• Journal of Korean Neurosurgical Society
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• v.63 no.3
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• pp.386-396
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• 2020

Objective : To generate synthetic spine magnetic resonance (MR) images from spine computed tomography (CT) using generative adversarial networks (GANs), as well as to determine the similarities between synthesized and real MR images. Methods : GANs were trained to transform spine CT image slices into spine magnetic resonance T2 weighted (MRT2) axial image slices by combining adversarial loss and voxel-wise loss. Experiments were performed using 280 pairs of lumbar spine CT scans and MRT2 images. The MRT2 images were then synthesized from 15 other spine CT scans. To evaluate whether the synthetic MR images were realistic, two radiologists, two spine surgeons, and two residents blindly classified the real and synthetic MRT2 images. Two experienced radiologists then evaluated the similarities between subdivisions of the real and synthetic MRT2 images. Quantitative analysis of the synthetic MRT2 images was performed using the mean absolute error (MAE) and peak signal-to-noise ratio (PSNR). Results : The mean overall similarity of the synthetic MRT2 images evaluated by radiologists was 80.2%. In the blind classification of the real MRT2 images, the failure rate ranged from 0% to 40%. The MAE value of each image ranged from 13.75 to 34.24 pixels (mean, 21.19 pixels), and the PSNR of each image ranged from 61.96 to 68.16 dB (mean, 64.92 dB). Conclusion : This was the first study to apply GANs to synthesize spine MR images from CT images. Despite the small dataset of 280 pairs, the synthetic MR images were relatively well implemented. Synthesis of medical images using GANs is a new paradigm of artificial intelligence application in medical imaging. We expect that synthesis of MR images from spine CT images using GANs will improve the diagnostic usefulness of CT. To better inform the clinical applications of this technique, further studies are needed involving a large dataset, a variety of pathologies, and other MR sequence of the lumbar spine.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.162-164
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• 2016

Stafne bone cavity is a rare mandibular defect that was first reported by Edward C. Stafne in 1942. It commonly presents with a well-demarcated, asymptomatic, unilateral radiolucency that indicates lingual invagination of the cortical bone. A 52-year-old female patient who with nasal bone fracture, visited the hospital. During facial bone computed tomography (CT) for facial area evaluation, a well-shaped cystic lesion was accidentally detected on the right side of the mandible. Compared to the left side, no swelling or deformity was observed in the right side of the oral lesion, and no signs of deformity caused by mucosal inflammation. 3D CT scans, and mandible series x-rays were performed, which showed a well-ossified radiolucent oval lesion. Axial CT image revealed a cortical defect containing soft tissue lesion, which has similar density as the submandibular gland on the lingual surface of the mandible. The fact that Stafne cavity is completely surrounded by the bone is the evidence to support the hypothesis that embryonic salivary gland is entrapped by the bone. In most cases, Stafne bone cavity does not require surgical treatment. We believe that the mechanical pressure from the salivary gland could have caused the defect.

• Investigative Magnetic Resonance Imaging
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• v.15 no.1
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• pp.41-47
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• 2011

Purpose : To evaluate the cause of internal jugular vein (IJV) obstruction on contrast enhanced 3D MR angiography (CE-MRA) using contrast enhanced computed tomography (CE-CT). Materials and Methods : A total number of 30 patients were enrolled, who underwent both head and neck CE-MRA and CE-CT from 2005 to 2008. We defined obstruction group which had IJV obstruction and control group which had no IJV obstruction on CE-MRA. The following parameters were measured from axial images of CE-CT: 1) diameter of IJV; 2) distance between the styloid process and ipsilateral lateral mass of the atlas; 3) maximum area of lateral mass of the atlas. Each parameter was compared between obstruction group and control group. Results : The diameter of IJV and distance between the styloid process and lateral mass of the atlas at IJV obstruction side in obstruction group were $1.6{\pm}1.0\;mm$ and $4.1{\pm}2.1\;mm$ respectively, which resulted in statistical significance (p<0.01). The maximum area of lateral mass of the atlas at IJV obstruction side in obstruction group was $103.4{\pm}25.3\;mm^2$ which is significantly larger than in control group (p<0.05). Conclusion : We found that the cause of IJV obstruction on CE-MRA could be narrow space between the styloid process and the lateral mass of the atlas, which was related with asymmetric larger area of lateral mass of atlas.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.113-114
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• 1998

In this paper, visualization of Visible Human data offered by NLM(National Library of Medicine) is performed using $VTK^{TM}$. Computed Tomography Data set(axial, $587\times341\times256$, and the distance between slices 1mm) is used throughout the study. Before the actual visualization routine, 8 bit-reader class of VTK is developed to transform CT data to VTK dataset. After that, the visualization procedures are done to display 3D image on PC. VTK is freeware, not a commercial software. The results of VTK show relatively good image quality and slower processing time compared with the commercial softwares like IAP, IDL, AVS. Thus if processing time is not the critical factor, VTK is worthy to be used in visualization of the medical images.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.2
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• pp.95-107
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• 2009

The purpose of this research was to examine the fitness of zirconia cores that were made by different sintering methods; generic electricity furnace and microwave furnace. Firstly, 12 cores for each group were made by using each different sintering process and attached them to a metal die with silicon. The internal and marginal gap of sintered zirconia was measured by using Skyscan 1076 micro-CT, then it was reorganized by CT-An software. To each samples, we extracted B-L image, M-D image of cutting side, and cross-sectional side of tooth long axis and calculated the mean value of marginal, axial, and occlusal gap each side. Results: 1. The mean marginal gap of sintered zirconia was $36.20{\mu}m$ for EVE, $47.67{\mu}m$ for LAV, $52.47{\mu}m$ for DEN, and $54.63{\mu}m$ for CER. 2. For the axial wall, the research showed the largest value of $63.49{\mu}m$ for EVE, but there were no statistical significance. 3. In related to the occlusal internal measurement, DEN showed the smallest value ($77.06{\mu}m$), EVE and CER showed significantly high value. From this study, it is suggested that CAD/CAM zirconia core which was made in the process of microwave sintering has clinically acceptable values in marginal and internal gap.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.399-405
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• 2010

Objective : Patients with spontaneous intracerebral hemorrhage (ICH) presenting within 24 hours of symptom onset are known to be increased risk of hematoma expansion which is closely correlated with morbidity and mortality. We investigated whether tiny enhancing foci ('Spot sign') on axial view of 3-dimensional computed tomography angiography (3D-CTA) source images can predict subsequent hematoma expansion in spontaneous ICH. Methods : During a 2-year period (March 2007-March 2009), we prospectively evaluated 3D-CTA of 110 patients with spontaneous ICH. Based on source images of 3D-CTA, patients were classified according to presence or absence of 'Spot sign'; 'Spot sign' (+) group, 'Spot sign' (-) group. Radiological factors and clinical outcomes were compared between two groups. Results : Hematoma expansion occurred in 16 patients (15%). Mean Glasgow Coma Scale (GCS) score of patients with hematoma expansion was significantly different compared to score of patients without hematoma expansion (5 vs. 9, P < 0.001). Nineteen patients (16%) of 110 ICH patients demonstrated 'spot sign' on 3D-CTA. Among the 'spot sign' (+) group, 53% of patients developed hematoma expansion. Conversely 7% of patients without 'spot sign' demonstrated the hematoma expansion (p < 0.001). Initial volume and location of hematoma were significantly not associated with hematoma expansion except shape of hematoma. Conclusion : Our study showed that patients with hematoma expansion of spontaneous ICH had significant clinical deterioration. And the fact that 'spot sign' (+) group have higher risk of hematoma expansion suggests the presence of 'spot sign' on source images of 3D-CTA can give a clue to predict hematoma expansion in spontaneous ICH.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.151-157
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• 2018

Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

• Journal of radiological science and technology
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• v.38 no.4
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• pp.421-427
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• 2015

In this study, we have observed the change of the Hounsfield (HU) in the alteration of by changing in size of physical area and setting size of region of interest (ROI) at focus on kVp and mAs. Four-channel multi-detector computed tomography was used to get transverse axial scanning images and HU. Three dimensional printer which is type of fused deposition modeling (FDM) was used to produce the Phantom. The structure of the phantom was designed to be a type of cylinder that contains 33 mm, 24 mm, 19 mm, 16 mm, 9 mm size of circle holes that are symmetrically located. It was charged with mixing iodine contrast agent and distilled water in the holes. The images were gained with changing by 90 kVp, 120 kVp, 140 kVp and 50 mAs, 100 mAs, 150 mAs, respectively. The 'image J' was used to get the HU measurement of gained images of ROI. As a result, it was confirmed that kVp affects to HU more than mAs. And it is suggested that the smaller size of physical area, the more decreasing HU even in material of a uniform density and the smaller setting size of ROI, the more increasing HU. Therefore, it is reason that to set maximum ROI within 5 HU is the best way to minimize in the alteration of by changing in size of physical area and setting size of region of interest.

• Journal of Korean Neurosurgical Society
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• v.49 no.2
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• pp.107-111
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• 2011

Objective : The aim of this study was to evaluate the utility of volume-rendered helical computerized tomography (CT) angiography focusing tracheostomy tube and innominate artery for prevention of tracheoinnominate artery fistula. Methods : The authors retrospectively analyzed 22 patients with tracheostomy who had checked CT angiography. To evaluate the relationship between tracheostomy tube and innominate artery, we divided into three categories. First proximal tube position based on cervical vertebra, named "tracheostomy tube departure level (TTDL)". Second, distal tube position and course of innominate artery, named "tracheostomy tube-innominate artery configuration (TTIC)". Third, the gap between the tube and innominate artery, named "tracheostomy tube to innominate artery gap (TTIG)". The TTDL/TTIC and TTIG are based on 3-dimensional (3D) reconstruction around tracheostomy and enhanced axial slices of upper chest, respectively. Results : First, mean TTDL was $6.8{\pm}0.6$. Five cases (23%) were lower than C7 vertebra. Second, TTIC were remote to innominate artery (2 cases; 9.1 %), matched with it (14 cases; 63.6%) or crossed it (6 cases; 27.3%). Only 9% of cases were definitely free from innominate artery injury. Third, average TTIG was $4.3{\pm}4.6$ mm. Surprisingly, in 6 cases (27.3%), innominate artery, trachea wall and tracheostomy tube were tightly attached all together, thus have much higher probability of erosion. Conclusion : If low TTDL, match or crossing type TTIC with reverse-L shaped innominate artery, small trachea and thin TTIG are accompanied all together, we may seriously consider early plugging and tube removal.

• Journal of the Korean Society of Radiology
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• v.11 no.5
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• pp.313-319
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• 2017

The purpose of this study is to confirm the double of optic foramen in Korean and apply it to the Rhese method. First, the angle between the right optic foramen and the MSP was measured on the axial image using MPR technique of the 3D CT. Second, we measured the angle between the right optic foramen and OML in sagittal of MPR images. As a result, the angle between the optic foramen and the MSP was $39.9{\pm}4.63^{\circ}$ on average, which was different from the $53^{\circ}$ presented by Rhese method(p<0.05). The angle between optic foramen and OML was $40.8{\pm}6.6^{\circ}$. In conclusion, this study confirms that the standard of the Rhese method proposed in current textbook is difficult to apply to Koreans. Therefore, it is necessary to study angle of Korean standard in various general x-ray technique.