• 대한방사선치료학회지
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• 제26권2호
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• pp.183-189
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• 2014

목 적 : 조영제는 CT모의치료시 정상조직과 악성종양을 구분하는데 뛰어난 대조도를 제공하기 때문에 CT모의치료에 널리 사용하고 있다. 하지만 조영제는 치료계획 CT에서 일시적으로 존재하기 때문에, 치료계획과 실제 치료 사이에는 Hounsfield Unit(HU)의 차이가 발생하게 된다. 이에 본 연구에서는 조영제 사용으로 인한 HU의 변화가 양성자 치료계획에 미치는 영향을 확인 하고자한다. 대상 및 방법 : 20명의 간암 환자에게서 Phase에 따른 HU값의 변화를 측정하였다, 그리고 5명의 양성자치료계획에서 HU변화에 따른 Range와 Spread-Out Bragg peak(SOBP)의 변화를 살펴보았다. Hand made water phantom을 이용하여 깊이와 HU의 변화에 따른 Range와 SOBP의 변화를 확인하였다. 결 과 : 20명 간암 환자의 HU 변화(Pre contrast, Arterial phase, Porta phase)는 간 조직에서 ($58{\pm}5.7$, $75{\pm}9.5$, $117{\pm}14.6$)이었으며 대동맥에서($40{\pm}6.1$, $279{\pm}49.0$, $154{\pm}22.8$)이었다. 5명의 간암 양성자치료계획에서 HU 변화에 따른 Range 변화는 평균 2.5 mm, SOBP 변화는 평균 1.4 mm 이었다. Hand made water phantom study에서는 HU가 증가함에 따라 Range는 감소되었고 SOBP는 줄어들었다. 결 론 : 양성자 치료계획에서 HU값의 변화는 양성자 Range와 SOBP를 변화시켰다. 실제 양성자 빔에서 HU 변화에 따른 Range와 SOBP의 변화에 대한 추가적인 연구가 필요할 것으로 사료 된다.

• 한국콘텐츠학회논문지
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• 제12권10호
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• pp.349-356
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• 2012

관상동맥 죽상경화반(atheromatous plaque)의 진단에 있어 혈관내초음파(Intravascular Ultrasound: IVUS)와 비교하여 심장전산화단층촬영(Cardiac Computed Tomographic Angiography: CCTA)의 진단 정확도를 알아보고, IVUS에서 발견된 죽상경화반의 성상을 CCTA에서 전산화단층촬영 수치(Hounsfield Unit: HU)로 구하고자 하였다. 2006년 4월부터 2008년 8월까지 관상동맥질환(Coronary Artery Disease: CAD)으로 확진 되었거나 CAD가 의심스러운 환자들 중 CCTA를 시행하여 죽상경화반을 발견하고 추후 IVUS를 시행한 200명의 환자를 대상으로 하였다. CCTA후 IVUS를 시행한 200명의 환자에서 476개의 죽상경화반이 발견되었으며, CCTA에서는 460개의 죽상경화반이 발견되었다. IVUS의 결과는 soft plaque(n; 84), fibrous plaque(n; 63), mixed plaque(n; 97), calcific plaque(n; 232)이었다. 이 결과에 따라 IVUS에서 분류된 죽상경화반의 HU는 soft plaque : $53.8{\pm}10.5$, fibrous plaque : $108.1{\pm}20.0$, mixed plaque : $371.2{\pm}113.1$, 그리고 calcific plaque : $731.0{\pm}160.4$ 이었으며, CCTA에서 민감도와 신뢰구간은 97%, 95.0-98.3이었다. CCTA를 이용한 관상동맥 죽상경화반의 진단을 위한 이번 연구에서 IVUS와 비교하여 높은 민감도와 신뢰구간을 확인할 수 있었고, IVUS 결과를 기준으로 CCTA에서 분석한 HU를 통해 죽상경화반의 성상을 구분할 수 있어 CAD 환자의 치료에 도움을 줄 수 있을 것으로 기대된다.

• 한국방사선학회논문지
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• 제13권2호
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• pp.185-192
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• 2019

DXA 검사는 작은 골량의 변화로 발생하는 생물학적 변화를 가장 잘 반영할 수 있어 임상에서 우수한 성능을 발휘하는 골밀도 검사 장치이다. 검사의 정확도와 정밀도의 유지를 위하여 정도관리가 필수적으로 수행되어야 하지만 팬텀의 제작이 어렵고 상대적으로 고가의 가격이기 때문에 병원마다 보유하지 않고 있는 경우가 많다. 따라서 본 연구에서는 3D 프린터 및 시중에서 손쉽게 구할 수 있는 필라멘트의 내부채움 정도의 변화를 이용하여 교차보정 팬텀을 개발하고 상용화된 팬텀과의 비교 평가를 통해 유용성을 평가하였다. 팬텀의 개발을 위해 ABS, TPU, PLA, 30% Cu-PLA, 30% Al-PLA의 HU을 평가하였으며 각각 내부 채움 100%에서 $-149.74{\pm}2.36$, $-55.62{\pm}7.14$, $-7.68{\pm}3.82$, $87.53{\pm}1.07$, $1795.20{\pm}16.15$의 HU를 나타내었다. 선형회귀분석이 적용된 3D 프린팅 팬텀의 L1, L2, L3 골밀도는 $0.620{\pm}0.010g/cm^2$, $1.092{\pm}0.025g/cm^2$, $1.554{\pm}0.026g/cm^2$으로, 기존 팬텀과 통계적으로 높은 관련성을 보였다. 이를 활용한다면, DXA 장치의 적절한 정도관리가 가능할 것이며, FDM 3D 프린팅을 이용한 다양한 의료용 팬텀 제작에 기초 자료로 활용될 것으로 사료된다.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.442-449
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• 2019

Objective : Bone mineral density (BMD) is an important consideration during fusion surgery. Although dual X-ray absorptiometry is considered as the gold standard for assessing BMD, quantitative computed tomography (QCT) provides more accurate data in spine osteoporosis. However, QCT has the disadvantage of additional radiation hazard and cost. The present study was to demonstrate the utility of artificial intelligence and machine learning algorithm for assessing osteoporosis using Hounsfield units (HU) of preoperative lumbar CT coupling with data of QCT. Methods : We reviewed 70 patients undergoing both QCT and conventional lumbar CT for spine surgery. The T-scores of 198 lumbar vertebra was assessed in QCT and the HU of vertebral body at the same level were measured in conventional CT by the picture archiving and communication system (PACS) system. A multiple regression algorithm was applied to predict the T-score using three independent variables (age, sex, and HU of vertebral body on conventional CT) coupling with T-score of QCT. Next, a logistic regression algorithm was applied to predict osteoporotic or non-osteoporotic vertebra. The Tensor flow and Python were used as the machine learning tools. The Tensor flow user interface developed in our institute was used for easy code generation. Results : The predictive model with multiple regression algorithm estimated similar T-scores with data of QCT. HU demonstrates the similar results as QCT without the discordance in only one non-osteoporotic vertebra that indicated osteoporosis. From the training set, the predictive model classified the lumbar vertebra into two groups (osteoporotic vs. non-osteoporotic spine) with 88.0% accuracy. In a test set of 40 vertebrae, classification accuracy was 92.5% when the learning rate was 0.0001 (precision, 0.939; recall, 0.969; F1 score, 0.954; area under the curve, 0.900). Conclusion : This study is a simple machine learning model applicable in the spine research field. The machine learning model can predict the T-score and osteoporotic vertebrae solely by measuring the HU of conventional CT, and this would help spine surgeons not to under-estimate the osteoporotic spine preoperatively. If applied to a bigger data set, we believe the predictive accuracy of our model will further increase. We propose that machine learning is an important modality of the medical research field.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.44-52
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• 2023

Objective : This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering. Methods : We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes. Data was then statistically analyzed for assessment of efficacy and risk prediction using stratified HU at UIV level alongside the effect of the TP hook system. Results : The screw pullout rate was 36.4% (27/74). Perioperative radiographic parameters were not significantly different between the pullout and non-pullout groups. The vertebral body HU and pedicle HU were significantly lower in the pullout group. K-means clustering stratified the vertebral body HU ≥205.3, <137.2, and pedicle HU ≥243.43, <156.03. The pullout rate significantly decreases in patients receiving the hook system when the pedicle HU was from ≥156.03 to < 243.43 (p<0.05), but the difference was not statistically significant in the vertebra HU stratified groups and when pedicle HU was ≥243.43 or <156.03. The postoperative clinical outcomes improved significantly with the implementation of the hook system. Conclusion : The UIV hook provides better clinical outcomes and can be considered a preventative strategy for screw-pullout in the certain pedicle HU range.

• Journal of Korean Dental Science
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• 제6권2호
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• pp.50-57
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• 2013

Purpose: Autogenous tooth bone graft is proven to be efficient. We evaluated the bone healing effect and clinical capabilities of autogenous tooth bone materials as a scaffold when growth factor is used together with this material. Materials and Methods: Subjects were those who needed implant placement and bone graft because of missing tooth or alveolar bone defect and who kept their autogenous tooth or needed extraction of other tooth. Group I included autogenous tooth bone graft with growth factor, whereas Group II had only autogenous tooth bone graft. We investigated the bone healing state through computed tomography taken just before surgery and 3 to 4 months after surgery to evaluate the effectiveness of bone graft. Group I had 9 patients, whereas Group II had 5 patients. We compared the pre- and post-operative increase of the Hounsfield unit and bone height by analyzing the computed tomography images. Result: Sinus bone grafts numbered 8 cases, and vertical ridge augmentation was performed together with 3 cases of these. Vertical ridge augmentation was performed in 2 cases, and horizontal ridge augmentation in 1 case alone. Socket graft was done in 3 cases. The post-operative mean value of the Hounsfield unit was 960 in Group I and 836.7 in Group II, but the increase was almost similar, i.e., 636.9 in Group I and 634.7 in Group II on the average. Increase of bone height was 7.6 mm in Group I and 11.1 mm in Group II on the average. This difference was attributable to the fact that most of the cases were sinus bone graft in Group II. Conclusion: In this study, we suggest the possibility of autogenous tooth bone graft materials as a scaffold besides their bone healing ability.

• 한국의학물리학회지:의학물리
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• 제28권3호
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• pp.106-110
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• 2017

The variable density phantom fabricated with varying the infill values of 3D printer to provide more accurate dose verification of radiation treatments. A total of 20 samples of rectangular shape were fabricated by using the $Finebot^{TM}$ (AnyWorks; Korea) Z420 model ($width{\times}length{\times}height=50mm{\times}50mm{\times}10mm$) varying the infill value from 5% to 100%. The samples were scanned with 1-mm thickness using a Philips Big Bore Brilliance CT Scanner (Philips Medical, Eindhoven, Netherlands). The average Hounsfield Unit (HU) measured by the region of interest (ROI) on the transversal CT images. The average HU and the infill values of the 3D printer measured through the 2D area profile measurement method exhibited a strong linear relationship (adjusted R-square=0.99563) in which the average HU changed from -926.8 to 36.7, while the infill values varied from 5% to 100%. This study showed the feasibility fabricating variable density phantoms using the 3D printer with FDM (Fused Deposition Modeling)-type and PLA (Poly Lactic Acid) materials.

• 한국임상수의학회지
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• 제27권6호
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• pp.686-692
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• 2010

컴퓨터 단층촬영술(computed tomography; CT)은 인의에서 췌장염의 진단 기준으로 이용되고 있으며, Balthazar CT severity index (CTSI)는 CT 영상을 바탕으로 췌장 괴사 부위를 측정하여 췌장염의 심각도를 평가하는 지수이다. 본 연구에서는, 25마리의 비글견을 정상 그룹과 대조군, 자가 담즙 주입을 통해 급성 괴사성 췌장염을 유발한 실험군으로 나누어 Balthazar CTSI 측정 결과와 조직 검사 결과를 비교하였다. 정상 개의 췌장의 Hounsfield unit (HU)은 $52.44{\pm}4.58$ 이었고, 급성 괴사성 췌장염에서는 유의적으로 감소하였다(P < .05). 조영 증강 CT 영상에서 확인한 췌장 실질의 괴사 부위를 찾아 Balthazar CTSI를 계산한 결과 조직 검사 결과와 밀접한 상관 관계를 보였으며, 민감도 100%, 특이도 88.89%로 확인되었다. Balthazar CTSI는 급성 췌장염이 발생한 개에서 심각도 평가에 유용한 방법으로 판단된다.

• 한국융합학회논문지
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• 제9권9호
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• pp.117-122
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• 2018

본 연구는 PET-CT 검사를 시행할 때 치과보철물에 의해 발생되는 CT의 HU(Hounsfield Unit) 값을 금속의 종류에 따라 측정하고, PET 영상의 왜곡정도와 표준섭취계수(SUV)의 변화를 확인하여 영상 판독 시 오류의 감소방안을 제시하고자 하였다. 실험방법은 실제 치아와 메탈 크라운, 골드크라운, 티타늄, 지르코니아의 치과보철물을 이용하여 PET-CT 검사를 실시하였다. 일반 치아와 비교한 결과 HU 값이 증가함에 따라 SUV 값이 증가되는 것을 확인하였고, 메탈 크라운, 티타늄, 지르코니아의 SUV 값은 37% 정도 증가되었고, 골드 크라운에서는 45.4%로 가장 많이 증가했다. 그리고 일반치아, 메탈크라운, 티타늄, 지르코니아에서 영상 왜곡은 미미했지만, 골드 크라운에서는 선속경화현상이 심하게 발생하였고, 영상 왜곡이 나타났다. 따라서 치과보철물의 금속종류는 SUV 값에 영향을 미치기 때문에 치과 보철물 중에서 골드 재질을 사용한 환자를 진단할 때에는 영상 판독 시 보정된 PET 영상보다는 NAC(무보정) PET 영상을 확인한다면 판독에 도움을 줄 수 있을 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제39권2호
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• pp.185-192
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• 2009

Purpose: The aim of this study was to examine the correlation of the subjective and the objective evaluation of edentulous ridge bone quality, and to evaluate the change of the dental implant stability in each bone density group for early healing period after implant installation. Methods: Sixty-seven implants(Osstem implant$^{(R)}$, Seoul, Korea) were included in this study. We evaluated the bone density by 2 methods. The one was the subjective method which was determined by practitioner s tactile sense, the other was the objective bone type was based on Hounsfield units. The implant stability in each bone type group was assessed by resonance frequency analyzer(Osstell mentor$^{(R)}$). Data were analyzed for the change of the implant stability, and they were compared to verify the difference of groups at the time of installation, 2, 6, 10, 14 weeks postoperatively. Spearman's correlation was used to demonstrate the correlation between the subjective and the objective evaluation of the bone density, and analysis of variance(ANOVA) was used to analyze the differences of implant stability at each time point. Results: There was no close relation between the subjective and the objective evaluation of the bone density(r=0.57). In the subjective groups, there was statistically significant difference between the type 1 and 3 at 10 weeks and between the type 2 and 3 at 14 weeks. In the objective groups, there was no statistically significant difference between the D 1, 2, 3, 4, and 5 group with regard to RFA from baseline to 14 weeks(P>0.1). Conclusions: The implant stability increased over time during the study, and it was improved with bone density proportionally after 2weeks postoperatively. It is recommended that the decision of bone density is base on Hounsfield unit for implant loading time.