• 한국방사선학회논문지
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• 제16권7호
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• pp.995-1006
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• 2022

본 연구는 방사선학 전공 학생들을 대상으로 비대면 온라인 환경에서의 실습 교과 운영 현황과 학습 효과, 학생들의 경험과 인식을 설문조사를 통해 알아보고자 하였다. 설문은 대상자의 일반적 특성, 현재 비대면 환경에서의 학습 참여실태, 학습 만족도, 학습 성과, 개선 및 요구사항의 5개 영역 총 34문항으로 구성하였다. 5단계 또는 5점 척도로 구조화된 응답 방식과 응답자 본인의 의견을 반영하는 개방형 답변방식을 입력하는 혼합방식으로 진행하였다. 설문 응답에 대한 분석은 각 항목에 대한 응답 빈도와 비율, 척도 등을 빈도 분석하였고, 설문 응답자의 일반적인 특성을 바탕으로 비대면 학습 참여실태, 학습 성과, 학습 만족도를 카이제곱 검정(chi-square test)을 이용한 교차분석을 시행하였다. 개선 및 요구사항은 동일한 의미를 가진 단어의 빈도를 질적 분석하였다. 총 397개의 설문 응답을 분석한 결과, 대상자의 특성에 따른 학습 참여 실태 응답 항목 중에서는 비대면 실습수업 시 집중도를 묻는 항목은 3학년 학생들에게서 수업 집중도가 높아지는 결과를 확인할 수 있었으며(p=0.003). 대상자의 특성에 따른 학습 성과는, 1학년과 3학년 학생에서 비대면 실습수업으로 인한 학습 성과 저하가 통계적으로 의미 있는 변화를 보이고 있으며(1학년 p=0.012, 3학년 p=0.02), 특히 3학년 학생들의 경우 대면 실습 대비 비대면 실습수업의 효과 비율이 50% 이하라고 응답하는 경향이 강함을 확인할 수 있었다(p=0.001). 통학 소요 시간이 오래 걸릴수록 비대면 실습수업에 대해 학습 성과 향상으로 응답하여 통계적으로 의미 있는 결과를 나타내고 있었다(p=0.032). 다른 항목 간에는 통계적으로 유의미한 차이를 확인할 수 없었다(p>0.05). 설문 결과를 통해 향후 비대면 환경에서의 실습수업의 설계 및 개발의 방향성과 효율적 운영에 대한 기초 정보와 효과에 대한 시사점을 확인하였다. 이를 바탕으로 포스트 코로나 시대의 효율적인 비대면 실습수업 운영에 대한 고민과 노력이 계속되어야 할 것이다.

• 한국방사선학회논문지
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• 제17권6호
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• pp.965-975
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• 2023

방사선학의 교육은 실습이 많은 비중을 차지하며 비대면 온라인 교육으로 진행되기 어려운 실정이다. 본 연구에서는 실습교육을 대체할 수 있는 메타버스 플랫폼을 활용하여 비대면 수업으로 접하기 어려운 실습실을 가상 세계로 구현 후 실습수업 이후 학습자들의 만족도 및 메타버스 플랫폼 수업의 실용성과 교육과정의 미래 지향성을 알아보고자 하였다. 메타버스 플랫폼인 제페토(빌드잇)와 ZEP(젭) 을 활용하여 S대 방사선학과 실습실을 가상 세계로 구현하여 학생들의 수업에 활용하였다. 총 50명의 학생이 각각 사전, 사후 조사로 나누어 총 2회 설문조사를 실시하였고, 모든 문항은 리커트 5점 척도가 사용되었다. 연구결과 메타버스 가상공간 이용하지 않은 교육은 2.32로 만족도가 낮은 반면 가상공간 활용을 통한 교육은 4.16으로 매우 높게 나왔다. 분석 결과, 새로운 교육 시스템의 만족도와 메타버스 플랫폼 수업의 실용성은 매우 높으며 추후 앱설명 등 추가 교육 진행 시 더욱 효과적인 교육 플랫폼이 될 것으로 사료된다.

• Korean Journal of Radiology
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• 제24권8호
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• pp.729-738
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• 2023

Objective: When multiple surveillance mammograms are performed within an annual interval, the current guidance for oneyear follow-up to determine breast cancer status results in shared follow-up periods in which a single breast cancer diagnosis can be attributed to multiple preceding examinations, posing a challenge for standardized performance assessment. We assessed the impact of using follow-up periods that eliminate the artifactual inflation of second breast cancer diagnoses. Materials and Methods: We evaluated surveillance mammograms from 2007-2016 in women with treated breast cancer linked with tumor registry and pathology outcomes. Second breast cancers included ductal carcinoma in situ or invasive breast cancer diagnosed during one-year follow-up. The cancer detection rate, interval cancer rate, sensitivity, and specificity were compared using different follow-up periods: standard one-year follow-up per the American College of Radiology versus follow-up that was shortened at the next surveillance mammogram if less than one year (truncated follow-up). Performance measures were calculated overall and by indication (screening, evaluation for breast problem, and short interval follow-up). Results: Of 117971 surveillance mammograms, 20% (n = 23533) were followed by another surveillance mammogram within one year. Standard follow-up identified 1597 mammograms that were associated with second breast cancers. With truncated follow-up, the breast cancer status of 179 mammograms (11.2%) was revised, resulting in 1418 mammograms associated with unique second breast cancers. The interval cancer rate decreased with truncated versus standard follow-up (3.6 versus 4.9 per 1000 mammograms, respectively), with a difference (95% confidence interval [CI]) of -1.3 (-1.6, -1.1). The overall sensitivity increased to 70.4% from 63.7%, for the truncated versus standard follow-up, with a difference (95% CI) of 6.6% (5.6%, 7.7%). The specificity remained stable at 98.1%. Conclusion: Truncated follow-up, if less than one year to the next surveillance mammogram, enabled second breast cancers to be associated with a single preceding mammogram and resulted in more accurate estimates of diagnostic performance for national benchmarks.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5089-5095
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• 2014

Background: As a common and essential contrast medium at present, gadobenate dimeglumine has shown better performance than some other agents when applied to Breast Magnetic Resonance Imaging Screening (Breast MRI Screening). Nevertheless, reports on the diagnostic performance of these two mediums (gadobenate dimeglumine and gadopentetate dimeglumine) are not completely consistent. Objective: To assess the diagnostic value of gadobenate dimeglumine and gadopentetate dimeglumine for Breast MRI Screening in patients suffering from breast cancer and to provide more convinced evidence to guide clinical practice in terms of appropriate contrast agents. Data Sources and Review Methods: Original articles in English and Chinese published before January 2013 were selected from available databases (The Cochrane Library, PUBMED, EMBASE, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, Chinese Journal Full-text). The criteria for inclusion and exclusion were based on the standard for diagnosis tests. Meta-Disc software (Version 1.4) was used for data analysis. Then, the area under curve (AUC) of SROC and the spearman rank correlation of sensitivity against (1-specificity) were calculated. Results: Total of 17 researches involving 1934 patients were included. The pooled sensitivity of gadobenate dimeglumine and gadopentetate dimeglumine were 0.99 (0.97, 1.00) and 0.93 (0.88, 1.00) respectively. The pooled specificity for these two contrast agents were 0.924 (0.902, 0.943) and 0.838 (0.817, 0.858) respectively, and the AUC of SROC curve were 0.9781 and 0.9215 respectively. Conclusions: Gadobenate dimeglumine can be regarded as a more effective and feasible contrast medium for Breast MRI Screening. At least 5% differences in diagnostic performance are usually considered as clinically relevant.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2717-2722
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• 2013

Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

• Korean Journal of Radiology
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• 제24권6호
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• pp.529-540
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• 2023

Objective: To compare the diagnostic performance and clinical outcomes of 2-mSv computed tomography (CT) and conventional-dose CT (CDCT), following radiology residents' interpretation of CT examinations for suspected appendicitis. Materials and Methods: Altogether, 3074 patients with suspected appendicitis aged 15-44 years (28 ± 9 years, 1672 females) from 20 hospitals were randomly assigned to the 2-mSv CT (n = 1535) or CDCT (n = 1539) groups in a pragmatic trial from December 2013 and August 2016. Overall, 107 radiology residents participated in the trial as readers in the form of daily practice after online training for 2-mSv CT. They made preliminary CT reports, which were later finalized by attending radiologists via addendum reports, for 640 and 657 patients in the 2-mSv CT and CDCT groups, respectively. We compared the diagnostic performance of the residents, discrepancies between preliminary and addendum reports, and clinical outcomes between the two groups. Results: Patient characteristics were similar between the 640 and 657 patients. Residents' diagnostic performance was not significantly different between the 2-mSv CT and CDCT groups, with a sensitivity of 96.0% and 97.1%, respectively (difference [95% confidence interval {CI}], -1.1% [-4.9%, 2.6%]; P = 0.69) and specificity of 93.2% and 93.1%, respectively (0.1% [-3.6%, 3.7%]; P > 0.99). The 2-mSv CT and CDCT groups did not significantly differ in discrepancies between the preliminary and addendum reports regarding the presence of appendicitis (3.3% vs. 5.2%; -1.9% [-4.2%, 0.4%]; P = 0.12) and alternative diagnosis (5.5% vs. 6.4%; -0.9% [-3.6%, 1.8%]; P = 0.56). The rates of perforated appendicitis (12.0% vs. 12.6%; -0.6% [-4.3%, 3.1%]; P = 0.81) and negative appendectomies (1.9% vs. 1.1%; 0.8% [-0.7%, 2.3%]; P = 0.33) were not significantly different between the two groups. Conclusion: Diagnostic performance and clinical outcomes were not significantly different between the 2-mSv CT and CDCT groups following radiology residents' CT readings for suspected appendicitis.

• Korean Journal of Radiology
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• 제23권10호
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• pp.959-975
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• 2022

Objective: To investigate the agreement and reliability of estimating the volumes and normative percentiles (N%) of segmented brain regions among NeuroQuant (NQ), DeepBrain (DB), and FreeSurfer (FS) software programs, focusing on the comparison between NQ and DB. Materials and Methods: Three-dimensional T1-weighted images of 145 participants (48 healthy participants, 50 patients with mild cognitive impairment, and 47 patients with Alzheimer's disease) from a single medical center (SMC) dataset and 130 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset were included in this retrospective study. All images were analyzed with DB, NQ, and FS software to obtain volume estimates and N% of various segmented brain regions. We used Bland-Altman analysis, repeated measures ANOVA, reproducibility coefficient, effect size, and intraclass correlation coefficient (ICC) to evaluate inter-method agreement and reliability. Results: Among the three software programs, the Bland-Altman plot showed a substantial bias, the ICC showed a broad range of reliability (0.004-0.97), and repeated-measures ANOVA revealed significant mean volume differences in all brain regions. Similarly, the volume differences of the three software programs had large effect sizes in most regions (0.73-5.51). The effect size was largest in the pallidum in both datasets and smallest in the thalamus and cerebral white matter in the SMC and ADNI datasets, respectively. N% of NQ and DB showed an unacceptably broad Bland-Altman limit of agreement in all brain regions and a very wide range of ICC values (-0.142-0.844) in most brain regions. Conclusion: NQ and DB showed significant differences in the measured volume and N%, with limited agreement and reliability for most brain regions. Therefore, users should be aware of the lack of interchangeability between these software programs when they are applied in clinical practice.

• Korean Journal of Radiology
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• 제21권9호
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• pp.1036-1044
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• 2020

Objective: To investigate the clinical feasibility of synthetic diffusion-weighted imaging (sDWI) at different b-values in patients with breast cancer by assessing the diagnostic image quality and the quantitative measurements compared with conventional diffusion-weighted imaging (cDWI). Materials and Methods: Fifty patients with breast cancer were assessed using cDWI at b-values of 800 and 1500 s/mm² (cDWI₈₀₀ and cDWI₁₅₀₀) and sDWI at b-values of 1000 and 1500 s/mm² (sDWI₁₀₀₀ and sDWI₁₅₀₀). Qualitative analysis (normal glandular tissue suppression, overall image quality, and lesion conspicuity) was performed using a 4-point Likert-scale for all DWI sets and the cancer detection rate (CDR) was calculated. We also evaluated cancer-to-parenchyma contrast ratios for each DWI set in 45 patients with the lesion identified on any of the DWI sets. Statistical comparisons were performed using Friedman test, one-way analysis of variance, and Cochran's Q test. Results: All parameters of qualitative analysis, cancer-to-parenchyma contrast ratios, and CDR increased with increasing b-values, regardless of the type of imaging (synthetic or conventional) (p < 0.001). Additionally, sDWI₁₅₀₀ provided better lesion conspicuity than cDWI₁₅₀₀ (3.52 ± 0.92 vs. 3.39 ± 0.90, p < 0.05). Although cDWI₁₅₀₀ showed better normal glandular tissue suppression and overall image quality than sDWI₁₅₀₀ (3.66 ± 0.78 and 3.73 ± 0.62 vs. 3.32 ± 0.90 and 3.35 ± 0.81, respectively; p < 0.05), there was no significant difference in their CDR (90.0%). Cancer-to-parenchyma contrast ratios were greater in sDWI₁₅₀₀ than in cDWI₁₅₀₀ (0.63 ± 0.17 vs. 0.55 ± 0.18, p < 0.001). Conclusion: sDWI₁₅₀₀ can be feasible for evaluating breast cancers in clinical practice. It provides higher tumor conspicuity, better cancer-to-parenchyma contrast ratio, and comparable CDR when compared with cDWI₁₅₀₀.

• 치과방사선
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• 제27권1호
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• pp.217-230
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• 1997

The location of the mandibular canal and the cortical thickness of the mandible is important in the practice of dentistry. This study was performed on twenty chosen dry mandibles, which were of adults and included fully erupted premolars and molars. The purpose of this study was to evaluate the location of the mandibular canal and the cortical thickness of the mandible on computed tomograms and to aid in the surgical treatment plans. The obtained results were as follows; 1. The horizontal distance between the mandibular canal and the buccal external border was 6.6±0.9mm on Somesial root of the first molar), and it was increased posteriorly. The horiwntal distance between the mandibular canal and the lingual external border was 4.1±1.lmm on S/sub 0/, and it was decreased posteriorly. 2. The vertical distance between the alveolar crest and the mandibular canal was 16.9±1.6mm on S/sub 0/, and it was decreased posteriorly. The vertical distance between the inferior border of mandible and the mandibular canal was 8.8±1.3mm on S/sub 0/, and it was increased anteriorly and posteriorly. 3. The thickness of the buccal cortical plate was 2.2±0.4mm on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 2.0±0.6mm on S/sub 0/ and it was decreased posteriorly. 4. The area of the buccal cortical plate was 66.5±1.0mm² on S/sub 0/. and it was increased posteriorly. But, that of the lingual cortical plate was 65.8±0.9mm² on S/sub 0/ and it was decreased posteriorly.

• Imaging Science in Dentistry
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• 제34권4호
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• pp.175-178
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• 2004

Purpose: Picture Archiving and Communication System (PACS) is difficult to implement in the best of situations, but evidence is growing that the benefits are significant. The aims of this study are to analyze the current status of full PACS and establish successful installation standard of dental PACS. Materials and Methods : Materials and methods were based on the investigation of current working status and installation standard of PACS, and observation of variable issues to installation of dental PACS. Results: By September 30,2004, full PACS implementations in their facilities were 88.1 % in specialized general hospitals (37 installations out of total 42 hospitals), 59.8% in general hospitals (144 installations out of total 241 hospitals), 12.3% in medical hospitals (116 installations out of total 941 hospitals) and 3.6% in dental hospitals (4 installations out of total 11 0 hospitals) Only 4 university dental hospitals currently have installed and are operating full PACS. Major obstacle to wide spread of dental PACS is initial high investments. Conclusions: Clinical environments of dental PACS differed from medical situation. Because of characteristic dental practice, the initial investments for dental PACS are generally much greater than those of medical PACS. Also new economic crisis makes users scruple. The best way to overcome these limitations is to establish an economic installation standard for dental PACS. Also the clear technical communication between the customer and the supplier before both sides are committed to the obstacles are critical to its success.