• Journal of Dental Rehabilitation and Applied Science
• /
• v.29 no.1
• /
• pp.11-21
• /
• 2013

The purpose of this study was to get a proper time when implant was loaded and superstructure was fabricated by tracing a change of the implant stability in bone type for 1 year. We carried out RFA(resonance frequency analysis) of 67 implants in 36 patients at the time of surgery, 2, 6, 10, 14weeks, and 1year postoperatively for each implant, and analyzed data for different bone density. The ISQ value at the time of 10 & 14weeks postoperatively were significant(P<0.01) in subjective grouping, while that were not significant in objective grouping(P>0.05). The change pattern of ISQ value could be expressed $y=y_0+a{\times}\{1-\exp(-b{\times}x)\}$ for 1 year in this study, ISQ value at surgery might be used to estimate the time of superstructure fabrication consequentially.

• Progress in Medical Physics
• /
• v.16 no.4
• /
• pp.192-201
• /
• 2005

Experiments and simulation were done to study the impact of contrast agent when CT scan was used to attenuation correction for PET Images in PET/CT system. Whole body phantom was imaged with various concentration of iodine-based contrast agent using CT. Mathematical emission and transmission density map with liver were made to simulate for whole body FDG Imaging. A variety of factors were estimated, including non-uniform enhancement of contrast agent, concentration and distribution size of contrast agent, noise level, image resolution, reconstruction algorithm, hypo-attenuation of contrast agent, and different time phases for contrast agent. Experimental studies showed that Hounsfield unit depends on the concentration of contrast agent and tube voltage. From the simulation data, contrast agents Introduced artifacts and degraded image quality on the attenuation-corrected PET images. The severity of these effects depends on a variety of factors, including the concentration and distribution size of contrast agent, the noise levels, and the Image resolution. These results Indicated that the impact of contrast agents should be considered with a full understanding of their potential problems in clinical PET/CT images.

• Archives of Plastic Surgery
• /
• v.35 no.4
• /
• pp.423-430
• /
• 2008

Purpose: Computed tomography theoretically should improve detection of foreign bodies and provide more information of adjacent soft tissues. And the CT scanner and PACS program proved to be an excellent instrument for detection and localization of most facial foreign bodies above certain minimum levels of detectability. The severity of injury in penetrating trauma to the face, it is often underestimated by physical examination. Diagnosis of a retained foreign object is always critical. Methods: From March, 2005 to February 2008 a study was done with 200 patients who had facial trauma. Axial and coronal CT images were obtained with a General Electric(Milwaukee, Wis) 9800 CT scanner at 130 kV, 90 mA, with a 2-mm section thickness and a $512{\times}512$ matrix. Results: Axial and coronal CT images at various window widths should be used as the first imaging modality to detect facial foreign bodies. The attenuation coefficients for the metallic and nonmetallic foreign bodies ranged from -437 to +3071 HU. As a general rule, metallic foreign bodies produced more Hounsfield artifacts than nonmetallic foreign bodies, thus providing a clue to their composition. All of the metallic foreign bodies were represented by a single peak and had a maximum attenuation coefficient of +3071 HU. Of the nonmetallic foreign bodies, glass had an attenuation coefficient that ranged from +105 to +2039, while plastic had a much lower coefficient that ranged from -62 to -35. wood had the lowest range of attenuation coefficients: -491 to -437. Conclusion: The PACS program allows one to distinguish metallic from nonmetallic foreign bodies and to individually identify the specific composition of many nonmetallic foreign bodies. This program does not, however, allow identification of the specific composition of a metallic foreign body. We recommend this type of software program for CT scanning of any patient with an injury to the face in which a foreign body is suspected.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.380-384
• /
• 2010

Purpose: Distinguishing different types of implants and assessing the position and size of implants by radiologic exam after orbital wall reconstruction is important in determining the surgery outcome and forecasting prognosis. We observed time-dependent density changes in three types of implants (porous polyethylene, resorbing plate and titanium mesh plate) by performing facial bone CT after orbital wall reconstructions. Methods: A total of 32 patients, who had underwent orbital wall fracture surgery from October 2006 to March 2009 and received facial bone CT as outpatients at 1 postoperative year were included in the study. Follow-up facial bone CT was performed on the patients pre- operatively, 1 month post-operatively, and 1 year post-operatively to observe the status of the orbital implants. Medpor $^{(R)}$ (Porex Surgical, Inc., Newnan, Ga.) was used as porous polyethylene and followed-up in 14 cases; for resorbing plate, Synthes mesh plate (Synthes, Oberdorf, Switzerland) was used in the reconstruction, and followed-up in 11 cases; and titanium mesh plate usage was followed-up in 7 cases. Computed tomographic scan (CT) and water's view were done for radiography, and hounsfield unit (HU) was used to compare density of those facial bone CT. Wilcoxon signed rank test was applied to statistically verify measurement difference in each group of hounsfield units. Results: Facial bone CT examination performed in 1 month post-operative showed that the density of porous polyethylene, resorbing plate and titanium mesh plate were -42.07, 105.67 and 539.48 on average, respectively. Among the three types of implants, titanium mesh plate showed the highest density due to its radiopaque feature. Following up the density of three types of implants in CT during 1 year after the orbital wall fracture surgery, the density of porous polyethylene increased in 10.52 House Field Units and the resorbing plate was decreased in 26.87 HouseField Units. There were no significant differences between densities in 1 month post-operatively and 1 year post-operatively in each group ($p{\geq}0.05$). Conclusion: We performed facial bone CT on patients with orbital fractures during follow-up period, distinguishing the types of implants by the different concentration of implant density, and the densities showed little change even at 1 year post-operative. To observe how implant densities change in facial bone CT, further studies with longer follow-up periods should be carried out.

• Progress in Medical Physics
• /
• v.23 no.4
• /
• pp.269-278
• /
• 2012

Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.

• Journal of Korean Neurosurgical Society
• /
• v.56 no.2
• /
• pp.86-90
• /
• 2014

Objective : The spot sign is related with the risk of hematoma expansion in spontaneous intracerebral hemorrhage (ICH). However, not all spot sign positive patients undergo hematoma expansion. Thus, the present study investigates the specific factors enhancing the spot sign positivity in predicting hematoma expansion. Methods : We retrospectively studied 316 consecutive patients who presented between March 2009 to March 2011 with primary ICH and whose initial computed tomography brain angiography (CTA) was performed at our Emergency Department. Of these patients, 47 primary ICH patients presented spot signs in their CTA. We classified these 47 patients into two groups based on the presence of hematoma expansion then analyzed them with the following factors : gender, age, initial systolic blood pressure, history of anti-platelet therapy, volume and location of hematoma, time interval from symptom onset to initial CTA, spot sign number, axial dimension, and Hounsfield Unit (HU) of spot signs. Results : Of the 47 spot sign positive patients, hematoma expansion occurred in 26 patients (55.3%) while the remaining 21 (44.7%) showed no expansion. The time intervals from symptom onset to initial CTA were $2.42{\pm}1.24$ hours and $3.69{\pm}2.57$ hours for expansion and no expansion, respectively (p=0.031). The HU of spot signs were $192.12{\pm}45.97$ and $151.10{\pm}25.14$ for expansion and no expansion, respectively (p=0.001). Conclusions : The conditions of shorter time from symptom onset to initial CTA and higher HU of spot signs are the emphasizing factors for predicting hematoma expansion in spot sign positive patients.

• The Journal of Korean Society for Radiation Therapy
• /
• v.14 no.1
• /
• pp.15-22
• /
• 2002

1. 목적 : 방사선종양학과에서 3차원 치료계획용 전산화단층촬영 시 조영제 주입율에 따른 CT 값(hounsfield unit, H.U) 변화를 정량적으로 평가하여 최적의 영상증강효과 및 방사선치료계획을 위한 기초 프로토콜을 제시하고자 한다. 2. 대상 및 방법: 연세암센터 방사선종양학과에서 3차원 치료계획용 전산화단층촬영을 시행한 상복부(폐암)환자 20명을 대상으로 하였다. 조영제 양(130mL)은 일정하게 고정하였고, 조영제주입율을 1.2, 1.5, 2.0 mL/sec로 변화시켜가며 조영제를 주입하면서 3차원 방사선치료계획영상에 적합한 조영제주입율(contrast flow rate)과 지연시간(delay time)을 도출하였고, CT 값을 측정하여 정량적 평가를 시행하였다. 관심부위는 폐동맥과 폐정맥으로 하였다. 그리고, 환자 기본정보, 조영제주입율, H.U 등 영상증강에 영향을 미치는 인자들을 통계처리 프로그램인 SPSS를 이용하여 최적의 영상을 획득할 수 있는 기초 프로토콜을 작성하였다. 3. 결과 : 폐암환자의 전산화단층촬영영상 획득 시 3차원 방사선치료계획에 적합한 영상을 얻을 수 있는 조건중 조영제주입율은 1.5 mL/sec 이었고, 지연시간은 $60{\sim}70$초이었다. 통계처리를 수행한 결과 환자의 기본정보 및 조영제주입율 등이 영상증강에 영향을 미치는 인자임을 알 수 있었다. 본 연구에서 작성한 기초 프로토콜을 이용하여 3차원 방사선치료계획 시 정확한 종양 및 정상조직 설정이 용이하게 되어 방사선치료 효율을 극대화 할 수 있었다. 4. 결론 : 방사선종양학과에서 3차원 치료계획용 전산화단층촬영 시 사용할 수 있는 기초적인 영상획득 프로토콜을 도출하였고, 향후 더 많은 임상경험과 정량적 평가가 수반된다면 임상에 적극 사용할 수 있을 것이라 사료된다.

• Journal of Korea Multimedia Society
• /
• v.9 no.12
• /
• pp.1588-1595
• /
• 2006

In this paper, we proposed a liver extracting procedure for computer aided liver diagnosis system. Extraction of liver region in an abdominal CT image is difficult due to interferences of other organs. For this reason, liver region is extracted in a region of interest(ROI). ROI is selected by the window which can measure the distribution of Hounsfield Unit(HU) value of liver region in an abdominal CT image. The distribution is measured by an existential probability of HU value of lever region in the window. If the probability of any window is over 50%, the center point of the window would be assigned to ROI. Actually, liver region is not clearly discerned from the adjacent organs like muscle, spleen, and pancreas in an abdominal CT image. Liver region is extracted by the watershed segmentation algorithm which is effective in this situation. Because it is very sensitive to the slight valiance of contrast, it generally produces over segmentation regions. Therefore these regions are required to merge into the significant regions for optimal segmentation. Finally, a liver region can be selected and extracted by prier information based on anatomic information.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.3
• /
• pp.1609-1614
• /
• 2013

Objective: To evaluate the effect of intravenous contrast on dose calculation in radiation treatment planning for oesophageal cancer. Methods: A total of 22 intravein-contrasted patients with oesophageal cancer were included. The Hounsfield unit (HU) value of the enhanced blood stream in thoracic great vessels and heart was overridden with 45 HU to simulate the non-contrast CT image, and 145 HU, 245 HU, 345 HU, and 445 HU to model the different contrast-enhanced scenarios. 1000 HU and -1000 HU were used to evaluate two non-physiologic extreme scenarios. Variation in dose distribution of the different scenarios was calculated to quantify the effect of contrast enhancement. Results: In the contrast-enhanced scenarios, the mean variation in dose for planning target volume (PTV) was less than 1.0%, and those for the total lung and spinal cord were less than 0.5%. When the HU value of the blood stream exceeded 245 the average variation exceeded 1.0% for the heart V40. In the non-physiologic extreme scenarios, the dose variation of PTV was less than 1.0%, while the dose calculations of the organs at risk were greater than 2.0%. Conclusions: The use of contrast agent does not significantly influence dose calculation of PTV, lung and spinal cord. However, it does have influence on dose accuracy for heart.

• Progress in Medical Physics
• /
• v.30 no.4
• /
• pp.160-166
• /
• 2019

This study examined the clinical use of two newly installed computed tomography (CT) simulators in the Department of Radiation Oncology. The accreditation procedure was performed by the Korean Institute for Accreditation of Medical Imaging. An Xi R/F dosimeter was used to measure the CT dose index for each plug of the CT dose index phantom. Image qualities such as the Hounsfield unit (HU) value of water, noise level, homogeneity, existence of artifacts, spatial resolution, contrast, and slice thickness were evaluated by scanning a CT performance phantom. All test items were evaluated as to whether they were within the required tolerance level. CT calibration curves-the relationship between CT number and relative electron density-were obtained for dose calculations in the treatment planning system. The positional accuracy of the lasers was also evaluated. The volume CT dose indices for the head phantom were 22.26 mGy and 23.70 mGy, and those for body phantom were 12.30 mGy and 12.99 mGy for the first and second CT simulators, respectively. HU accuracy, noise, and homogeneity for the first CT simulator were -0.2 HU, 4.9 HU, and 0.69 HU, respectively, while those for second CT simulator were 1.9 HU, 4.9 HU, and 0.70 HU, respectively. Five air-filled holes with a diameter of 1.00 mm were used for assessment of spatial resolution and a low contrast object with a diameter of 6.4 mm was clearly discernible by both CT scanners. Both CT simulators exhibited comparable performance and are acceptable for clinical use.