• 한국방사선학회논문지
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• 제16권5호
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• pp.619-625
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• 2022

영상의학 분야에서 컴퓨터단층촬영(Computed Tomography, CT) 검사는 가장 보편화된 검사 방법 중의 하나이고 병원에서 이용 빈도가 매우 높은 검사 방법 중의 하나이다. 그러나 다른 검사 방법에 비해 매우 높은 방사선 피폭을 동반한다. 피폭 저감화를 위해서 CT 검사가 꼭 필요한 경우만 검사를 시행하는 방법과 꼭 필요해서 검사를 시행하는 경우에도 검사의 목적에 부합하고 적은 선량으로 검사를 시행할 수 있는 프로토콜을 사용해야 한다. 본 연구에서는 지역의 대표적 종합병원에서 사용하고 있는 가장 최신의 방사선량 사용정보를 알아보고 진단기준수준(Dignostic Reference Level, DRL)을 개발하고자 하였다. 실험결과 두부 CT, 복부 CT검사에서 DLP는 NRPB(U.K) 와 Korea DRL보다 높게 나타났다. 흉부 CT의 사용 DLP 값은 CT장치 3종 모두 낮게 나타났다. 해당 병원에서는 CT 검사 시 피폭 저감화를 위한 노력을 해야 하는 것을 알 수 있었고 특히 두부 CT, 복부 CT에서 피폭 저감의 노력이 필요하다고 판단한다.

• 대한치과의사협회지
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• 제58권7호
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• pp.388-397
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• 2020

Objective: The purpose of the study was to calculate the effective and absorbed organ doses of cone-beam computed tomography (CBCT) in pediatric patient using personal computer-based Monte Carlo (PCXMC) software and to compare them with those measured using thermoluminescent dosimeters (TLDs) and anthropomorphic phantom. Materials and Methods: Alphard VEGA CBCT scanner was used for this study. A large field of view (FOV) (20.0 cm × 17.9 cm) was selected because it is a commonly used FOV for orthodontic analyses in pediatric patients. Ionization chamber of dose-area product (DAP) meter was located at the tube side of CBCT scanner. With the clinical exposure settings for a 10-year-old patient, DAP value was measured at the scout and main projection of CBCT. Effective and absorbed organ doses of CBCT at scout and main projection were calculated using PCXMC and PCXMCRotation software respectively. Effective dose and absorbed organ doses were compared with those obtained by TLDs and a 10-year-old child anthropomorphic phantom at the same exposure settings. Results: The effective dose of CBCT calculated by PCXMC software was 292.6 μSv, and that measured using TLD and anthropomorphic phantom was 292.5 μSv. The absorbed doses at the organs largely contributing to effective dose showed the small differences between two methods within the range from -18% to 20%. Conclusion: PCXMC software might be used as an alternative to the TLD measurement method for the effective and absorbed organ dose estimation in CBCT of large FOV in pediatric patients.

• 한국의학물리학회지:의학물리
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• 제32권3호
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• pp.59-69
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• 2021

Purpose: The relationship between computed tomography (CT) number and electron density (ED) has been investigated in previous studies. However, the role of these measures for guiding cancer treatment remains unclear. Methods: The CT number was plotted against ED for different imaging protocols. The CT number was imported into ED tables for the Pinnacle treatment planning system (TPS) and was used to determine the effect on dose calculations. Conversion tables for radiation dose calculations were generated and subsequently monitored using a dosimeter to determine the effect of different CT scanning protocols and treatment sites. These tables were used to retrospectively recalculate the radiation therapy plans for 41 patients after an incorrect scanning protocol was inadvertently used. The gamma index was further used to assess the dose distribution, percentage dose difference (DD), and distance-to-agreement (DTA). Results: For densities <1.1 g/cm³, the standard deviation of the CT number was ±0.6% and the greatest variation was noted for brain protocol conditions. For densities >1.1 g/cm³, the standard deviation of the CT number was ±21.2% and the greatest variation occurred for the tube voltage and head and neck (H&N) protocol conditions. These findings suggest that the factors most affecting the CT number are the tube voltage and treatment site (brain and H&N). Gamma index analyses for the 41 retrospective clinical cases, as well as brain metastases and H&N tumors, showed gamma passing rates >90% and <90% for the passing criterion of 2%/2 and 1%/1 mm, respectively. Conclusions: The CT protocol should be carefully decided for TPS. The correct protocol should be used for the corresponding TPS based on the treatment site because this especially affects the dose distribution for brain metastases and H&N tumor recognition. Such steps could help reduce systematic errors.

• Imaging Science in Dentistry
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• 제50권4호
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• pp.365-371
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• 2020

While silent sinus syndrome (SSS) is familiar to otolaryngologists and ophthalmologists, it is a rare clinical entity in dentistry and is likely to be underdiagnosed due to dentists' lack of awareness of this condition. SSS presents a diagnostic challenge to dentists, as patients typically have no history of trauma or sinusitis. The characteristic feature of SSS is a gradual retreat of the maxillary sinus walls, resulting in enophthalmos and hypoglobus. Multidetector (multislice) computed tomography is the imaging modality of choice for SSS and other paranasal sinus diseases. Cone-beam computed tomography promises to be an alternative low-dose imaging modality. This report describes 3 cases of SSS in adults, who had no identified clinical symptoms except diminutive and opacified maxillary sinuses, as well as the inward bowing of the sinus walls as noted on cone-beam computed tomographic imaging.

• 대한방사선기술학회지:방사선기술과학
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• 제41권3호
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• pp.215-221
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• 2018

Cone beam Computed Tomography(CBCT) is an increasing trend in clinical applications due to its ability to increase the accuracy of radiation therapy. However, this leaded to an increase in exposure dose. In this study, the simulation using Monte Carlo method is performed and the absorbed dose of CBCT is analyzed and standardized data is presented. First, after simulating the CBCT, the photon spectrum was analyzed to secure the reliability and the absorbed dose of the tissue in the human body was evaluated using the MIRD phantom. Compared with SRS-78, the photon spectrum of CBCT showed similar tendency, and the average absorbed dose of MIRD phantom was 8.12 ~ 25.88 mGy depending on the body site. This is about 1% of prescription dose, but dose management will be needed to minimize patient side effects and normal tissue damage.

• 대한방사선기술학회지:방사선기술과학
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• 제39권4호
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• pp.535-541
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• 2016

심장혈관검사에서 전산화단층검사(cardiac computed tomography; CCTA)와 혈관조영검사(coronary angiography; CAG)의 입사표면선량을 후향적 방법으로 분석하여 선량의 저감화 방안을 알아보고 조영제 사용량을 실제 측정하여 신기능 저하 환자 및 부작용 발생 확률이 높은 환자 등의 검사 선택 결정에 대한 역할을 확인하고자 하였다. 양 검사의 입사표면선량인 전산화단층촬영지수($CTDI_{vol}$)값과 공기 커마(air kerma)값, 그리고 프레임 수에 따른 조영제 사용량 등을 비교 분석하였다. 실험 대상으로는 2014년 5월부터 2016년 5월까지 본원에서 CCTA와 CAG를 시행한 21명(남11, 여10)을 대상으로 하였고 연령대는 48~85세(평균 $65{\pm}10$세)이고, 몸무게는 37.6~83.3 kg(평균 $63{\pm}6kg$)였다. CAG보다 CCTA를 이용한 심장혈관 검사가 선량의 감소를 기대할 수 있고 조영제 사용량에 있어서는 CCTA보다 CAG가 더 적은 양을 사용한다는 것을 알 수 있었다. 특히 CAG에서 프레임 수가 증가함에 따라 조영제 사용량이 늘어나므로 촬영범위에 적합한 프레임 수를 선택하여 검사 할수록 조영제 사용량을 더욱 감소시킬 수 있을 것으로 사료된다.

• 한국의학물리학회지:의학물리
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• 제32권1호
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• pp.18-24
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• 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.

• 한국방사선학회논문지
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• 제11권3호
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• pp.109-115
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• 2017

본 연구의 목적은 128 MDCT(Multi-detector computed tomography)의 CareDose 4D 선량감소 효과와 임상적 유용성을 평가하고자 시행되었다. Phantom과 임상 복부 검사 연구라는 두 가지 방법을 통해 128 MDCT CareDose 4D 시스템 적용 전후의 피사체 피폭선량과 영상 평가를 실시하였다. Phantom 연구에서는 CareDose 4D 적용 전후의 두 그룹에 대하여 중앙과 3, 6, 9, 12시의 방향으로 ROI(Region of interest)를 위치시켰고, 임상 연구에서는 간의 각 8구획에 대하여 CareDose 4D 적용 전 후 두 그룹에 대하여 ROI를 위치하여 CT Number, Noise, DLP(Dose length product)선량을 측정하였다. 측정결과 Phantom 및 임상연구에서 CT Number는 적용 전 후 값에 차이가 없었고(p>.05), 선량관련 CTDIvol(CT dose index volume) 측정값 및 유효선량은 CareDose 4D 적용 후가 낮았다 (p<.05). 결론적으로 CareDose 4D를 사용하면 영상의 화질을 저하시키지 않고 최적의 영상정보를 획득하면서 환자 선량이 감소되는 효과를 얻을 수 있다.

• Journal of Cardiovascular Imaging
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• 제31권2호
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• pp.116-117
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• 2023

• 대한방사선기술학회지:방사선기술과학
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• 제39권1호
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• pp.71-79
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• 2016

본 연구는 전산화단층검사(computed tomography; CT)에서 저농도 조영제와 저관전압 기법이 선량과 영상에 미치는 유용성을 팬텀으로 평가하였다. 조영제 농도별로 희석정도를 달리하여 실험팬텀에 삽입 후 관전압과 관전류를 단계적으로 변화하여 촬영하였고, 획득된 팬텀영상을 통해 선량과 HU를 평가하였다. 그 결과 표준조건(350 mgI/ml, 120 kV)보다 저농도 조영제와 저관전압 조건(300 mgI/ml, 100 kV)설정이 체적 선량평가(CTDIvol; computed tomography dose $index_{vol}$)에서 평균 21% 감소하였다. SNR은 저농도 조영제와 저관전압 조건이 팬텀에서 측정한 모든 깊이(center, 4.5cm, 2.25cm)의 조영제와 생리식염수를 1:10, 1:20으로 희석한 실험에서 각각 12.2(26%), 6.2(17%) 증가하였다. CNR은 각각 11.5(32%), 6.3(26%) 증가하였다. CT 검사에서 조영제 부작용 감소를 위한 저농도 조영제의 사용과 피폭선량 감소를 위한 저관전압 사용으로 영상에서 높은 감약계수를 통한 다양한 연구가 필요할 것으로 사료된다.