• Title/Summary/Keyword: Enhanced CT

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Signal Change of Iodinated Contrast Agents in MR Imaging (요오드화 조영제가 MR영상에 미치는 신호 변화)

  • Jeong, HK;Kim, Seongho;Kang, Chunghwan;Lee, Suho;Yi, Yun;Kim, Mingi;Kim, Hochul
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.131-138
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    • 2016
  • In this study, we tried to analyze the influence of ICM(Iodinated Contrast Media) in MR imaging compare to GBCA(Gadolinium Based Contrast Agent), and as this result we discussed whether resonable or not the protocol which is MRI scan after enhanced CT scan without proper time interval in clinical field. For this research, we assembled two phantoms. which one was iodine and another one was gadolinium. We did test two phantoms in conventional MRI scan which is T1, T2, T2 FLAIR and 3D angio. After that, quantitative analysis was progressed. The results of study were as follow : SSI(Saline's Signal Intensity) was shown as each sequences 175, 1231, 333, 37 [a.u] at iodine. and 1297, 123, 757, 232 [a.u] was recorded at gadolinium. BDEPS(the Biggest Difference of EPS) was shown as each sequences 1297, 123, 757, 232 [a.u] at iodine and 793, 6, 1495, 365 [a.u] was recorded at gadolinium. At this time, EPS(Enhancement Percentage to Saline) was shown 641.1, -90.0, 127.3, 527% at iodine and 685.1, 99.4, 365.7, 1077.4% was recorded at gadolinium. BP(BDEPS's point) was shown 900, 900, 477, 900 mmol at iodine and 4, 0.2, 0.2, 40 mmol was recorded at gadolinium. CPSS(Change Point of SI to SSI) was shown 63, 423, 63, 29 mmol at iodine and each [50, 30], [4, 0.2], [4, 1], 0.2 mmol was recorded at gadolinium. According to this research, we could not only discover the fact that was iodine could effect on MR signal, but also the pattern is different as various sequences compare to gadolinium. Therefore, we expect useful diagnostic MR image in clinical field with this quantitative data for deciding protocol regarding MRI and CT scan order.

Multi-classification of Osteoporosis Grading Stages Using Abdominal Computed Tomography with Clinical Variables : Application of Deep Learning with a Convolutional Neural Network (멀티 모달리티 데이터 활용을 통한 골다공증 단계 다중 분류 시스템 개발: 합성곱 신경망 기반의 딥러닝 적용)

  • Tae Jun Ha;Hee Sang Kim;Seong Uk Kang;DooHee Lee;Woo Jin Kim;Ki Won Moon;Hyun-Soo Choi;Jeong Hyun Kim;Yoon Kim;So Hyeon Bak;Sang Won Park
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.187-201
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    • 2024
  • Osteoporosis is a major health issue globally, often remaining undetected until a fracture occurs. To facilitate early detection, deep learning (DL) models were developed to classify osteoporosis using abdominal computed tomography (CT) scans. This study was conducted using retrospectively collected data from 3,012 contrast-enhanced abdominal CT scans. The DL models developed in this study were constructed for using image data, demographic/clinical information, and multi-modality data, respectively. Patients were categorized into the normal, osteopenia, and osteoporosis groups based on their T-scores, obtained from dual-energy X-ray absorptiometry, into normal, osteopenia, and osteoporosis groups. The models showed high accuracy and effectiveness, with the combined data model performing the best, achieving an area under the receiver operating characteristic curve of 0.94 and an accuracy of 0.80. The image-based model also performed well, while the demographic data model had lower accuracy and effectiveness. In addition, the DL model was interpreted by gradient-weighted class activation mapping (Grad-CAM) to highlight clinically relevant features in the images, revealing the femoral neck as a common site for fractures. The study shows that DL can accurately identify osteoporosis stages from clinical data, indicating the potential of abdominal CT scans in early osteoporosis detection and reducing fracture risks with prompt treatment.

Patient Position Verification and Corrective Evaluation Using Cone Beam Computed Tomography (CBCT) in Intensity.modulated Radiation Therapy (세기조절방사선치료 시 콘빔CT (CBCT)를 이용한 환자자세 검증 및 보정평가)

  • Do, Gyeong-Min;Jeong, Deok-Yang;Kim, Young-Bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.21 no.2
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    • pp.83-88
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    • 2009
  • Purpose: Cone beam computed tomography (CBCT) using an on board imager (OBI) can check the movement and setup error in patient position and target volume by comparing with the image of computer simulation treatment in real.time during patient treatment. Thus, this study purposed to check the change and movement of patient position and target volume using CBCT in IMRT and calculate difference from the treatment plan, and then to correct the position using an automated match system and to test the accuracy of position correction using an electronic portal imaging device (EPID) and examine the usefulness of CBCT in IMRT and the accuracy of the automatic match system. Materials and Methods: The subjects of this study were 3 head and neck patients and 1 pelvis patient sampled from IMRT patients treated in our hospital. In order to investigate the movement of treatment position and resultant displacement of irradiated volume, we took CBCT using OBI mounted on the linear accelerator. Before each IMRT treatment, we took CBCT and checked difference from the treatment plan by coordinate by comparing it with the image of CT simulation. Then, we made correction through the automatic match system of 3D/3D match to match the treatment plan, and verified and evaluated using electronic portal imaging device. Results: When CBCT was compared with the image of CT simulation before treatment, the average difference by coordinate in the head and neck was 0.99 mm vertically, 1.14 mm longitudinally, 4.91 mm laterally, and 1.07o in the rotational direction, showing somewhat insignificant differences by part. In testing after correction, when the image from the electronic portal imaging device was compared with DRR image, it was found that correction had been made accurately with error less than 0.5 mm. Conclusion: By comparing a CBCT image before treatment with a 3D image reconstructed into a volume instead of a 2D image for the patient's setup error and change in the position of the organs and the target, we could measure and correct the change of position and target volume and treat more accurately, and could calculate and compare the errors. The results of this study show that CBCT was useful to deliver accurate treatment according to the treatment plan and to increase the reproducibility of repeated treatment, and satisfactory results were obtained. Accuracy enhanced through CBCT is highly required in IMRT, in which the shape of the target volume is complex and the change of dose distribution is radical. In addition, further research is required on the criteria for match focus by treatment site and treatment purpose.

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Technical Review of Target Volume Delineation on the Posterior Fossa Tumor : An Optimal Head and Neck Position (후두와 종양의 방사선치료 시 표적용적의 결정을 위한 적절한 치료자세 연구)

  • Yoon Sang Min;Lee Sang-wook;Ahn Seung Do;Kim Jong Hoon;YE Byong Yong;Ra Young Shin;Kim Tae Hyung;Choi Eun Kyung
    • Radiation Oncology Journal
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    • v.21 no.1
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    • pp.94-99
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    • 2003
  • Purpose : To explore a 3D conformal radiotherapy technique for a posterior fossa boost, and the potential advantages of a prone position for such radiotherapy. Materials and Methods :A CT simulator and 3D conformal radiotherapy Planning system was used for the posterior fossa boost treatment on a 13-year-old medulloblastoma patient. He was placed In the prone position and Immobilized with an aquaplast mask and immobilization mold. CT scans were obtained of the brain from the top of the skull to the lower neck, with IV contrast enhancement. The target volume and normal structures were delineated on each slice, with treatment planning peformed using non-coplanar conformal beams. Results : The CT scans, and treatment In the prone position, were peformed successfully. In the prone position, the definition of the target volume was made easier due to the well enhanced tentorium, In audition, the posterior fossa was located anteriorly, and with the greater choice of beam arrangements, more accurate treatment planning was possible as the primary beams were not obstructed by the treatment table. Conclusion : .A posterior fossa boost, in the prone position, Is feasible in cooperating patients, but further evaluation is needed to define the optimal and most comfortable treatment positions.

Effect of CT Contrast Media on Radiation Therapy Planning (Head & Neck Cancer and Prostate Cancer) (CT조영제가 방사선치료계획(두경부, 전립선)에 미치는 영향)

  • Jang, Jaeuk;Han, Manseok;Kim, Minjeong;Kang, Hyeonsoo
    • Journal of the Korean Magnetics Society
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    • v.26 no.5
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    • pp.173-178
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    • 2016
  • This study is to evaluate the effect of a Contrast Media (CM) on dose calculations and clinical significance in Radiation (Electromagnetic wave) Therapy (RT) plans for head & neck (H&N) and prostate cancer. Pinnacle 8.0 system was used to measure the change of Electron Density (ED) of the tissue for CM. To determine the effect of dose calculation due to CM, we did the RT planning for 30 patients. To compare the ED and dose calculations of RT plans, 3D CRT and IMRT plans were do with pinnacle and Tomotherapy planning system. Mean difference of ED between enhanced and unenhanced CT was less than 4%: H&N Target Volume (TV) 2.1%, parotid 1.9%, SMG 3.6%, tongue 0.9%, spinal cord 0.3%, esophagus 2.6%, mandible 0.1% and prostate TV 0.7%, lymph node 1.1%, bladder 1.2%, rectum 1.5%, small bowel 1.2%, colon 0.6%, penile bulb 0.8%, femoral head -0.2%. The dose difference between RT plan using CM and without CM showed an increase of dose in TV. The rate of increase was less than 2.5% (3D CRT: H&N 0.69~2.51%, prostate 0.04~1.14%, IMRT: H&N 0.58~1.31%, prostate 0.36~1.04%). RT plans using a CM has the insignificant effect on the organs and TV, so this error is allowable clinically. However, the much more accurate plan is possible as to image fusion (CM and without CM images) to ROI contour and when dose calculation, use the without CM image. Using the fusion of 'ROI import' perform calculations on without CM, it will be able to reduce the error (1~3%) caused by the CM.

VR, AR Simulation and 3D Printing for Shoulder and Elbow Practice (VR, AR 시뮬레이션 및 3D Printing을 활용한 어깨와 팔꿈치 수술실습)

  • Lim, Wonbong;Moon, Young Lae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.53 no.12
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    • pp.175-179
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    • 2016
  • Recent advances in technology of medical image have made surgical simulation that is helpful to diagnosis, operation plan, or education. Improving and enhancing the medical imaging have led to the availability of high definition images and three-dimensional (3D) visualization, it allows a better understanding in the surgical and educational field. The Real human field of view is stereoscopic. Therefore, with just 2D images, stereoscopic reconstruction process through the surgeon's head, is necessary. To reduce these process, 3D images have been used. 3D images enhanced 3D visualization, it provides significantly shorter time for surgeon for judgment in complex situations. Based on 3D image data set, virtual medical simulations, such as virtual endoscopy, surgical planning, and real-time interaction, have become possible. This article describes principles and recent applications of newer imaging techniques and special attention is directed towards medical 3D reconstruction techniques. Recent advances in technology of CT, MR and other imaging modalities has resulted in exciting new solutions and possibilities of shoulder imaging. Especially, three-dimensional (3D) images derived from medical devices provides advanced information. This presentation describes the principles and potential applications of 3D imaging techniques, simulation and printing in shoulder and elbow practice.

Head and neck extra nodal NHL (HNENL) - Treatment Outcome and Pattern of failure - A Single Institution Experience

  • Giridhar, Prashanth;Mallick, Supriya;Bhasker, Suman;Pathy, Sushmita;Mohanti, Bidhu Kalyan;Biswas, Ahitagni;Sharma, Atul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6267-6272
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    • 2015
  • Background: Extra nodal lymphoma (ENL) constitutes about 33 % of all non-Hodgkin's lymphoma. 18-28% develops in the head and neck region. A multimodality treatment with multi-agent chemotherapy (CT) and radiotherapy (RT) is considered optimum. Materials and Methods: We retrieved the treatment charts of patients of HNENL treated in our institute from 2001-2012. The charts were reviewed and the demographic, treatment details and outcome of HNENL patients were retrieved using predesigned pro-forma. Results: We retrieved data of 75consecutive patients HNENL. Median age was 47years (Range: 8-76 years). Of the 75 patients 51 were male and 24 were female. 55patients were evaluable. The patient and tumor characteristics are summarized in Table 1. All patients were staged comprehensively with contrast enhanced computed tomography of head, neck, thorax, abdomen, pelvis and bone marrow aspiration and biopsy 66 patients received a combination multi-agent CT with CHOP being the commonest regimen. 42 patients received 4 or lesser number of cycles of chemotherapy whereas 24received more than 4 cycles chemotherapy. Post radiotherapy, 41 out of 42 patients had a complete response at 3 months. Only 21patients had a complete response after chemotherapy. All patients received radiation (mostly involved field radiation) as a part of the treatment. The median radiation dose was 45 Gray (Range: 36 Gray-50 Gray). The radiation was planned by 2D fluoro simulation based technique in 37cases and by 3 Dimensional conformal radiation therapy (3DCRT) in 36 cases. Two patients were planned by the intensity modulated radiation therapy (IMRT) technique. IMRT was planned for one thyroid and one nasal cavity primary. 5 patients experienced relapse after a median follow up of 19 months. The median survival was not reached. The estimated two and three year survival were 92.9% (95%CI- 68.6- 95.35) and 88% (95%CI- 60.82 - 92.66) respectively. Univariate analysis revealed higher stage and poorer baseline performance status to be significantly associated with worse progression free survival. 5 patients progressed (relapse or primary disease progression) after treatment. Of the 5 patients, two patients were primary orbital NHL, two patients had NHL nasal cavity and one was NHL thyroid. Conclusions: Combined modality treatment in HNENL confers excellent disease control with acceptable side effects.

Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

Preparation of Dual-functionalized Polymeric Membrane Electrolyte and Ni, Co-based Nanowire/MOF Array on Carbon Cloth for High-performance Supercapacitor (이중 기능 고분자 전해질 막의 제조 및 탄소 섬유에 니켈, 코발트 기반의 나노와이어/MOF 배열을 통한 고성능 슈퍼커패시터 연구)

  • Hye Jeong Son;Bong Seok Kim;Ji Min Kwon;Yu Bin Kang;Chang Soo Lee
    • Membrane Journal
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    • v.33 no.4
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    • pp.211-221
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    • 2023
  • This study presents a comprehensive study on the synthesis and characterization of PVI-PGMA/LiTFSI polymeric membrane electrolytes and CxNy-C flexible electrodes for energy storage applications. The dual-functional PVI-PGMA copolymer exhibited excellent ionic conductivity, with the PVI-PGMA73/LiTFSI200 membrane electrolyte achieving the highest conductivity of 1.0 × 10-3 S cm-1. The electrochemical performance of the CxNy-C electrodes was systematically investigated, with C3N2-C demonstrating superior performance, achieving the highest specific capacitance of 958 F g-1 and lowest charge transfer resistance (Rct) due to its highly interconnected hybrid structure comprising nanowires and polyhedrons, along with binary Co/Ni oxides, which provided abundant redox-active sites and facilitated ion diffusion. The presence of a graphitic carbon shell further contributed to the enhanced electrochemical stability during charge-discharge cycles. These results highlight the potential of PVI-PGMA/LiTFSI polymeric membrane electrolytes and CxNy-C electrodes for advanced energy storage devices, such as supercapacitors and lithium-ion batteries, paving the way for further advancements in sustainable and high-performance energy storage technologies.

Subjective and Objective Assessment of Monoenergetic and Polyenergetic Images Acquired by Dual-Energy CT in Breast Cancer

  • Xiaoxia Wang;Daihong Liu;Shixi Jiang;Xiangfei Zeng;Lan Li;Tao Yu;Jiuquan Zhang
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.502-512
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    • 2021
  • Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40-80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Zeff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40-50 keV showed increased CNR and SNRbreast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNRbreast lesion: 40 keV, 21.01; 50 keV, 16.28; vs. PEI, 10.77; p < 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Zeff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion: Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.