• Journal of Korean Neurosurgical Society
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• 제54권5호
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• pp.384-389
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• 2013

Objective : Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. Methods : A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. Results : The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. Conclusion : The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

• 한국방사선학회논문지
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• 제14권1호
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• pp.31-37
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• 2020

본 연구에서는 이중에너지 방사선 흡수계측법을 이용한 골다공증 검사 시 검사자의 숙련도에 따라 발생되는 부정확한 검사결과의 종류와 빈도를 확인하고 자주 발생하는 오류에 관해서는 교육을 통하여 개선이 가능하도록 하고자 연구를 진행하였다. 분석결과 주로 고관절 검사에서 잘못된 환자자세로 검사하거나 압박골절이나 퇴행성 변화가 있는 부위는 결과에서 배제하여야 하지만 압박골절 및 퇴행성 변화의 소견이 보이는 경우에도 결과에 포함된 경우가 많이 관찰되었으며 수술기구 등도 결과 값에서 배제하여야 하지만 포함되어 분석되어진 경우가 많은 것으로 확인되었다. 오류의 내용 중 가장 많은 부분을 차지하는 것은 환자자세의 오류로 모두 56건(척추 6건, 고관절 50건)이었으며, 다음으로 분석과정의 오류 37건(척추 35건 고관절 2건), 관심영역 오류 33건(척추 28건, 고관절 5건)의 순으로 나타났으며 품질관리의 미비로 인한 오류는 발생하지 않았다.

• 대한방사선기술학회지:방사선기술과학
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• 제23권2호
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• pp.13-19
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• 2000

There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and Febuary in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry(DEXA). The result was compared using age matched paired T test. The results were as follows ; 1. The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. 2. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. 3. The bone density of neck, Ward's triangle, trochanter(P<0.05) and lumbar spine(P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. 4. The bone density of neck, Ward's triangle, trochanter(P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. 5. The bone density of neck, Ward's triangle, trochanter and lumbar spine(P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities(BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.

• 대한한방부인과학회지
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• 제19권1호
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• pp.188-201
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• 2006

Purpose : This study was conducted to investigate the effect of pregnancy and parity on bone marrow density using Dual Energy X-ray Absorptiometry (DXA) after parturition Methods : The observation cases who was over 20 and under 35 years old just after childbirth were admitted twice to woosuk university hospital from Aug 2000 to July 2005. During the first admission period, we measured the bone marrow density(BMD) using DXA in 13th day, and when the patient came to the hospital just after childbirth again, we followed up the BMD in 13th day. The evaluation index of this report was comparison of the T-score which was about the lumbar spine(L1-L4) BMD and femur neck BMD. Results : The continuous parturition was increased the lumbar spine BMD(P<<0.05), and decreased the femur neck BMD but it had no meaning. In the cases of the parturition interval under 24 months regarded as siblings born within a year of each other, the analysis results of BMD showed increase in lumbar spine BMD. In the cases of the parturition interval over 24 months, there was increased in lumbar BMD, and decreased in femur neck BMD. To the analysis of the weight variation, the increased BMI group has a significant increase in lumbar spine BMD, and the decreased BMI group also increase in lumbar spine BMD but there was no meaning about that. Conclusion : The continuous parturition was increased the lumbar spine BMD.

• Nutrition Research and Practice
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• 제15권1호
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• pp.95-105
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• 2021

BACKGROUND/OBJECTIVES: The measurement of body composition, including muscle and fat mass, remains challenging in large epidemiological studies due to time constraint and cost when using accurate modalities. Therefore, this study aimed to develop and validate prediction equations according to sex to measure lean body mass (LBM), appendicular skeletal muscle mass (ASM), and body fat mass (BFM) using anthropometric measurement, serum creatinine level, and lifestyle factors as independent variables and dual-energy X-ray absorptiometry as the reference method. SUBJECTS/METHODS: A sample of the Korean general adult population (men: 7,599; women: 10,009) from the Korean National Health and Nutrition Examination Survey 2008-2011 was included in this study. The participants were divided into the derivation and validation groups via a random number generator (with a ratio of 70:30). The prediction equations were developed using a series of multivariable linear regressions and validated using the Bland-Altman plot and intraclass correlation coefficient (ICC). RESULTS: The initial and practical equations that included age, height, weight, and waist circumference had a different predictive ability for LBM (men: R2 = 0.85, standard error of estimate [SEE] = 2.7 kg; women: R2 = 0.78, SEE = 2.2 kg), ASM (men: R2 = 0.81, SEE = 1.6 kg; women: R2 = 0.71, SEE = 1.2 kg), and BFM (men: R2 = 0.74, SEE = 2.7 kg; women: R2 = 0.83, SEE = 2.2 kg) according to sex. Compared with the first prediction equation, the addition of other factors, including serum creatinine level, physical activity, smoking status, and alcohol use, resulted in an R2 that is higher by 0.01 and SEE that is lower by 0.1. CONCLUSIONS: All equations had low bias, moderate agreement based on the Bland-Altman plot, and high ICC, and this result showed that these equations can be further applied to other epidemiologic studies.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.422-424
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• 2002

The accuracy of DXA(Dual Energy X-ray Absorptiometry) highly depends on the detection and separation capability of dual energy X-ray X-ray photons. In addition both of scan time and patient exposure are affected by detection efficiency. A CZT detector with a good energy resolution and high detection efficiency was evaluated for the application of bone densitometry. Its performance was compared to a photomultiplier tube with a NaI(T1) scintillator in terms of energy resolution, detection efficiency and the accuracy of bone mineral density measurement. The comparison study was performed with CZT detector and PM tube using DXA equipments(OSTEO Plus, OSTEO Prima, ISOL Technology). The energy spectrum was acquired using MCA(Multi-Channel Analyzer). The used X-ray energy ranged from 20keV to 86keV. The MCA result of the CZT detector showed a slightly sharper energy spectrum than that of NaI(T1). Detection efficiency of the CZT detector at 59.5keV was 1.4 times better. Remarkably the final results of bone mineral density measurements demonstrate only less than 1% difference. The CZT detector appears to have many benefits for the application of bone densitometry. Its excellent energy resolution can enhance the counting accuracy of dual energy X-ray spectrum. Furthermore its compactness in physical dimension and no cooling requirement will be additional benefits for a more compact and accurate bone densitometer.

• 대한방사선기술학회지:방사선기술과학
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• 제40권2호
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• pp.311-316
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• 2017

골다공증 검사의 표준검사법은 이중 에너지 X선 흡수율(DEXA) 차이를 이용한 방식이고, 임상에서는 유사한 방식의 이중 에너지 X선 전산화단층영상장치(DECT)가 사용되고 있다. 본 논문의 목적은 기존 방식의 DEXA와 DECT 장비를 활용하였을 때 골밀도 차이를 확인하고 DECT 활용의 유용성을 알아보고자 한다. 기존 방식의 DEXA (QDR 4500W, Hologic)와 DECT (750 HD, GE Healthcare system) 장비를 이용하여 동일한 부위의 허리척추 팬텀 대상으로 검사 시행과 측정을 하였고, 1개월 내 기존 DEXA와 DECT 검사를 동일하게 허리 척추 검사를 시행한 환자 50명을 대상으로 골밀도를 측정 분석하였다. 허리척추 팬텀 대상 골밀도 측정 결과 두 영상장비 간에 통계적으로 높은 상관성(r=0.93, p<0.05)을 나타냈고, 사람을 대상으로 하였을 때도 비교적 높은 상관성(r=0.635, p<0.05; ${\tau}=0.46$, p<0.05)을 나타냈다. DECT를 이용한 골다공증 검사는 일반적으로 시행한 CT 영상 정보를 추가로 분석하여 골밀도 값을 얻는 것으로 추가적인 방사선 노출 없이 유용한 골밀도 정보를 제공해줄 수 있다는 유용성이 있다.

• 대한지역사회영양학회지
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• 제23권5호
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• pp.424-430
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• 2018

Objectives: The purpose of this study was to compare predictions and measurements of the resting energy expenditure (REE) of overweight and obese adult women in Korea. Methods: The subjects included 65 overweight or obese adult women ranging in age from 20~60 with a recorded body mass index (BMI) of 23 or higher. Their height, weight, waist-hip ratio, and blood pressure were measured. The investigator also measured their body fat, body fat percentage, and body composition of total weight without fat using Dual energy X-ray absorptiometry (DXA) and measured resting energy expenditure by indirect calorimetry. Measured resting energy expenditures were compared with predictions from six methods: Harris-Benedict, Mifflin, Owen, WHO-WH, Henry-WH, and KDRI. Results: Harris-Benedict predictions showed the smallest differences from measured resting energy expenditure at an accurate prediction rate of 70%. The study analyzed regression between measured resting energy expenditure and body measurements including height, weight and age. The formula proposed by this research is as follows: Proposed REE equation for overweight and obese Korean women = $721-(1.5{\times}age)+(0.4{\times}height)+(9.9{\times}weight)$. Conclusions: These findings suggest that age is a significant variable when predicting resting energy expenditure in overweight and obese women. Therefore, prediction of resting energy expenditure should consider age when determining energy requirements in overweight and obese women.

• 한국멀티미디어학회논문지
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• 제12권9호
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• pp.1233-1241
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• 2009

골다공증은 45세 이상의 여성 50% 이상이 갖고 있는 질환이다. 더욱이 질병의 증상을 환자가 느끼지 못하여 병을 심화시키기 때문에 조기 진단으로 골다공증을 예방하는 것이 중요하다. 이를 위해 골밀도(Bone Mineral Density)의 효과적인 측정을 위한 다양한 연구가 국내외적으로 수행되고 있다. 골밀도 측정을 위해서는 X-선 영상이 활용되고 있으며, 이 중에서 이중 에너지 X 선 흡수법(DEXA)을 이용하여 골밀도를 측정하는 방법은 많은 관심을 받고 있는 분야이다. DEXA 영상은 서로 다른 두 에너지준위의 X선으로부터 영상을 획득함으로써 생체조직의 중첩에 의한 잡음을 효과적으로 줄여 진단효과를 높이는데 유용하다. 하지만, DEXA 영상에서 골영역을 추출하기 위해서는 실험적으로 계수를 결정해야 하는 문제점이 있다. 본 논문에서는 두 에너지 흡수 영상에서 골영역을 추출하기 위해 실험적으로 결정하는 변수를 X-선 영상의 물리적 의미와 각 에너지에 반응하는 생체조직들의 감쇠상수 특성을 기반으로 분석하여 골영역을 효과적으로 검출하는 방법을 제안한다. 더불어 다양한 영상을 적용한 실험으로 제안한 알고리즘의 효율성을 확인하였다.

• Imaging Science in Dentistry
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• 제52권1호
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• pp.53-60
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• 2022

Purpose: The aim of this study was to compare the fractal dimension (FD) measured at 2 bone sites (second cervical vertebra and mandible) on cone-beam computed tomography (CBCT). The research question was whether FD could serve as an accessory tool to refer postmenopausal women for densitometric analysis. Therefore, the reliability and accuracy of FD were evaluated. Materials and Methods: In total, 103 postmenopausal women were evaluated, of whom 52 had normal bone mineral density and 51 had osteoporosis, according to dual X-ray absorptiometry of the lumbar spine and hip. On the CBCT scans, 2 regions of interest were selected for FD analysis: 1 at the second cervical vertebra and 1 located at the mandible. The correlations between both measurements, intra- and inter-observer agreement, and the accuracy of the measurements were calculated. A P value less than 0.05 was considered to indicate statistical significance for all tests. Results: The mean FD values were significantly lower at the mandibular region of interest in osteoporotic patients than in individuals with normal bone mineral density. The areas under the curve were 0.644 (P=0.008) and 0.531 (P=0.720) for the mandibular and vertebral sites, respectively. Conclusion: FD at the vertebral site could not be used as an adjuvant tool to refer women for osteoporosis investigation. Although FD differed between women with normal BMD and osteoporosis at the mandibular site, it demonstrated low accuracy and reliability.