• Korean Journal of Radiology
• /
• v.25 no.7
• /
• pp.662-672
• /
• 2024

Since the emergence of the first photon-counting computed tomography (PCCT) system in late 2021, its advantages and a wide range of applications in all fields of radiology have been demonstrated. Compared to standard energy-integrating detector-CT, PCCT allows for superior geometric dose efficiency in every examination. While this aspect by itself is groundbreaking, the advantages do not stop there. PCCT facilitates an unprecedented combination of ultra-high-resolution imaging without dose penalty or field-of-view restrictions, detector-based elimination of electronic noise, and ubiquitous multi-energy spectral information. Considering the high demands of orthopedic imaging for the visualization of minuscule details while simultaneously covering large portions of skeletal and soft tissue anatomy, no subspecialty may benefit more from this novel detector technology than musculoskeletal radiology. Deeply rooted in experimental and clinical research, this review article aims to provide an introduction to the cosmos of PCCT, explain its technical basics, and highlight the most promising applications for patient care, while also mentioning current limitations that need to be overcome.

• Journal of the Korean Society of Radiology
• /
• v.85 no.3
• /
• pp.520-530
• /
• 2024

Infections and inflammatory conditions of immature musculoskeletal systems in pediatric patients also affect the adjacent muscles, connective tissues, and joints. Rapid diagnosis leading to appropriate treatment can significantly impact the occurrence of complications and mortality rates due to these conditions. When a radiologist becomes familiar with the imaging findings of pediatric musculoskeletal infections and inflammatory diseases, rapid differential diagnoses and more timely and appropirate treatment could be possible. In this paper, we introduce the imaging findings of infectious and inflammatory diseases affecting the immature musculoskeletal system, such as osteomyelitis, pyogenic arthritis, juvenile idiopathic arthritis, and hemophilic arthritis, based on the anatomical and pathophysiological characteristics of the immature musculoskeletal system in children.

• The Journal of the Korean bone and joint tumor society
• /
• v.14 no.2
• /
• pp.86-94
• /
• 2008

$^{18}F$-FDG PET/CT has led to advancement in diagnostic imaging, providing correlation of both physiology and anatomic information, and to new and innovative ways to utilize PET/CT imaging for the evaluation of musculoskeletal tumors. Recently, the most widely utilized musculoskeletal application of PET/CT imaging is for the detection and characterization of bone metastases, staging and restaging of primary malignant bone tumors and soft tissue sarcomas. And it is also useful in evaluating response to therapy for malignant musculoskeletal tumors and in detecting local recurrences or distant metastases during follow up. The future likely holds even more unique and potentially quite useful applications of PET/CT imaging for primary bone and soft tissue tumors. This article will review the useful applications of $^{18}F$-FDG PET/CT imaging for evaluating musculoskeletal tumors.

• Journal of Yeungnam Medical Science
• /
• v.18 no.2
• /
• pp.170-186
• /
• 2001

Musculoskeletal ultrasound (MSUS) has newly evolved by the mechanical improvement of the machine over past several years, becoming a part of imaging techniques for the evaluation of variable diseases in the musculoskeletal system. MSUS has proven diagnostic superiority in pathologies including rotator cuff disease of the shoulder, lateral epicondylitis of the elbow, diseases of the peripheral nerve, detection of intra-articular loose bodies and soft tissue foreign bodies, and in evaluating small superficial soft tissue tumors such as ganglion, epidermoid cyst, and glomus tumor. Besides, MSUS is very useful for obtaining tissue or fluid via percutaneous fine needle aspiration and/or biopsy for the histopathologic diagnosis. Combining MSUS with MR would play a great role in the field of the diagnostic imaging of the musculoskeletal system. The MSUS examiner should have the knowledge of cross-sectional anatomy, and of the mechanical and physical properties of ultrasound in order to interpret the ultrasound findings accurately and properly, and to avoid diagnostic errors due to variable artifacts subsequently. The goal of this article is to introduce the capabilities of MSUS in certain kinds of clinical situation and to familiarize the reader with MSUS. For the purpose, author intends to describe this article according not to the disease-, or organ-based, but to the clinical problem-based format.

• Journal of the Korean Society of Radiology
• /
• v.81 no.1
• /
• pp.21-40
• /
• 2020

Magnetic resonance imaging (MRI) is an essential modality for the diagnosis of musculoskeletal system defects because of its higher soft-tissue contrast and spatial resolution. With the recent development of MRI-related technology, faster imaging and various image plane reconstructions are possible, enabling better assessment of three-dimensional musculoskeletal anatomy and lesions. Furthermore, the image quality, diagnostic accuracy, and acquisition time depend on the MRI protocol used. Moreover, the protocol affects the efficiency of the MRI scanner. Therefore, it is important for a radiologist to optimize the MRI protocol. In this review, we will provide guidance on patient positioning; selection of the radiofrequency coil, pulse sequences, and imaging planes; and control of MRI parameters to help optimize the MRI protocol for the six major joints of the musculoskeletal system.

• Clinical Pain
• /
• v.20 no.1
• /
• pp.7-14
• /
• 2021

Musculoskeletal ultrasound has evolved as the essential tool to diagnose and guide intervention procedures in people with neuromusculoskeletal conditions. Image optimization and understanding device operations are core components for ultrasound guided intervention procedure training. All ultrasound machines share the common operative features and there are various buttons for the features in the device control panel. Ultrasound "knobology" refers to the thorough understanding of imaging optimization. This review addressed basic information for the transducers, depth setting, gain and focus control, different modes focusing on brightness and doppler modes.

• Korean Journal of Radiology
• /
• v.23 no.9
• /
• pp.854-865
• /
• 2022

Photon-counting detector (PCD) CT is a new CT technology utilizing a direct conversion X-ray detector, where incident X-ray photon energies are directly recorded as electronical signals. The design of the photon-counting detector itself facilitates improvements in spatial resolution (via smaller detector pixel design) and iodine signal (via count weighting) while still permitting multi-energy imaging. PCD-CT can eliminate electronic noise and reduce artifacts due to the use of energy thresholds. Improved dose efficiency is important for low dose CT and pediatric imaging. The ultra-high spatial resolution of PCD-CT design permits lower dose scanning for all body regions and is particularly helpful in identifying important imaging findings in thoracic and musculoskeletal CT. Improved iodine signal may be helpful for low contrast tasks in abdominal imaging. Virtual monoenergetic images and material classification will assist with numerous diagnostic tasks in abdominal, musculoskeletal, and cardiovascular imaging. Dual-source PCD-CT permits multi-energy CT images of the heart and coronary arteries at high temporal resolution. In this special review article, we review the clinical benefits of this technology across a wide variety of radiological subspecialties.

• Korean Journal of Radiology
• /
• v.22 no.12
• /
• pp.2006-2016
• /
• 2021

The expanding scope of interventional musculoskeletal procedures has resulted in increased pressure on general radiologists. The confidence of general radiologists in performing ultrasound-guided musculoskeletal procedures varies with their clinical exposure. This didactic review provides a methodologically and clinically oriented approach to enhancing user understanding and confidence in performing ultrasound-guided musculoskeletal procedures. The body of the text is accompanied by figures depicting the procedural approach, injection site, and labeled ultrasonography images. This paper aims to provide a teaching and bedside aid for education on and the execution of musculoskeletal procedures to ensure the provision of quality health care.

• The Journal of the Korea Contents Association
• /
• v.18 no.8
• /
• pp.338-344
• /
• 2018

The purpose of this study was to determine the optimal number of excitations(NEX) of diffusion weighted imaging(DWI) which is clinically useful in patients with musculoskeletal diseases while the scan time is relatively long. In this study, 30 patients underwent knee MRI using diffusion weighted image sequence using b values targeted on the bone and muscle. The NEX were varied from 1 to 5 and the ADC values were measured and analyzed. As a result of the study, 4 NEX and 2 NEX showed an statistically identical effect with the existing NEX on the bone and muscle diffusion weighted images, respectively. Also, it proved that the scan time could be significantly reduced by 21.2 % and 59.6 % compared to the established NEX which meant the optimal NEX could replace the existing NEX. In conclusion, applying the optimal NEX on the musculoskeletal bone and soft tissue DWI could improve the problems caused by the long scan time.

• Proceedings of the KSMRM Conference
• /
• 1998.03a
• /
• pp.104-111
• /
• 1998