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CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

Usefulness of 18F-FDG PET/CT and Multiphase CT in the Differential Diagnosis of Hepatocellular Carcinoma and Combined Hepatocellular Carcinoma-Cholangiocarcinoma (간세포암종과 혼합성 간세포암종-담관암종에서 다위상 전산단층촬영술 소견과 18F-FDG PET/CT에서 섭취율 차이에 대한 분석 )

  • Jae Chun Park; Jung Gu Park;Gyoo-Sik Jung;Hee Kang;Sungmin Jun
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1424-1435
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    • 2020
  • Purpose The purpose of this study was to evaluate the usefulness of multiphasic CT and 18F-fluorodeoxyglucose (FDG) PET/CT for the differentiation of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) from hepatocellular carcinoma (HCC). Materials and Methods From January 2007 to April 2016, 93 patients with pathologically confirmed HCC (n = 84) or cHCC-CCA (n = 9) underwent CT and PET/CT imaging. Contrast enhancement patterns were divided into three types based on the attenuation of the surrounding liver parenchyma: type I (early arterial enhancement with delayed washout), type II (early arterial enhancement without delayed washout), and type III (early hypovascular, infiltrative appearance, or peripheral rim enhancement). Results cHCC-CCAs (89%) had a higher PET/CT positive rate than did HCCs (61%), but the PET/CT positive rate did not differ significantly (p = 0.095). Among the 19 cases of the type II enhancement pattern, 3 (21%) of 14 HCCs and 4 (80%) of 5 cHCC-CCAs were PET/CT positive. cHCC-CCAs had a significantly higher PET/CT positive rate (p = 0.020) in the type II enhancement pattern. Conclusion The PET/CT positive rate of cHCC-CCA was significantly higher than that of HCC in lesions with a type II enhancement pattern. The 18F-FDG PET/CT can be useful for the differentiation of cHCC-CCA from HCC in lesions with a type II enhancement pattern on multiphasic CT.

Operation of dry distillation process on the production of radionuclide 131I at Puspiptek area Serpong Indonesia, 2021 to 2022

  • Chaidir Pratama;Daya Agung Sarwono;Ahid Nurmanjaya;Abidin Abidin;Triyatna Fani;Moch Subechi;Endang Sarmini;Enny Lestari;Yanto Yanto;Kukuh Eka Prasetya;Maskur Maskur;Fernanto Rindiyantono;Indra Saptiama;Anung Pujiyanto;Herlan Setiawan;Tita Puspitasari;Marlina Marlina;Hasnel Sofyan;Budi Setiawan;Miftakul Munir;Heny Suseno
    • Nuclear Engineering and Technology
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    • v.56 no.4
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    • pp.1526-1531
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    • 2024
  • 131I is a fission product produced in a nuclear reactor by irradiating tellurium dioxide, with a half-life of 8.02 day. The most important and widely used method for making 131I is irradiation using a nuclear reactor and post-irradiation followed by dry distillation. The advantage of the dry distillation process is that the process and the equipment are relatively simple, namely TeO2 (m.p. 750 ℃), which can withstand heating during reactor irradiation. Based on TeO2 irradiation by neutron following the technique of dry distillation was explained for production of 131I on a large scale. A dry distillation followed the radioisotope production operation using the 30 MW GA Siwabessy nuclear reactor to meet national demand. TeO2 targets are 25 and 50 g irradiated for 87-100 h. The resulting 131I activity is 20.29339-368.50335GBq. According to the requirements imposed on the radionuclide purity of the preparation, the contribution of 131I training in the resulting preparation was not less than 99.9 %

Does an extensive diagnostic workup for upfront resectable pancreatic cancer result in a delay which affects survival? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Jemimah Denson;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ashray Rajagopalan;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Teresa Perra;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.403-414
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    • 2023
  • Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.

Prevalence of Incidentally Detected Spondylolysis in Children (소아 환자에서 우연히 발견되는 척추분리증의 유병률)

  • Boram Song;Sun Kyoung You;Jeong Eun Lee;So Mi Lee;Hyun-Hae Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.127-137
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    • 2022
  • Purpose To assess the prevalence of incidentally detected lumbar spondylolysis in children. Materials and Methods We retrospectively reviewed the data of 809 patients under the age of 11 years (mean age, 7.0 ± 2.7 years; boys:girls = 479:330) who underwent abdominal and pelvic CT between March 2014 and December 2018. We recorded the presence, level, and laterality (unilateral or bilateral) of spondylolysis. Patients were divided into two groups based on the presence of spondylolysis: the spondylolysis (SP) and non-SP groups. Results In total, 21 cases of spondylolysis were detected in 20 patients (20/809, 2.5%). The mean age of the SP group was higher than that of the non-SP group (7.8 ± 1.8 vs. 6.9 ± 2.7 years, p > 0.05). The prevalence of spondylolysis in boys was higher than that in girls (15/479 [3.1%] vs. 5/330 [1.5%], p > 0.05). The prevalence of spondylolysis in school-age children (6-10 year olds) was higher than that in preschool-age children (0-5 year olds) (17/538 [3.2%] vs. 3/271 [1.1%], p > 0.05). L5 was the most common level of spondylolysis (76.2%); one 8-year-old boy had two-level spondylolysis. One case of isthmic spondylolisthesis was detected in a 10-year-old boy (1/809, 0.1%). There were 11 unilateral spondylolysis cases (11/21, 52.4%). Conclusion In our study, the prevalence of spondylolysis in children under the age of 11 was 2.5%. The prevalence was higher in boys than in girls and in school-age than in preschool-age children, despite the lack of any statistically significant differences.

Comparison of True and Virtual Non-Contrast Images of Liver Obtained with Single-Source Twin Beam and Dual-Source Dual-Energy CT (간의 단일선원 Twin Beam과 이중선원 이중에너지 전산화단층촬영의 비조영증강 영상과 가상 비조영증강 영상의 비교 연구)

  • Jeong Sub Lee;Guk Myung Choi;Bong Soo Kim;Su Yeon Ko;Kyung Ryeol Lee;Jeong Jae Kim;Doo Ri Kim
    • 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.

A Case Study on the Processing of Siji(試紙) in the Mid-19th Century - Focusing on Lee Mangi's Sigwon(試卷) - (19세기 중반 시지(試紙)의 가공 사례 연구 - 이만기(李晩耆) 시권(試卷)을 중심으로 -)

  • CHUN Jiyoun;OH Joonsuk
    • Korean Journal of Heritage: History & Science
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    • v.57 no.3
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    • pp.90-101
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    • 2024
  • The test answer sheets submitted by examinees in the Joseon Dynasty were called Sigwon (test papers with answers, 試卷), and Siji (blank test papers, 試紙) were generally prepared by the examinees themselves. At that time, paper was not produced as a standard product, so there was no uniformity in size or manufacturing method. Mulberry paper in the Joseon Dynasty was basically transparent, so various paper processing methods were applied for examinees to write answers on both sides. In order for ink lines to be written smoothly, Dochim (hitting paper with a wooden bat on the stone, 搗砧) or surface processing was treated. We found a 19th-century Siji (試紙) that was processed in a unique way, which led to this study. An unusual Sigwon (試卷) is one by Lee Mangi (李晩耆) from 1848 owned by the National Folk Museum of Korea. We found that an opaque white substance was thickly applied between the papers of this Siji (試紙). Through component analysis using infrared spectrophotometry, fluorescence X-ray spectroscopy, optical and polarizing microscopy, and electron microscopy, this white substance was proved to be rice starch. From these analyses, it is presumed that this Siji (試紙) was made by soaking rice flour in water to remove a significant amount of protein, and then applying wet starch containing a small amount of protein between sheets of paper. In addition, with a Siji (試紙) reproduction experiment, we found that the paper reproduced by this processing method was thick and high in whiteness and opacity. This is believed to be a production method designed to produce double-sided paper without using multiple sheets of paper, which was difficult to obtain at that time. In this study, the material processed between the sheets of paper was disclosed only from < Lee Mangi (李晩耆)'s Sigwon (試卷)(Minsok 71745)>, but this appears to be one of several processing methods to treat the paper during the Joseon Dynasty. We hope that more similar Sigwons will be discovered in the future and that extensive research on processing methods will be conducted.

Evaluation of Effective Dose for Asian Adult Men on Dental Cone-Beam Computed Tomography using Personal Computer Based Monte Carlo Simulation (개인용 컴퓨터 기반 몬테카를로 시뮬레이션을 이용한 동양인 성인 남성의 치과용 콘빔시티 유효선량 평가)

  • Hae-Soo Joun;Youngjun Kim;Jungsu Kim
    • Journal of the Korean Society of Radiology
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    • v.18 no.6
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    • pp.741-747
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    • 2024
  • Cone-Beam Computed Tomography (CBCT) for dental diagnosis has been used for maxillofacial imaging in dental radiology for many years, and increasing in popularity. The number of such inspections increased by approximately 32.4% from 850,000 in 2020 to 1.12 million in 2022. With the increase in dental radiology examinations, the collective effective dose from dental radiology increased by approximately 19.4% from 766 man·Sv in 2020 to approximately 914 man·Sv in 2022. In this study, the effective dose of Cone Beam CT examination was evaluated using Personal Computer(PC)-based computer simulation. The simulation were set identically to the test conditions of the imaging equipment (RCT-820 Ray Co., Ltd.) and compared two methods with Field Of View(FOV) values of 18×16.5 cm and 16×10 cm and an asian adult men phantom was used. The average result at 18×16.5 cm FOV was 223.1 µSv, and the effective dose value at 16×10 cm FOV was averaged at 122.8 µSv. As the irradiation area became smaller, the effective dose value decreased, and the absorbed dose to organ was 1.6 mSv in the 18×16.5 cm FOV, indicating a considerably high tissue equivalent dose. As a result, this study finds the importance of appropriate FOV setting and protective equipment such as a thyroid protector when Cone Beam CT test is performed at a dental site. Also, It is believed that it can be expected that dental medical workers will be able to actively and carefully control irradiation dose settings using the easy-to-use PCXMC program.

Crystal Structures of $Cd_6-A$ Dehydrated at $750^{\circ}C$ and Dehydrated $Cd_6-A$ Reacted with Cs Vapor ($750^{\circ}C$ 에서 탈수한 $Cd_6-A$의 결정구조와 이 결정을 세슘 증기로 반응시킨 결정구조)

  • Se Bok Jang;Yang Kim
    • Journal of the Korean Chemical Society
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    • v.37 no.2
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    • pp.191-198
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    • 1993
  • The crystal structures of $Cd_{6-}A$ evacuated at $2{\times}10^{-6}$ torr and $750^{\circ}C$ (a = 12.204(1) $\AA$) and dehydrated $Cd_{6-}A$ reacted with 0.1 torr of Cs vapor at $250^{\circ}C$ for 12 hours (a = 12.279(1) $\AA$) have been determined by single crystal X-ray diffraction techniques in the cubic space group Pm3m at $21(1)^{\circ}C.$ Their structures were refined to final error indices, $R_1=$ 0.081 and $R_2=$ 0.091 with 151 reflections and $R_1=$ 0.095 and $R_2=$ 0.089 with 82 reflections, respectively, for which I > $3\sigma(I).$ In vacuum dehydrated $Cd_{6-}A$, six $Cd^{2+}$ ions occupy threefold-axis positions near 6-ring, recessed 0.460(3) $\AA$ into the sodalite cavity from the (111) plane at O(3) : Cd-O(3) = 2.18(2) $\AA$ and O(3)-Cd-O(3) = $115.7(4)^{\circ}.$ Upon treating it with 0.1 torr of Cs vapor at $250^{\circ}C$, all 6 $Cd^{2+}$ ions in dehydrated $Cd_{6-}A$ are reduced by Cs vapor and Cs species are found at 4 crystallographic sites : 3.0 $Cs^+$ ions lie at the centers of the 8-rings at sites of $D_{4h}$ symmetry; ca. 9.0 Cs+ ions lie on the threefold axes of unit cell, ca. 7 in the large cavity and ca. 2 in the sodalite cavity; ca. 0.5 $Cs^+$ ion is found near a 4-ring. In this structure, ca. 12.5 Cs species are found per unit cell, more than the twelve $Cs^+$ ions needed to balance the anionic charge of zeolite framework, indicating that sorption of Cs0 has occurred. The occupancies observed are simply explained by two unit cell arrangements, $Cs_{12}-A$ and $Cs_{13}-A$. About 50% of unit cells may have two $Cs^+$ ions in sodalite unit near opposite 6-rings, six in the large cavity near 6-ring and one in the large cavity near a 4-ring. The remaining 50% of unit cells may have two Cs species in the sodalite unit which are closely associated with two out of 8 $Cs^+$ ions in the large cavity to form linear $(Cs_4)^{3+}$ clusters. These clusters lie on threefold axes and extend through the centers of sodalite units. In all unit cells, three $Cs^+$ ions fill equipoints of symmetry $D_{4h}$ at the centers of 8-rings.

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Usefulness of LIFE in diagnosis of bronchogenic carcinoma (기관지 암의 진단에서 형광기관지 내시경검사의 유용성)

  • Lee, Sang Hwa;Shim, Jae Jeong;Lee, So Ra;Lee, Sang Youb;Suh, Jung Kyung;Cho, Jae Yun;Kim, Han Gyum;In, Kwang Ho;Choi, Young Ho;Kim, Hark Jei;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.69-84
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    • 1997
  • Background : Although the overall prognosis of patients with lung cancer is poor, highly effective treatment exists for the small subset of patients with early lung cancer(carcinoma in situ/micro- invasive cancer). But very few patients have benefit from them because these lesions are difficult to detect and localize with conventional white-light bronchoscopy. To overcome this problem, a Lung Imaging Fluorescence Endoscopic device(LIFE) was developed to detect and clearly delineate the exact location and extent of premalignant and early lung cancer lesions using differences in tissue autofluorescence. Purpose : The purpose of this study was to determine the difference of sensitivity and specificity in detecting dysplasia and carcinoma between fluorescence imaging and conventional white light bronchoscopy. Material and Methods : 35 patients (16 with abnormal chest X-ray, 2 with positive sputum study, 2 with undiagnosed pleural effusion, 15 with respiratory symptom) have been examined by LIFE imaging system. After a white light bronchoscopy, the patients were submitted to fluorescence bronchoscopy and the findings of both examinations have been classified in 3 categories(class I, II, III). From of all class n and III sites, 79 biopsy specimens have been collected for histologic examination: a comparison between histologic results and white light or fluorescence bronchoscopy has been performed for assessing sensitivity and specificity of the two methods. Results : 1) Total 79 sires in 35 patients were examined. Histology demonstrated 8 normal mucosa, 21 hyperplasia, 23 dysplasia, and 27 microinvasive and invasive carcinoma. 2) The sensitivity of white light or fluorescence bronchoscopy in detecting dysplasia was 60.9% and 82.6%, respectively. 3) The results of this study showed 70.3 % sensitivity for microinvasive or invasive carcinoma with LIFE system, versus 100% sensitivity for white light in 27 cases of carcinoma. The false negative study of LIFE system was 8 cases(3 adenocarcinoma and 5 small cell carcinoma), which were infiltrated in submucosal area and had normal epithelium. Conclusion : To improve the ability 10 diagnose and stage more accurately, fluorescence imaging may become an important adjunct to conventional bronchoscopic examination because of its high detection rate of premalignant and malignant epithelial lesion. But. it has limitation to detect in submucosal infiltrating carcinoma.

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