• Nuclear Medicine and Molecular Imaging
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• v.43 no.5
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• pp.505-507
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• 2009

A 60-year-old woman, who had non-small-cell lung cancer (NSCLC) in left lower lobe underwent brain F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for evaluation of cerebral metastasis. On follow-up FDG-PET/CT, only hypometaolic lesion was detected and progressed in right frontal lobe at 6 months and 10 months, later. Hypermetabolic metastasis was not detected even at last scan time of FDG-PET/CT. Brain MRI showed brain metastasis in right frontal lobe. As might be expected, the physician should take cerebral metastasis into consideration even though there is only hypometabolic change on subsequent FDG-PET/CT in patients with NSCLC.

• Proceedings of the KOSOMBE Conference
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• v.1998 no.11
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• pp.285-286
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• 1998

Virtual Brain-endoscopy is an effective method to detect lesion in brain. Brain is the most part of the human and is not easy part to operate so that reconstructing in 3D may be very helpful to doctors. In this paper, it is suggested that to increase the reliability, method of matching 3D object with the 2D CT slice. 3D Brain-endoscopy is reconstructed with 35 slices of 2D CT images. There is a plate in 3D brain-endoscopy so as to drag upward or downward to match the relevant 2D CT image. Relevant CT image guides the user to recognize the exact part he or she is investigating. VRML Script is used to make the change in images and PlaneSensor node is used to transmit the y coordinate value with the CT image. The result is test on the PC which has the following spec. 400MHz Clock-speed, 512MB ram, and FireGL 3000 3D accelerator is set up. The VRML file size is 3.83MB. There was no delay in controlling the 3D world and no collision in changing the CT images. This brain-endoscopy can be also put to practical use on medical education through internet.

• Korean Journal of Radiology
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• v.22 no.3
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• pp.435-441
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• 2021

Objective: To evaluate the usefulness of the ventricular volume percentage quantified using three-dimensional (3D) brain computed tomography (CT) data for interpreting serial changes in hydrocephalus. Materials and Methods: Intracranial and ventricular volumes were quantified using the semiautomatic 3D threshold-based segmentation approach for 113 brain CT examinations (age at brain CT examination ≤ 18 years) in 38 patients with hydrocephalus. Changes in ventricular volume percentage were calculated using 75 serial brain CT pairs (time interval 173.6 ± 234.9 days) and compared with the conventional assessment of changes in hydrocephalus (increased, unchanged, or decreased). A cut-off value for the diagnosis of no change in hydrocephalus was calculated using receiver operating characteristic curve analysis. The reproducibility of the volumetric measurements was assessed using the intraclass correlation coefficient on a subset of 20 brain CT examinations. Results: Mean intracranial volume, ventricular volume, and ventricular volume percentage were 1284.6 ± 297.1 cm³, 249.0 ± 150.8 cm³, and 19.9 ± 12.8%, respectively. The volumetric measurements were highly reproducible (intraclass correlation coefficient = 1.0). Serial changes (0.8 ± 0.6%) in ventricular volume percentage in the unchanged group (n = 28) were significantly smaller than those in the increased and decreased groups (6.8 ± 4.3% and 5.6 ± 4.2%, respectively; p = 0.001 and p < 0.001, respectively; n = 11 and n = 36, respectively). The ventricular volume percentage was an excellent parameter for evaluating the degree of hydrocephalus (area under the receiver operating characteristic curve = 0.975; 95% confidence interval, 0.948-1.000; p < 0.001). With a cut-off value of 2.4%, the diagnosis of unchanged hydrocephalus could be made with 83.0% sensitivity and 100.0% specificity. Conclusion: The ventricular volume percentage quantified using 3D brain CT data is useful for interpreting serial changes in hydrocephalus.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.951-958
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• 2021

Objective: To evaluate the usefulness of virtual monochromatic images (VMIs) obtained using dual-layer dual-energy CT (DL-DECT) for evaluating brain tumors. Materials and Methods: This retrospective study included 32 patients with brain tumors who had undergone non-contrast head CT using DL-DECT. Among them, 15 had glioblastoma (GBM), 7 had malignant lymphoma, 5 had high-grade glioma other than GBM, 3 had low-grade glioma, and 2 had metastatic tumors. Conventional polychromatic images and VMIs (40-200 keV at 10 keV intervals) were generated. We compared CT attenuation, image noise, contrast, and contrast-to-noise ratio (CNR) between tumor and white matter (WM) or grey matter (GM) between VMIs showing the highest CNR (optimized VMI) and conventional CT images using the paired t test. Two radiologists subjectively assessed the contrast, margin, noise, artifact, and diagnostic confidence of optimized VMIs and conventional images on a 4-point scale. Results: The image noise of VMIs at all energy levels tested was significantly lower than that of conventional CT images (p < 0.05). The 40-keV VMIs yielded the best CNR. Furthermore, both contrast and CNR between the tumor and WM were significantly higher in the 40 keV images than in the conventional CT images (p < 0.001); however, the contrast and CNR between tumor and GM were not significantly different (p = 0.47 and p = 0.31, respectively). The subjective scores assigned to contrast, margin, and diagnostic confidence were significantly higher for 40 keV images than for conventional CT images (p < 0.01). Conclusion: In head CT for patients with brain tumors, compared with conventional CT images, 40 keV VMIs from DL-DECT yielded superior tumor contrast and diagnostic confidence, especially for brain tumors located in the WM.

• Journal of Biomedical Engineering Research
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• v.39 no.3
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• pp.116-123
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• 2018

This study is a model experimental study using a phantom to propose an optimized brain CT scan protocol that can reduce the radiation dose of a patient and remain quality of image. We investigate the CT scan parameters of brain CT in clinical medical institutions and to measure the important parameters that determine the quality of CT images. We used 52 multislice spiral CT (SOMATOM Definition AS+, Siemens Healthcare, Germany). The scan parameters were tube voltage (kVp), tube current (mAs), scan time, slice thickness, pitch, and scan field of view (SFOV) directly related to the patient's exposure dose. The CT dose indicators were CTDIvol and DLP. The CT images were obtained while increasing the imaging conditions constantly from the phantom limit value (Q1) to the maximum value (Q4) for AAPM CT performance evaluation. And statistics analyzed with Pearson's correlation coefficients. The result of tube voltage that the increase in tube voltage proportionally increases the variation range of the CT number. And similar results were obtained in the qualitative evaluation of the CT image compared to the tube voltage of 120 kVp, which was applied clinically at 100 kVp. Also, the scan conditions were appropriate in the tube current range of 250 mAs to 350 mAs when the tube voltage was 100 kVp. Therefore, by applying the proposed brain CT scanning parameters can be reduced the radiation dose of the patient while maintaining quality of image.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.809-817
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• 2023

Single source and dual source measurements using anthropomorphic phantoms in which the phantoms are lined up in human body equivalents use OSLD (Optically Stimulated Luminescence Dosimeter), so the effective dose is calculated using OSLD. For hospital images, SNR (Signal to Noise Ratio) and CNR (Contrast to Noise Ratio) were measured in MCA (Middle Cerebral Artery) for single source and dual source, and for phantom images, SNR and CNR were measured for brain parenchyma of single source and dual source. For hospital imaging, SNR and CNR were measured in MCA for both single-source and dual-source, and for phantom images, SNR and CNR were measured for brain parenchyma from single-source and dual-source. As a result of comparing the SNR and CNR of the hospital image and the phantom image, there was no statistical difference. Comparing patient doses in hospital images, the effective dose of the dual source was 53.53% less and the effective dose of the dual energy phantom was 57.94% less. The dose can be increased in other areas, but the cerebrovascular area is useful because the dose is small.

• Journal of Biomedical Engineering Research
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• v.25 no.1
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• pp.33-41
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• 2004

Accuracy of registration between images acquired from various medical image modalities is one of the critical issues in radiation treatment planing. In this study, a method of accuracy evaluation of image registration using a homemade brain phantom was investigated. Chamfer matching of CT-MR and CT-SPECT imaging was applied for the multimodal image registration. The accuracy of image correlation was evaluated by comparing the center points of the inserted targets of the phantom. The three dimensional root-mean-square translation deviations of the CT-MR and CT-SPECT registration were 2.1${\pm}$0.8 mm and 2.8${\pm}$1.4 mm, respectively. The rotational errors were ＜ 2$^{\circ}$ for the three orthogonal axes. These errors were within a reasonable margin compared with the previous phantom studies. A visual inspection of the superimposed CT-MR and CT- SPECT images also showed good matching results.

• Journal of radiological science and technology
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• v.14 no.1
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• pp.29-44
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• 1991

A Study on the distribution and types of the total 40 CT units, as of 1st October 1990, in Pusan area(29 for whole body CT units, 11 for brain CT units) were carried out during the period from January 1989 to December 1989 to find out the status of operation and utilization of whole body CT units. The results were as following ; 1. As of 1st October 1990 in Pusan area, a total of 40 CT units(29 for whole body CT units, 11 for brain CT units) were set up and operated. The number of cases of CT examination performed per day per unit were appeared to be less than 5 cases among 59.5% of CT units, and 2.7% of the total units has peformed more than 16 examinations. 2. The CT units under operation occupied 93.5% of the total and 2.6% of the total units was not properly been operated due to mechanical breakdown. This results is appeared to be better than other reports. 3. The average number of scanning per week for each CT were 35 cases and the average days under operation of the unit per week were 6.7 days. Consequently, the average days under operation of units was higher than that of the other reports, but the average number of scanning was lower. 4. The cases referred from other institutes to hospitals were 6.4% of total cases. 5. As a site of scanning, the brain appeared most frequently with 71.2% of the total cases and followed by spine 12.4%, abdomen 8.5%, and thorax 3.6%, respectively. 6. Positive rate by scanning was 70.8% of total cases, and it was 98.9% with thorax, abdomen 96.3%, spine 93.1%, and brain 38.4%, respectively. According to the results of this study, it is highly recommended that the regulations and the guidelines for setting-up of such high cost medical equipments as CT units be provided in order to ensure the cost-effectiveness of the system.

• Progress in Medical Physics
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• v.32 no.3
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• pp.59-69
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• 2021

Purpose: The relationship between computed tomography (CT) number and electron density (ED) has been investigated in previous studies. However, the role of these measures for guiding cancer treatment remains unclear. Methods: The CT number was plotted against ED for different imaging protocols. The CT number was imported into ED tables for the Pinnacle treatment planning system (TPS) and was used to determine the effect on dose calculations. Conversion tables for radiation dose calculations were generated and subsequently monitored using a dosimeter to determine the effect of different CT scanning protocols and treatment sites. These tables were used to retrospectively recalculate the radiation therapy plans for 41 patients after an incorrect scanning protocol was inadvertently used. The gamma index was further used to assess the dose distribution, percentage dose difference (DD), and distance-to-agreement (DTA). Results: For densities <1.1 g/cm³, the standard deviation of the CT number was ±0.6% and the greatest variation was noted for brain protocol conditions. For densities >1.1 g/cm³, the standard deviation of the CT number was ±21.2% and the greatest variation occurred for the tube voltage and head and neck (H&N) protocol conditions. These findings suggest that the factors most affecting the CT number are the tube voltage and treatment site (brain and H&N). Gamma index analyses for the 41 retrospective clinical cases, as well as brain metastases and H&N tumors, showed gamma passing rates >90% and <90% for the passing criterion of 2%/2 and 1%/1 mm, respectively. Conclusions: The CT protocol should be carefully decided for TPS. The correct protocol should be used for the corresponding TPS based on the treatment site because this especially affects the dose distribution for brain metastases and H&N tumor recognition. Such steps could help reduce systematic errors.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.209-216
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• 2012

Purpose: The objectives of this study are to classify chronic subdural hematomas based on brain computerized tomographic scan (CT scan) findings and to determine the mechanism of evolution and treatment methods. Methods: One hundred thirty-nine patients who were diagnosed with a chronic subdural hematoma and who available for follow up assessment 6 months post-surgery were analyzed retrospectively. The presence of trauma and past medical history were reviewed and evaluation criteria based on brain CT scan findings were examined. Results: Initial brain CT scans revealed a chronic subdural hematoma in 106 patients, a subdural hygroma in 24 patients, and an acute subdural hematoma in 9 patients. In all cases where the initial acute subdural hematoma had progressed to a chronic subdural hematoma, final was a hypo-density chronic subdural hematoma. In case where the initial subdural hygroma had progressed to a chronic subdural hematoma, the most cases of hematoma were hyper-density and mixed-density chronic subdural hematoma. In total, 173 surgeries were performed, and they consisted of 97 one burr-hole drainages, 70 two burr-hole drainages and 6 craniotomies. Conclusion: This study demonstrates that rebleeding and osmotic effects are mechanisms for enlarging of a chronic subdural hematoma. In most cases, one burr-hole drainage is a sufficient for treatment. However, in cases of mixed or acute-on-chronic subdural hematomas, other appropriate treatment strategies are required.