• Journal of Trauma and Injury
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• v.22 no.1
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• pp.24-28
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• 2009

Purpose: This was conducted to assess the need for conventional radiographs of the thoracolumbar spine for routine screening of trauma patients who revealed no spinal trauma on chest and abdominal computed tomography (CT). Methods: We performed a retrospective review of the medical records of trauma patients who underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. Results: Two hundred seventy-five trauma patients underwent conventional radiographs of the thoracolumbar spine following a chest and abdominal CT that revealed no spinal trauma. In 274 of the cases, the thoracolumbar spine series was also negative. Conclusion: CT of the chest and abdomen is an adequate evaluation of the thoracolumbar spine in trauma patients who require routine thoracolumbar spine screening, making subsequent conventional radiographs of the thoracolumbar spine unnecessary.

• Korean Journal of Radiology
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• v.21 no.11
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• pp.1265-1272
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• 2020

Objective: We investigated the prevalence of pneumonia in novel coronavirus disease 2019 (COVID-19) patients using chest radiographs to identify the characteristics of those with initially negative chest radiographs, who were positive for pneumonia on follow-up. Materials and Methods: Retrospective cohort data of 236 COVID-19 patients were reviewed. Chest radiography was performed on admission, with serial radiographs obtained until discharge. The 'positive conversion group' was defined as patients whose initial chest radiographs were negative but were positive for pneumonia during follow-up. Patients with initially positive chest radiographs were defined as the 'initial pneumonia group.' Patients with negative initial and follow-up chest radiographs were defined as the 'non-pneumonia group.' Clinical and laboratory findings were compared between groups, and predictors of positive conversion were investigated. Results: Among 236 patients, 108 (45.8%) were in the non-pneumonia group, 69 (29.2%) were in the initial pneumonia group, and 59 (25%) were in the positive conversion group. The patients in the 'initial pneumonia group' and 'positive conversion group' were older, had higher C-reactive protein (CRP) and lactate dehydrogenase levels, and lower absolute lymphocyte counts than those in the 'non-pneumonia group' (all p < 0.001). Among patients with negative initial chest radiographs, age ≥ 45 years (odds ratio [OR]: 3.93, 95% confidence interval [CI]: 1.76-8.75, p = 0.001), absolute lymphocyte count < 1500 cells/μL (OR: 2.25, 95% CI: 1.03-4.89, p = 0.041), and CRP > 0.5 mg/dL (OR: 3.91, 95% CI: 1.54-9.91, p = 0.004) were independent predictors for future development of pneumonia. Conclusion: More than a half of COVID-19 patients initially had normal chest radiographs; however, elderly patients (≥ 45 years of age) with abnormal laboratory findings (elevated CRP and low absolute lymphocyte counts) developed pneumonia on follow-up radiographs.

• Korean Journal of Radiology
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• v.24 no.2
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• pp.155-165
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• 2023

Objective: Little is known about the effects of using different expert-determined reference standards when evaluating the performance of deep learning-based automatic detection (DLAD) models and their added value to radiologists. We assessed the concordance of expert-determined standards with a clinical gold standard (herein, pathological confirmation) and the effects of different expert-determined reference standards on the estimates of radiologists' diagnostic performance to detect malignant pulmonary nodules on chest radiographs with and without the assistance of a DLAD model. Materials and Methods: This study included chest radiographs from 50 patients with pathologically proven lung cancer and 50 controls. Five expert-determined standards were constructed using the interpretations of 10 experts: individual judgment by the most experienced expert, majority vote, consensus judgments of two and three experts, and a latent class analysis (LCA) model. In separate reader tests, additional 10 radiologists independently interpreted the radiographs and then assisted with the DLAD model. Their diagnostic performance was estimated using the clinical gold standard and various expert-determined standards as the reference standard, and the results were compared using the t test with Bonferroni correction. Results: The LCA model (sensitivity, 72.6%; specificity, 100%) was most similar to the clinical gold standard. When expert-determined standards were used, the sensitivities of radiologists and DLAD model alone were overestimated, and their specificities were underestimated (all p-values < 0.05). DLAD assistance diminished the overestimation of sensitivity but exaggerated the underestimation of specificity (all p-values < 0.001). The DLAD model improved sensitivity and specificity to a greater extent when using the clinical gold standard than when using the expert-determined standards (all p-values < 0.001), except for sensitivity with the LCA model (p = 0.094). Conclusion: The LCA model was most similar to the clinical gold standard for malignant pulmonary nodule detection on chest radiographs. Expert-determined standards caused bias in measuring the diagnostic performance of the artificial intelligence model.

• Journal of radiological science and technology
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• v.8 no.2
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• pp.11-14
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• 1985

The author came to analize and get the following problems after researched radiographic quality in order to find out the necessary factors to improve in radiographs of frontal projection of the chest selected at random of the adult patients (1545 male, 1520 female) who had been examined in 4 departments of radiology of the general hospitals in Seoul and Kyungki area. 1. Problems of x-ray film or of radiographic cassette appeared in 2.97% radiographs on account of selection of the film size (except costophrenic sinus) (1.79%), poor screen-film contact (0.85%), light leakage of cassette (0,33%). 2. Problems of patients' positioning or breathing appeared in 16.57% radiographs of all because of overlapping of lung apex and clavicle (6.98%), overlapping of scapula and lung field (5.87%), asymmetrical projection of clavicles (1.76%), errors in positioning and breathing of the patient (1.96%). 3. Problems of x-ray exposure factors or film processing appeared in 22.25% radiographs because of over-density (2.64%), under-density (3.95%), fog (0.59%), demonstration density under clavicles or lung marking unsharply (3.82%), not clear of lung marking from breast region (0.94%), not clear the lung marking from the part overlapped of heart and lungs (3.92%), not clear the lung marking from the part overlapped of liver and lung (6.49%).

• Journal of Preventive Medicine and Public Health
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• v.22 no.3 s.27
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• pp.328-336
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• 1989

27 shipyard welders were diagnosed as pneumoconiosis and suspected pneumoconiosis(1976-1988) by chest radiographs and were observed over three years. 27 welders were divided into three groups by the state of exposure to welding fume i.e. cessation, decresase or continuity of exposure. And we observed the changing pattern of the chest radiographs of 27 welders with the passage of time. The results were as follows; 1. Grour I (ceased exposure to welding fume) were 10 cases(3 cases: suspected pneumoconiosis,7 cases: pneumoconiosis). Chest radiographs of all cases were improved. The shape and size of small opacities was improved in 6 cases(85.7%) and did not changed in 1 case(14.3%) out of 7 pneumoconiosis welders. 2. Group II (decreased exposure to welding fume) were S cases(2 cases: suspected pneumoconiosis, 3 cases: pneumoconiosis). Chest radiographs were progressed in 2 cases(40%), did not changed in 1 case(20%), were improved in 2 cases(40%) out of 5 cases. The shape and size of small opacities was progressed in 1 case(33.3%) and was improved in 2 cases(66.7%) out of 3 pneumoconiosis welders. 3. Group III(continued expoxsure to welding fume) were 12 cases(1 case: suspected pneumoconiosis, 11 cases: pneumoconiosis). Chest radiographs were progressed in 9 cases(75%), did not changed in 3 cases(25%) out of 12 cases. The shape and size of small opacities was progressed in 1 case(9.1%) and did not changed in 10 cases(90.9%) out of 11 pneumoconiosis welders. 4. The average duration for development into suspected pneumoconiosis was 6.6 years and for progression of each one category after that was 2.2 years(p<0.01). The radiological appearance of pneumoconiosis had disappeared or decreased after cessation of exposure to the welding fume. So that, early detection and control e.g., change of department of pneumoconiosis of welders by screening program will be important for medical surveillance of welders.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1298-1311
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• 2022

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.442-445
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• 2002

We present an algorithm for automatic anatomically adaptive image enhancement of digital chest radiographs. Chest images were exposed using digital radiography system with a 0.143 mm pixel pitch, l4-bit gray levels, and 3121 ${\times}$ 3121 matrix size. A chest radiograph was automatically divided into two classes (lung field and mediastinum) by using a maximum likelihood method. Each pixel in an image was processed using fuzzy domain transformation and enhancement of both the dynamic range and local gray level variations. The lung fields were enhanced appropriately to visualize effectively vascular tissue, the bronchus, and lung tissue, etc as well as pneumothorax and other lung diseases at the same time with the desired mediastinum enhancement. A prototype implementation of the algorithm is undergoing trials in the clinical routine of radiology department of major Korean hospital.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.454-456
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• 2002

The evaluation of interval changes between temporally sequential chest radiographs is necessary for the detection of new abnormalities or interval changes, such as pulmonary nodules and interstitial disease. For interstitial lung disease, the interval changes are very important for diagnosis and treatment. Especially, interstitial lung disease may show rapid changes in the radiographs, show changes in the entire lung field in minute detail, or show changes in multiple parts depending on the type. It is therefore difficult to have an accurate grasp of the condition of the disease only with conventional radiographs. The temporal subtraction technique which was developed at the University of Chicago, provides a subtraction image of the current warped image and the previous image. A temporal subtraction image, shows only differences and changes between the two images, can be very useful for a diagnosis of interstitial lung disease. However, the evaluation of the temporal subtraction technique for interstitial lung disease using receiver operating characteristic(ROC) studies has not been reported yet. Therefore, we have evaluated the clinical usefulness of a temporal subtraction technique for detection of interval changes of interstitial lung disease by ROC analysis.

• Progress in Medical Physics
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• v.20 no.4
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• pp.199-207
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• 2009

It is important to initialize Image Plate (IP) completely for removing residual latent image by sodium lamp for reliability and repeatability of computed radiography (CR) system. The purpose of this study was to evaluate latent images of computed radiography (CR) images respect to delay time after erasure of foregone latent image and its effect, and erasure level. Erasure thoroughness for CR acceptance test from American Association of Physicist in Medicine (AAPM) Report 93 (2006) was also evaluated. Measurements were made on a CR (Agfa CR 25; Agfa, BELGIUM) system. Chest postero-anterior (PA), Hand PA, L-spine lateral radiographs were chosen for evaluation. Chest phantom (3D-torso; CIRS, USA) was used for Chest PA and L-spine lateral radiography. For Hand PA radiography, projections was done without phantom. Except Hand PA radiographs, noise was increased with delay time, and ghost image was appeared on overexposed area. Effect of delay after erasure on latent image was not seen on naked eye, but standard deviation (SD) of pixel value on overexposed area was relatively higher than that of other areas. On Hand PA and Chest PA radiographs, noise were not occurred by adjustment of erasure level. On L-spine lateral images at lower erasure level than standard level, noise including ghost image were occurred because of high tube current. Erasure thoroughness of CR system in our department was to be proved by these evaluation. The results of this study could be used as a baseline for IP initialization and reliability of CR images.

• Journal of The Korean Radiological Technologist Association
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• v.28 no.1
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• pp.112-119
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• 2002

Purpose : The purpose of this study is to evaluate the usefulness, after we compare and analyze the difference about the location of a lesion and the result of diagnosis on chest radiographs(CR) and low dose computed tomography(LDCT) in subjects for healt