• Hip & pelvis
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• 제30권4호
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• pp.233-240
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• 2018

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

• 대한방사선기술학회지:방사선기술과학
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• 제46권6호
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• pp.535-542
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• 2023

This study aimed to implement a deep learning model that can perform quantitative quality control through ACTS software used for quantitative evaluation of ACR phantom in CT quality control and evaluate its usefulness. By changing the scanning conditions, images of three modules of the ACR phantom's slice thickness (ST), low contrast resolution (LC), and high contrast resolution (HC) were obtained and classified as ACTS software. The deep learning model used ResNet18, implementing three models in which ST, HC, and LC were learned with epoch 50 and an integrated model in which three modules were learned with Epoch 10, 30, and 50 at once. The performance of each model was evaluated through Accuracy and Loss. When comparing and evaluating the accuracy and loss function values of the deep learning models by ST, LC, and HC modules, the Accuracy and Loss of the HC model were the best with 100% and 0.0081, and in the integrated model according to the Epoch value, Accuracy and Loss with epoch 50 were the best with 96.29% and 0.1856. This paper showed that quantitative quality control is possible through a deep learning model, and it can be used as a basis and evidence for applying deep learning to the CT quality control.

• Korean Journal of Radiology
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• 제23권4호
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• pp.402-412
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• 2022

Objective: To evaluate the image quality and lesion detectability of lower-dose CT (LDCT) of the abdomen and pelvis obtained using a deep learning image reconstruction (DLIR) algorithm compared with those of standard-dose CT (SDCT) images. Materials and Methods: This retrospective study included 123 patients (mean age ± standard deviation, 63 ± 11 years; male:female, 70:53) who underwent contrast-enhanced abdominopelvic LDCT between May and August 2020 and had prior SDCT obtained using the same CT scanner within a year. LDCT images were reconstructed with hybrid iterative reconstruction (h-IR) and DLIR at medium and high strengths (DLIR-M and DLIR-H), while SDCT images were reconstructed with h-IR. For quantitative image quality analysis, image noise, signal-to-noise ratio, and contrast-to-noise ratio were measured in the liver, muscle, and aorta. Among the three different LDCT reconstruction algorithms, the one showing the smallest difference in quantitative parameters from those of SDCT images was selected for qualitative image quality analysis and lesion detectability evaluation. For qualitative analysis, overall image quality, image noise, image sharpness, image texture, and lesion conspicuity were graded using a 5-point scale by two radiologists. Observer performance in focal liver lesion detection was evaluated by comparing the jackknife free-response receiver operating characteristic figures-of-merit (FOM). Results: LDCT (35.1% dose reduction compared with SDCT) images obtained using DLIR-M showed similar quantitative measures to those of SDCT with h-IR images. All qualitative parameters of LDCT with DLIR-M images but image texture were similar to or significantly better than those of SDCT with h-IR images. The lesion detectability on LDCT with DLIR-M images was not significantly different from that of SDCT with h-IR images (reader-averaged FOM, 0.887 vs. 0.874, respectively; p = 0.581). Conclusion: Overall image quality and detectability of focal liver lesions is preserved in contrast-enhanced abdominopelvic LDCT obtained with DLIR-M relative to those in SDCT with h-IR.

• Korean Journal of Radiology
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• 제22권1호
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• pp.63-71
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• 2021

Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HU_post) and non-enhanced CT (HU_pre). The degree of appendiceal wall enhancement (HU_sub) was calculated as the subtracted value between HU_post and HU_pre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HU_post (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HU_sub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

• 대한의용생체공학회:의공학회지
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• 제32권3호
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• pp.257-263
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• 2011

Sparse-view CT imaging is considered to be a solution to reduce x-ray dose of CT. Sparse-view CT imaging may have severe streak artifacts that could compromise the image qualities. We have compared quality of sparseview images reconstructed with two representative iterative reconstruction techniques, SIRT and TV-minimization, in terms of image error and edge preservation. In the comparison study, we have used the Shepp-Logan phantom image and real CT images obtained with a micro-CT. In both phantom image and real CT image tests, TV-minimization technique shows the best performance in error reduction and preserving edges. However, the excessive computation time of TV-minimization is a technical challenge for the practical use.

• 핵의학기술
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• 제25권2호
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• pp.15-24
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• 2021

SPECT/CT는 보급 초기에 뛰어난 보정방법과 융합영상을 기반으로 한 정성적 기능이 주목받았고, 최근 동반진단치료(Theranostics)등의 도입으로 그 정량적 기능에 대한 관심과 활용이 증가되는 추세이다. PET/CT와 달리 SPECT/CT의 절대 정량화는 조준기의 종류, 검출기 회전과 같은 조건들이 영상획득과 재구성 방법 등에 까다로운 요소로 작용하고 있다. 따라서 본 연구에서는 SPECT/CT 촬영조건 중 투영상수와 투영상당 획득시간에 따른 총 획득시간(검사시간)의 증·감이 방사능농도 추정치에 미치는 영향을 알아보고자 한다. 부피 9,293 ml의 원통형 팬텀에 멸균수를 가득 채운 후 99mTcO4- 91.76 MBq를 희석하여 총 획득시간 600 sec(10 sec/frame × 120 frames, matrix size 128 × 128)의 조건으로 기준영상을 촬영하였고, 체적감도와 교정인자를 확인하였다. 기준영상을 중심으로 총 획득시간을 60(-90%), 150(-75%), 300(-50%), 450(-25%), 900(+50%), 1200(+100%) sec/frame으로 증·감시켜 비교영상을 획득하였고, 각 영상별 세부조건은 투영상당 획득시간(sec/frame)을 1.0, 2.5, 5.0, 7.5, 15.0, 20.0 sec/frame(투영상수 120frames 고정)로, 투영상수를 12, 30, 60, 90, 180, 240 frames(투영상당 획득시간 10 sec/frame 고정)로 설정하였다. 획득된 각 영상에서 관심체적을 통하여 측정한 계수를 바탕으로 정성적 평가로서 CNR(Contrast to Noise Ratio)의 변동률(%)을 확인하였고, 방사능농도 추정치의 변동률(%)을 통해서는 정량적 평가를 시행하였다. 이때 방사능농도 추정치(cps/ml)와 실제 방사능농도(Bq/ml)의 관계는 회복계수(RC_Recovery Coefficients)를 지표로 비교·분석하였다. 투영상수 변화에 따른 결과[CNR 변동률(%), 방사능농도 추정치 변동률(%), RC]는 총 획득시간 증감률(%) -90%에서 [-89.5%, +3.90%, 1.04], -75%에서 [-77.9%, +2.71%, 1.03], -50%에서 [-55.6%, +1.85%, 1.02], -25%에서 [-33.6%, +1.37%, 1.01], +50%에서 [+33.7%, +0.71%, 1.01], +100%에서 [+93.2%, +0.32%, 1.00]이었으며, 투영상당 획득시간 변화에 따른 결과는 총 획득시간 증감률(%)-90%에서 [-89.3%, -3.55%, 0.96], -75%에서 [-73.4%, -0.17%, 1.00], -50%에서 [-49.6%, -0.34%, 1.00], -25%에서 [-24.9%, 0.03%, 1.00], +50%에서 [+49.3%, -0.04%, 1.00], +100%에서 [+99.0%, +0.11%, 1.00]이었다. SPECT/CT에서 총 획득시간의 증·감에 따라 획득된 총 계수와 그에 따른 영상품질(CNR)은 비례하여 변화하는 양상을 보였지만, 절대 정량화를 통한 정량적 평가에서는 모든 실험조건에서 5% 미만(-3.55에서 +3.90%)의 변화를 보여 큰 영향을 받지 않고 정량적 정확성(RC 0.96에서 1.04)을 유지하였다. 검사시간의 증가보다는 단축을 우선하여 고려하였을 때 총 획득시간 감소는 정성적 기능에 있어서 기존에도 배제할 수 없었던 사항이지만 정량적 기능은 큰 손실 없이 적용 가능하여 임상적으로 실효성이 있다고 판단된다. 다만 총 획득시간의 증·감 시 동일한 검사시간이라면 투영상수의 변경보다는 투영상당 획득시간의 변경이 정성적, 정량적으로 조건변화에 따른 변동 폭이 적은 것으로 나타났다.

• 핵의학기술
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• 제19권2호
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• pp.93-101
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• 2015

SPECT영상에서 산란계수는 정량적 계수오차와 영상품질 저하의 요인이다. 이에 다양한 산란보정(Scatter Correction, SC)방법이 연구되어 왔으며, 본 연구에서는 기존의 에너지창(Energy Window, EW) 기반 SC(EWSC)와의 비교로 SPECT/CT에서 사용되는 CT 기반 SC(CTSC)의 정확성을 평가하고자 한다. 중앙에 열소막대(hot rod, 74.0 MBq)를 설정한 Triple line insert 팬텀의 내부에 산란계수의 영향이 없는 기준영상의 획득을 위하여 공기를 채운 후 SPECT /CT영상을 획득하였고, 같은 조건에서 산란계수의 영향을 유도하기 위하여 공기대신 물을 채운 후 SPECT/CT영상을 각각 별도로 획득하였다. 두 조건 모두 Astonish(iterative : 4, subset : 16) 재구성 방법과 CT감쇠보정을 공통 적용하였고, 물을 채운 영상에 비산란보정(NSC), EWSC, CTSC 3가지 유형의 산란보정방법을 사용하였다. EWSC를 위하여 주(=peak) 에너지창(140 keV, 20%) 이외에 보조 에너지창 9개를 추가 설정한 후 영상을 동시 획득하였고, EWSC의 종류는 DPW(dual photopeak window) 10%, DEW (dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% 5가지를 사용하였다. 일차(primary)계수의 변동이 없는 조건하에, 두 조건의 영상에 VOI를 그려 총계수를 측정한 후 총계수 중 산란계수의 비를 %SF(percent scatter fraction)로 구하고, 공기를 채운 영상을 기준으로 물을 채운 영상과의 계수차이를 %NMSE (per cent normalized mean-square error)로 평가하였다. 공기를 채운 영상을 기준으로 각 산란보정방법이 적용된 물을 채운 영상의 %SF는 NSC 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57로 CTSC에서 제거된 산란계수가 가장 많았으며, %NMSE는 NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35로 CTSC에서 가장 낮게 나타났다. SPECT/CT영상에서 실험에 사용된 각 산란보정 방법의 적용은 산란계수의 영향으로 발생된 정량적 계수오차를 개선시킬 수 있었다. 특히, CTSC의 경우 기존의 EWSC방법들과 비교하여 가장 낮은 %NMSE (=0.35)를 보여 비교적 정확한 산란보정이 가능하였다.

• 한국지반공학회논문집
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• 제36권9호
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• pp.45-55
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• 2020

X-ray CT는 암석시편의 공극 및 균열과 같은 내부 미세구조와 손상들의 정량적 분석에 활용되어 왔다. 원위치 CT는 외력 등 다양한 외적 요인에 영향을 받고 있는 암석 시편의 내외부 변화 과정을 관찰할 수 있게 해준다. 이의 확인을 위해, 암반/지반재료 특성분석에 활용한 원위치 X-ray CT 기술에 관한 최신 연구동향을 파악하였으며, 원위치 CT이미징이 가능한 암석의 수리-역학적 실험용 삼축셀을 개발하였다. 직경 25~50 mm 화강암 및 사암 코아시편의 원위치 CT이미징이 성공적으로 진행되었으며, 34~105 ㎛ 범위의 픽셀피치의 해상도를 취득할 수 있었다. 본 사전검토 촬영 실험을 통해 마이크로미터 스케일에서 암석의 내부구조 변화의 원위치 CT관찰이 가능한 것을 파악하였다. 요오드화 칼륨 용액은 CT이미지의 대비를 증가시키고 암석의 수리-역학 실험에서 주입유체로 사용할 수 있다.

• 대한방사선기술학회지:방사선기술과학
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• 제44권6호
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• pp.645-653
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• 2021

With the recent development of precision medicine(Theranostics), interest and utilization of the quantitative function of SPECT/CT are increasing. This study aims to investigate the effect on the radioactivity concentration estimate by the increase or decrease in the total time of SPECT/CT imaging conditions. A standard image was obtained by the conditions of a total acquisition time of 600 sec(10 sec/f × 120 frames) by diluting ^99mTc 91.76 MBq in a cylindrical phantom filled with sterile water, and a comparative image was obtained by increasing the total acquisition time by -90%, -75%, -50%, -25%, +50%, +100%. The CNR, radioactive concentration estimate(cps/ml), and the variation rate(%) of the recovery coefficient(RC) were analyzed by measuring the overall coefficient of interest in each image. The results[CNR, Radiation Concentration, RC] by the change in the number of projections for each increase or decrease rate(-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.5%, +3.90%, 1.04] at -90%, [-77.9%, +2.71%, 1.03] at -75%, [-55.6%, +1.85%, 1.02] at -50%, [-33.6%, +1.37%, 1.01] at -25%, [-33.7%, +0.71%, 1.01] at +50%, [+93.2%, +0.32%, 1.00] at +100%. and also The results[CNR, Radiation Concentration, RC] by the acquisition time change for each increase or decrease rate(-90%, -75%, -50%, -25%, +50%, +100%) of total acquisition time are as follows. [-89.3%, -3.55%, 0.96] at -90%, [-73.4%, -0.17%, 1.00] at -75%, [-49.6%, -0.34%, 1.00] at -50%, [-24.9%, 0.03%, 1.00] at -25%, [+49.3%, -0.04%, 1.00] at +50%, [+99.0%, +0.11%, 1.00] at +100%. Image quality(CNR) showed a pattern of change in proportion to the increase or decrease in the total acquisition time of SPECT/CT, but the result at quantitative evaluation showed a change of less than 5% in all experimental conditions, maintaining quantitative accuracy(RC less than 0.05) without much influence.

• Korean Journal of Radiology
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• 제24권11호
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• pp.1142-1150
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• 2023

Objective: To evaluate ^99mtechnetium-three polyethylene glycol spacers-arginine-glycine-aspartic acid (^99mTc-3PRGD₂) single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging for diagnosing lymph node metastasis of primary malignant lung neoplasms. Materials and Methods: We prospectively enrolled 26 patients with primary malignant lung tumors who underwent ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT imaging. Both imaging methods were analyzed in qualitative (visual dichotomous and 5-point grades for lymph nodes and lung tumors, respectively) and semiquantitative (maximum tissue-to-background radioactive count) manners for the lymph nodes and lung tumors. The performance of the differentiation of lymph nodes with and without metastasis was determined at the per-lymph node station and per-patient levels using histopathological results as the reference standard. Results: Total 42 stations had metastatic lymph nodes and 136 stations had benign lymph nodes. The differences between metastatic and benign lymph nodes in the visual qualitative and semiquantitative analyses of ^99mTc-3PRGD₂ SPECT/CT and ¹⁸F-FDG PET/CT were statistically significant (all P < 0.001). The area under the receiver operating characteristic curve (AUC) in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT was 0.908 (95% confidence interval [CI], 0.851-0.966), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.86 (36/42), 0.88 (120/136), 0.69 (36/52), and 0.95 (120/126), respectively. Among the 26 patients (including two patients each with two lung tumors), 15 had pathologically confirmed lymph node metastasis. The difference between primary lung lesions in patients with and without lymph node metastasis was statistically significant only in the semi-quantitative analysis of ^99mTc-3PRGD₂ SPECT/CT (P = 0.007), with an AUC of 0.807 (95% CI, 0.641-0.974). Conclusion: ^99mTc-3PRGD₂ SPECT/CT imaging may notably perform in the direct diagnosis of lymph node metastasis of primary malignant lung tumors and indirectly predict the presence of lymph node metastasis through uptake in the primary lesions.