• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.273-279
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• 2022

Objectives: The aim of this study was to present the baseline results of a pilot project conducted to evaluate the effectiveness of lung cancer screening using low-dose chest computed tomography (CT) in regions with excessive radon levels in the Republic of Kazakhstan. Methods: In total, 3671 participants were screened by low-dose chest CT. Current, former, and never-smokers who resided in regions with elevated levels of radon in drinking water sources and indoor air, aged between 40 and 75 with no history of any cancer, and weighing less than 140 kg were included in the study. All lung nodules were categorized according to the American College of Radiology Lung Imaging Reporting and Data System (Lung-RADS 1.0). Results: Overall, 614 (16.7%) participants had positive baseline CT findings (Lung-RADS categories 3 and 4). Seventy-four cancers were detected, yielding an overall cancer detection rate of 2.0%, with 10.8% (8/74) stage I and a predominance of stage III (59.4%; 44/74). Women never-smokers and men current smokers had the highest cancer detection rates, at 2.9% (12/412) and 6.1% (12/196), respectively. Compared to never-smokers, higher odds ratios (ORs) of lung cancer detection were found in smokers (OR,2.48; 95% confidence interval [CI], 1.52 to 4.05, p<0.001) and former smokers (OR, 2.32; 95% CI, 1.06 to 5.06, p=0.003). The most common histologic type of cancer was adenocarcinoma (58.1%). Conclusions: Implementation of low-dose CT screening for lung cancer in regions with elevated radon levels is an effective method for both smokers and never-smokers.

• Journal of radiological science and technology
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• v.32 no.2
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• pp.129-140
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• 2009

As CT has been increasingly used as an accurate screening tool for lung disease, radiation dose becomes an important issue for both radiographers and patients. Many researches have been done for a low-dose CT as a screening tool for early detection of asymptomatic lung diseases. From those studies, it has been reported that chest dose rate from the low-dose CT is considerably lower than from standard CT. The patient dose is determined by scanning parameters such as kVp, mAs, pitch, scan time and the radiation risk of lung in screening examination may not be negligible. Herein, we suggest that Low-dose CT is useful as a screening tool in routine clinical practice on the basis of published articles, but further study is necessary because Low-dose CT has poor sensitivity and specificity for screening early stage of lung cancer according to the results of the studies. This article is to provide a brief overview of the screening examinations by Low-dose CT.

• Journal of Radiation Protection and Research
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• v.37 no.2
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• pp.84-89
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• 2012

The purpose of this study was to compare radiation dose and image quality between low-dose (LDP) and standard-dose protocol (SDP). LDP (120 kVp, 30 mAs, 2-mm thickness) and SDP (120 kVp, 180 mAs, 1.2-mm thickness) images obtained from 61 subjects were retrospectively evaluated at level of carina bifurcation, using multi-detector CT (Brilliance 16, Philips Medical Systems). Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated at ascending aorta and infraspinatus muscle, from CT number and back-ground noise. Radiation dose from two protocols measured at 5-point using acrylic-phantom, and CT number and noise measured at 4-point using water-phantom. All statistical analysis were performed using SPSS 19.0 program. LDP images showed significantly more noise and a significantly lower SNR and CNR than did SDP images at ascending aorta and infraspinatus muscle. Noise, SNR and CNR were significantly correlated with body mass index (p<0.001). Radiation dose, SNR and CNR from phantom were significant differences between two protocols. LDP showed a significant reduction of radiation dose with a significant change in SNR and CNR compared with SDP. Therefore, exposure dose on LDP in clinical applications needs resetting highly more considering image quality.

• Journal of the Korean Society of Radiology
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• v.16 no.4
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• pp.411-417
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• 2022

This study aimed to learn and evaluate the effectiveness of VGGNet in the detection of pulmonary emphysema using low-dose chest computed tomography images. In total, 8000 images with normal findings and 3189 images showing pulmonary emphysema were used. Furthermore, 60%, 24%, and 16% of the normal and emphysema data were randomly assigned to training, validation, and test datasets, respectively, in model learning. VGG16 and VGG19 were used for learning, and the accuracy, loss, confusion matrix, precision, recall, specificity, and F1-score were evaluated. The accuracy and loss for pulmonary emphysema detection of the low-dose chest CT test dataset were 92.35% and 0.21% for VGG16 and 95.88% and 0.09% for VGG19, respectively. The precision, recall, and specificity were 91.60%, 98.36%, and 77.08% for VGG16 and 96.55%, 97.39%, and 92.72% for VGG19, respectively. The F1-scores were 94.86% and 96.97% for VGG16 and VGG19, respectively. Through the above evaluation index, VGG19 is judged to be more useful in detecting pulmonary emphysema. The findings of this study would be useful as basic data for the research on pulmonary emphysema detection models using VGGNet and artificial neural networks.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1505-1523
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• 2021

Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

• Korean Journal of Digital Imaging in Medicine
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• v.16 no.2
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• pp.9-14
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• 2014

Purpose: The purpose of this study has attempted to evaluate and compare the image evaluation and exposure dose by respectively applying Filtered Back Projection(FBP), the existing test method, and Adaptive Statistical Iterative Reconstruction(ASIR) with different values of tube voltage during the Low Dose Computed Tomography(LDCT). Materials and Methods: With the image reconstruction method as basis, Chest Phantom was utilized with the FBP and ASIR set at 10%, 20% respectively, and the change of Tube Voltage (100kVp, 120kVp). For image evaluation, Back ground noise, Signal to Noise ratio(SNR) and Contrast to Noise ratio(CNR) were measured, and, for dose evaluation, CTDIvol and DLP were measured respectively. The statistical analysis was tested with SPSS(ver. 22.0), followed by ANOVA Test conducted after normality test and homogeneity test. (p<0.05). Results: In terms of image evaluation, there was no outstanding difference in Ascending Aorta(AA) SNR and Infraspinatus Muscle(IM) SNR with the different values of ASIR application(p<0.05), but a significant difference with the different amount of tube voltage(p>0.05). Also, there wasn't noticeable change in CNR with ASIR and different amount of Tube Voltage (p<0.05). However, in terms of dose evaluation, CTDIvol and DLP showed contrasting results(p<0.05). In terms of CTDIvol, the measured values with the same tube voltage of 120kVp were 2.6mGy with No-ASIR and 2.17mGy with 20%-ASIR respectively, decreased by 0.43mGy, and the values with 100kVp were 1.61mGy with No-ASIR and 1.34mGy with 20%-ASIR, decreased by 0.27mGy. In terms of DLP, the measured values with 120kVp were $103.21mGy{\cdot}cm$ with No-ASIR and $85.94mGy{\cdot}cm$ with 20%-ASIR, decreased by $17.27mGy{\cdot}cm$(about 16.7%), and the values with 100kVp were $63.84mGy{\cdot}cm$ with No-ASIR and $53.25mGy{\cdot}cm$ with 20%-ASIR, a decrease by $10.62mGy{\cdot}cm$(about 16.7%). Conclusion: At lower tube voltage, the rate of dose significantly decreased, but the negative effects on image evaluation was shown due to the increase of noise. For the future, through the result of the experiment, it is considered that the method above would be recommended for follow-up patients or those who get health checkup as long as there is no interference on the process of diagnosis due to the characteristics of Low Dose examination.

• Journal of radiological science and technology
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• v.39 no.3
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• pp.329-336
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• 2016

The purpose of this study was to evaluate the usefulness of low-dose CT (LDCT) for emphysema compared with high-resolution CT (HRCT). Measurements of radiation dose and noise were repeated 3 times in same exposure condition which was similar with obtaining HRCT and LDCT images. We analysed reading results of 146 subjects. Six images per participants selected for emphysema grading. Emphysema was graded for all 6 zones on the left and right sides of the lungs by the consensus reading of two chest radiologists using a 4-point scale. Between the HRCT and LDCT images, diagnostic differences and agreements for emphysema were analyzed by McNemar's and unweighted kappa tests, and radiation doses and noise by a Mann-Whitney U-test, using the SPSS 19.0 program. Radiation dose from HRCT was significantly higher than that of LDCT, but the noise was significantly lower in HRCT than in LDCT. Diagnostic agreement for emphysema between HRCT and LDCT images was excellent (k-value=0.88). Emphysema grading scores were not significantly different between HRCT and LDCT images for all six lung zones. Emphysema grading scores from LDCT images were significantly correlated with increased scores on HRCT images (r=0.599, p < 0.001). Considering the tradeoff between radiation dose and image noise, LDCT could be used as the gold standard method instead of HRCT for emphysema detection and grading.

• Journal of radiological science and technology
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• v.34 no.4
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• pp.305-314
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• 2011

The purpose of this study was to compare the findings on the chest low-dose CT (LDCT) images between the negative and positive groups for pneumoconiosis in the group exposed to inorganic dust. From May 30, 2007 to August 31, 2008, total 328 subjects were examined by a LDCT. LDCT images were read by a chest radiologist who has much experience for reading of pneumoconiosis. All subjects were classified into two groups based on digital images after consensus reading of two radiologists according to the ILO 2000 guidelines; negative group (87, 26.5%) without pneumoconiosis and positive group (241, 73.5%). Statistical analysis was performed using a SPSS 14.0. There were significant differences in age (60.9 vs. 65.0, p<0.001), and in dust expose duration (17.0 vs. 19.2, p=0.024) between two groups, but no significant difference in smoking (p=0.784). Of the 328 subjects, 13 diagnosis were extracted from 245 subjects (74.7%). Coronary artery calcification (CAC) was significantly higher in positive group than that in negative group (36.9% vs. 25.3%, p=0.049). Honeycombing showed higher frequency in positive group than in negative group (6.2% vs. 1.2%, p=0.079). Pneumoconiosis findings caused by inorganic dusts exposure showed the significant relation with CAC on LDCT images. Future studies need to prove that pneumoconiosis finding is independent risk factor for CAC using a coronary artery angiography.

• Radiation Oncology Journal
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• v.14 no.2
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• pp.123-128
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• 1996

Purpose : This is a retrospective study to compare the Palliation rates, survival rates and complications of low dose rate and high dose rate endobronchial brachytherapy in the management of malignant airway obstruction. Materials and methods : Forty three consecutive patients with malignant airway compromise from primary or metastatic lung tumors were treated with low dose rate(LDR) endobronchial Iridium-192 insertion(21 patients) between October 1988 and June 1992, and high dose rate(HDR) endobronchial brachytherapy(22 patients) between August 1992 and April 1994 with palliative aim Flexible fiberoptic bronchoscopy under fluoroscopic control was utilized in all 91 procedures. Twenty seven LDR Procedures delivered a dose of 5-7.5 Gy to a 1.0 cm radius respectively. Results : Subjective and objective responses to treatments were evaluated on follow-up examinations by clinical examination, chest x-rays and CT scan of the chest on some patients. Fifteen of 21 LDR patients and 19 of 22 HDR Patients showed subjective improvement in terms of better breathing and less Productive cough as well as complete disappearance of hemoptysis. Objective improvement on chest x-rays and CT scan of the chest had been demonstrated on 8 LDR Patients and 10 HDR patients. Conclusion : The technique of LDR and HDR endobronchial brachytherapy is simple and well tolerated procedure with minimal morbidity It Provides excellent palliation by keeping airway Patent in these short life-spanned patients.

• Journal of Radiation Protection and Research
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• v.35 no.4
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• pp.135-141
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• 2010

Purpose : The patients who visited this department for pulmonary disease and need CT scans for Follow-up to observe change of CT value, evaluation of image quality and decrease of radiation dose as change of kVp. Subjects and Methods : Subjects were the patients of 20 persons visited this department for pulmonary disease and Somatom Sensation 16(Semens, Enlarge, Germany) was used. Measurement of CT value as change of kVp was done by setting up ROI diameter of 1cm at the height of thyroid, aortic arch, right pulmonary artery in arterial phase image using 100 kVp, measuring 3 times, and recorded the average. CT value of phantom was measured by scanning phantoms which means contrast media diluted by normal saline by various ratio with tube voltage of 80 kVp, 100 kVp, 120 kVp, 140 kVp and recorded the average of 3 CT values of center of phantom image. In analysing radiation dose, CTDIVOL values of the latest arterial phase image of 120 kVp and as this research set that of 100 kVp were analyzed comparatively. 2 observers graded quality of chest images by 5 degrees (Unacceptable, Suboptimal, Adequate, Good, Excellent). Results : CT value of chest image increased at 100 kVp by 14.06%~27.26% in each ROI than 120 kVp. CT value of phantom increased as tube voltage lowered at various concentration of contrast media. CTDIVOL decreased at 100 kVp(5.00 mGy) by 36% than 120 kVp(7.80 mGy) in radiation dose analysis. here were 0 Unacceptable, 1 Suboptimal, 3 Adequate, 10 Good, 6 Excellent in totally 20 persons. Conclusion : Chest CT scanning with low kilo-voltage for patients who need CT scan repeatedly can bring images valuable for diagnose, and decrease radiation dose against patients.