• Title/Summary/Keyword: Multi-Modality

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Usefulness of Multi-Detector Computed Tomography before Bronchoscopy and/or Bronchial Arterial Embolization for Hemoptysis (객혈 환자에서 기관지경술이나 기관지동맥색전술 시행 전의 다중절편 전산화 단층촬영의 유용성)

  • Lee, Shin-Jae;Rho, Ji-Young;Yoo, Seung-Min;Kim, Man-Deuk;Lee, Ji-Hyun;Kim, Eun-Kyung;Cho, Young-Ah;Lee, Sang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.2
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    • pp.80-86
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    • 2010
  • Background: Recently, many institutions have acquired multi-detector computed tomography (MDCT) systems. This made it easier and more convenient to use MDCT as a initial diagnostic modality for hemoptysis. The purpose of this study was to evaluate the usefulness of MDCT before bronchoscopy and/or bronchial arterial embolization (BAE) for hemoptysis. Methods: We studied a total of 125 patients with hemoptysis who underwent, between 2006 and 2008, MDCT in a routine protocol before bronchoscopy and/or BAE. One hundred two patients underwent bronchoscopy and 29 patients underwent BAE. We compared the usefulness of MDCT and bronchoscopy for detecting the bleeding site and identifying the cause. We also evaluated our ability, using MDCT, to detect instances where the bronchial artery caused hemoptysis. Results: The rate of detection of a bleeding site was 75.5% on MDCT and 50.9% on bronchoscopy. MDCT and bronchoscopy detected the bleeding site in agreement in 62.7% of patients. MDCT alone found the bleeding site in 27.5% of cases. MDCT identified the cause of hemoptysis in 77.5% and bronchoscopy in 11.8%. In 29 patients who underwent BAE, we detected a total of 37 hypertrophied bronchial arteries that were causing hemoptysis. Of 37 bronchial arteries, 23 (62.2%) were depicted on MDCT. Conclusion: MDCT is superior to bronchoscopy for detecting the bleeding site and identifying the cause of hemoptysis. MDCT can also predict the side of affected bronchial artery with depiction of hypertrophied bronchial artery and localizing the bleeding site. Doing MDCT before bronchoscopy and BAE can provide a guideline for the next step.

Development of Independent Target Approximation by Auto-computation of 3-D Distribution Units for Stereotactic Radiosurgery (정위적 방사선 수술시 3차원적 공간상 단위분포들의 자동계산법에 의한 간접적 병소 근사화 방법의 개발)

  • Choi Kyoung Sik;Oh Seung Jong;Lee Jeong Woo;Kim Jeung Kee;Suh Tae Suk;Choe Bo Young;Kim Moon Chan;Chung Hyun-Tai
    • Progress in Medical Physics
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    • v.16 no.1
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    • pp.24-31
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    • 2005
  • The stereotactic radiosurgery (SRS) describes a method of delivering a high dose of radiation to a small tar-get volume in the brain, generally in a single fraction, while the dose delivered to the surrounding normal tissue should be minimized. To perform automatic plan of the SRS, a new method of multi-isocenter/shot linear accelerator (linac) and gamma knife (GK) radiosurgery treatment plan was developed, based on a physical lattice structure in target. The optimal radiosurgical plan had been constructed by many beam parameters in a linear accelerator or gamma knife-based radiation therapy. In this work, an isocenter/shot was modeled as a sphere, which is equal to the circular collimator/helmet hole size because the dimension of the 50% isodose level in the dose profile is similar to its size. In a computer-aided system, it accomplished first an automatic arrangement of multi-isocenter/shot considering two parameters such as positions and collimator/helmet sizes for each isocenter/shot. Simultaneously, an irregularly shaped target was approximated by cubic structures through computation of voxel units. The treatment planning method by the technique was evaluated as a dose distribution by dose volume histograms, dose conformity, and dose homogeneity to targets. For irregularly shaped targets, the new method performed optimal multi-isocenter packing, and it only took a few seconds in a computer-aided system. The targets were included in a more than 50% isodose curve. The dose conformity was ordinarily acceptable levels and the dose homogeneity was always less than 2.0, satisfying for various targets referred to Radiation Therapy Oncology Group (RTOG) SRS criteria. In conclusion, this approach by physical lattice structure could be a useful radiosurgical plan without restrictions in the various tumor shapes and the different modality techniques such as linac and GK for SRS.

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Image Registration for PET/CT and CT Images with Particle Swarm Optimization (Particle Swarm Optimization을 이용한 PET/CT와 CT영상의 정합)

  • Lee, Hak-Jae;Kim, Yong-Kwon;Lee, Ki-Sung;Moon, Guk-Hyun;Joo, Sung-Kwan;Kim, Kyeong-Min;Cheon, Gi-Jeong;Choi, Jong-Hak;Kim, Chang-Kyun
    • Journal of radiological science and technology
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    • v.32 no.2
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    • pp.195-203
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    • 2009
  • Image registration is a fundamental task in image processing used to match two or more images. It gives new information to the radiologists by matching images from different modalities. The objective of this study is to develop 2D image registration algorithm for PET/CT and CT images acquired by different systems at different times. We matched two CT images first (one from standalone CT and the other from PET/CT) that contain affluent anatomical information. Then, we geometrically transformed PET image according to the results of transformation parameters calculated by the previous step. We have used Affine transform to match the target and reference images. For the similarity measure, mutual information was explored. Use of particle swarm algorithm optimized the performance by finding the best matched parameter set within a reasonable amount of time. The results show good agreements of the images between PET/CT and CT. We expect the proposed algorithm can be used not only for PET/CT and CT image registration but also for different multi-modality imaging systems such as SPECT/CT, MRI/PET and so on.

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An Experimental Comparative Study of Radiography, Ultrasonography and CT Imaging in the IV Catheter Fragment (정맥내 카테터 조각의 엑스선, 초음파 및 CT 영상의 실험적 비교 연구)

  • Kweon, Dae Cheol
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.185-191
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    • 2016
  • The objective of this study was to detect the fragments generated during IV (intravenous) catheter injection of contrast medium and drug administration in a clinical setting and removal was performed by experimentally producing a phantom, and to compare the radiography, ultrasonography, and multi-detector computed tomography (MDCT) imaging and radiation dose. A 1 cm fragment of an 18 gage Teflon$^{(R)}$ IV catheter with saline was inserted into the IV control line. Radiography, CT, and ultrasonography were performed and radiography and CT dose were calculated. CT and ultrasonography showed an IV catheter fragment clinically and radiography showed no visible difference in the ability to provide a useful image of an IV catheter fragment modality (p >.05). Radiography of effective dose ($0.2139mSv{\cdot}Gy^{-1}{\cdot}cm^{-2}$) form DAP DAP ($0.93{\mu}Gy{\cdot}m^2 $), and dose length product (DLP) ($201mGy{\cdot}cm$) to effective dose was calculated as 0.483 mSv. IV catheter fragment were detected of radiography, ultrasonography and CT. These results can be obtained by menas of an excellent IV catheter fragment of detection capability CT. However, CT is followed by radiation exposure. IV catheter fragment confirming the position and information recommend an ultrasonography.

Effect of Multimodal cues on Tactile Mental Imagery and Attitude-Purchase Intention Towards the Product (다중 감각 단서가 촉각적 심상과 제품에 대한 태도-구매 의사에 미치는 영향)

  • Lee, Yea Jin;Han, Kwanghee
    • Science of Emotion and Sensibility
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    • v.24 no.3
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    • pp.41-60
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    • 2021
  • The purpose of this research was to determine whether multimodal cues in an online shopping environment could enhance tactile consumer mental imagery, purchase intentions, and attitudes towards an apparel product. One limitation of online retail is that consumers are unable to physically touch the items. However, as tactile information plays an important role in consumer decisions especially for apparel products, this study investigated the effects of multimodal cues on overcoming the lack of tactile stimuli. In experiment 1, to explore the product, the participants were randomly assigned to four conditions; picture only, video without sound, video with corresponding sound, and video with discordant sound; after which tactile mental imagery vividness, ease of imagination, attitude, and purchase intentions were measured. It was found that the video with discordant sound had the lowest average scores of all dependent variables. A within-participants design was used in experiment 2, in which all participants explored the same product in the four conditions in a random order. They were told that they were visiting four different brands on a price comparison web site. After the same variables as in experiment 1, including the need for touch, were measured, the repeated measures ANCOVA results revealed that compared to the other conditions, the video with the corresponding sound significantly enhanced tactile mental imagery vividness, attitude, and purchase intentions. However, the discordant condition had significantly lower attitudes and purchase intentions. The dual mediation analysis also revealed that the multimodal cue conditions significantly predicted attitudes and purchase intentions by sequentially mediating the imagery vividness and ease of imagination. In sum, vivid tactile mental imagery triggered using audio-visual stimuli could have a positive effect on consumer decision making by making it easier to imagine a situation where consumers could touch and use the product.

Utility of Multidetector Computed Tomographic Angiography as an Alternative to Transesophageal Echocardiogram for Preoperative Transcatheter Mitral Valve Repair Planning

  • Craig Basman;Caroline Ong;Tikal Kansara;Zain Kassam;Caleb Wutawunashe;Jennifer Conroy;Arber Kodra;Biana Trost;Priti Mehla;Luigi Pirelli;Jacob Scheinerman;Varinder P Singh;Chad A Kliger
    • Journal of Cardiovascular Imaging
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    • v.31 no.1
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    • pp.18-23
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    • 2023
  • BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

A Study on the Analysis of Educational Objectives of 'Library and Information Life' Textbooks Based on the Eisner Curriculum (아이즈너 교육과정에 의한 '도서관과 정보생활' 교과서 교육목표 분석에 관한 연구)

  • Byeong-Kee Lee
    • Journal of the Korean Society for Library and Information Science
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    • v.58 no.2
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    • pp.57-80
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    • 2024
  • Eisner emphasized the importance of problem-solving objectives and expressive objectives in addition to behavioral objectives, and communication through multiple modalities including linguistic, visual, aural, spatial, gestural modes. This study analyzes 'Libraries and Information Life,' a textbook developed for information literacy instruction, by dividing it into educational objectives types(behavioral, problem-solving, expressive) and multimodal modes(linguistic, visual, auditory, spatial, and gestural), and seeks to derive implications for setting educational objectives for information literacy instruction and developing textbooks. The textbook has four volumes for elementary low-grade, elementary high-grade, middle school, and high school levels. Educational objectives were extracted from the textbooks, and 3 librarian-teachers were engaged in the analysis of these objectives. The main findings and implications of this study are as follows. First, when looking at the types of educational objectives, the proportion of behavioral objectives was found to be excessively high, and there is a need to strengthen the proportion of problem-solving objectives and expressive objectives. Second, problem-solving objectives tend to overlap with behavioral objectives, indicating a need to develop problem-solving objectives with defined conditions and solution requirements. Third, expressive objectives concentrated in specific units need to be placed evenly in other units. Fourth, in the case of multi-modality mode, the proportion of the linguistic mode must be reduced, the proportion of the visual, auditory, spatial, and gestural modes must be increased, and it is necessary to set educational objectives with clear characteristics of each mode.

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.

Clinical Study of Vascular Injuries (혈관 손상의 임상적 고찰)

  • Chung, Sung-Woon;Kim, Young-Kyu
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.480-484
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    • 2007
  • Background: Major vascular injuries can jeopardize a patient's life or imperil limb survival. We performed this study to establish an optimal management plan for vascular injuries. Material and Method: We retrospectively reviewed 26 cases of vascular injury that were treated at Pusan National University Hospital from May, 1999 to September, 2004. The age and sex distribution, the locations and causes of vascular injury, the diagnostic tools, the degree of injuries, clinical manifestations, the treatment modality and complications were reviewed. Result: The mean age was 39.5 years (range: $12{\sim}86$) and the male to female ratio was 22 : 4. The injuries were in 6 descending thoracic aortas, 4 femoral arteries, 4 popliteal veins and so on. The causes of injury were iatrogenic in 8 cases, traffic accident in 7, stab injury in 6 and industrial accident in 5. The most commonly used diagnostic tools were CT and angiography. The degrees of arterial injury were pseudoaneurysm in 10 cases, partial severance in 5, complete severance in 3 and thrombosis in 3. The degrees of venous injury were partial severance in 6 cases, complete severance in 2 and arteriovenous fistula in 2. The clinical manifestations were absence of pulse in 8 cases, coldness in 7, chest pain in 6, swelling in 5, bleeding in 5 and so on. The most frequently used type of revascularization was graft interposition in 11 cases. Two arteriovenous fistulae were repaired by endovascular procedure. There was one case of mortality due to multi-organ failure after hemorrhagic shock, There were three major amputations, and two of them were due to delayed diagnosis and treatment. Conclusion: A system for the early diagnosis and treatment is essential for improving limb salvage and patient mortality. As a consequence of the widespread application of endovascular procedures, the incidence of iatrogenic injuries has recently increased. Educating physicians is important for the prevention of iatrogenic injury. Easy communication and cooperation for earlier involvement of a vascular surgeon is also an important factor.

Dose Planning of Forward Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer using Compensating Filters (보상여과판을 이용한 비인강암의 전방위 강도변조 방사선치료계획)

  • Chu Sung Sil;Lee Sang-wook;Suh Chang Ok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.1
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    • pp.53-65
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    • 2001
  • Purpose : To improve the local control of patients with nasopharyngeal cancer, we have implemented 3-D conformal radiotherapy and forward intensity modulated radiation therapy (IMRT) to used of compensating filters. Three dimension conformal radiotherapy with intensity modulation is a new modality for cancer treatments. We designed 3-D treatment planning with 3-D RTP (radiation treatment planning system) and evaluation dose distribution with tumor control probability (TCP) and normal tissue complication probability (NTCP). Material and Methods : We have developed a treatment plan consisting four intensity modulated photon fields that are delivered through the compensating tilters and block transmission for critical organs. We get a full size CT imaging including head and neck as 3 mm slices, and delineating PTV (planning target volume) and surrounding critical organs, and reconstructed 3D imaging on the computer windows. In the planning stage, the planner specifies the number of beams and their directions including non-coplanar, and the prescribed doses for the target volume and the permissible dose of normal organs and the overlap regions. We designed compensating filter according to tissue deficit and PTV volume shape also dose weighting for each field to obtain adequate dose distribution, and shielding blocks weighting for transmission. Therapeutic gains were evaluated by numerical equation of tumor control probability and normal tissue complication probability. The TCP and NTCP by DVH (dose volume histogram) were compared with the 3-D conformal radiotherapy and forward intensity modulated conformal radiotherapy by compensator and blocks weighting. Optimization for the weight distribution was peformed iteration with initial guess weight or the even weight distribution. The TCP and NTCP by DVH were compared with the 3-D conformal radiotherapy and intensitiy modulated conformal radiotherapy by compensator and blocks weighting. Results : Using a four field IMRT plan, we have customized dose distribution to conform and deliver sufficient dose to the PTV. In addition, in the overlap regions between the PTV and the normal organs (spinal cord, salivary grand, pituitary, optic nerves), the dose is kept within the tolerance of the respective organs. We evaluated to obtain sufficient TCP value and acceptable NTCP using compensating filters. Quality assurance checks show acceptable agreement between the planned and the implemented MLC(multi-leaf collimator). Conclusion : IMRT provides a powerful and efficient solution for complex planning problems where the surrounding normal tissues place severe constraints on the prescription dose. The intensity modulated fields can be efficaciously and accurately delivered using compensating filters.

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