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Quantitative Ultrasound Radiofrequency Data Analysis for the Assessment of Hepatic Steatosis in Nonalcoholic Fatty Liver Disease Using Magnetic Resonance Imaging Proton Density Fat Fraction as the Reference Standard

  • Sun Kyung Jeon;Jeong Min Lee;Ijin Joo;Sae-Jin Park
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1077-1086
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    • 2021
  • Objective: To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods: In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results: The participants were classified based on MRI-PDFF: < 5% (n = 38), 5-10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF (r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786-0.918) and 0.835 (95% CI: 0.757-0.897), and those of SC-TSI were 0.964 (95% CI: 0.913-0.989) and 0.935 (95% CI: 0.875-0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion: AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

Evaluation of the Image Quality According to the Pre-set Method in PET/CT Image (PET/CT 영상 획득 시 사전설정법 차이에 따른 영상 질 평가)

  • Park, Sun-Myung;Lee, Hyuk;Hong, Gun-Chul;Chung, Eun-Kyung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.41-46
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    • 2011
  • Purpose: The result of exam using an imaging device is very closely related with the image quality. Moreover, this image quality can be changed according to the condition of image acquisition and evaluation method. In this study, we evaluated the image quality according to the difference of pre-set method in PET/CT image. Materials & Methods: PET/CT Discovery STe16 (GE Healthcare, Milwaukee, USA), Chest PET phantom (Experiment 1) and 94 NEMA phantom (Experiment 2) were used. Phantom were filled with $^{18}F$-FDG maintaining hot sphere and background ratio to 4:1. In the case of experiment 1, we set the radio activity concentration on 3.5, 6.0, 8.6 kBq/mL. In the case of experiment 2, we set the radio activity concentration on 3.3, 5.5, 7.7, 9.9, 12.1, 16.5 kBq/mL. All experiments were performed with the time-set method for 2 minutes 30 seconds per frame and the count-set method with one hundred million counts in 3D mode after CT transmission scan. For the evaluation of the image quality, we compared each results by using the NECR and SNR. Results: In the experiment 1, both the NECR and SNR were increased as radioactivity concentration getting increased. The NECR was shown as 53.7, 66.9, 91.4. and SNR was shown as 7.9, 10.0, 11.7. Both the NECR and SNR were increased in time-set method. But the count-set method's pattern was not similar with the time-set method. The NECR was shown as 53.8, 69.1, 97.8, and SNR was shown as 14.1, 14.7 14.4. The SNR was not increased in count-set method. In experiment 2, results of both the NECR and SNR were shown as 45.1, 70.6, 95.3, 115.6, 134.6, 162.2 and 7.1, 8.8, 10.6, 11.5, 12.7, 14.0. These results were shown similar patten with the experiment 1. Moreover, when the count-set method was applied, the NECR was shown as 42.1, 67.3, 92.1, 112.2, 130.7, 158.7, and SNR was shown as 15.2, 15.9, 15.6, 15.4, 15.5, 14.9. The NECR was increased but SNR was not shown same pattern. Conclusion: Increment of administered radioactivity improves the quality of image unconcerned with the pre-set method. However, NECR was not influenced by increment of total acquisition counts through simple increasing scan duration without increment of administered activity. In case of count-set method, the SNR was shown similar value despite of increment of radioactivity. So, the administered activity is more important than the scan duration. And we have to consider that evaluation of image quality using only SNR may not be appropriate.

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[ $^1H$ ] MR Spectroscopy of the Normal Human Brains: Comparison between Signa and Echospeed 1.5 T System (정상 뇌의 수소 자기공명분광 소견: 1.5 T Signa와 Echospeed 자기공명영상기기에서의 비교)

  • Kang Young Hye;Lee Yoon Mi;Park Sun Won;Suh Chang Hae;Lim Myung Kwan
    • Investigative Magnetic Resonance Imaging
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    • v.8 no.2
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    • pp.79-85
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    • 2004
  • Purpose : To evaluate the usefulness and reproducibility of $^1H$ MRS in different 1.5 T MR machines with different coils to compare the SNR, scan time and the spectral patterns in different brain regions in normal volunteers. Materials and Methods : Localized $^1H$ MR spectroscopy ($^1H$ MRS) was performed in a total of 10 normal volunteers (age; 20-45 years) with spectral parameters adjusted by the autoprescan routine (PROBE package). In all volunteers, MRS was performed in a three times using conventional MRS (Signa Horizon) with 1 channel coil and upgraded MRS (Echospeed plus with EXCITE) with both 1 channel and 8 channel coil. Using these three different machines and coils, SNRs of the spectra in both phantom and volunteers and (pre)scan time of MRS were compared. Two regions of the human brain (basal ganglia and deep white matter) were examined and relative metabolite ratios (NAA/Cr, Cho/Cr, and mI/Cr ratios) were measured in all volunteers. For all spectra, a STEAM localization sequence with three-pulse CHESS $H_2O$ suppression was used, with the following acquisition parameters: TR=3.0/2.0 sec, TE=30 msec, TM=13.7 msec, SW=2500 Hz, SI=2048 pts, AVG : 64/128, and NEX=2/8 (Signa/Echospeed). Results : The SNR was about over $30\%$ higher in Echospeed machine and time for prescan and scan was almost same in different machines and coils. Reliable spectra were obtained on both MRS systems and there were no significant differences in spectral patterns and relative metabolite ratios in two brain regions (p>0.05). Conclusion : Both conventional and new MRI systems are highly reliable and reproducible for $^1H$ MR spectroscopic examinations in human brains and there are no significant differences in applications for $^1H$ MRS between two different MRI systems.

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Seismic wave propagation through surface basalts - implications for coal seismic surveys (지표 현무암을 통해 전파하는 탄성파의 거동 - 석탄 탄성파탐사에 적용)

  • Sun, Weijia;Zhou, Binzhong;Hatherly, Peter;Fu, Li-Yun
    • Geophysics and Geophysical Exploration
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    • v.13 no.1
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    • pp.1-8
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    • 2010
  • Seismic reflection surveying is one of the most widely used and effective techniques for coal seam structure delineation and risk mitigation for underground longwall mining. However, the ability of the method can be compromised by the presence of volcanic cover. This problem arises within parts of the Bowen and Sydney Basins of Australia and seismic surveying can be unsuccessful. As a consequence, such areas are less attractive for coal mining. Techniques to improve the success of seismic surveying over basalt flows are needed. In this paper, we use elastic wave-equation-based forward modelling techniques to investigate the effects and characteristics of seismic wave propagation under different settings involving changes in basalt properties, its thickness, lateral extent, relative position to the shot position and various forms of inhomogeneity. The modelling results suggests that: 1) basalts with high impedance contrasts and multiple flows generate strong multiples and weak reflectors; 2) thin basalts have less effect than thick basalts; 3) partial basalt cover has less effect than full basalt cover; 4) low frequency seismic waves (especially at large offsets) have better penetration through the basalt than high frequency waves; and 5) the deeper the coal seams are below basalts of limited extent, the less influence the basalts will have on the wave propagation. In addition to providing insights into the issues that arise when seismic surveying under basalts, these observations suggest that careful management of seismic noise and the acquisition of long-offset seismic data with low-frequency geophones have the potential to improve the seismic results.

Evaluation of Retro recon for SRS planning correction according to the error of recognize to coordinate (SRS의 좌표 인식 오류 시 Retro recon을 이용한 수정 방법에 관한 평가)

  • Moon, hyeon seok;Jeong, deok yang;Do, gyeong min;Lee, yeong cheol;Kim, sun myung;Kim, young bum
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.101-108
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    • 2016
  • Purpose : The purpose of this study was to evaluate the Retro recon in SRS planning using BranLAB when stereotactic location error occurs by metal artifact. Materials and Methods : By CT simulator, image were acquired from head phantom(CIRS, PTW, USA). To observe stereotactic location recognizing and beam hardening, CT image were approved by SRS planning system(BrainLAB, Feldkirchen, Germany). In addition, we compared acquisition image(1.25mm slice thickness) and Retro recon image(using for 2.5 mm, 5mm slice thickness). To evaluate these three images quality, the test were performed by AAPM phantom study. In patient, it was verified stereotactic location error. Results : All the location recognizing error did not occur in scanned image of phantom. AAPM phantom scan images all showed the same trend. Contrast resolution and Spatial resolution are under 6.4 mm, 1.0 mm. In case of noise and uniformity, under 11, 5 of HU were measured. In patient, the stereotactic location error was not occurred at reconstructive image. Conclusion : For BrainLAB planning, using Retro recon were corrected stereotactic error at beam hardening. Retro recon may be the preferred modality for radiation treatment planning and approving image quality.

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Real-time Body Surface Motion Tracking using the Couch Based Computer-controlled Motion Phantom (CBMP) and Ultrasonic Sensor: A Feasibility Study (CBMP (Couch Based Computer-Controlled Motion Phantom)와 초음파센서에 기반한 실시간 체표면 추적 시스템 개발: 타당성 연구)

  • Lee, Suk;Yang, Dae-Sik;Park, Young-Je;Shin, Dong-Ho;Huh, Hyun-Do;Lee, Sang-Hoon;Cho, Sam-Ju;Lim, Sang-Wook;Jang, Ji-Sun;Cho, Kwang-Hwan;Shin, Hun-Joo;Kim, Chul-Yong
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.27-34
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    • 2007
  • Respiration sating radiotherapy technique developed In consideration of the movement of body surface and Internal organs during respiration, is categorized into the method of analyzing the respiratory volume for data processing and that of keeping track of fiducial landmark or dermatologic markers based on radiography. However, since these methods require high-priced equipments for treatment and are used for the specific radiotherapy. Therefore, we should develop new essential method whilst ruling out the possible problems. This study alms to obtain body surface motion by using the couch based computer-controlled motion phantom (CBMP) and US sensor, and to develop respiration gating techniques that can adjust patients' beds by using opposite values of the data obtained. The CBMP made to measure body surface motion is composed of a BS II microprocessor, sensor, host computer and stopping motor etc. And the program to control and operate It was developed. After the CBMP was adjusted by entering random movement data, and the phantom movements were acquired using the sensors, the two data were compared and analyzed. And then, after the movements by respiration were acquired by using a rabbit, the real-time respiration gating techniques were drawn by operating the phantom with the opposite values of the data. The result of analysing the acquisition-correction delay time for the data value shows that the data value coincided within 1% and that the acquistition-correction delay time was obtained real-time $(2.34{\times}10^{-4}sec)$. And the movement was the maximum movement was 6 mm In Z direction, In which the respiratory cycle was 2.9 seconds. This study successfully confirms the clinical application possibility of respiration gating techniques by using a CBWP and sensor.

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A study on the state of inservice education for dental hygienists and their relevant awareness (치과위생사의 보수교육 실태 및 인식에 관한 연구)

  • Jung, Jae-Yeon;Kim, Kyung-Mi;Cho, Myung-Sook;Ahn, Geum-Sun;Song, Kyoung-Hee;Choi, Hye-Jung;Choi, Youn-Seon;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.1
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    • pp.73-89
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    • 2007
  • The purpose of this study was to examine the reality of inservice education provided to members of Korean Dental Hygienists Association, the state of relevant academic conferences, and the perception of the members about inservice education and academic conference. It's basically meant to help boost their participation in inservice education and their satisfaction with it, and to show some of the right directions for that. The subjects in this study were dental hygienists who attended a symposium on July 1, 2006. After a survey was conducted, the answer sheets from 489 participants were analyzed, and the findings of the study were as follows: 1. General hospitals and university hospitals made up the largest group(91.4%) that gave a monthly leave of absence, and the second largest group was dental hospitals(75.4%), followed by dental clinics(58.3%) and public dental clinics(48.0%). The most common closing time in dental clinics and dental hospitals was 5 p.m., and that was 12 p.m. in general hospitals and university hospitals. The dental hygienists in public dental clinics didn't work on Saturdays. By type of workplace, treatment was the most common duty for the dental hygienists in dental clinics and dental hospitals to perform, and those who worked at general hospitals, university hospitals and public health clinics were in charge of extensive range of jobs. 2. The rates of the dental hygienists who took that education stood at 94.9% in public dental clinics, 78.7% in dental hospitals and 75.3% in dental clinics, general hospitals and university hospitals. Regarding how many marks they got on an yearly basis, those who got eight marks or more made up the largest group(55.6%), followed by four marks or more(11.8%), six marks or more(3.4%), and two marks or more(1.5%). As for the usefulness of inservice education for their job performance, the largest number of the dental hygienists(40.8%) found it to be helpful, and the second greatest group(37.5%) considered its effectiveness to be so-so. The third largest group(8.4%) found it to be of great use, and the fourth biggest group(4.2%) considered it to be of no service. The fifth biggest group(l.3%) thought it was absolutely useless. By type of workplace, the workers in dental clinics, dental hospitals, general hospitals and university hospitals wanted the most to learn how to take care of clinical work(acquisition of up-to-date technology), and those in public health clinics hoped the most to learn about public dental health. By type of workplace, the workers in dental clinics had their sight set on self-development the most, and the dental hygienists in dental hospitals, general hospitals, university hospitals and public health clinics were most in pursuit of acquiring new knowledge. By type of workplace, the specific given conditions at work were most singled out by the dental clinic workers as the reason, and the dental hospital employees pointed out time constraints the most. The dental hygienists in general hospitals and university hospitals cited time constraints and financial burden the most, and the public health clinic personnels mentioned inaccessibility of a place for inservice education as the reason. 3. The public health clinic workers participated in academic conferences the most(90.8%), followed by the general and university hospital personnels(68.8%), dental hospital employees(65.6%) and dental clinic workers(65.5%). By type of workplace, the public health clinic workers(73.5%) expressed the most satisfaction, followed by the general and university hospital employees(67.7%), dental clinic workers(62.3%) and dental hospital personnels(54.1%). By type of workplace, the employees of dental clinics, dental hospitals, general hospitals and university hospitals preferred Saturdays, and the public health clinic workers had a liking for weekdays. As for a favored place, hotels were most preferred, followed by university hospitals, general hospitals, college lecture rooms, district halls and local public institutions. Hotels were most favored regardless of the type of workplace. 4. Regarding outlook on inservice education, they had the highest opinion on the facilities and given conditions of lecture rooms($3.41{\pm}0.83$), followed by the professionalism of lecturers($3.34{\pm}0.83$), procedures of receipt and attendance confirmation($3.34{\pm}0.83$) and class size($3.13{\pm}0.89$). On the contrary, they took the most dismal view of the inaccessibility of a place of inservice education($2.08{\pm}0.92$), followed by limited opportunity and limited date for that education($2.51{\pm}0.99$), extra financial burden($2.53{\pm}1.18$) and high tuition fee($2.57{\pm}0.96$).

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Evaluation of Average CT to Reduce the Artifact in PET/CT (PET/CT 검사에서 호흡에 따른 인공산물을 줄이기 위한 Average CT의 유용성)

  • Kim, Jung-Sun;Nam, Ki-Pyo;Park, Seung-Yong;Ryu, Jae-Kwang;Cha, Min-Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.3-7
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    • 2010
  • Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

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Evaluation of Metabolic Abnormality in Brain Tumors by In Viuo $^1$H MR Spectroscopy at 3 Tesla (3T 양성자 자기공명분광에 의한 뇌종양의 대사물질 이상소견)

  • Choe, Bo-Young;Jeun, Sin-Soo;Kim, Bum-Soo;Lee, Jae-Mun;Chung, Sung-Taek;Ahn, Chang-Beom;Oh, Chang-Hyun;Kim, Sun I.;Lee, Hyoung-Koo
    • Progress in Medical Physics
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    • v.13 no.3
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    • pp.120-128
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    • 2002
  • To investigate differences between the metabolic ratios of normal controls and brain tumors such as astrocytomas and glioblastoma multiforme (GM) by proton MR spectroscopy (MRS) at 37 high field system. Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16$\pm$0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of glioblastoma multiforme was significantly higher than that of astrocytomas (P=0.001). Lactate was observed in all tumor cases. The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy.

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A Study on the Effects of Creative STEAM System Given by Center of Gravity Experiment (창의적 융합교육을 위한 무게중심 프로그램 개발과 적용사례 연구)

  • Kim, Su Geum;Ryu, Shi Kyu;Kim, Sun Bae
    • Journal of Educational Research in Mathematics
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    • v.24 no.3
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    • pp.333-357
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    • 2014
  • This study resulted from a study regarding creative STEAM System based upon an experiment with the center of gravity. The results of the study are constructed by a fusion of mathematics and physics, showing that they are the same as mathematical calculations. Also, students can find that center of gravity of an object is in equilibrium on a metal rod when the center of gravity exactly is placed on the rod. The fact that an experimental results are correspond to calculations can maximize the effectiveness of teaching. And also this study has the following effectiveness. First, the exact construction and calculations arouses good competition among students. Second, this experiment can give students a motivation for study and increase their thinking in classes because the theoretical background of center of gravity experiment is basically attributed to math and science classes in school. This study includes three different types of center-of-gravity experiments. One is a simple type of experiment in which center of gravity exists inside of an object. Another is a complicated one in which the center of gravity is also inside of an object. However, the third type is an experiment in where the center of gravity is outside of an object. Therefore, it gives students an opportunity to discuss how to confirm equilibrium on a metal rod when the object has its center of gravity outside. Having discussions in class will allow students to have a critical way of thinking. In addition, searching for a way to solve a problem will increase creativity of students as well. And the last type is finding the center of gravity of a big acrylic panel where multiple objects are on the panel. According to the survey and interview conducted by students who participated in this program, teaching based on creative STEAM system helps students to get a better understanding and more fast acquisition of knowledge. We can expect that a well-planned creative STEAM system through a continuous study will be both effective and efficient in educating critical and creative students.

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