rare complication and brings forth a disastrous result. Early detection using the chest radiography, electrocardiogram, upper Gl study, echocardiography and a review of physical examination, and an immediate treatment are therefore mandatory.

• Korean Journal of Radiology
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• v.24 no.3
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• pp.259-270
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• 2023

Objective: It is unknown whether artificial intelligence-based computer-aided detection (AI-CAD) can enhance the accuracy of chest radiograph (CR) interpretation in real-world clinical practice. We aimed to compare the accuracy of CR interpretation assisted by AI-CAD to that of conventional interpretation in patients who presented to the emergency department (ED) with acute respiratory symptoms using a pragmatic randomized controlled trial. Materials and Methods: Patients who underwent CRs for acute respiratory symptoms at the ED of a tertiary referral institution were randomly assigned to intervention group (with assistance from an AI-CAD for CR interpretation) or control group (without AI assistance). Using a commercial AI-CAD system (Lunit INSIGHT CXR, version 2.0.2.0; Lunit Inc.). Other clinical practices were consistent with standard procedures. Sensitivity and false-positive rates of CR interpretation by duty trainee radiologists for identifying acute thoracic diseases were the primary and secondary outcomes, respectively. The reference standards for acute thoracic disease were established based on a review of the patient's medical record at least 30 days after the ED visit. Results: We randomly assigned 3576 participants to either the intervention group (1761 participants; mean age ± standard deviation, 65 ± 17 years; 978 males; acute thoracic disease in 472 participants) or the control group (1815 participants; 64 ± 17 years; 988 males; acute thoracic disease in 491 participants). The sensitivity (67.2% [317/472] in the intervention group vs. 66.0% [324/491] in the control group; odds ratio, 1.02 [95% confidence interval, 0.70-1.49]; P = 0.917) and false-positive rate (19.3% [249/1289] vs. 18.5% [245/1324]; odds ratio, 1.00 [95% confidence interval, 0.79-1.26]; P = 0.985) of CR interpretation by duty radiologists were not associated with the use of AI-CAD. Conclusion: AI-CAD did not improve the sensitivity and false-positive rate of CR interpretation for diagnosing acute thoracic disease in patients with acute respiratory symptoms who presented to the ED.

• Korean Journal of Radiology
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• v.23 no.10
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• pp.1009-1018
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• 2022

Objective: This study aimed to investigate the feasibility of using artificial intelligence (AI) to identify normal chest radiography (CXR) from the worklist of radiologists in a health-screening environment. Materials and Methods: This retrospective simulation study was conducted using the CXRs of 5887 adults (mean age ± standard deviation, 55.4 ± 11.8 years; male, 4329) from three health screening centers in South Korea using a commercial AI (Lunit INSIGHT CXR3, version 3.5.8.8). Three board-certified thoracic radiologists reviewed CXR images for referable thoracic abnormalities and grouped the images into those with visible referable abnormalities (identified as abnormal by at least one reader) and those with clearly visible referable abnormalities (identified as abnormal by at least two readers). With AI-based simulated exclusion of normal CXR images, the percentages of normal images sorted and abnormal images erroneously removed were analyzed. Additionally, in a random subsample of 480 patients, the ability to identify visible referable abnormalities was compared among AI-unassisted reading (i.e., all images read by human readers without AI), AI-assisted reading (i.e., all images read by human readers with AI assistance as concurrent readers), and reading with AI triage (i.e., human reading of only those rendered abnormal by AI). Results: Of 5887 CXR images, 405 (6.9%) and 227 (3.9%) contained visible and clearly visible abnormalities, respectively. With AI-based triage, 42.9% (2354/5482) of normal CXR images were removed at the cost of erroneous removal of 3.5% (14/405) and 1.8% (4/227) of CXR images with visible and clearly visible abnormalities, respectively. In the diagnostic performance study, AI triage removed 41.6% (188/452) of normal images from the worklist without missing visible abnormalities and increased the specificity for some readers without decreasing sensitivity. Conclusion: This study suggests the feasibility of sorting and removing normal CXRs using AI with a tailored cut-off to increase efficiency and reduce the workload of radiologists.

• Journal of radiological science and technology
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• v.39 no.1
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• pp.13-17
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• 2016

In this study, standard model of medical radiation dosage quality control system will be suggested and the useful of this system in clinical field will be reviewed. Radiation dosage information of modalities are gathered from digital imaging and communications in medicine(DICOM) standard data(such as DICOM dose SR and DICOM header) and stored in database. One CT scan, two digital radiography modalities and two mammography modalities in one health promotion center in Seoul are used to derive clinical data for one month. After 1 months research with 703 CT scans, the study shows CT $357.9mGy{\cdot}cm$ in abdomen and pelvic CT, $572.4mGy{\cdot}cm$ in brain without CT, $55.9mGy{\cdot}cm$ in calcium score/heart CT, screening CT at $54mGy{\cdot}cm$ in chest screening CT(low dose screening CT scan), $284.99mGy{\cdot}cm$ in C-spine CT and $341.85mGy{\cdot}cm$ in L-spine CT as health promotion center reference level of each exam. And with 1955 digital radiography cases, it shows $274.0mGy{\cdot}cm2$ and for mammography 6.09 mGy is shown based on 536 cases. The use of medical radiation shall comply with the principles of justification and optimization. This quality management of medical radiation exposure must be performed in order to follow the principle. And the procedure to reduce the radiation exposure of patients and staff can be achieved through this. The results of this study can be applied as a useful tool to perform the quality control of medical radiation exposure.

• Journal of the Korean Society of Radiology
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• v.15 no.2
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• pp.165-171
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• 2021

To prevent the secondary hospital-acquired infection (cross-infection) from occurring in the general radiographic room in the department of radiology, the microbial measurement was conducted at the points making direct close contact with radiologists and patients. For the case of radiologists, the microbial measurement and incubation were focused on the x-ray tube handle of the radiation generating device, and, for the case of patients, the microbial measurement and incubation were focused on the chin supporting device, chest-contact point, and handle. Once disinfected with Aniosurf, the sterilized media were gathered and identified, and the microorganisms were confirmed. Based on the identification results, it was confirmed that the points making direct close contact with radiologists showed a value of 103 CFU for Proteus mirabilis, Staphylococcus epidermidis, Bacillus spp. and Candida spp., and that the points making direct close contact with patients showed a value of 103~5 CFU for Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, NTM(Non-Tuberculosis Mycobacteria) and Candida spp.. It was also confirmed that the types and number of microorganisms gathered from the points making direct close contact with patients were greater. Fortunately, most of the involved microorganisms were observed to be on the skin surface and are known to become extinct when disinfected in accordance with the hospital-acquired infection control rules. However, since even minor exposure to such microorganisms may be lethal for patients with reduced immunity, caution must be taken. In particular, since the points making contact with patients showed a high level of microbial measurement, it was thought that it would be necessary for radiologists and personnel having frequent access to strictly disinfect the parts, such as instruments and handles, making frequent contact with patients. The purpose of this study was to announce the importance of safe microbial control in the radiographic inspection room in hospital, and this study is expected to be used as the baseline data for preventing hospital-acquired secondary infection and Nth infectious diseases.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.27-35
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• 2017

The purpose of this study was to investigate the features of CsI:Tl and $Gd_2O_2S$ detectors with an indirect conversion method using phantom in the DR (digital radiography) system by obtaining images of thick chest phantom, medium thickness thigh phantom, and thin hand phantom and by analyzing the SNR and CNR. As a result of measuring the SNR and CNR according to the thickness change of the subject, the SNR and CNR were higher in CsI:Tl detector than in $Gd_2O_2S$ detector when the medium thickness thigh phantom and thin hand phantom were scanned. However, when the thick chest phantom was used, for the SNR at 80~125 kVp and the CNR at 80~110 kVp in the $Gd_2O_2S$ detector, the values were higher than those of CsI:Tl detector. The SNR and CNR both increased as the tube voltage increased. The SNR and CNR of CsI:Tl detector in the medium thickness thigh phantom increased at 40~50 kVp and decreased as the tube voltage increased. The SNR and CNR of $Gd_2O_2S$ detector increased at 40~60 kVp and decreased as the tube voltage increased. The SNR and CNR of CsI:Tl detctor in the thin hand phantom decreased at the low tube voltage and increased as the tube voltage increased, but they decreased again at 100~110 kVp, while the SNR and CNR of $Gd_2O_2S$ detector were found to decrease as the tube voltage increased. The MTF of CsI:Tl detector was 6.02~90.90% higher than that of $Gd_2O_2S$ detector at 0.5~3 lp/mm. The DQE of CsI:Tl detector was 66.67~233.33% higher than that of $Gd_2O_2S$ detector. In conclusion, although the values of CsI:Tl detector were higher than those of $Gd_2O_2S$ detector in the comparison of MTF and DQE, the cheaper $Gd_2O_2S$ detector had higher SNR and CNR than the expensive CsI:Tl detector at a certain tube voltage range in the thick check phantom. At chest X-ray, if the $Gd_2O_2S$ detector is used rather than the CsI:Tl detector, chest images with excellent quality can be obtained, which will be useful for examination. Moreover, price/performance should be considered when determining the detector type from the viewpoint of the user.