• Radiation Oncology Journal
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• v.22 no.1
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• pp.55-63
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• 2004

Purpose : To evaluate the reflection of tumor motion according to the planning CT scan time. Material and Methods : A model of N-shape, which moved aiong the longitudinal axis during the ventilation caused by a mechanical ventilator, was produced. The model was scanned by planning CT, while setting the relative CT scan time (T: CT scan time/ventilatory period) to 0.33, 0.50, 0.67, 0.75, 1.00, 1.337, and 1.537. In addition, three patients with non-small cell lung cancer who received stereotactic radiosurgery In the Department of Radiation Oncology, Asan Medical Center from 03/19/2002 to 05/21/2002 were scanned. Slow (10 Premier, Picker, scan time 2.0 seconds per slice) and fast CT scans (Lightspeed, GE Medical Systems, with a scan time of 0.8 second per slice) were peformed for each patient. The magnitude of reflected movement of the N-shaped model was evaluated by measuring the transverse length, which reflected the movement of the declined bar of the model at each slice. For patients' scans, all CT data sets were registered using a stereotactic body frame scale with the gross tumor volumes delineated in one CT image set. The volume and three-dimensional diameter of the gross tumor volume were measured and analyzed between the slow and fast CT scans. Results : The reflection degree of longitudinal movement of the model increased in proportion to the relative CT scan times below 1.00 7, but remained constant above 1.00 T Assuming the mean value of scanned transverse lengths with CT scan time 1.00 T to be $100\%$, CT scans with scan times of 0.33, 0.50, 0.57, and 0.75 T missed the tumor motion by 30, 27, 20, and $7.0\%$ respectively, Slow (scan time 2.0 sec) and Fast (scan time 0.8 sec) CT scans of three patients with longitudinal movement of 3, 5, and 10 mm measured by fluoroscopy revealed the increases in the diameter along the longitudinal axis Increased by 6.3, 17, and $23\%$ in the slow CT scans. Conculsion : As the relative CT scan time increased, the reflection of the respiratory tumor movement on planning CT also Increased, but remained constant with relative CT scan times above 1.00 T When setting the planning CT scan time above one respiration period (>1.00 T), only the set-up margin is needed to delineate the planning target volume. Therefore, therapeutic ratio can be increased by reducing the radiation dose delivered to normal lung tissue.

• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.475-480
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• 2018

In lower abdominal MRI scan, patients have been tested by physically contacting with the body array coil. In this study, we have designed the acrylic assistant equipment (ACR) which allows the contactless scan of the patient to the coil and evaluated the feasibility by comparing the acquired images with ACR to those obtained without ACR. We tested 10 cases (F: 5, m: 5) by using the Ingenia $3.0T^{TM}$ MR system and dStreamTM torso coil (Philips Healthcare, Netherlands). We implemented T1 AX TSE and eTHRIVE (GRE) techniques. The scanned images were quantitatively and qualitatively assessed. In qualitatively, the TSE shows 4.44 and 4.56 mean values with and without the ACR and 4.34 and 4.28 at the GRE, respectively. In quantitatively, the TSE shows 12.15 CNR, 17.95 SNR and 12.71 CNR, 18.96 SNR with and without the ACR. And GRE shows 17.72 CNR, 22.59 SNR and 18.26 CNR, 24.47 SNR with and without the ACR, respectively. We have designed and implemented the acrylic assistant equipment to lower abdominal patients. Our data indicate that it is possible to obtain similar image qualities to current lower abdominal MRI scan without the physical contact to the patient.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.4
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• pp.330-336
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• 2015

Purpose: This study evaluated the effect of loss of interproximal papilla, creating an undercut, on the accuracy of impression materials. Materials and methods: Two addition type silicone impression materials ($Extrude^{(R)}$ Speed Wash, $Imprint^{TM}$ II Quick Step Light Body) and one alginate impression material (Cavex Impressional) were used to make impressions of a maxillary master model simulating clinical conditions with or without interproximal papilla. Stone was poured in the impressions and working casts were fabricated. A total of 6 groups with 6 working casts in each group were scanned using 3-dimensional optical scanner. The accuracy of the impressions was assessed by measuring the dimensional changes (${\Delta}I$ (%)) of 6 distances on working casts compared to a master model with a 3-dimensional digitizing and inspection software. The data were analyzed by two-way ANOVA (P<.05). Results: Three of 6 distances showed statistically significant differences among the impression materials. Only 1 of 6 distances in alginate impression showed a statistically significant difference between casts with and without interproximal papilla (P=.047). Conclusion: The presence of undercut due to loss of interproximal papilla did not significantly influence the dimensional accuracy of addition type silicone and alginate impression materials.

• Journal of the Korean Society of Radiology
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• v.15 no.3
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• pp.273-279
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• 2021

Metal material inserted into the body have a large difference in density from human tissues or bones around the Metal during CT scans.. Therefore, the Metal material inserted into the body produces Artifact. Metal Artifact, which occurs around Metals, can degrade the quality of CT images, causing confusion when medical team diagnose lesions. Through this experiment, we confirm that the occurrence of Artifacts decrease by using Dual energy CT and MAR algorithm in Single source Dual energy CT. We also want to present basic data on clinical application methods by comparing and analyzing the characteristics of images obtained by each method. Using GE 750HD CT, artificial implants were scanned using general method and Dual energy. Then we apply the MAR algorithm to each image obtained. And all previously acquired images were compared and analyzed the characteristics of the examination, such as image quality evaluation and dose evaluation. Images with MAR algorithm and Dual Energy confirmed a decrease in Metal Artifact. Images with MAR algorithm have reduced Metal Artifact, but have the disadvantage of distorting the details of artificial joint implants. On the other hand images teseted with Dual Energy have the advantage of being able to implement details than those applied with MAR algorithms, it takes longer to reconstruct the image and the exposure dose was about four times higher than those applied with MAR algorithm. In order to locate Metals, such as the post-operative follow-up period, it is useful to apply MAR algorithm to obtain images. And it is more useful to examine with Dual Energy when micro lesion identification, such as cardiac examination, and surgical planning or when tests are performed in diagnostic way.

• Progress in Medical Physics
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• v.32 no.4
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• pp.99-106
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• 2021

Purpose: In this study, we aimed to manufacture a patient-specific gel phantom combining three-dimensional (3D) printing and polymer gel and evaluate the radiation dose and dose profile using gel dosimetry. Methods: The patient-specific head phantom was manufactured based on the patient's computed tomography (CT) scan data to create an anatomically replicated phantom; this was then produced using a ColorJet 3D printer. A 3D polymer gel dosimeter called RTgel-100 is contained inside the 3D printing head phantom, and irradiation was performed using a 6 MV LINAC (Varian Clinac) X-ray beam, a linear accelerator for treatment. The irradiated phantom was scanned using magnetic resonance imaging (Siemens) with a magnetic field of 3 Tesla (3T) of the Korea Institute of Nuclear Medicine, and then compared the irradiated head phantom with the dose calculated by the patient's treatment planning system (TPS). Results: The comparison between the Hounsfield unit (HU) values of the CT image of the patient and those of the phantom revealed that they were almost similar. The electron density value of the patient's bone and brain was 996±167 HU and 58±15 HU, respectively, and that of the head phantom bone and brain material was 986±25 HU and 45±17 HU, respectively. The comparison of the data of TPS and 3D gel revealed that the difference in gamma index was 2%/2 mm and the passing rate was within 95%. Conclusions: 3D printing allows us to manufacture variable density phantoms for patient-specific dosimetric quality assurance (DQA), develop a customized body phantom of the patient in the future, and perform a patient-specific dosimetry with film, ion chamber, gel, and so on.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.35-42
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• 2018

Purpose Standardized uptake value(SUV) has been widely used as a quantitative metric of uptake in PET/CT for diagnosis of malignant tumors and evaluation of tumor therapy response. However, the SUV depends on various factor including PET/CT scanner specifications and reconstruction parameter. The purpose of this study is to validate a EQ PET to evaluate SUV across different PET/CT systems. Materials and Methods First, NEMA IEC body phantom data were used to calculate the EQ filter for OSEM3D with PSF and TOF reconstruction from three different PET/CT systems in order to obtain EARL compliant recovery coefficients of each spheres. The Biograph true point 40 PET/CT images were reconstructed with a OSEM3D+PSF reconstruction, images of the Biograph mCT 40 and Biograph mCT 64 PET/CT scanners were reconstructed with a OSEM3D+PSF, OSEM3D+TOF, OSEM3D+PSF+TOF. Post reconstructions, the proprietary EQ filter was applied to the reconstruction data. Recovery coefficient can be estimated by ratio of measured to true activity concentration for spheres of different volume and coefficient variability(CV) value of RC for each sphere was compared. For clinical study, we compared SUVmax applying different reconstruction algorithms in FDG PET images of 61 patients with lung cancer using Biograph mCT 40 PET/CT scanner. Results For the phantom studied, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.05, 0.04, 0.04 and 0.03 respectively for RC. Application of the proprietary EQ filter, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.04, 0.03, 0.03 and 0.02 respectively for RC. Clinical study, there were no statistical significance of the difference applying EQ PET on SUVmax of 61 patients FDG PET image. (p=1.000) Conclusion This study indicates that CV values of RC in phantom were decreased after applying EQ PET for different PET/CT system and The EQ PET reduced reconstruction dependent variation in SUVs for 61 lung cancer patients, Therefore, EQ PET will be expected to provide accurate quantification when the patient is scanned on different PET/CT system.

• Journal of the Korean Society of Radiology
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• v.12 no.4
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• pp.443-450
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• 2018

The Geant 4 simulated the linear accelerator (VARIAN CLINAC) based on the previously implemented BEAMnrC data, using the head structure of the linear accelerator. In the 10 MV photon flux, Geant4 was compared with the measured value of the percentage of the deep dose and the lateral dose of the water phantom. In order to apply the dose calculation to the body part, the actual patient's lung area was scanned at 5 mm intervals. Geant4 dose distributions were obtained by irradiating 10 MV photons at the irradiation field ($5{\times}5cm^2$) and SAD 100 cm of the water phantom. This result is difficult to measure the dose absorbed in the actual lung of the patient so the doses by the treatment planning system were compared. The deep dose curve measured by water phantom and the deep dose curve calculated by Geant4 were well within ${\pm}3%$ of most depths except the build-up area. However, at the 5 cm and 20 cm sites, 2.95% and 2.87% were somewhat higher in the calculation of the dose using Geant4. These two points were confirmed by the geometry file of Genat4, and it was found that the dose was increased because thoracic spine and sternum were located. In cone beam CT, the dose distribution error of the lungs was similar within 3%. Therefore, if the contour map of the dose can be directly expressed in the DICOM file when calculating the dose using Geant4, the clinical application of Geant4 will be used variously.

• The Korean Journal of Nuclear Medicine
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• v.39 no.3
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• pp.182-190
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• 2005

Purpose: There are differences between Standard Uptake Value (SUV) of CT attenuation corrected PET and that of $^{137}Cs$. Since various causes lead to difference of SUV, it is important to know what is the cause of these difference. Since only the X-ray CT and $^{137}Cs$ transmission data are used for the attenuation correction, in Philips GEMINI PET/CT scanner, proper transformation of these data into usable attenuation coefficients for 511 keV photon has to be ascertained. The aim of this study was to evaluate the accuracy in the CT measurement and compare the CT and $^{137}Cs$-based attenuation correction in this scanner. Methods: For all the experiments, CT was set to 40 keV (120 kVp) and 50 mAs. To evaluate the accuracy of the CT measurement, CT performance phantom was scanned and Hounsfield units (HU) for those regions were compared to the true values. For the comparison of CT and $^{137}Cs$-based attenuation corrections, transmission scans of the elliptical lung-spine-body phantom and electron density CT phantom composed of various components, such as water, bone, brain and adipose, were performed using CT and $^{137}Cs$. Transformed attenuation coefficients from these data were compared to each other and true 511 keV attenuation coefficient acquired using $^{68}Ge$ and ECAT EXACT 47 scanner. In addition, CT and $^{137}Cs$-derived attenuation coefficients and SUV values for $^{18}F$-FDG measured from the regions with normal and pathological uptake in patients' data were also compared. Results: HU of all the regions in CT performance phantom measured using GEMINI PET/CT were equivalent to the known true values. CT based attenuation coefficients were lower than those of $^{68}Ge$ about 10% in bony region of NEMA ECT phantom. Attenuation coefficients derived from $^{137}Cs$ data was slightly higher than those from CT data also in the images of electron density CT phantom and patients' body with electron density. However, the SUV values in attenuation corrected images using $^{137}Cs$ were lower than images corrected using CT. Percent difference between SUV values was about 15%. Conclusion: Although the HU measured using this scanner was accurate, accuracy in the conversion from CT data into the 511 keV attenuation coefficients was limited in the bony region. Discrepancy in the transformed attenuation coefficients and SUV values between CT and $^{137}Cs$-based data shown in this study suggests that further optimization of various parameters in data acquisition and processing would be necessary for this scanner.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.12-16
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• 2012

Purpose : In conventional PET image reconstruction, iterative reconstruction methods such as OSEM (Ordered Subsets Expectation Maximization) have now generally replaced traditional analytic methods such as filtered back-projection. This includes improvements in components of the system model geometry, fully 3D scatter and low noise randoms estimates. SharpIR algorithm is to improve PET image contrast to noise by incorporating information about the PET detector response into the 3D iterative reconstruction algorithm. The aim of this study is evaluation of SharpIR reconstruction method in PET/CT. Materials and Methods: For the measurement of detector response for the spatial resolution, a capillary tube was filled with FDG and scanned at varying distances from the iso-center (5, 10, 15, 20 cm). To measure image quality for contrast recovery, the NEMA IEC body phantom (Data Spectrum Corporation, Hillsborough, NC) with diameters of 1, 13, 17 and 22 for simulating hot and 28 and 37 mm for simulating cold lesions. A solution of 5.4 kBq/mL of $^{18}F$-FDG in water was used as a radioactive background obtaining a lesion of background ratio of 4.0. Images were reconstructed with VUE point HD and VUE point HD using SharpIR reconstruction algorithm. For the clinical evaluation, a whole body FDG scan acquired and to demonstrate contrast recovery, ROIs were drawn on a metabolic hot spot and also on a uniform region of the liver. Images were reconstructed with function of varying iteration number (1~10). Results: The result of increases axial distance from iso-center, full width at half maximum (FWHM) is also increasing in VUE point HD reconstruction image. Even showed an increasing distances constant FWHM. VUE point HD with SharpIR than VUE point HD showed improves contrast recovery in phantom and clinical study. Conclusion: By incorporating more information about the detector system response, the SharpIR algorithm improves the accuracy of underlying model used in VUE point HD. SharpIR algorithm improve spatial resolution for a line source in air, and improves contrast recovery at equivalent noise levels in phantoms and clinical studies. Therefore, SharpIR algorithm can be applied as through a longitudinal study will be useful in clinical.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.51-56
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• 2015

Purpose As medical radiation exposures on patients are being social issues an interest in a relief of radiation exposures on patients is increasing. Further, there are many cases where some patients among who are getting PET/CT tests choose to get implanted with metal artifacts in their bodies. This study is to find out effects of presence or absence of metal artifacts when dose change or CT attenuation correction for the relief of radiation exposures are applied using phantoms through changes in standard uptake value (SUV). Materials and Methods GE company's Discovery 710 machine was used for PET/CT test equipments. We used NEMA IEC body phantoms. We also used screw and mesh cage made of titanium which are used in real clinical processes for the metal artifacts. Two experiments were conducted: One is to test and measure repeatedly about SUV about differences in CT attenuation corrections according to dose changes and another is to do the same procedure for SUV about the presence and absence of the metal artifacts. We injected $^{18}F-FDG$ into NEMA IEC body phantoms with a TBR ratio of 4:1 and then put the metal material into the transformation phantoms. Once a scanning for the metal artifacts was done we eliminated the metal artifacts and went on non-metal artifacts. For the each two experiments, we scanned repeatedly with CT kVp (140, 120, 100, 80) and mA (120, 80, 40, 20, 10) for an experimental condition. For PET, we reconstructed each with standard AC (STD) technique and quantitation achieved cnsistently QAC) technique among CT attenuation correction methods. We conducted a comparative analysis on measured average values and variations which were measured through repeated measure of SUV of region 1, 2, 3 spheres for each conditions of non-metal /metal scan. Results For each kVp, 120, 80, 40 (mA) of non/metal (screw, mesh cage) showed low frequency of fluctuation rates of above 2%. In 20, 10 mA above 2% of fluctuation rates appeared in high frequency. Also, when we compared the fluctuation rates of STD and QAC techniques in non/metal (screw, mesh cage) tests QAC technique showed about 1-10% of differences for each conditions compared to STD technique. In addition, metal types did not have significant effects on fluctuation rates. Conclusion We confirmed that SUV fluctuation rates for both STD and QAC techniques increase as dosage is lower. We also found that the SUV of PET data was maintained steadily in a low dosage for QAC technique when compared with STD technique. Hence, when the low dosage is used for the relief of radiation exposures on patients QAC technique may be exploited helpfully and this could be applied in the same way for patients with metal artifacts implanted in their bodies.