• Korean Journal of Radiology
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• v.25 no.5
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• pp.481-492
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• 2024

Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.

• Proceedings of the Korean Society of Medical Physics Conference
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• 1999.11a
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• pp.90-90
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• 1999

• Korean Journal of Radiology
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• v.21 no.12
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• pp.1334-1344
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• 2020

Objective: Compressed sensing (CS) has gained wide interest since it accelerates MRI acquisition. We aimed to compare the 3D post-contrast T1-weighted volumetric isotropic turbo spin echo acquisition (VISTA) with CS (VISTA-CS) and without CS (VISTA-nonCS) in intracranial vessel wall MRIs (VW-MRI). Materials and Methods: From April 2017 to July 2018, 72 patients who underwent VW-MRI, including both VISTA-CS and VISTA-nonCS, were retrospectively enrolled. Wall and lumen volumes, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were measured from normal and lesion sites. Two neuroradiologists independently evaluated overall image quality and degree of normal and lesion wall delineation with a four-point scale (scores ≥ 3 defined as acceptable). Results: Scan coverage was increased in VISTA-CS to cover both anterior and posterior circulations with a slightly shorter scan time compared to VISTA-nonCS (approximately 7 minutes vs. 8 minutes). Wall and lumen volumes were not significantly different with VISTA-CS or VISTA-nonCS (interclass correlation coefficient = 0.964-0.997). SNR was or trended towards significantly higher values in VISTA-CS than in VISTA-nonCS. At normal sites, CNR was not significantly different between two sequences (p = 0.907), whereas VISTA-CS provided lower CNR in lesion sites compared with VISTA-nonCS (p = 0.003). Subjective wall delineation was superior with VISTA-nonCS than with VISTA-CS (p = 0.019), although overall image quality did not differ (p = 0.297). The proportions of images with acceptable quality were not significantly different between VISTA-CS (83.3-97.8%) and VISTA-nonCS (75-100%). Conclusion: CS may be useful for intracranial VW-MRI as it allows for larger scan coverage with slightly shorter scan time without compromising image quality.

• Korean Journal of Radiology
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• v.21 no.6
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• pp.736-745
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• 2020

Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

• Imaging Science in Dentistry
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• v.36 no.1
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• pp.49-54
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• 2006

Purpose : To evaluate accuracy and reliability of program to measure facial soft tissue thickness using 3D computed tomographic images by comparing with direct measurement. Materials and Methods : One cadaver was scanned with a Helical CT with 3 mm slice thickness and 3 mm/sec table speed. The acquired data was reconstructed with 1.5 mm reconstruction interval and the images were transferred to a personal computer. The facial soft tissue thickness were measured using a program developed newly in 3D image. For direct measurement, the cadaver was cut with a bone cutter and then a ruler was placed above the cut side. The procedure was followed by taking pictures of the facial soft tissues with a high-resolution digital camera. Then the measurements were done in the photographic images and repeated for ten times. A repeated measure analysis of variance was adopted to compare and analyze the measurements resulting from the two different methods. Comparison according to the areas was analyzed by Mann-Whitney test. Results : There were no statistically significant differences between the direct measurements and those using the 3D images (p>0.05). There were statistical differences in the measurements on 17 points but all the points except 2 points showed a mean difference of 0.5 mm or less. Conclusion : The developed software program to measure the facial soft tissue thickness using 3D images was so accurate that it allows to measure facial soft tissues thickness more easily in forensic science and anthropology.

• Imaging Science in Dentistry
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• v.31 no.4
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• pp.235-240
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• 2001

Purpose: To evaluate displacement and morphologic changes of the temporomandibular joint (TMJ) disc in patient with internal derangement using magnetic resonance imaging (MRI). Materials and Methods: One hundred and forty five MR images of TMJs in 73 patients were evaluated. Positional and morphologic changes of the TMJ discs were assessed. Lateral or medial disc displacement was also evaluated on coronal images. Results: Among 63 discs with anterior disc displacement, 37 discs were assessed as a biconcave disc and 21 as a deformed disc. Rotational disc displacement was observed in 35 discs. Anteromedial disc displacement was observed in 29 discs, and anterolateral direction in 6 discs. Among 35 rotational displacement, 5 biconcave discs and 21 deformed discs were observed. Conclusion : Rotational and sideways displacement of TMJ discs were found to be common and an important aspect of internal derangement. This study also suggests that sagittal and coronal images of the TMJ have complementary abilities for an assessment of joint abnormality.

• Imaging Science in Dentistry
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• v.34 no.3
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• pp.165-169
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• 2004

Craniofacial dysostosis is considered to be one of rarely observed syndromes characterized by premature closing of all cranial sutures. The first patient was a 4-year-old male infant who had been complaining of empyema. Clinical findings showed exophthalmos, hypertelorism and facial asymmetry. Conventional radiographs demonstrated abscence of cranial sutures and underdeveloped maxilla. CT scan demonstrated the digital impressions of the inner surface of the cranial vault, enlarged and depressed sella turcica. The second patient was a 2-year-old female infant who had been complaining of facial deformity. Clinical findings showed hypertelorism and underdeveloped maxilla. Radiographs showed premature synostosis of all cranial sutures, depressed and enlarged sella turcica, and hypoplastic maxilla. 3 years after operation, her look improved. However, resurgery may be considered to decreasing intracranial pressure and for correction of facial deformity. Two interesting cases showing ‘cloverleaf’ skulls were presented.

• Imaging Science in Dentistry
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• v.40 no.2
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• pp.83-87
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• 2010

Purpose : This study was to determine the relationship between age and the mandibular cortical bone thickness on panoramic radiograph. Materials and Methods : Panoramic radiographs of 360 patients (180 men and 180 women) over 20 years old, who visited the Chonbuk National University Hospital from January to December in 2007, were assessed. The subjects were divided into 5 age groups. Five indices such as cortical bone thickness at the gonion (GI), antegonion (AI), and below the mental foramen (MI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) were measured on panoramic radiographs. Results : All five indices including GI, AI, MI, PMI, and MCI showed significant differences between third decade and over 8 decade groups (p<0.05). PMI, MI and GI showed significant differences with gender statistically (p<0.05). Conclusion : The mandibular cortical bone thickness showed negative correlation with age, and the value of the thickness (PMI, MI, and GI) was greater in men than in women.

• Investigative Magnetic Resonance Imaging
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• v.23 no.3
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• pp.251-258
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• 2019

Purpose: To assess the feasibility of the use of spin-echo echo-planar imaging (SE-EPI) magnetic resonance elastography (MRE) in livers of children and young adults. Materials and Methods: Patients (${\leq}20$ years old) who underwent 3T SE-EPI MRE were included retrospectively. Subjects were divided into three groups according to the purpose of the liver MRI: suspicion of fatty liver or focal fat deposition in the liver (FAT group), liver fibrosis after receiving a Kasai operation from biliary atresia (BA group), and hepatic iron deposition after receiving chemotherapy or transfusions (IRON group). Technical failure of MRE was defined when a stiffness map showed no pixel value with a confidence index higher than 95%, and the patients were divided as success and failure groups accordingly. Clinical findings including age, gender, weight, height, and body mass index and magnetic resonance imaging results including proton density fat fraction (PDFF), $T2^*$, and MRE values were assessed. Factors affecting failure of MRE were evaluated and the image quality in wave propagation image and stiffness map was evaluated using the appropriate scores. Results: Among total 240 patients (median 15 years, 211 patients in the FAT, 21 patients in the BA, and 8 patients in the IRON groups), technical failure was noted in six patients in the IRON group (6/8 patients, 75%), while there were no failures noted in the FAT and BA groups. These six patients had $T2^*$ values ranging from 0.9 to 3.8 ms. The image quality scores were not significantly different between the FAT and BA groups (P > 0.999), while the scores were significantly lower in the IRON group (P < 0.001). Conclusion: The 3T SE-EPI MRE in children and young adults had a high technical success rate. The technical failure was occurred in children with decreased $T2^*$ value (${\leq}3.8ms$) from iron deposition.

• Imaging Science in Dentistry
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• v.38 no.1
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• pp.7-15
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• 2008

Purpose: This study provides comparative measurements of absorbed and effective doses for newly developed cone beam computed tomography (CT) in comparison with these doses for conventional CT. Materials and Methods: Thermoluminescent dosimeter rods (TLD rod: GR-200, Thermo Fisher Scientific Inc., Waltham, MA, USA) were placed at 25 sites throughout the layers of Male ART Head and Neck Phantom (Radiology Support Devices Inc., Long Beach, USA) for dosimetry. Implagraphy, DCT Pro (Vatech Co., Hwasung, Korea) units, SCT-6800TXL (Shimadzu Corp., Kyoto, Japan), and Crane x 3+(Soredex Orion Corp., Helsinki, Finland) were used for radiation exposures. Absorption doses were measured with Harshaw 3500TLD reader (Thermo Fisher Scientific Inc., Waltham, MA, USA). Radiation weighted doses and effective doses were measured and calculated by 2005 ICRP tissue weighting factors. Results: Absorbed doses in Rt. submandibular gland were 110.57 mGy for SCT 6800TXL (Implant), 24.56 mGy for SCT 6800TXL (3D), 22.39 mGy for Implagraphy 3, 7.19 mGy for DCT Pro, 5.96 mGy for Implagraphy 1, 0.70 mGy for Cranex 3+. Effective doses $(E_{2005draft)$ were 2.551 mSv for SCT 6800TXL (Implant), 1.272 mSv for SCT 6800TXL (3D), 0.598 mSv for Implagraphy 3, 0.428 mSv for DCT Pro and 0.146 mSv for Implagraphy 1. These are 108.6, 54.1, 25.5, 18.2 and 6.2 times greater than panoramic examination (Cranex 3+) doses (0.023mSv). Conclusion: Cone beam CT machines recently developed in Korea, showed lower effective doses than conventional CT. Cone beam CT provides a lower dose and cost alternative to conventional CT, promising to revolutionize the practice of oral and maxillofacial radiology.