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Comparison of Sizes of Anatomical Structures according to Scan Position Changes in Patients with Interstitial Lung Disease Using High-Resolution Thoracic CT (고해상도 흉부 전산화단층촬영을 이용한 간질성 폐질환을 가진 환자의 자세에 따른 해부학적 구조물 크기 비교)

  • Lee, Jae-min;Park, Je-heon;Kim, Ju-seong;Lim, Cheong-Hwan;Lee, Ki-Baek
    • Journal of radiological science and technology
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    • v.44 no.2
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    • pp.91-100
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    • 2021
  • High-Resolution thoracic CT (HRCT) is a scanning protocol in which thin slice thickness and sharpness algorithm are utilized to enhance image resolution for diagnosis and assessment of interstitial lung disease (ILD). This examination is sometimes performed in both supine and prone position to improve sensitivity to early changes of these conditions. Anatomical structures (the size of lung field and heart and descending aorta) of 150 patients who underwent HRCT were retrospectively compared. HRCT had been conducted in two positions (supine and prone). Data were divided into five groups according to patient body weights (from 40 to more than 80kg, 10kg intervals, 60 patients/each group). Quantitative analysis was utilized in Image J program. In the supine position defined as the control group, the average values of lung fields and heart size and aorta were compared with the prone position defined as the experimental group. The size of the lungs was found to be higher in the supine position, and it was confirmed that there was a statistically significant difference in patients over 70 kg (p<0.05). In addition, both sizes of the heart and descending aorta were larger in prone position, but in the case of the heart, there was no correlation with the presence or absence of ILD disease (p>0.05). Also, the area of prone in the descending aorta was higher than supine position, but there was no statistically significant difference between supine and prone position (p>0.05). In conclusion, when the severity of ILD disease was severe, there was no statistically significant difference in the area difference between supine and prone position, so it is considered that it will be helpful in diagnostic decision.

Prior to Breast MRI Guidelines in Korea, Where Were We?

  • Hwang, Cheong Hoon;Rho, Miribi;Lee, Minah;Kim, Ga Ram;Park, Vivian Youngjean;Yoon, Jung Hyun;Kim, Min Jung
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.1
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    • pp.35-42
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    • 2021
  • Purpose: To evaluate and analyze the adequacy of breast magnetic resonance imaging (MRI)s taken before publication of the 2018 recommendation in South Korea. Materials and Methods: We enrolled 87 cases of breast MRIs, from January 2010 to November 2013, taken at external hospitals in the study. Breast MRI protocol elements are divided into three categories based on the recommendation by the Breast Imaging Study Group of the Korean Society of Magnetic Resonance: (1) Essential elements for breast MRI protocol; (2) Element to consider when evaluating imaging quality; and (3) Optional element for breast MRI protocol. Also, we divided enrolled cases into three groups based on their conducting locations -- (1) Primary hospitals, (2) Secondary hospitals, and (3) Tertiary hospitals-and analyzed them for the adequacy of imaging protocols based on the 2018 recommendation. We used a Chi-square test and Fisher's exact test to identify differences between categorical variables. Results: Over 98% of the criteria for 'essential elements for breast MRI protocol' were satisfied when compared with the 2018 Recommendation. Over 96% of the criteria for 'elements to consider when evaluating imaging quality' were also satisfied, except for the slice thickness (83.9%). Optional elements for breast MRI protocol were satisfied with various percentages. There were no statistically significant differences between groups of tertiary, secondary, and primary hospitals; however, 3 tesla of MRI (P = 0.04), subtraction image protocol (P = 0.032), and DWI protocol (P = 0.03) were used more frequently in the tertiary hospitals than in the others. Conclusion: We found that the categories of 'essential elements' and 'elements to consider when evaluating imaging quality' were satisfied at 98% and 96%, respectively, when compared with the 2018 Recommendation by the Breast Imaging Study Group of the Korean Society of Magnetic Resonance.

Mapping the Posterior Ledge and Optic Foramen in Orbital Floor Blowout Fractures

  • Yu Cong Wong;Doreen S.L. Goh;Celine S.Y. Yoong;Cowan Ho;Elijah Z. Cai;Angela Hing;Hanjing Lee;Vigneswaran Nallathamby;Yan L. Yap;Jane Lim;Sundar Gangadhara;Thiam C. Lim
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.370-376
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    • 2023
  • Background The posterior ledge (PL) is a vital structure that supports the implant posteriorly during orbital floor reconstruction. This study describes a technique for mapping the PL in relation to the infraorbital margin (IM) in patients with orbital floor blowout fractures. This study establishes the location of the optic foramen in relation to the PL. Methods Facial computed tomography (FCT) scans of 67 consecutive patients with isolated orbital floor blowout fractures were analyzed using Osirix. Planes of reference for orbital fractures, a standardized technique for performing measurements on FCT, was used. Viewed coronally, the orbit was divided into seven equal sagittal slices (L1 laterally to L7 medially) with reference to the midorbital plane. The distances of PL from IM and location of optic foramen were determined. Results The greatest distance to PL is found at L5 (median: 30.1 mm, range: 13.5-37.1 mm). The median and ranges for each slice are as follows: L1 (median: 0.0 mm, range: 0.0-19.9 mm), L2 (median: 0.0 mm, range: 0.0-21.5 mm), L3 (median: 15.8 mm, range: 0.0-31.7 mm), L4 (median: 26.1 mm, range: 0.0-34.0 mm), L5 (median: 30.1 mm, range: 13.5-37.1 mm), L6 (median: 29.0 mm, range: 0.0-36.3 mm), L7 (median: 20.8 mm, range: 0.0-39.2 mm). The median distance of the optic foramen from IM is 43.7 mm (range: 37.0- 49.1) at L7.

Evaluation of Image for Phantom according to Normalization, Well Counter Correction in PET-CT (PET-CT Normalization, Well Counter Correction에 따른 팬텀을 이용한 영상 평가)

  • Choong-Woon Lee;Yeon-Wook You;Jong-Woon Mun;Yun-Cheol Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.27 no.1
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    • pp.47-54
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    • 2023
  • Purpose PET-CT imaging require an appropriate quality assurance system to achieve high efficiency and reliability. Quality control is essential for improving the quality of care and patient safety. Currently, there are performance evaluation methods of UN2-1994 and UN2-2001 proposed by NEMA and IEC for PET-CT image evaluation. In this study, we compare phantom images with the same experiments before and after PET-CT 3D normalization and well counter correction and evaluate the usefulness of quality control. Materials and methods Discovery 690 (General Electric Healthcare, USA) PET-CT equiptment was used to perform 3D normalization and well counter correction as recommended by GE Healthcare. Based on the recovery coefficients for the six spheres of the NEMA IEC Body Phantom recommended by the EARL. 20kBq/㎖ of 18F was injected into the sphere of the phantom and 2kBq/㎖ of 18F was injected into the body of phantom. PET-CT scan was performed with a radioacitivity ratio of 10:1. Images were reconstructed by appliying TOF+PSF+TOF, OSEM+PSF, OSEM and Gaussian filter 4.0, 4.5, 5.0, 5.5, 6.0, 6,5 mm with matrix size 128×128, slice thickness 3.75 mm, iteration 2, subset 16 conditions. The PET image was attenuation corrected using the CT images and analyzed using software program AW 4.7 (General Electric Healthcare, USA). The ROI was set to fit 6 spheres in the CT image, RC (Recovery Coefficient) was measured after fusion of PET and CT. Statistical analysis was performed wilcoxon signed rank test using R. Results Overall, after the quality control items were performed, the recovery coefficient of the phantom image increased and measured. Recovery coefficient according to the image reconstruction increased in the order TOF+PSF, TOF, OSEM+PSF, before and after quality control, RCmax increased by OSEM 0.13, OSEM+PSF 0.16, TOF 0.16, TOF+PSF 0.15 and RCmean increased by OSEM 0.09, OSEM+PSF 0.09, TOF 0.106, TOF+PSF 0.10. Both groups showed a statistically significant difference in Wilcoxon signed rank test results (P value<0.001). Conclusion PET-CT system require quality assurance to achieve high efficiency and reliability. Standardized intervals and procedures should be followed for quality control. We hope that this study will be a good opportunity to think about the importance of quality control in PET-CT

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Classification of Urinary Stone into Uric Acid & Non-uric Acid by Dual-Energy (이중에너지 전산화단층촬영을 이용한 요로결석의 성분 분석에 관한 연구)

  • Myung-Jin Jung;Sung-Gil Kim
    • Journal of the Korean Society of Radiology
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    • v.17 no.6
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    • pp.835-841
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    • 2023
  • The aim of this study is to evaluate the diagnostic ability of dual-energy computed tomography (DECT) for Composition determination of urinary stones in phantom model. Seventeen cases with urinary stones who underwent DECT were enrolled in the study. The composition of the urinary stones was extracted from the seventeen patients were analyzed with DECT in phantom model with fresh pork. The volume scan method using Dual-energy software was used and the scanned image sets were assessed. All 17 urinary stones of the phantom model were analyzed according to the stone composition using DE stone Analysis were divided into uric acid stones (n=6, 35.29%) and non-uric acid stones (n=11, 64.71%). These urinary stones were pathologically confirmed. The mean attenuation values of uric acid stones at 135 kV, 100 kV and 80 kV was 348.87 ± 166.37 HU, 345.33 ± 151.18 HU and 337.94 ± 172.77 HU, respectively. The mean attenuation values of non-uric acid stones at 135 kV, 100 kV and 80 kV was 551.93 ± 297.09 HU, 747.04 ± 351.31 HU and 958.19 ± 424.72 HU, respectively. At 80 kV, uric acid stones and non-uric acid stones showed significant difference in the attenuation values(P<0.05). The attenuation values of DECT could differentiate the compositions of urinary stones between uric acid and non-uric acid stones at 80 kV in phantom model.

Automatic Detection and Classification of Rib Fractures on Thoracic CT Using Convolutional Neural Network: Accuracy and Feasibility

  • Qing-Qing Zhou;Jiashuo Wang;Wen Tang;Zhang-Chun Hu;Zi-Yi Xia;Xue-Song Li;Rongguo Zhang;Xindao Yin;Bing Zhang;Hong Zhang
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.869-879
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    • 2020
  • Objective: To evaluate the performance of a convolutional neural network (CNN) model that can automatically detect and classify rib fractures, and output structured reports from computed tomography (CT) images. Materials and Methods: This study included 1079 patients (median age, 55 years; men, 718) from three hospitals, between January 2011 and January 2019, who were divided into a monocentric training set (n = 876; median age, 55 years; men, 582), five multicenter/multiparameter validation sets (n = 173; median age, 59 years; men, 118) with different slice thicknesses and image pixels, and a normal control set (n = 30; median age, 53 years; men, 18). Three classifications (fresh, healing, and old fracture) combined with fracture location (corresponding CT layers) were detected automatically and delivered in a structured report. Precision, recall, and F1-score were selected as metrics to measure the optimum CNN model. Detection/diagnosis time, precision, and sensitivity were employed to compare the diagnostic efficiency of the structured report and that of experienced radiologists. Results: A total of 25054 annotations (fresh fracture, 10089; healing fracture, 10922; old fracture, 4043) were labelled for training (18584) and validation (6470). The detection efficiency was higher for fresh fractures and healing fractures than for old fractures (F1-scores, 0.849, 0.856, 0.770, respectively, p = 0.023 for each), and the robustness of the model was good in the five multicenter/multiparameter validation sets (all mean F1-scores > 0.8 except validation set 5 [512 x 512 pixels; F1-score = 0.757]). The precision of the five radiologists improved from 80.3% to 91.1%, and the sensitivity increased from 62.4% to 86.3% with artificial intelligence-assisted diagnosis. On average, the diagnosis time of the radiologists was reduced by 73.9 seconds. Conclusion: Our CNN model for automatic rib fracture detection could assist radiologists in improving diagnostic efficiency, reducing diagnosis time and radiologists' workload.

Functional Magnetic Resonance Imaging and Diffusion Tensor Imaging for Language Mapping in Brain Tumor Surgery: Validation With Direct Cortical Stimulation and Cortico-Cortical Evoked Potential

  • Koung Mi Kang;Kyung Min Kim;In Seong Kim;Joo Hyun Kim;Ho Kang;So Young Ji;Yun-Sik Dho;Hyongmin Oh;Hee-Pyoung Park;Han Gil Seo;Sung-Min Kim;Seung Hong Choi;Chul-Kee Park
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.553-563
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    • 2023
  • Objective: Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging-derived tractography (DTI-t) contribute to the localization of language areas, but their accuracy remains controversial. This study aimed to investigate the diagnostic performance of preoperative fMRI and DTI-t obtained with a simultaneous multi-slice technique using intraoperative direct cortical stimulation (DCS) or corticocortical evoked potential (CCEP) as reference standards. Materials and Methods: This prospective study included 26 patients (23-74 years; male:female, 13:13) with tumors in the vicinity of Broca's area who underwent preoperative fMRI and DTI-t. A site-by-site comparison between preoperative (fMRI and DTI-t) and intraoperative language mapping (DCS or CCEP) was performed for 226 cortical sites to calculate the sensitivity and specificity of fMRI and DTI-t for mapping Broca's areas. For sites with positive signals on fMRI or DTI-t, the true-positive rate (TPR) was calculated based on the concordance and discordance between fMRI and DTI-t. Results: Among 226 cortical sites, DCS was performed in 100 sites and CCEP was performed in 166 sites. The specificities of fMRI and DTI-t ranged from 72.4% (63/87) to 96.8% (122/126), respectively. The sensitivities of fMRI (except for verb generation) and DTI-t were 69.2% (9/13) to 92.3% (12/13) with DCS as the reference standard, and 40.0% (16/40) or lower with CCEP as the reference standard. For sites with preoperative fMRI or DTI-t positivity (n = 82), the TPR was high when fMRI and DTI-t were concordant (81.2% and 100% using DCS and CCEP, respectively, as the reference standards) and low when fMRI and DTI-t were discordant (≤ 24.2%). Conclusion: fMRI and DTI-t are sensitive and specific for mapping Broca's area compared with DCS and specific but insensitive compared with CCEP. A site with a positive signal on both fMRI and DTI-t represents a high probability of being an essential language area.

Reliability of Skeletal Muscle Area Measurement on CT with Different Parameters: A Phantom Study

  • Dong Wook Kim;Jiyeon Ha;Yousun Ko;Kyung Won Kim;Taeyong Park;Jeongjin Lee;Myung-Won You;Kwon-Ha Yoon;Ji Yong Park;Young Jin Kee;Hong-Kyu Kim
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.624-633
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    • 2021
  • Objective: To evaluate the reliability of CT measurements of muscle quantity and quality using variable CT parameters. Materials and Methods: A phantom, simulating the L2-4 vertebral levels, was used for this study. CT images were repeatedly acquired with modulation of tube voltage, tube current, slice thickness, and the image reconstruction algorithm. Reference standard muscle compartments were obtained from the reference maps of the phantom. Cross-sectional area based on the Hounsfield unit (HU) thresholds of muscle and its components, and the mean density of the reference standard muscle compartment, were used to measure the muscle quantity and quality using different CT protocols. Signal-to-noise ratios (SNRs) were calculated in the images acquired with different settings. Results: The skeletal muscle area (threshold, -29 to 150 HU) was constant, regardless of the protocol, occupying at least 91.7% of the reference standard muscle compartment. Conversely, normal attenuation muscle area (30-150 HU) was not constant in the different protocols, varying between 59.7% and 81.7% of the reference standard muscle compartment. The mean density was lower than the target density stated by the manufacturer (45 HU) in all cases (range, 39.0-44.9 HU). The SNR decreased with low tube voltage, low tube current, and in sections with thin slices, whereas it increased when the iterative reconstruction algorithm was used. Conclusion: Measurement of muscle quantity using HU threshold was reliable, regardless of the CT protocol used. Conversely, the measurement of muscle quality using the mean density and narrow HU thresholds were inconsistent and inaccurate across different CT protocols. Therefore, further studies are warranted in future to determine the optimal CT protocols for reliable measurements of muscle quality.

Studies on the Effects of Rice Plant on the Changes of Materials in Submerged Paddy Soils (수도재배(水稻栽培)가 답상태토양(畓狀態土壤)의 물질변화(物質變化)에 미치는 영향(影響)에 관(關)한 연구(硏究))

  • Kim, Kwang Sik
    • Korean Journal of Soil Science and Fertilizer
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    • v.7 no.2
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    • pp.71-97
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    • 1974
  • Many studies on the changes of the materials in the water-logged paddy soil have been reported, but there will be several problems to apply them on the field soil. The main differences between the method of soil packed in beaker or column tube to that of natural field furrow slice are with or without of the rice root and the effect of water percolation. On the other hand, the mechanism of the water percolation on the changes of material in the natural field furrow slice are gradually understood. The purpose of this experiment is to know the effect of the rice cultivation on the chemical and physical changes of material in the water-logged paddy soil. Obtained results are as follows. 1. The physical and chemical changes on the water-logged paddy soil in the non-planted control-plot were nearly the same as the beaker or column tube experiment, while in the planted plot, slightly altered patterns were observed. 2. The relation between the number of tillers and total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, Fe and Mn in the leachate showed very high significance. T hisresult showed that the leaching of those cation was promoted by growing of the rice r- of the rice root. 3. On the other hand, the concentration of the potassium, silica and phosphorus in leachates was gradually decreased and that of $NH_4$-N could not detect after the stage of active tillering. These facts revealed that such components were absorbed by rice plant. 4. The highly significant correlation between the number of tillers and the concentration of the total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$, Fe and Mn in the percolated water was observed except that of $Mg^{{+}{+}}$. It was also showed that the rice root promoted the leaching of those cation. 5. The very high significance in the correlation between $HCO_3{^-}$ and the number of tillers indicated that the higher activity of the rice root was, the more $HCO_3{^-}$ concentration in the leachate was increased. 6. The relationship between the $HCO_3{^-}$ and the total cation, $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$, Fe and Mn was appeared very highly significant. $HCO_3{^-}$, the metabolite of the rice root, promoted the leaching of $Ca^{{+}{+}}$, $Mg^{{+}{+}}$, $Fe^{{+}{+}}$ and Mn. This fact might be a result that these cations were leached as the form of bicarbonate. 7. The iron in the leachate was the form of $Fe^{{+}{+}}$ and the correlation between $Fe^{{+}{+}}$ and $HCO_3{^-}$ was very highly significant. This result indicated that it seemed to be ferrous bicarbonate when it is leached out. 8. In the rhizosphere, ferrous iron was decreased gradually and the concentration of glucose was as high as 2 to 3 times in comparison with the other parts of the soil. These facts were the same as the previous reports in which rhizosphere was oxidized by the oxigen excreted from the root, and was enriched by the organic matter which was also excreted from the root and accumulated residues of the root. 9. ${\beta}$-Glucosidase and phosphatase activity in the rhizosphere was higher than that of the other parts of the soil. This facts might be attributed to the vigorous activity of microorganism in the rhizosphere where glucose concentration was high. 10. The pH in the leachate of the planted plot was lower than that of control, and the Eh on the planted soil was elevated in the last stage.

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Evaluation of Clinical Availability for Shoulder Forced Traction Method to Minimize the Beam Hardening Artifact in Cervical-spine Computed Tomography (CT) (경추부 전산화단층촬영에서 선속 경화 인공물을 최소화하기 위한 견부 강제 견인법에 대한 임상적 유용성 평가)

  • Kim, Moonjeung;Cho, Wonjin;Kang, Suyeon;Lee, Wonseok;Park, Jinwoo;Yu, Yunsik;Im, Inchul;Lee, Jaeseung;Kim, Hyeonjin;Kwak, Byungjoon
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.37-44
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    • 2013
  • In study suggested clinical availability to shoulder forced traction method in term of quality of image, the patient's convenience and stability, according to whether to use of shoulder forced traction bend using computed tomography(CT) that X-ray calibration and various mathematic calibration algorithm application can be applied by AEC. To achieve this, 79 patients is complaining of cervical pain oriented that shoulder forced traction bend use the before and after acquires lateral projection scout image and transverse image. transverse image of a fixed size in concern field of pixel and figure the average HU value compare that quantitative analysis. Artifact and pixel and resolution to qualitative clinical estimation image analysis. the patient feel inconvenience degree that self-diagnosis survey that estimate. As a result, lateral projection scout image if you used shoulder forced traction bend for the depicted has been an increase in the number of a cervical vertebrae. transverse image concern field shoulder forced traction bend use the before and after for pixel and the average HU-value changes was judged to be almost irrelevant. Artifact and resolution and contrast, in qualitative analysis of the results relating the observer to the unusual result. So, the patients of 82.27% complained discomfort that use of shoulder forced traction bend in self-diagnosis survey. No merit of medical image by using of bend from result was analyzed quality of image to quantitative and qualitative method judged. Nowadays, CT is supplied possible revision of quality of radiation by reduction of slice and automatic exposure controller, etc and application of preconditioning filter process due to various mathematic revision algorithm. So, image noise by beam hardening artifact should not be a problem. shoulder forced traction bend of use no longer judged clinically availability because have not influence of image quality and give discomfort, have extra dangerousness.