• Title/Summary/Keyword: Abdomen CT

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The effect of atrophied pancreas as shown in the preoperative imaging on the leakage rate after pancreaticoduodenectomy

  • Ashraf Imam;Harbi Khalayleh;Meni Brakha;Ariel A. Benson;Naama Lev-Cohain;Gidon Zamir;Abed Khalaileh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.2
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    • pp.184-189
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    • 2022
  • Backgrounds/Aims: The soft texture of the pancreas parenchyma may influence the incidence of pancreatic leakage after pancreaticcoduodenectomy (PD). One possible method to assess pancreatic texture and atrophy, is via computed tomography (CT) scan of the abdomen. The purpose of our study was to evaluate the relation between the preoperative CT scan and the incidence of pancreatic fistula after PD. Methods: A retrospective single-center study including patients who underwent PD for a benign and malignant tumor of the periampullary region between the years 2000 and 2016. Demographic and imaging data were analysed and a correlation with the post-operative leak was evaluated. Results: Pancreatic leak was documented in 34 out of 154 (22.1%) patients. All the leakage cases occurred in the preserved pancreas group (33.1% of the total preserved pancreas group alone). No leak was documented in the atrophic pancreas group. This difference between the two groups was found to be statistically significant (p ≤ 0.00001). Conclusions: Atrophic pancreas in the preoperative CT scan may be protective against leakage after PD. These findings may help the surgeon to risk stratify patients accordingly. In addition, the findings suggest that patients with a preserved pancreas may require more protective methods to prevent leakage.

Development of Respiratory Signal Analysis Program for Accurate Phase Reassignment in 4D CT Reconstruction (4D CT 영상 재구성 시 정확한 위상 변환을 위한 호흡 신호 분석 프로그램 개발)

  • Park, Hae-Jin;Jung, Won-Gyun;Yoon, Jai-Woong;Song, Ju-Young;Suh, Tae-Suk
    • Progress in Medical Physics
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    • v.19 no.4
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    • pp.241-246
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    • 2008
  • Patient's respiration can have an effect on movement of tumor range and peripheral organs. Therefore, the respiratory signal was acquired by relation between external markers and movement of patient's abdomen during radiational therapy in order to minimize the effect of respiration. Based on this technique, many studies of rational therapy to irradiate at particular part of stable respiratory signals have executed and they have been clinically applied. Nevertheless, the phase-based method is preferred to the amplitude-based method for the rational therapy related to respiration. Because stabilization of the respiratory signal are limited. In this study, a in-house respiratory signal analysis program was developed for the phase reassignment and the analysis of the irregular respiratory signals. Various irregular respiratory patterns was obtained from clinical experimental volunteers. After then, the in-house program analyzed the factors affecting to phase assignment which is directly related to irradiated sector. Subsequently, accuracy of phase assignment was improved with removement of irregular signals by self-developed algorithm. This study is considered to be useful for not only image reconstruction and elevation of irradiating accuracy through phase assignment of RPM system but also analysis of respiratory signals. Moreover, development of 4D CT image is planed with phantom researches or clinical experiments based on this program.

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MTF Evaluation and Clinical Application according to the Characteristic Kernels in the Computed Tomogrsphy (Kernel 특성에 따른 MTF 평가 및 임상적 적용에 관한 연구)

  • Yoo, Beong-Gyu;Lee, Jong-Seok;Kweon, Dae-Cheol
    • Progress in Medical Physics
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    • v.18 no.2
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    • pp.55-64
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    • 2007
  • Our objective was to evaluate the clinical feasibility of spatial domain filtering as an alternative to additional image reconstruction using different kernels in CT. Kernels were grouped as H30 (head medium smooth), B30 (body medium smooth), S80 (special) and U95 (ultra sharp). Derived from thin coilimated source images, four sets of images were generated using phantom kernels. MTF (50%, 10%, 2%) measured with H30 (3.25, 5.68, 7.45 Ip/cm) B30 (3.84, 6.25, 7.72 Ip/cm), S80 (4.69, 9.49, 12.34 Ip/cm), and U95 (14.19, 20.31, 24.67 Ip/cm). Spatial resolution for the U95 kernel (0.6 mm) was 33.3% greater than that of the H30 and B30 (0.8 mm) kernels. Initially scanned kernels images were rated for subjective image qualify, using a five-point scale. Image scanned with a convolution kernel led to an increase in noise (U95), whereas the results for CT attenuation coefficient were comparable. CT images increase the diagnostic accuracy in head (H30), abdomen (B30), temporal bone and lung (U95) kernels may be controlled by adjusting CT various algorithms, which should be adjusted to take into account the kernels of the CT undergoing the examination.

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Selection of mAs with Using Table Strap in Computed Tomography Scan (전산화단층촬영 시 환자 고정 밴드를 이용한 선량의 선택)

  • Lee, Young-Hyen;An, Hyeong-Theck
    • Korean Journal of Digital Imaging in Medicine
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    • v.13 no.2
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    • pp.63-69
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    • 2011
  • Table strapis patient fixture for securing the patient movements and falls. if it designed to measure the abdominal circumference and used as an indicator of dose selection at CT scan. it will prevent the overexposure of dose without degradation of image quality and efficiently manage dose of each type of body to technician to deal with CT. First, in order to compare the dose used in CT image and qualitative characteristics. reference image is obtained by examining the abdominal phantom in same conditions with the hospital 120 kVp, 200 mAs, D-Dom (Dynamic Dose Of Modulation). SNR, PSNR, RMSE, MAE, CTDIvol of CT images are compared with reference image. for comparing with reference image, the image that Umbilicus level image of Abdomen CT is stored in the PACS were used. For comparison, the top 12 o'clock portion of the air drawn from the same ROI was measured. CTDIvol, mAs, etc. In order to analyze the characteristics of the image, by measuring the length of the umbilicus circumference, pattern of the dose was analyzed. by using the analyzed perimeter and dose information, To be identified visually, fixed band that scale marked were produced. Use them, If the length of circumference of less than 60 cm 100 mAs, Case of 61~80 cm 120 mAs, Case of 80~100 cm 150 mAs, more than 100 cm 200 mAs, dose selection based on the perimeter, the image was applied. by compare analyzed with the Reference Image, image quality was assessed. by compare with existing tests that equally 200 mAs applied, How much was confirmed that the dose reduction. 1. Depending on the Abdominal circumference, the average PSNR(dB) of the image that differently dose applied was 45.794. 2. Comparing with existing test. the dose of scan that adjusted the mAs depending on the circumference was decreased about 40%. SNR and PSNR of the image that obtained by adjusting the standard mAs based on dose modulation were not much different. Therefore, By choosing a low mAs. dose reduction can be obtained. and the dose selection method that measured Abdominal circumference using a fixed band can protect the overexposure and uniformly apply dose of each type of body to technician to deal with CT.

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Analysis of the Imaging Dose for IGRT/Gated Treatments (영상유도 및 호흡동조 방사선치료에서의 영상장비에 의한 흡수선량 분석)

  • Shin, Jung-Suk;Han, Young-Yih;Ju, Sang-Gyu;Shin, Eun-Hyuk;Hong, Chae-Seon;Ahn, Yong-Chan
    • Radiation Oncology Journal
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    • v.27 no.1
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    • pp.42-48
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    • 2009
  • Purpose: The introduction of image guided radiation therapy/four-dimensional radiation therapy (IGRT/4DRT) potentially increases the accumulated dose to patients from imaging and verification processes as compared to conventional practice. It is therefore essential to investigate the level of the imaging dose to patients when IGRT/4DRT devices are installed. The imaging dose level was monitored and was compared with the use of pre-IGRT practice. Materials and Methods: A four-dimensional CT (4DCT) unit (GE, Ultra Light Speed 16), a simulator (Varian Acuity) and Varian IX unit with an on-board imager (OBI) and cone beam CT (CBCT) were installed. The surface doses to a RANDO phantom (The Phantom Laboratory, Salem, NY USA) were measured with the newly installed devices and with pre-existing devices including a single slice CT scanner (GE, Light Speed), a simulator (Varian Ximatron) and L-gram linear accelerator (Varian, 2100C Linac). The surface doses were measured using thermo luminescent dosimeters (TLDs) at eight sites-the brain, eye, thyroid, chest, abdomen, ovary, prostate and pelvis. Results: Compared to imaging with the use of single slice non-gated CT, the use of 4DCT imaging increased the dose to the chest and abdomen approximately ten-fold ($1.74{\pm}0.34$ cGy versus $23.23{\pm}3.67$cGy). Imaging doses with the use of the Acuity simulator were smaller than doses with the use of the Ximatron simulator, which were $0.91{\pm}0.89$ cGy versus $6.77{\pm}3.56$ cGy, respectively. The dose with the use of the electronic portal imaging device (EPID; Varian IX unit) was approximately 50% of the dose with the use of the L-gram linear accelerator ($1.83{\pm}0.36$ cGy versus $3.80{\pm}1.67$ cGy). The dose from the OBI for fluoroscopy and low-dose mode CBCT were $0.97{\pm}0.34$ cGy and $2.3{\pm}0.67$ cGy, respectively. Conclusion: The use of 4DCT is the major source of an increase of the radiation (imaging) dose to patients. OBI and CBCT doses were small, but the accumulated dose associated with everyday verification need to be considered.

Sertoli-Leydig Cell Tumor of the Ovary in a 4 year-old Girl - A Case Report - (4세 영아의 난소에서 발생한 Sertoli-Leydig 세포 종양 -1예 보고-)

  • Kim, Hye-Jin;Choe, Byung-Ho;Park, Jin-Young
    • Advances in pediatric surgery
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    • v.15 no.1
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    • pp.73-79
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    • 2009
  • Sertoli-Leydig cell tumor is a rare sex-cord stromal tumor of the ovary. They make up less than 0.5 % of all ovarian tumors. We experienced a case of an ovarian Sertoli-Leydig cell tumor in a 4 year-old girl who presented with nausea, vomiting, and lower abdominal pain of 2 days' duration. On physical examination, there was mild tenderness in the right lower quadrant of the abdomen. Abdominal ultrasonography and computed tomography (CT) scan revealed a pelvic mass measuring $5{\times}3cm$ that appeared to arise from the right ovary. At exploratory laparotomy, a $6{\times}5{\times}3cm$ solid right ovarian mass without torsion was found. A right salpingo-oophorectomy was performed. The postoperative course was uneventful. The child was discharged 5 days after surgery.

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Torsion of Omental Cystic Teratoma in a Child: - A Case Report - (소아에서 발생된 대망 낭성 기형종의 염전 1예)

  • Jeong, Yeon-Jun;Yu, Hee-Chul;Cho, Baik-Hwan;Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.64-67
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    • 2000
  • Although intraperitoneal teratomas are rare, teratomas of the greater omentuma are seldom reported. A single case of omental teratoma with torsion in a 26-month-old girl is reported. The patient presented with abdominal pain and a palpable mass. Ultrasonography and CT of the abdomen showed a large cystic mass with a non homgenious solid component composed of fat and calcification. The lesion was surgically excised. Pathology revealed a mature omental teratoma. The hospital course was uneventful.

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A Case Report of Chylous Mesenteric Cyst (유미성 장간막 낭종 1예 보고)

  • Joo, In-Ho;Chun, Yong-Soon;Lee, Nan-Joo;Yoon, Won-Hwa
    • Advances in pediatric surgery
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    • v.14 no.1
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    • pp.98-103
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    • 2008
  • Chylous mesenteric cyst is a rare variant of mesenteric cystic lesions. Pathologically there is lack of communication of the main lymphatic vessels, resulting in cystic mass formation. Clinical presentation is diverse and can range from an incidentally apparent abdominal mass to symptoms of an acute abdomen. A 5-year-old girl presented with abdominal distension without pain. CT scan showed a huge and thin-walled cystic mass without solid portion. Laparotomy showed a $20{\times}18cm$ sized huge mesenteric cyst containing chylous fluid. Pathological diagnosis was cystic lymphangioma.

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A Study to Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET/CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Ban, Yung-Kak;Lim, Han-Sang;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Purpose: Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to $^{99m}Tc$ emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radiotechnologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radiotechnologists. Materials and Methods: Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8$ cm and mean weight: $65.9{\pm}1.4$ kg). Radiation were measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150 and 200 cm. Then, all the procedure was given with a portable radiation shielding on the location of head, chest and abdomen at the distance of 100, 150 and 200 cm and transmittance was calculated. Results: In 10 cm, head (105.40 ${\mu}Sv/h$) was the highest and foot (15.85 ${\mu}Sv/h$) was the lowest. In 200 cm, head, chest and abdomen showed similar. On head, the measured dose rates were 9.56 ${\mu}Sv/h$, 5.23 ${\mu}Sv/h$, and 3.40 ${\mu}Sv/h$ in 100, 150 and 200 cm respectively. When using shielder, it shows 2.24 ${\mu}Sv/h$, 1.67 ${\mu}Sv/h$, and 1.27 ${\mu}Sv/h$ in 100, 150 and 200 cm on head. On chest, the measured dose rates were 8.54 ${\mu}Sv/h$, 4.90 ${\mu}Sv/h$, 3.44 ${\mu}Sv/h$ in 100, 150 and 200 cm, respectively. When using shielder, it shows 2.27 ${\mu}Sv/h$, 1.34 ${\mu}Sv/h$, and 1.13 ${\mu}Sv/h$ in 100, 150 and 200 cm on chest. On abdomen, the measured dose rates were 9.83 ${\mu}Sv/h$, 5.15 ${\mu}Sv/h$ and 3.18 ${\mu}Sv/h$ in 100, 150 and 200cm respectively. When using shielder, it shows 2.60 ${\mu}Sv/h$, 1.75 ${\mu}Sv/h$ and 1.23 ${\mu}Sv/h$ in 100, 150 and 200 cm on abdomen. Transmittance was increased as the distance was expanded. Conclusion: As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the radiotechnologists.

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Staging of Esophageal Cancer Using Positron Emission Tomography : Comparing to Computed Tomography (양전자방출단층촬영술(PET)을 이용한 식도암 환자의 병기 결정 -전산화단층촬영술(CT)과의 비교-)

  • 심영목;박승준;김병태;김성철
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.388-393
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    • 1999
  • Background: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). Material and Method: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. Result: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*$\chi$2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed. Conclusion: Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

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