• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.188-201
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• 2020

Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

• Journal of the Korean Society of Radiology
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• v.14 no.2
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• pp.111-120
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• 2020

Research should be actively conducted for the ability of X-ray equipment and Retrospective image analysis of X-ray equipment used in hospitals. Retrospective image analysis of X-ray machines, CT and MRI of radiology and medical equipment has been actively conducted. However, image quality measurement using angiography equipment of angiography room is mostly measured with phantom, and image quality measurement on image after being taken by actual patient is insufficient and researches on accurate image quality measurement method are remarkable. It is in short supply. Therefore, through this study, the researcher devised a method to measure the image quality of the acquired image after coronary angiography, and to provide a high quality image to the operator. The equipment and programs used were angiographic examination equipment (Axiom Artis Zee Ceiling) and Image J program. Subjects were images automatically saved in PACS program after coronary angiography.For image quality measurement, selected the AP Caudal 30° image that show the LCA vessel well and the LAO 30° image that show the RCA vessel well during the coronary angiography. In order to measure the background and ROI of the selected image by selecting an image, a criterion on how to find and measure a section where the overlap of the shadow, such as blood vessel, liver and lung is minimized, is presented. In conclusion, there is no exact standard for analyzing an image quality measurement method of angiography image. Therefore, in order to provide quality images to the practistioners, not only the technicians of the equipment but also the users who actually use them should become researchers and conduct research on image quality measurement in various ways. Thus, it is expected to provide excellent images to patients.

• 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 the Korea Society of Computer and Information
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• v.17 no.3
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• pp.51-57
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• 2012

Hepatic vessel tree is the key structure for hepatic disease diagnosis and liver surgery planning. Especially, it is used to evaluate the donors' and recipients' liver for the LDLT(Living Donors Liver Transplantation) and estimate the volumes of left and right hepatic lobes for securing their life in the LDLT. In this study, we propose a method to apply canny edge detection that is not affected by noise to the liver images for automatic segmentation of hepatic vessels tree in contrast abdominal MDCT image. Using histograms and average pixel values of the various liver CT images, optimized parameters of the Canny algorithm are determined. It is more time-efficient to use the common parameters than to change parameters manually according to CT images. Candidates of hepatic vessels are extracted by threshold filtering around the detected the vessel edge. Finally, using a system which detects the true-negatives and the false-positives in horizontal and vertical direction, the true-negatives are added in candidate of hepatic vessels and the false-positives are removed. As a result of the process, the various hepatic vessel trees of patients are accurately reconstructed in 3D.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.28 no.1
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• pp.225-234
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• 1998

We used five adult dog mandibles embedded in resin block and six different cross-sectional planes for each mandible were choosen. According to the angle of mandibular occulsal plane to vertical plane(mandibular angle) and gantry angle of CT machine, we classified 4 experimental groups and 1 control group. The control group images were taken at the mandibular angel 0° and gantry angle 0°. The experimental images were taken at the mandibular angle 15° and gantry angle 0°(group 1); 30° and 0°(group 2); 15° and 15°(group 3) ;30° and 30°(group 4), respectively. Using the reformatted cross-sectional images, the distance from the mandibular canal to the alveolar crest and the distance from the mandibular canal to the buccal cortex and to the lingual cortex was measured and compared. The obtained results were as follows: 1. The distance from the mandibular canal to the alveolar crest of group 1 and 2 was larger than control group, but the distance of group 3 and 4 was smaller. The distance from the mandibular canal to the buccal cortex and to the lingual cortex of all experimental groups was smaller than control group. 2. The distance from the mandibular canal to the alveolar crest showed the largest difference from control group in all experimental groups, especially in group 2 and 4(p<0.05). 3. In the distance from the mandibular canal to the alveolar crest, the number of deviation value under 1 mm was 20 in group 3 and was 11 in group 2 and 4, respectively. 4. The deviation value of the distance from the mandibular canal to the buccal cortex and to the lingual cortex was under 1 mm in most cases.

• Journal of the Korean Society of Radiology
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• v.17 no.2
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• pp.207-213
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• 2023

Computed tomography (CT) images are used as the basis for proton Bragg peak position estimation and treatment plan simulation. During the Hounsfield Unit (HU) based proton stopping power ratio (SPR) estimation, small differences in the patient's density and elemental composition lead to uncertainty in the Bragg peak positions along the path of the proton beam. In this study, we investigated the potential of dual-energy computed tomography image-based proton SPRs prediction accuracy to reduce the uncertainty of Bragg peak position prediction. Single- and dual-energy images of an electron density phantom (CIRS Model 062M electron density phantom, CIRS Inc., Norfolk, VA, USA) were acquired using a computed tomography system (Somatom Definition AS, Siemens Health Care, Forchheim, Germany) to estimate the SPRs of the proton beam. To validate the method, it was compared to the SPRs estimated from standard data provided by the National Institute of Standards and Technology (NIST). The results show that the dual-energy image-based method has the potential to improve accuracy in predicting the SPRs of proton beams, and it is expected that further improvements in predicting the position of the proton's Bragg peak will be possible if a wider variety of substitutes with different densities and elemental compositions of the human body are used to predict the SPRs.

• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.663-670
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• 2023

In this study, we aimed to perform a comparative evaluation using quantitative factors between a region-growing based segmentation with noise reduction algorithms and a U-Net based segmentation. Initially, we applied median filter, median modified Wiener filter, and fast non-local means algorithm to computed tomography (CT) images, followed by region-growing based segmentation. Additionally, we trained a U-Net based segmentation model to perform segmentation. Subsequently, to compare and evaluate the segmentation performance of cases with noise reduction algorithms and cases with U-Net, we measured root mean square error (RMSE) and peak signal to noise ratio (PSNR), universal quality image index (UQI), and dice similarity coefficient (DSC). The results showed that using U-Net for segmentation yielded the most improved performance. The values of RMSE, PSNR, UQI, and DSC were measured as 0.063, 72.11, 0.841, and 0.982 respectively, which indicated improvements of 1.97, 1.09, 5.30, and 1.99 times compared to noisy images. In conclusion, U-Net proved to be effective in enhancing segmentation performance compared to noise reduction algorithms in CT images.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.317-326
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• 2011

The mental foramen and anterior loop of the mandibular canal are important landmarks for mandibular surgical procedures. The purpose of this study was to analyze the shape and position of the mental foramen and anterior loop of the mandibular canal on the computed tomography (CT) images, and apply the results clinically. CT images of 96 patients (33 male, 36 female, age range 17~43 years, mean $24.6{\pm}4.99$ years) were enrolled. The horizontal and vertical position of the mental foramen, as well as the distance from the root apices were measured. The distance of the anterior loop of the mandibular canal to the root apices, and the buccal angle were measured. The mental foramen was found mostly below the second premolar observed in 81 cases (46.0%), between the first and second premolars in 67 cases (38.0%), and between the second premolar and first molar in 19 cases (10.2%). The mean distance between the mental foramen and the lower border of the mandible was $12.20{\pm}1.77$ mm, the mean distance between the mental foramen and root apex was $5.16{\pm}0.98$ mm. The mean distance of the anterior loop of the mandibular canal was $5.80{\pm}2.00$ mm. The buccal angle measured at $47.7{\pm}9.07^{\circ}$. The distance between the root apex and mental foramen measured as $5.16{\pm}0.98$ mm on panoramic radiography, and $6.2{\pm}3.07$ mm on CT. The mean distance between the mental foramen and mandibular canal was $5.39{\pm}1.62$ mm. When performing surgical procedures such as installing dental implants, it is important to minimize surgical trauma, especially the risk of damage to the mental nerve. To optimize the surgical outcome, a careful assessment of the shape and position of the mental foramen and the anterior loop of the mandibular canal must be made. CT images are useful for finding such anatomic structures.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.171-175
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• 2008

Purpose: There have been something difficulties in locating focuses and quantitative analysis in case of pediatric patients because of the relatively small body compared to adults. This author of this study, therefore, evaluated the usefulness of DFOV (Display Field Of View) according to its changes in PET/CT image reconstruction by means of the phantom experiment and pediatric patients examination. Materials & Methods: 0.023 MBq/cc of $^{18}F$-FDG was put into the uniform NU2-94 phantom, and then emission scan was acquired for 10 minutes. For reconstruction, DFOV values were changed to 50, 45, 40, 35, 30, and 25 cm respectively. As for patient images, 20 patients who were diagnosed as the one or suspicion of the children tumor are targeted from Oct 2007 to Jan 2008. For image reconstruction, 50 cm was the basis of DFOV, and the value was adjusted to DFOV 45 cm to 25 cm respectively. In the phantom and the reconstruction image of pediatric patients, the changes in pixel size and $SUV_{max}$ according to DFOV changes were analyzed. Results: As DFOV decreased to 50, 45, 40, 35, 30, and 25 cm by means of the phantom, the pixel size was changed to 3.906, 3.515, 3.125, 2.734, 2.343, and 1.953 mm respectively. Besides, as a result of reconstruction DFOV in images of pediatric patients to 50, to 25 cm, the different values of $SUV_{max}$ are shown as 3.3, 7.3, 12, 14, 18% and 2.6, 4.3, 5.0, 7.0, 10.0% on respectively when 50 cm was the standard. Conclusion: In $SUV_{max}$ using the phantom, as DFOV decreased every 5 cm, the mean value gradually increased. With 50 cm as the standard, the increase rates were 3.7, 6.5, 11.2, 19.5, and 32.1% respectively. As for pediatric patients image too, as DFOV decreased, the rates increased as in the phantom experiment. In image reconstruction, since DFOV decrease regardless of matrix size change reduced the pixel size, the image quality can be improved. This would be more useful than reconstruction and enlarge images of pediatric patients in the same way of examining adults. However, when the value of 35 cm DFOV was applied, this may result in truncated artifact, and thus the application should be properly controlled. Change of DFOV may produce better image for pediatric patients, but changes of SUV values according to DFOV change should be considered in reading.

• Journal of the Korean Society of Radiology
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• v.15 no.6
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• pp.891-897
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• 2021

With the development of Amyloid PET Tracer, the accuracy of Alzheimer's diagnosis can be improved through the identification of beta-amyloid neurites. However, the long image acquisition time of 20 minutes can be difficult for the patient. PET/CT scans are sensitive to patient movement and may partially affect test results. In this study, we studied the proper image acquisition time without affecting the quantitative evaluation of the image through the list mode acquisition method according to the time of the distribution of radioactive drugs in the body. The list mode includes information about time compared to the existing frame mode, and it is easy to analyze data because it can reconstruct images about the time that researchers want. The research method obtained a reconstructed image by time using a list mode of 5min frame/bed, 10min frame/bed, 15min frame/bed, and 20min frame/bed to compare the difference between signal-to-pons take ratio (SNR) and lesion-to-pons uptake ratio (LPR) and the difference in reading time to obtain an appropriate image. As a result of quantitative analysis, when measuring in list mode, SUVmean values decreased in 6 regions of interest as the image acquisition time increased, but showed the largest difference in 5 min/bed images, followed by 10 min/bed and 15 min/bed. As a result, the difference in SUVmean values decreased. Therefore, it was found that SUVmean values at 15 min/bed did not differ enough to not affect image evaluation. There was no difference in LPR values. As a result of the qualitative analysis, there was no change in the reading findings according to the PET image acquisition time and there was no significant difference in the qualitative analysis score of the image reconstruction according to time. As a result of the study, there is no significant difference between 15 min/bed and 20 min/bed images during the ¹⁸F-flutemetamol PET/CT test, so it can be said that it is clinically useful to reduce the image acquisition time selectively using 15 min/bed via list mode depending on the patient's condition.