• The Journal of Korean Academy of Prosthodontics
• /
• v.57 no.4
• /
• pp.425-431
• /
• 2019

This clinical case report describes the digital workflow that combines a face scan, cone beam computed tomography and an intraoral scan to visualize the outcome of prosthodontic treatment in the anterior region. This approach improves communication between clinic, laboratory and patients. A patient with healthy general condition came for a restorative treatment to treat post-traumatic central incisors of maxilla. A virtual patient replica was made by incorporating a face scan, cone beam computed tomography and an intraoral scan. Design mockup of definitive restorations was shown to the patient and modified according to the patient's desire. This digital workflow facilitates the fabrication of optimal esthetic restorations, and enhances the predictability of outcome of restorations.

• Journal of Magnetics
• /
• v.20 no.1
• /
• pp.40-46
• /
• 2015

This study investigated the accuracy of magnetic resonance angiography (MRA) and computed tomography angiography (CTA) in terms of reflecting the actual vascular length. Three-dimensional time of flight (3D TOF) MRA, 3D contrast-enhanced (CE) MRA, volume-rendering after CTA and maximum intensity projection were investigated using a flow model phantom with a diameter of 2.11 mm and area of $0.26cm^2$. 1.5 and 3.0 Tesla devices were used for 3D TOF MRA and 3D CE MRA. CTA was investigated using 16 and 64 channel CT scanners, and the images were transmitted and reconstructed by volume-rendering and maximum intensity projection, followed by conduit length measurement as described above. The smallest 3D TOF MRA measure was $2.51{\pm}0.12mm$ with a flow velocity of 40 cm/s using the 3.0 Tesla apparatus, and $2.57{\pm}0.07mm$ with a velocity of 71.5 cm/s using the 1.5 Tesla apparatus; both images were magnified from the actual measurement of 2.11 mm. The measurement with the 16 channel CT scanner was smaller ($3.83{\pm}0.37mm$) than the reconstructed image on maximum intensity projection. The images from CTA from examination apparatus and reconstruction technique were all larger than the actual measurement.

• The korean journal of orthodontics
• /
• v.49 no.3
• /
• pp.161-169
• /
• 2019

Objective: To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images. Methods: Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment. Results: The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by $2.25^{\circ}$, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by $2.76^{\circ}$ (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01). Conclusions: The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.

• The korean journal of orthodontics
• /
• v.51 no.3
• /
• pp.189-198
• /
• 2021

Objective: To estimate the projected cancer risk attributable to diagnostic cone-beam computed tomography (CBCT) performed under different exposure settings for orthodontic purposes in children and adults. Methods: We collected a list of CBCT machines and their specifications from 38 orthodontists. Organ doses were estimated using median and maximum exposure settings of 105 kVp/156.8 mAs and 130 kVp/200 mAs, respectively. The projected cancer risk attributable to CBCT procedures performed 1-3 times within 2 years was calculated for children (aged 5 and 10 years) and adult (aged 20, 30, and 40 years) male and female patients. Results: For maximum exposure settings, the mean lifetime fractional ratio (LFR) was 14.28% for children and 0.91% for adults; this indicated that the risk to children was 16 times the risk to adults. For median exposure settings, the mean LFR was 5.25% and 0.58% for children and adults, respectively. The risk of cancer decreased with increasing age. For both median and maximum exposure settings, females showed a higher risk of cancer than did males in all age groups. Cancer risk increased with an increase in the frequency of CBCT procedures within a given period. Conclusions: The projected dental CBCT-associated cancer risk spans over a wide range depending on the machine parameters and image acquisition settings. Children and female patients are at a higher risk of developing cancer associated with diagnostic CBCT. Therefore, the use of diagnostic CBCT should be justified, and protective measures should be taken to minimize the harmful biological effects of radiation.

• Progress in Medical Physics
• /
• v.32 no.1
• /
• pp.18-24
• /
• 2021

Purpose: Kilovoltage computed tomography (kV-CT) is essential for radiation treatment planning. However, kV-CT images are significantly distorted by artifacts when a metallic prosthesis is present in the patient's body. Thus, the accuracies of target delineation and treatment dose calculation are inevitably lowered. We evaluated the accuracy of the calculated doses using an image restoration method with hybrid CT, which was introduced in our previous study. Methods: A cylindrical phantom containing four metals, namely, silver, copper, tin, and tungsten, was scanned using kV-CT and megavoltage CT to produce hybrid CT images. We created six verification plans for three head and neck patients on kV-CT and hybrid CT images of the phantom and calculated their doses. The actual doses were measured with film patches during beam delivery using tomotherapy. We used the gamma evaluation method to compare dose distribution between kV-CT and hybrid CT with three gamma criteria, namely, 3%/3 mm, 2%/2 mm, and 1%/1 mm. Results: The gamma pass rates decreased as the gamma criteria were strengthened, and the pass rate of hybrid CT was higher than that of kV-CT in all cases. When the 1%/1 mm criterion was used, the difference in gamma pass rates between them was up to 13%p. Conclusions: According to our findings, we expect that the use of hybrid CT can be a suitable approach to avoid the effect of severe metal artifacts on the accuracy of dose calculation and contouring.

• Nuclear Engineering and Technology
• /
• v.54 no.2
• /
• pp.514-522
• /
• 2022

Non-destructive testing (NDT) technology is a widely used inspection method for agricultural products. Compared with the conventional inspection method, there is no extensive sample preparation for NDT technology, and the sample is not damaged. In particular, NDT technology is used to inspect the internal structure of agricultural products infested by pests. The introduction and spread of pests during the import and export process can cause significant damage to the agricultural environment. Until now, pest detection in agricultural products and quarantine processes have been challenging because they used external inspection methods. However, NDT technology is advantageous in these inspection situations. In this pilot study, we investigated the feasibility of X-ray computed tomography (X-ray CT) and magnetic resonance imaging (MRI) to identify pest infestation in agricultural products. Three kinds of artificially pest-infested fruits (mango, tangerine, and chestnut) were non-destructively inspected using X-ray CT and MRI. X-ray CT was able to identify all pest infestations in fruits, while MRI could not detect the pest-infested chestnut. In addition, X-ray CT was superior to the quarantine process than MRI based on the contrast-to-noise ratio (CNR), image acquisition time, and cost. Therefore, X-ray CT is more appropriate for the pest quarantine process of fruits than MRI.

• Journal of Trauma and Injury
• /
• v.35 no.1
• /
• pp.12-18
• /
• 2022

Purpose: Pedicle screw fixation provides 3-column stabilization, multidimensional control, and a higher rate of interbody fusion. Although computed tomography (CT) is recommended for the postoperative assessment of pedicle screw fixation, its use is limited due to the radiation exposure dose. The purpose of this preliminary retrospective study was to assess the clinical usefulness of low-dose mobile cone-beam CT (CBCT) for the postoperative evaluation of pedicle screw fixation. Methods: The author retrospectively reviewed postoperative mobile CBCT images of 15 patients who underwent posterior pedicle screw fixation for spinal disease from November 2019 to April 2020. Pedicle screw placement was assessed for breaches of the bony structures. The breaches were graded based on the Heary classification. Results: The patients included 11 men and four women, and their mean age was 66±12 years. Of the 122 pedicle screws, 34 (27.9%) were inserted in the thoracic segment (from T7 to T12), 82 (67.2%) in the lumbar segment (from L1 to L5), and six (4.9%) in the first sacral segment. Although there were metal-related artifacts, the image of the screw position (according to Heary classification) after surgery could be assessed using mobile CBCT at all levels (T7-S1). Conclusions: Mobile CBCT was accurate in determining the location and integrity of the pedicle screw and identifying the surrounding bony structures. In the postoperative setting, mobile CBCT can be used as a primary modality for assessing the accuracy of pedicle screw fixation and detecting postoperative complications.

• Progress in Medical Physics
• /
• v.33 no.4
• /
• pp.142-149
• /
• 2022

Purpose: This study seeks to compare the dosimetric parameters of the bulk electron density (ED) approach and synthetic computed tomography (CT) image in terms of position variation of the air cavity in magnetic resonance-guided radiotherapy (MRgRT) for patients with pancreatic cancer. Methods: This study included nine patients that previously received MRgRT and their simulation CT and magnetic resonance (MR) images were collected. Air cavities were manually delineated on simulation CT and MR images in the treatment planning system for each patient. The synthetic CT images were generated using the deep learning model trained in a prior study. Two more plans with identical beam parameters were recalculated with ED maps that were either manually overridden by the cavities or derived from the synthetic CT. Dose calculation accuracy was explored in terms of dose-volume histogram parameters and gamma analysis. Results: The D_95% averages were 48.80 Gy, 48.50 Gy, and 48.23 Gy for the original, manually assigned, and synthetic CT-based dose distributions, respectively. The greatest deviation was observed for one patient, whose D_95% to synthetic CT was 1.84 Gy higher than the original plan. Conclusions: The variation of the air cavity position in the gastrointestinal area affects the treatment dose calculation. Synthetic CT-based ED modification would be a significant option for shortening the time-consuming process and improving MRgRT treatment accuracy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.1
• /
• pp.41-49
• /
• 2022

Objectives: We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative. Materials and Methods: In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants. Results: There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05). Conclusion: The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.

• Korean Journal of Radiology
• /
• v.22 no.5
• /
• pp.735-741
• /
• 2021

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter²). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001). The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion: Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.