• Imaging Science in Dentistry
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• v.48 no.1
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• pp.21-30
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• 2018

Purpose: To calculate the effective doses of cone-beam computed tomography (CBCT) using personal computer-based Monte Carlo (PCXMC) software (Radiation and Nuclear Safety Authority, Helsinki, Finland) and to compare the calculated effective doses with those measured using thermoluminescent dosimeters (TLDs) and an anthropomorphic phantom. Materials and Methods: An Alphard VEGA CBCT scanner (Asahi Roentgen Ind. Co., Kyoto, Japan) with multiple fields of view (FOVs) was used for this study. The effective doses of the scout and main projections of CBCT using 1 large and 2 medium FOVs with a height >10 cm were calculated using PCXMC and PCXMCRotation software and then were compared with the doses obtained using TLD-100 LiF and an anthropomorphic adult human male phantom. Furthermore, it was described how to determine the reference points on the Y- and Z-axes in PCXMC, the important dose-determining factors in this software. Results: The effective doses at CBCT for 1 large ($20.0cm{\times}17.9cm$) and 2 medium FOVs ($15.4cm{\times}15.4cm$ and $10.2cm{\times}10.2cm$) calculated by the PCXMC software were 181, 300, and $158{\mu}Sv$, respectively. These values were comparable (16%-18% smaller) to those obtained through TLD measurements in each mode. Conclusion: The use of PCXMC software could be an alternative to the TLD measurement method for effective dose estimation in CBCT with large and medium FOVs.

• The Journal of the Korea Contents Association
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• v.12 no.5
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• pp.303-310
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• 2012

In radiotherapy, accurate patient positioning and set up are important factor that treatment can influence success. In generally, the 3-laser system is used when the patient set up. But today the body surface scanning system(C-Rad system) is trying to use. Compare and evaluate the C-Rad system and the 3-laser system to check availability. Head and neck that are no movement of internal organs and easy to apply fixation device are limited. Alderson Rando anthropomorphic phantom and 10 patients who have lesions of head and neck are targeted. C-RAD system's setup error mean and standard deviation are the X axis($0.55{\pm}0.51mm$), Y axis($-0.2mm{\pm}0.523mm$), Z axis($-0.85{\pm}0.587mm$) in the phantom study, and in the patient study X axis($-0.05{\pm}0.621mm$), Y axis($0.075{\pm}0.755mm$) Z axis($-1.025{\pm}0.617mm$). So C-RAD system is better than 3-laser system mostly, but C-RAD system's error rate is a little worse than 3-laser system in the Z axis. When radiation treatment of head and neck, body surface contour scanning system contribute to correct positioning and minimize the set up error.

• 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 Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.55-62
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• 2015

Purpose Various methods for reducing radiation exposure have been continuously being developed. The aim of this study is to evaluate effectiveness of dose reduction, image quality and PET SUV changes by applying combination of automatic exposure dose(AEC), automated dose-optimized selection of X-ray tube voltage(CAREkV) and sinogram affirmed iterative reconstruction(SAFIRE) which can be controled by user. Materials and Methods Torso, AAPM CT performance and IEC body phantom images were acquired using biograph mCT64, (Siemens, Germany) PET/CT scanner. Standard CT condition was 120 kV, 40 mAs. Radiation exposure and noise were evaluated by applying AEC, CAREkV(120 kV, 40 mAs) and SAFIRE(120 kV, 25 mAs) with torso phantom compare to standard CT condition. And torso, AAPM and IEC phantom images were acquired with combination of 3 methods in condition of 120 kV, 25 mAs to evaluate radiation exposure, noise, spatial resolution and SUV changes. Results When applying AEC, CTDIvol and DLP were decreased by 50.52% and 50.62% compare to images which is not applying AEC. mAs was increased by 61.5% to compensate image quality according to decreasing 20 kV when applying CAREkV. However, CTDIvol and DLP were decreased by 6.2% and 5.5%. When reference mAs was the lower and strength was the higher, reduction of radiation exposure rate was the bigger. Mean SD and DLP were decreased by 2.2% and 38% when applying SAFIRE even though mAs was decreased by 37.5%(from 40 mAs to 25 mAs). Combination of 3 methods test, SD decreased by 5.17% and there was no significant differences in spatial resolution. And mean SD and DLP were decreased by 6.7% and 36.9% compare to 120 kV, 40 mAs with AEC. For SUV test, there was no statistical differences(P>0.05). Conclusion Combination of 3 methods shows dose reduction effect without degrading image quality and SUV changes. To reduce radiation exposure in PET/CT study, continuous effort is needed by optimizing various dose reduction methods.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.134-139
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• 2014

Purpose: Adaptive statistical iterative reconstruction (ASIR) technique is a reconstruction method of CT image using statistical noise modeling which is known to reduce image noise and to preserve image quality despite reducing radiation dose. The aim of this study is to evaluate images using ASIR on bone SPECT/CT which is primarily performed in our hospital. Materials and Methods: We compared the images of applied ASIR (ASIR level: 20-80%) and none ASIR by changing the mA based on 120 kVp, 100 mA using Discovery NM/CT 670 (GE, U.S.A). First, we evaluated attenuation correction in SPECT image by changing the ASIR level using Anthropomorphic phantom. Second, we compared the contrast to noise ratio (CNR), image noise and spatial resolution in CT image using ACR phantom. Third, after selecting the ASIR level applicable patient using lower torso phantom, we examined 2 patients who followed up bone SPECT/CT and we performed blind test. Results: The degree of attenuation correction in SPECT image showed no significant difference between applied ASIR and none ASIR (P>0.05). When applied ASIR, the noise of CT image were reduced at least 17 up to 52% by changing the mA. The CNR of image with ASIR was maintained more than 0.8 at 40 mA (ASIR 60%) while those without ASIR showed 0.42 at standard 40 mA. In comparison of the high contrast object, we distinguished 12 line pairs/cm at 40 mA regardless of appling ASIR. Comparison of the patients image applied ASIR level 60% (40 mA) which found out by spine image of lower torso phantom showed no signigicant difference between applied ASIR and none ASIR in blind test. The CTDIvol and DLP for applied ASIR 60% showed decreased by 60%, 60% on average than using standard mA. Conclusion: The study show that the radiation dose in SPECT/CT using ASIR can be reduced despite degradation of SPECT and CT images. In addition, higher ASIR level could be possibly applied characteristics of SPECT/CT that region of interest is limited to bone.

• Journal of Radiation Protection and Research
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• v.46 no.3
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• pp.120-126
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• 2021

Background: This paper aims to evaluate the clinical utility and radiation dosimetry, for the mobile X-ray imaging of patients with known or suspected infectious diseases, through the window of an isolation room. The suitability of this technique for imaging coronavirus disease 2019 (COVID-19) patients is of particular focus here, although it is expected to have equal relevance to many infectious respiratory disease outbreaks. Materials and Methods: Two exposure levels were examined, a "typical" mobile exposure of 100 kVp/1.6 mAs and a "high" exposure of 120 kVp/5 mAs. Exposures of an anthropomorphic phantom were made, with and without a glass window present in the beam. The resultant phantom images were provided to experienced radiographers for image quality evaluation, using a Likert scale to rate the anatomical structure visibility. Results and Discussion: The incident air kerma doubled using the high exposure technique, from 29.47 µGy to 67.82 µGy and scattered radiation inside and outside the room increased. Despite an increase in beam energy, high exposure technique images received higher image quality scores than images acquired using lower exposure settings. Conclusion: Increased scattered radiation was very low and can be further mitigated by ensuring surrounding staff are appropriately distanced from both the patient and X-ray tube. Although an increase in incident air kerma was observed, practical advantages in infection control and personal protective equipment conservation were identified. Sites are encouraged to consider the use of this technique where appropriate, following the completion of standard justification practices.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.3-7
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• 2012

Purpose : In myocardial perfusion SPECT, the type of orbit (circular vs. body contouring) that affect the image quality is still on the debate. Presently in the nuclear medicine field, the body contouring orbit acquisition is widely used to improve the image quality on the myocardial perfusion SPECT. But in case of body contouring acquisition using the vertical method with dual detect machine, there is a tendency of increasing the radius. In this research, we compared body contouring orbit acquisition with circular orbit acquisition, so we suggest ideal method that reduces the radius for improving image quality. Materials and Methods : Phantom and clinical studies were performed. The anthropomorphic torso phantom was made on equally with counts from patient's body. The study was performed under six different conditions. To compare image quality according to the radius, we increased radius sequentially per step during circular orbit acquisition. On the other hand, sensors that protect a collision and reduce the radius automatically were used to acquire image during body contouring orbit acquisition. So we compared FWHM value of apex. In clinical studies, we analyzed the 40 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Medical Center in August 2011. To acknowledge the differences according to the radius, we acquired the results two times using circular orbit acquisition and body contouring orbit acquisition. Results : In phantom study, we analyzed that increase of radius resulted in changes of FWHM value. It was 5.41, 6.24, 6.33, 6.42, 6.93 mm. On the other hand, using the body contouring orbit acquisition, FWHM value was 6.23 mm. In clinical study, difference of average radius between two methods was 2.5 cm (circular orbit acquisition was more close to patients). Conclusion : Through the experiments using Anthropomorphic torso phantom and patients data, we found that FWHM value of circular orbit acquisition was lower than body contouring orbit acquisition. As a result, if the difference of average radius exists approximately 3 cm, circular orbit type acquisition is better than body contouring type acquisition. But clinical investigation is only aimed to average radius, so it needs more investigation in comparison of patient's image.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.33-38
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• 2014

Purpose Auto exposure control (AEC) in SPECT/CT automatically controls the exposure dose (mA) according to patient's shape and size. The aim of this study was to evaluate the effect of AEC in SPECT/CT on exposure dose reduction and image quality. Materials and Methods The model of SPECT/CT used in this study was Discovery 670 (GE, USA), Smart mA for AEC; and $^{99m}Tc$ as a radioisotope. To compare SPECT and CT images by CT exposure dose variation, we used a standard technique set at 80, 100, 120, 140 kVp, 10, 30, 50, 100, 150, 200, 250 mA, and AEC at 80, 100, 120, 140 kVp, 10-250 mA. To evaluate resolution and contrast of SPECT images, triple line phantom and flangeless Esser PET phantom were used. For CT images, noise and uniformity were checked by anthropomrphic chest phantom. For dose evaluation to find DLP value, anthropomorphic chest phantom was used and the CT protocol of torso was applied by standard technique (120 kVp, 100 mA) and AEC (120 kVp, 10-250 mA). Results When standard and AEC were applied, the resolutions at SPECT images with attenuation correction (AC) were the same as FWHM by center 3.65 mm, left 3.48 mm, right 3.61 mm. Contrasts of standard and AEC showed no significant difference: standard 53.5, 29.8, 22.5, 15.8, 6.0, AEC 53.5, 29.6, 22.4, 15.7, 6.1 In CT images, noise values at standard and AEC were 15.4 and 18.5 respectively. The application of AEC increases noise but the value of coefficient variation were 33.8, 24.9 respectively, obtaining uniform noise image. The values of DLP at standard and AEC were 426.78 and 352.09 each, which shows that the application of AEC decreases exposure dose more than standard by approximately 18%. Conclusion The results of our study show that there was no difference of AC in SPECT images based on the CT exposure dose variation at SPECT/CT images. It was found that the increased CT exposure dose leads to the improvement of CT image quality but also increases the exposure dose. Thus, the use of AEC in SPECT/CT contributes to obtaining equal AC SPECT images, and uniform noise in CT images while reducing exposure dose.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.122-127
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• 2010

Purpose: The Xpress3.$cardiac^{TM}$ which is a kind of wide beam reconstruction (WBR) method developed by UltraSPECT (Haifa, Israel) enables the acquisition of at quarter time while maintaining image quality. The purpose of this study is to investigate the usefulness of WBR method for decreasing scan times and to compare to it with filtered back projection (FBP), which is the method routinely used. Materials and Methods: Phantom and clinical studies were performed. The anthropomorphic torso phantom was made on an equality with counts from patient's body. The Tl-201 concentrations in the compartments were 74 kBq (2 ${\mu}Ci$)/cc in myocardium, 11.1 kBq (0.3 ${\mu}Ci$)/cc in soft tissue, and 2.59 kBq (0.07 ${\mu}Ci$)/cc in lung. The non-gated Tl-201 myocardial perfusion SPECT data were acquired with the phantom. The former study was scanned for 50 seconds per frame with FBP method, and the latter study was acquired for 13 seconds per frame with WBR method. Using the Xeleris ver. 2.0551, full width at half maximum (FWHM) and average image contrast were compared. In clinical studies, we analyzed the 30 patients who were examined by Tl-201 gated myocardial perfusion SPECT in department of nuclear medicine at Asan Medical Center from January to April 2010. The patients were imaged at full time (50 second per frame) with FBP algorithm and again quarter-time (13 second per frame) with the WBR algorithm. Using the 4D MSPECT (4DM), Quantitative Perfusion SPECT (QPS), and Quantitative Gated SPECT (QGS) software, the summed stress score (SSS), summed rest score (SRS), summed difference score, end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were analyzed for their correlations and statistical comparison by paired t-test. Results: As a result of the phantom study, the WBR method improved FWHM more than about 30% compared with FBP method (WBR data 5.47 mm, FBP data 7.07 mm). And the WBR method's average image contrast was also higher than FBP method's. However, in result of quantitative indices, SSS, SDS, SRS, EDV, ESV, EF, there were statistically significant differences from WBR and FBP(p<0.01). In the correlation of SSS, SDS, SRS, there were significant differences for WBR and FBP (0.18, 0.34, 0.08). But EDV, ESV, EF showed good correlation with WBR and FBP (0.88, 0.89, 0.71). Conclusion: From phantom study results, we confirmed that the WBR method reduces an acquisition time while improving an image quality compared with FBP method. However, we should consider significant differences in quantitative indices. And it needs to take an evaluation test to apply clinical study to find a cause of differences out between phantom and clinical results.

• Progress in Medical Physics
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• v.14 no.2
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• pp.74-80
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• 2003

The purpose of this study was to evaluate the performance of the teflon encapsulated TLD rod, which may be used in nuclear medicine for the direct in vivo measurements of radiation dose. We analyzed the influence of teflon encapsulation for measuring absorbed dose. An experiment was carried out to evaluate and observe the response of a LiF TLD-100 rod in a thin-wall teflon capsule at different depths in a solid phantom. An adult anthropomorphic phantom was used to measure the absorbed dose using thin teflon encapsulated TLD. The measurements of PDD-, and TMR in solid phantom and athe bsorbed dose in humanoid phantom performed with normal TLD were compared with values obtained by teflon encapsulated TLD. It was demonstrated that the difference of TL response of LiF in phantom with and without teflon thin-wall capsule was less than 3％ under the same conditions beyond the build-up region. However, significant differences were observed near the phantom surface because of the build-up effect caused by the thin-wall thickness of the teflon capsule. Thus, our study showed that the contribution of teflon thin-wall capsule to TLD response for the megavoltage photon beams was negligible and that it did not significantly effect dose measurement. The teflon encapsulated TLD described in this work has been proven to be appropriate for in vivo dosimetry in therapeutic environments.