• Radiation Oncology Journal
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• v.28 no.3
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• pp.177-183
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• 2010

Purpose: Simulation using computed tomography (CT) is now widely available for radiation treatment planning for breast cancer. It is an important tool to help define the tumor target and normal tissue based on anatomical features of an individual patient. In Korea, most patients have small sized breasts and the purpose of this study was to review the margin of treatment field between conventional two-dimensional (2D) planning and CT based three-dimensional (3D) planning in patients with small breasts. Materials and Methods: Twenty-five consecutive patients with early breast cancer undergoing breast conservation therapy were selected. All patients underwent 3D CT based planning with a conventional breast tangential field design. In 2D planning, the treatment field margins were determined by palpation of the breast parenchyma (In general, the superior: base of the clavicle, medial: midline, lateral: mid - axillary line, and inferior margin: 2 m below the inframammary fold). In 3D planning, the clinical target volume (CTV) ought to comprise all glandular breast tissue, and the PTV was obtained by adding a 3D margin of 1 cm around the CTV except in the skin direction. The difference in the treatment field margin and equivalent field size between 2D and 3D planning were evaluated. The association between radiation field margins and factors such as body mass index, menopause status, and bra size was determined. Lung volume and heart volume were examined on the basis of the prescribed breast radiation dose and 3D dose distribution. Results: The margins of the treatment field were smaller in the 3D planning except for two patients. The superior margin was especially variable (average, 2.5 cm; range, -2.5 to 4.5 cm; SD, 1.85). The margin of these targets did not vary equally across BMI class, menopause status, or bra size. The average irradiated lung volume was significantly lower for 3D planning. The average irradiated heart volume did not decrease significantly. Conclusion: The use of 3D CT based planning reduced the radiation field in early breast cancer patients with small breasts in relation to conventional planning. Though a coherent definition of the breast is needed, CT-based planning generated the better plan in terms of reducing the irradiation volume of normal tissue. Moreover it was possible that 3D CT based planning showed better CTV coverage including postoperative change.

• Journal of the Korean Society of Radiology
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• v.13 no.7
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• pp.1005-1014
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• 2019

The purpose of this study is to evaluate the usefulness of coronary computed tomography angiography of coronary artery disease for the purpose fo health screening according to gender and age. In addition the association between hematological factors (Glucose, total cholesterol, visceral fat, body mass index, triglycerides, high density lipoprotein (HDL), low density lipoprotein (LDL)) and coronary artery disease is investigated. A retrospective analysis of coronary computed tomography angiography with 299 subjects showed that the detection rate of coronary artery disease was higher in men over 50 years of age and it was statistically significant. In particular, the prevalence rate of men (37.9%) was about 2 times higher than that of women (17.0%). Glucose and HDL as hematological factors associated with coronary artery disease were statistically significant. The prevention and management of coronary artery disease seems to require the control of glucose and high density lipoprotein (HDL). Although it is not statistically significant with other hematological factors, the need for management of coronary artery disease was identified. the coronary computed tomography angiography of coronary artery has higher radiation doses than other CT scans. Therefore, for the purpose of screening, coronary computed tomography angiography should be considered in consideration of the sex and age of the examinee, and detection of coronary artery disease through other non-invasive tests should be prioritized over coronary computed tomography angiography.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1260-1265
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• 2020

Kaposi's sarcoma (KS) is a multicentric human immunodeficiency virus-associated neoplasm characterized by multiple vascular nodules in the skin, mucous membranes, and viscera. Gastrointestinal acquired immunodeficiency syndrome (AIDS)-related KS is the most common visceral involvement reported in disseminated disease. Here, we present the findings of a rare case of KS involving multiple organs with abdominal pain and active bleeding in the colon. Multiple intraluminal lesions were found in the terminal ileum, sigmoid colon, and rectum by ileocolonoscopy, and in the jejunum and ileum by fluoroscopy. Abdominopelvic CT revealed multiple enhanced flat lesions in the ileum and enlarged lymph nodes. The diagnosis was confirmed by histopathology, and antiretroviral therapy was initiated as the treatment of choice for KS. Owing to the increasing number of AIDS patients, it is essential for radiologists and clinicians to be aware of the imaging characteristics of KS to protect physicians from indiscriminate exposure to AIDS.

• Tuberculosis and Respiratory Diseases
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• v.40 no.3
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• pp.259-266
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• 1993

Background: To evaluate the risk factor of pneumothorax (PNX) which is the most common complication of CT-guided needle aspiration of the lung, we have examined the frequency of PNX according to the presence of obstructive ventilatory impairment determined by pulmonary function tests. Methods: A comparative study of analysis of forecd expiratory volume and folw-volume curves, and determinations of diffusing capacity taken before procedure were made between each 16 cases with PNX and controls with no PNX. Each of the control group was matched for sex, age, height, and size and depth of lesion with the former. Results: 1) In comparison of vital capacity and parameters derived from forced expiratory volume curve between two groups, VC and FVC were not significantly different, whereas $FEV_1$, $FEV_1$/FVC%, and FEF25-75% showed a significant decrease in the PNX gorup. Also, in the PNX group, all the observed values of parameters analyzed from flow-volune curve were siginificantly reduced in the PNX group compared with those in the control group. 2) The diffusing capacity tended to decrease along with varying individual differences in the PNX group. 3) Patients who had obstructive ventilatory impairment according to the results of pulmonary function tests experienced a twofold increase in the frequency of PNX and a sixfold increase in the frequency of chest tube drainage for treatment of PNX compared with those whose results were normal. Conclusion: These findings suggest that the exact evaluation of obstructive lung disease determined by pulmonary function test be considered assessing a pastient's risk for PNX in the patients who will take the CT-guided needle aspiration of the lung.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.276-284
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• 2000

Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.4
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• pp.368-376
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• 2020

The primary maxillary second molars usually have three roots. However, an additional root located mesiopalatally is occasionally observed. This study aimed to determine the relationship between a mesiopalatal root of primary maxillary second molars and an abnormal eruption pattern of maxillary second premolars. The study was performed on cone beam computed tomography images taken from 916 children who visited the Dental Hospital of Kyung Hee University from 2010 to 2018. 744 serial cross-sectional cone beam computed tomography images were evaluated. The overall incidence of the mesiopalatal root of primary maxillary second molars was 3.2% (n = 24) and the abnormal eruption pattern of maxillary second premolars was 19.2% (n = 143). Especially, patients with the mesiopalatal root of primary maxillary second molars were significantly more likely to have the abnormal eruption pattern on maxillary second premolars (p = 0.000). The odds of the abnormal eruption pattern of maxillary second premolars with the mesiopalatal root of primary maxillary second molars was about 13 times higher than those without. The eruption pattern of the permanent successor should be carefully observed and treated if the mesiopalatal root of primary maxillary second molar is existent.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1212-1217
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• 1996

From Dec. 1993 to May 1995, 9 male and 5 female patients ranging in age from 25 to 65 years, were operated on for ascending aorta and/or aortic arch diseases. Six patients had acute aortic dissection, type A(ruptured in 4 cases); four had ruptured ascending aortic aneurysm; three had annuloaortic ectasia(ruptured in 1 cases); one had aortic arch aneurysm. The diagnostic procedures were echo cardiography and dynamic CT scan in all patients having acute dissection or rupture. The aortic angiography was performed in two cases. Indications for operations were rupture in five cases, acute aortic dissection in five cases, severe congestive heart failure in two cases, progressive aortic insufficiency in one case and impending rupture in one case. The emergent repair was performed in ten cases(71%). The surgical treatment consisted of 6 Cabrol operations, a Cabrol operation combined with arch replacement, a modified Bentall operation, 4 replacement of ascending aorta, a replacement of aortic arch, and a replacement of ascending aorta and aortic arch. Complications were a hypoxic encephalopathy, two atrial fibrillations, a sternal deheiscence, and a mediastinitis. Two early mortality(14%) were due to intractable bleeding and multiple organ failure, and one late mortality(7%) was due to ventricular arrhythmia. In eleven survivors, follow-up period was from 2 months to 12 months and the course was uneventful.

• The Journal of Korean Society for Radiation Therapy
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• v.20 no.1
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• pp.45-53
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• 2008

Purpose: We are trying to analyze 130 patients' conditions by using our Helical Tomotherapy, which was installed in our center in Oct. 2007. We will be statistically approach this examination and analyze so that we will be able to figure out adaptive plans according to the change in place of the tumor, GTV (gross tumor volume), total amount of time it took, vector (${\upsilon}=\surd$x2+y2+z2) and the change in size of the tumor. Materials and Methods: Objectives were the patients who were medicated with Tomotherapy in our medical center since Oct. 2007 August 2008. The Average age of the patients were 53 years old (Minimum 25 years old, Maximum 83 years old). The parts of the body we operated were could be categorized as Head&neck (n=22), Chest (n=47), Abdomen (n=25), Pelvis (n=11), Bone (n=25). MVCT had acted on 2702 times, and also had acted on our adaptive plan toward patients who showed big difference in the size of tumor. Also, after equalizing our gained MVCT and kv-CT we checked up on the range of possible mistake, using x, y, z, roll and vector. We've also investigated on Set-up, MVCT, average time of operation and target volume. Results: Mean time on table was 22.8 minutes. Mean treatment time was 13.26 minutes. Mean correction (mm) was X=-0.7, Y=-1.4, Z=5.77, roll=0.29, vector=8.66 Head&neck patients had 2.96 mm less vector value in movement than patients of Chest, Abdomen, Bone. In increasing order, Head&neck, Bone, Abdomen, Chest, Pelvis showed the vector value in movement. Also, there were 27 patients for adaptive plan, 39 patients, who had long or multiple tumor. We could know that When medical treatment is one cure plan, it takes 32 minutes, and when medical treatment is two cure plan, it takes 40 minutes that one medical treatment takes 21 minutes, and the other medical treatment takes 19 minutes. Conclusion:With our basic tools, we could bring more accurate IMRT with MVCT. Also, through our daily image, we checked up on the change in tumor so that adaptive plan could work. It was made it possible to take the cure of long or multiple tumor, the cure in a nearby OAR, and the complicated cure that should make changes of gradient dose distribution.

• Journal of the Korean Society of Radiology
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• v.8 no.7
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• pp.401-408
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• 2014

The purpose of this study is confirmed to usefulness between division exam and combine exam of chest and abdomen according to comparing chest and abdomen radiation dose of division exam and combine exam in CT exam method. This study was conducted on patients who were admitted to the E hospital from July 2013 to March 2014 underwent CT studies for the diagnosis of chest and abdomen disease. In study result, male dose were more higher than female dose according to gender analysis of exposure dose that combine exam effective dose were male $33.10{\pm}2.75mSv$, female $31.66{\pm}3.12mSv$ and chest exam effective dose were male $9.07{\pm}2.62mSv$, female $8.30{\pm}2.18mSv$(p<0.05). And, division exam dose and combine exam dose were similar in gender comparison (p>0.05). And, combine exam effective dose, only chest exam effective dose, only abdomen exam effective dose were more higher than DRL(Diagnostic Reference Level) in comparison of patient exposure dose with DRL (p<0.05). In conclusion, chest-abdomen combine exam dose and division exam dose were similar. The chest-abdomen combine study can be used as follow-up and emergency trauma patients. That study will be reduce exam time and the occurrence risk of side effect of the contrast medium.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.318-323
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• 2008

It is difficult to distinguish a lung cancer from a pulmonary tuberculoma or other benign nodule. It is even more difficult to identify the type of lesion if the mass shows no change in size or demonstrates slow growth. Only a pathological confirmation can possibly reveal the nature of the lesion. A 61-year-old-woman was referred for a solitary pulmonary nodule. The nodule showed no change in size for the first two years and continued to grow slowly. Pathological and immunological analyses were conducted for confirmation of the nodule. The nodule was identified as a well-differentiated primary pulmonary adenocarcinoma. An LULobectomy was performed, and the post surgical stage of the nodule was IIIA (T2N2M0). Even though there are few risk factors, there is still the possibility of a malignancy in cases of non-growing or slow growing solitary pulmonary nodules. Therefore, pathological confirmation is encouraged to obtain a firm diagnosis.