• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.29-34
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• 2012

Purpose : Presently, hardwares and softwares for reducing radiation exposure are continually developed for PET/CT examination. Purpose of this study is to evaluate effectiveness of reducing radiation exposure dose of CT and SUV changes of PET when applied each kernel to ACCT (Attenuation Correction Computed Tomography) according to adopted IRIS (Iterative Reconstruction in Image Space) software. Materials and Methods : Biograph mCT (Siemens, Germany) was used as a PET/CT scanner. Using AAPM CT performance phantom, from standard (120 kVp, 100 mAs), 7 scans were conducted by reducing 15 mAs each. After image reconstruction by FBP (Filtered Back Projection) and IRIS, noise and spatial resolution were evaluated. The same method was applied to anthropomorphic chest phantom and acquired images were compared. NEMA IEC body phantom was used for SUV evaluation. Injected dose rate for hot sphere (hot) and background cylinder (BKG) were 1:8. CT dose condition (120 kVp, 50 mAs) was the same for each scan and PET scan durations were 1, 2, 3 and 4min. After scanning, each kernel of IRIS was applied to ACCT. And PET images were reconstructed by ACCT adopted IRIS for comparing SUV changes. Results : AAPM phantom test for noise evaluation, SD for FBP 100 mAs, IRIS 55 mAs were 8.8 and 8.9. FBP 85 mAs, IRIS 40 mAs were 9.5 and 9.7. FBP 70 mAs, IRIS 25 mAs were 11.9 and 11.1. Above mAs condition for FBP and IRIS, SD showed similar values. And for spatial resolution test, there was no significant difference. For chest phantom test, when applied the same mAs and kernel to both of FBP and IRIS, every applied kernels showed reduced noise. Lower mAs and higher kernel value showed higher noise reduction. There was no considerable difference only except for I70 very sharp kernel for SUV comparison using NEMA IEC body phantom. Conclusion : In this study, low mAs (55 mAs) applied IRIS and standard mAs (100 mAs) applied FBP showed similar noise. And only except for I70 kernel, there was no significant SUV changes. It is possible to reduce needless radiation exposure and acquire better image quality than FBP's through applying appropriate kernel of IRIS to PET/CT.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.1
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• pp.31-39
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• 2011

Purpose: Helical Tomotherapy allows only coplanar beam delivery because it does not allow couch rotation. We investigated a method to introduce non-coplanar beam by tilting a patient's head for Tomotherapy. The aim of this study was to compare intrafractional movement during Tomotherapy between coplanar and non-coplanar patient's setup. Materials and Methods: Helical Tomotherapy was used for treating eight patients with intracranial tumor. The subjects were divided into three groups: one group (coplanar) of 2 patients who lay on S-plate with supine position and wore thermoplastic mask for immobilizing the head, second group (non-coplanar) of 3 patients who lay on S-plate with supine position and whose head was tilted with Variable Axis Baseplate and wore thermoplastic mask, and third group (non-coplanar plus mouthpiece) of 3 patients whose head was tilted and wore a mouthpiece immobilization device and thermoplastic mask. The patients were treated with Tomotherapy after treatment planning with Tomotherapy Planning System. Megavoltage computed tomography (MVCT) was performed before and after treatment, and the intrafractional error was measured with lateral(X), longitudinal(Y), vertical(Z) direction movements and vector ($\sqrt{x^2+y^2+z^2}$) value for assessing overall movement. Results: Intrafractional error was compared among three groups by taking the error of MVCT taken after the treatment. As the correction values (X, Y, Z) between MVCT image taken after treatment and CT-simulation image are close to zero, the patient movement is small. When the mean values of movement of each direction for non-coplanar setup were compared with coplanar setup group, X-axis movement was decreased by 13%, but Y-axis and Z-axis movement were increased by 109% and 88%, respectively. Movements of Y-axis and Z-axis with non-coplanar setup were relatively greater than that of X-axis since a tilted head tended to slip down. The mean of X-axis movement of the group who used a mouthpiece was greater by 9.4% than the group who did not use, but the mean of Y-axis movement was lower by at least 64%, and the mean of Z-axis was lower by at least 67%, and the mean of Z-axis was lower by at least 67%, and the vector was lower by at least 59% with the use of a mouthpiece. Among these 8 patients, one patient whose tumor was located on left frontal lobe and left basal ganglia received reduced radiation dose of 38% in right eye, 23% in left eye, 30% in optic chiasm, 27% in brain stem, and 8% in normal brain with non-coplanar method. Conclusion: Tomotherapy only allows coplanar delivery of IMRT treatment. To complement this shortcoming, Tomotherapy can be used with non-coplanar method by artificially tilting the patient's head and using an oral immobilization instrument to minimize the movement of patient, when intracranial tumor locates near critical organs or has to be treated with high dose radiation.

• Korean Journal of Soil Science and Fertilizer
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• v.43 no.4
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• pp.415-423
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• 2010

Pore network models are useful tools to investigate soil pore geometry. These models provide quantitative information of pore geometry from 3D images. This study presents a pore network model to quantify pore structure and hydraulic characteristics. The objectives of this work were to apply the pore network model to characterize pore structure from large images to quantify pore structure, calculate water retention and hydraulic conductivity properties from a three dimensional soil image, and to combine measured hydraulic properties from experiments with calculated hydraulic properties from image. Soil samples were taken from a site located at the Baltimore science center, which is located inside of the city. Undisturbed columns were taken from the site and scanned with a computer tomographer at resolutions of 22 ${\mu}m$. Pore networks were extracted by medial-axis transformation and were used to measure pore geometry from one of the scanned samples. Water retention and unsaturated hydraulic conductivity values were calculated from the soil image. Properties of soil bulk density, water retention and unsaturated hydraulic conductivity were measured from three replicates of scanned soil samples. 3D image analysis provided accurate detailed pore properties such as individual pore volumes, pore length, and tortuosity of all pores. These data made possible to calculate accurate estimations of water retention and hydraulic conductivity. Combination of the calculated and measured hydraulic properties gave more accurate information on pore sizes over wider range than measured or calculated data alone. We could conclude that the hydraulic property computed from soil images and laboratory measurements can describe a full structure of intra- and inter-aggregate pores in soil.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.169-175
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• 2005

Purpose: Although computed tomography (CT) simulators are commonly used in radiation therapy department, many Institution still use conventional CT for treatments. In this study the setup errors that occur during simulation, CT scan (diagnostic CT scanner), and treatment were evaluated for the twenty one breast cancer patients. Materials and Methods: Errors were determined by calculating the differences in isocenter location, SSD, CLD, and locations of surgical clips implanted during surgery. The anatomic structures on simulation film and DRR image were compared to determine the movement of isocenter between simulation and CT scan. The isocetner point determined from the radio-opaque wires placed on patient's surface during CT scan was moved to new position if there was anatomic mismatch between the two images Results: In 7/21 patients, anatomic structures on DRR Image were different from the simulation Image thus new isocenter points were placed for treatment planning. The standard deviations of the diagnostic CT setup errors relative to the simulator setup in lateral, longitudinal, and anterior-posterior directions were 2.3, 1.6, and 1.6 mm, respectively. The average variation and standard deviation of SSD from AP field were 1.9 mm and 2.3 mm and from tangential fields were 2.8 mm and 3.7 mm. The variation of the CLD for the 21 patients ranged from 0 to 6 mm between simulation and DRR and 0 to 5 mm between simulation and treatment. The group systematic errors analyzed based on clip locations were 1.7 mm in lateral direction, 2.1 mm in AP direction, and 1.7 mm in SI direction. Conclusion: These results represent that there was no significant differences when SSD, CLD, clips' locations and isocenter locations were considered. Therefore, it is concluded that when a diagnostic CT scanner is used to acquire an image, the set-up variation is acceptable compared to using CT simulator for the treatment of breast cancer. However, the patient has to be positioned with care during CT scan in order to reduce the setup error between simulation and CT scan.

• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.252-259
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• 2011

To identify the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with the other two factors of body mass Index (BMI) and tube potential on radiation dose in cardiac CT. The patient receiving operation the cardiac CT examination was divided four groups into according to kVp.[A group(n=20), Non-ASIR, BMI < 25, 100 kVp; B group(n=20), Non-ASIR, BMI > 25, 120 kVp; C group(n=20), 40% ASIR BMI < 25, 100 kVp; D group(n=20), 40% ASIR, BMI > 25, 120 kVp] After setting up the region of interest in the main artery central part and right coronary artery and left anterior descending artery, the CT number was measured and an average and standard deviation were analyzed. There were A group and the difference which the image noise notes statistically between C. And A group was high so that the noise could note than C group (group A, 494 ${\pm}$ 32 HU; group C, 482 ${\pm}$ 48 HU: P<0.05) In addition, there were B group and the difference noted statistically between D. And B group was high so that the noise could note than D group (group B, 510 ${\pm}$ 45 HU; group D, 480 ${\pm}$ 82 HU: P<0.05). In the qualitative analysis of an image, there was no difference (p>0.05) which a group, B group, C group, and D as to average, A group 4.13${\pm}$0.2, B group 4.18${\pm}$0.1, and C group 4.1${\pm}$0.2 and D group note statistically altogether with 4.15${\pm}$0.1 as a result of making the clinical evaluation according to the coronary artery segments. And the inappropriate image was shown to the diagnosis in all groups. As to the radiation dose, a group 8.6${\pm}$0.9 and B group 14.9${\pm}$0.4 and C group 5.8${\pm}$0.5 and D group are 10.1${\pm}$0.6 mSv.

• Tuberculosis and Respiratory Diseases
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• v.48 no.3
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• pp.357-364
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• 2000

Background : Complicated exudative pleural fluid collections have traditionally been treated by either closed tube thoracostomy drainage or by open surgical drainage. Complete drainage is important in order to control pleural sepsis, restore pulmonary function, and entrapment. Recently intracavitary fibrinolytic therapy has been advocated as a method to facillitate drainage of complicated exudative pleural effusion and to allow enzymatic debridemant of the restrictive fibrinous sheets covering the pleural surface. The purpose of this study is to prospectively evaluate the effects of image-guided catheter drainage with high dose urokinase(UK) instillation in the treatment of complicated pleural effusions. Patients : Twenty complicated pleural effusion patients that poorly respond to image-guided drainage were allocated to receive UK. There were 8 pneumonia and 12 tuberculosis. Methods : Drugs were diluted in 250 mL normal saline and were infused intrapleurally through the chest tube or pig-tail catheter in a daily dose of 250,000 IU of UK. Response was assessed by clinical outcome, fluid drainage, chest radiography, pleural ultrasound and/or computed tomography. Results : The mean UK instillation time was $1.63{\pm}0.10$. The mean volume drained UK instillation was $381.3{\pm}314.4\;mL$, and post-UK was $321.6{\pm}489.5\;mL$. The follow up duration after UK therapy was mean $212.9{\pm}194.5$ days. We had successful results in 19 cases (95.0%). There were 12 pleural thickenings (60.0%), 2 markedly decreased effusions (10.0%) and 5 cases of no thickening or effusion. There was recurrence after treatment in only one patient(5%) with complicated pleural effusiondue to tuberculosis. Conclusions : Image-guided drainage with high dose UK instillation (250,000 U/day) in complicated pleural effusion is a safe and more effective method than closed thoracostomy drainage. And this management, in turn, can obviate surgery in most cases.

• Journal of the Korean Society of Radiology
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• v.16 no.6
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• pp.673-680
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• 2022

In this study, based on PLA, we analyzed the Hounsfield Unit (HU) of materials containing 20% each of aluminum, wood, copper, carbon, and marble, and tried to analyze how they affect the image. A cylindrical phantom of 5×30×30 ㎣ (thickness×diameter×height) was fabricated using a entry-level 3D printer. The kV was changed to 80, 100 and 120, and the mAs was changed to 100 and 200 mAs, and the phantom in the center of the table was cross-scanned under a total of six conditions. A circular ROI was set using image J program and the quantification value of the material part HU and the quantification value of the peripheral part CNR were obtained. The HU average of the material part increased in the order of [PLA - wood 20%], [PLA - marble 20%], [PLA - carbon 20%], [PLA 100%], [PLA - aluminum 20%], [PLA - copper 20%] (p<0.05) a negative correlation was confirmed with the HU by increasing kV. It was confirmed that the CNR value in the peripheral area increased in the order of [PLA - marble 20%], [PLA - copper 20%], [PLA - carbon 20%], [PLA - wood 20%], [PLA - aluminum 20%], and [PLA - 100%] (p<0.05). Human organs with similar HU values for each material are [PLA - copper 20%] compact bone, [PLA - aluminum 20%] cancellous bone, [PLA 100%] coagulated blood, [PLA - carbon 20%] and [PLA - marble 20%] liver, muscle, spleen and [PLA - wood 20%] had similar values to fat. In addition, we confirmed the blur phenomenon that blurs the image around the filament with all materials, and confirmed that [PLA 100%] especially has the most blur around the filament. Therefore, it is considered desirable to reflect the HU value of the target organ and consider cloudiness around the phantom when selecting materials for medical phantom fabrication, and this research can provide basic data.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.170-184
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• 2023

Purpose To assess the magnitude of differences between attenuation values of the true non-contrast image (TNC) and virtual non-contrast image (VNC) derived from twin-beam dual-energy CT (tbDECT) and dual-source DECT (dsDECT). Materials and Methods This retrospective study included 62 patients who underwent liver dynamic DECT with tbDECT (n = 32) or dsDECT (n = 30). Arterial VNC (AVNC), portal VNC (PVNC), and delayed VNC (DVNC) were reconstructed using multiphasic DECT. Attenuation values of multiple intra-abdominal organs (n = 11) on TNCs were subsequently compared to those on multiphasic VNCs. Further, we investigated the percentage of cases with an absolute difference between TNC and VNC of ≤ 10 Hounsfield units (HU). Results For the mean attenuation values of TNC and VNC, 33 items for each DECT were compared according to the multiphasic VNCs and organs. More than half of the comparison items for each DECT showed significant differences (tbDECT 17/33; dsDECT 19/33; Bonferroni correction p < 0.0167). The percentage of cases with an absolute difference ≤ 10 HU was 56.7%, 69.2%, and 78.6% in AVNC, PVNC, and DVNC in tbDECT, respectively, and 70.5%, 78%, and 78% in dsDECT, respectively. Conclusion VNCs derived from the two DECTs were insufficient to replace TNCs because of the considerable difference in attenuation values.

• Progress in Medical Physics
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• v.22 no.4
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• pp.184-189
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• 2011

The purpose of this study was to compare the image between DSA and MDCT Angiography and to examine whether MDCT Angiography could be useful as a screening test for the diagnosis of cerebral aneurysm in patients who were diagnosed with cerebral aneurysm on DSA. Of patients who were diagnosed with cerebral aneurysm DSA at University Hospital, 194 patients who concomitantly underwent MDCT Angiography were enrolled in the current retrospective study. The methods for analyzing cerebral aneurysm were to analyze the presence of cerebral aneurysm on DSA and MDCT Angiography. In cases in which it exceeded 1, the corresponding cases were classified as narrow-neck aneurysms. In otherwise cases, they were classified as wide-neck aneurysms. Thus, a comparative analysis could be performed to ascertain if cases were narrow-neck or wide-neck aneurysms. As compared with DSA, the sensitivity of MDCT Angiography for cerebral aneurysm was measured to be 97.4%. The degree of consistency between narrow-neck and wide-neck aneurysms was 90.2% and the proportion of undetectable an at MDCT Angiography was 2.54%. mean size was 2.4 mm. It is expected that a non-invasive diagnostic modality for a screening test for cerebral aneurysm, MDCT Angiography might be a very useful regimen as compared with an invasive one, DSA.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.109-115
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• 2015

Background: This study sought to determine safe ranges of oblique angle, skin entry point and needle length by reviewing computed tomography (CT) scans and to evaluate the usefulness of a bent tip needle during celiac plexus block (CPB). Methods: CT scans of 60 CPB patients were reviewed. Image of the uppermost margin of L2 vertebral body was used to measure the minimal and maximal oblique angles and the distances from the midline to skin puncture point. The imaginary needle trajectory distance was calculated by three-dimensional measurement. When the procedure was performed by using a $10^{\circ}$ bent tip needle under a $20^{\circ}$ oblique X-ray fluoroscopic view, the distance (GF/G'F) from the midline to the actual puncture site was measured. Results: The imaginary safe oblique angle range was $26.4-34.2^{\circ}$ and $27.7-36.0^{\circ}$ on the right and left, respectively. The distance from the midline to skin puncture point was 6.1-7.6 cm on the right and 6.3-7.6 cm on the left. The needle trajectory distance at minimal angle was 9.6-11.6 cm on the right and 9.5-11.5 cm on the left. The distance of GF/G'F was 5.1-6.5 cm and 5.0-6.4 cm on the right and left, respectively. All imaginary parameters were correlated with BMI except for GF/G'F. All complications were mild and transient. Conclusions: We identified safe values of angles and distances using a straight needle. Furthermore, using a bent tip needle under a $20^{\circ}$ oblique fluoroscopic view, we could safely perform CPB with smaller parameter values.