• Title/Summary/Keyword: CT Images

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Effect of LCD monitor type and observer experience on diagnostic performance in soft-copy interpretations of the maxillary sinus on panoramic radiographs

  • Kim, Tae-Young;Choi, Jin-Woo;Lee, Sam-Sun;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.41 no.1
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    • pp.11-16
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    • 2011
  • Purpose : The aim of this study was to evaluate the effect of liquid crystal display (LCD) monitor type and observer experience on the diagnostic performance in soft-copy interpretations of maxillary sinus inflammatory lesions on panoramic radiographs. Materials and Methods : Ninety maxillary sinuses on panoramic images were grouped into negative and positive groups according to the presence of inflammatory lesions, using CT for confirmation. Monochrome and color LCDs were used. Six observers participated and ROC analysis was performed to evaluate the diagnostic performance. The reading time, fatigue score, and inter-/intra-observer agreements were assessed. Results : The interpretation of maxillary sinus inflammatory lesions was affected by the LCD monitor type used and by the experience of the observer. The reading time was not significantly different, however the fatigue score was significantly different between two LCD monitors. Inter-observer agreement was relatively good in experienced observers, while the intra-observer agreement for all observers was good with monochrome LCD but not with color LCD. Conclusion : The less experienced observers showed lowered diagnostic ability with a general color LCD.

Manual Contouring Based Volumetric Evaluation for Colorectal Cancer with Liver Limited Metastases: A Comparison with RECIST

  • Fang, W.J.;Lam, K.O.;Ng, S.C.Y.;Choi, C.W.;Kwong, D.L.W.;Zheng, S.S.;Lee, V.H.F.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4151-4155
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    • 2013
  • Background: To compare response evaluation criteria in solid tumours (RECIST) and volumetric evaluation (VE) for colorectal cancer with liver-limited metastasis. Patients and Methods: VE of liver metastases was performed by manual contouring before and after chemotherapy on 45 pairs of computed tomography (CT) images in 36 patients who suffered from metastatic colorectal cancer (mCRC) with liver metastasis only. Cohen kappa was used to compare the agreement between VE and RECIST. Pearson correlation was performed for their comparison after cubic root transformation of the aggregate tumor volumes. Logistic regression was done to identify clinical and radiographic factors to account for the difference which may be predictive in overall response (OR). Results: There were 16 partial response (PR), 23 stable disease (SD) and 6 progressive disease (PD) cases with VE, and 14 PR, 23 SD and 8 PD with RECIST. VE demonstrated good agreement with RECIST (${\chi}$=0.779). Discordant objective responses were noted in 6 pairs of comparisons (13.3%). Pearson correlation also showed excellent correlation between VE and RECIST ($r^2$=0.966, p<0.001). Subgroup analysis showed that VE was in slightly better agreement with RECIST for enlarging lesions than for shrinking lesions ($r^2$=0.935 and $r^2$=0.780 respectively). No factor was found predictive of the difference in OR between VE and RECIST. Conclusions: VE exhibited good agreement with RECIST. It might be more useful than RECIST in evaluation shrinking lesions in cases of numerous and conglomerate liver metastases.

Virtual Reality and 3D Printing for Craniopagus Surgery

  • Kim, Gayoung;Shim, Eungjune;Mohammed, Hussein;Kim, Youngjun;Kim, Yong Oock
    • Journal of International Society for Simulation Surgery
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    • v.4 no.1
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    • pp.9-12
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    • 2017
  • Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.

Open Surgical Evacuation of Spontaneous Putaminal Hematomas: Prognostic Factors and Comparison of Outcomes between Transsylvian and Transcortical Approaches

  • Shin, Dong-Sung;Yoon, Seok-Mann;Kim, Sung-Ho;Shim, Jai-Joon;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.1-7
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    • 2008
  • Objective : The purpose of this study was to investigate the factors affecting the surgical outcome and to compare the surgical results between transsylvian and transcortical approaches in patients with putaminal hematomas. Methods : Retrospective review of charts and CT scan images was conducted in 45 patients (20 transsylvian and 25 transcortical approaches) who underwent open surgical evacuation of putaminal hematomas. Mean Glasgow coma scale (GCS) score and hematoma volume were $7.5{\pm}3.2$ and $78.1{\pm}29.3\;cc$, respectively. The factors affecting the functional mortality were investigated using a multivariate logistic regression analysis. In addition, surgical results between transsylvian and transcortical approaches were compared. Results : None of the patients had a good recovery after the surgery. Overall functional survival rate and mortality were 37.7% and 31%, respectively. The only risk factor for functional mortality was GCS motor score after controlling age, history of hypertension, side of hematoma, hematoma amount midline shift, presence of intraventricular hemorrhage and surgical approach (p=0.005). Even though a transcortical approach was shorter in operative time (4.4 versus 5.1 hour) and showed a higher mortality rate (40% versus 20%) and lower functional survival (45% versus 35%) compared to the transsylvian approach, the differences were not statistically significant between the two groups. Conclusion : In patients who have large amounts of hematoma and require open surgical evacuation, the only significant risk factor for functional survival is the preoperative GCS score. Cortical incision methods such as transsylvian and transcortical approaches have no influence on the surgical outcome. To decompress the swollen brain rapidly, transcortical approach seems to be more suitable than transsylvian approach.

Three-dimensional functional unit analysis of hemifacial microsomia mandible-a preliminary report

  • Choi, Ji Wook;Kim, Byung Hoon;Kim, Hyung Soo;Yu, Tae Hoon;Kim, Bong Chul;Lee, Sang-Hwy
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.28.1-28.7
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    • 2015
  • Background: The aim of this study was to present three-dimensional (3D) structural characteristics of the mandible in the hemifacial microsomia. The mandible has six distinct functional units, and its architecture is the sum of balanced growth of each functional unit and surrounding matrix. Methods: In order to characterize the mandibular 3D architecture of hemifacial microsomia, we analyzed the mandibular functional units of four hemifacial microsomia patients using the 3D reconstructed computed tomography (CT) images. And we compared the functional unit size between affected and non-affected side. Results: The length of condyle and angle showed significant differences between affected and non-affected sides. However, the length of mandibular body showed insignificant differences. The size differences between affected and non-affected side were observed at the condyle, angle, and body in descending order. Conclusions: This preliminary study suggests that the main etiopathogenic units are condyle and angle in the hemifacial microsomia mandible. Further investigation with the increased number of subjects will be helpful to establish treatment modality by etiopathogenic targeting of hemifacial microsomia.

Optimization of Energy Modulation Filter for Dual Energy CBCT Using Geant4 Monte-Carlo Simulation

  • Ju, Eun Bin;Ahn, So Hyun;Choi, Sang Gyu;Lee, Rena
    • Progress in Medical Physics
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    • v.27 no.3
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    • pp.125-130
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    • 2016
  • Dual energy computed tomography (DECT) is used to classify two materials and quantify the mass density of each material in the human body. An energy modulation filter based DECT could acquire two images, which are generated by the low- and high-energy photon spectra, in one scan, with one tube and detector. In the case of DECT using the energy modulation filter, the filter should perform the optimization process for the type of materials and thicknesses for generating two photon spectra. In this study, Geant4 Monte-Carlo simulation toolkit was used to execute the optimization process for determining the property of the energy modulation filter. In the process, various materials used for the energy modulation filter are copper (Cu, $8.96g/cm^3$), niobium (Nb, $8.57g/cm^3$), stannum (Sn, $7.31g/cm^3$), gold (Au, $19.32g/cm^3$), and lead (Pb, $11.34g/cm^3$). The thickness of the modulation filter varied from 0.1 mm to 1.0 mm. To evaluate the overlap region of the low- and high-energy spectrum, Geant4 Monte-Carlo simulation is used. The variation of the photon flux and the mean energy of photon spectrum that passes through the energy modulation filter are evaluated. In the primary photon spectrum of 80 kVp, the optimal modulation filter is a 0.1 mm lead filter that can acquire the same mean energy of 140 kVp photon spectrum. The lead filter of 0.1 mm based dual energy CBCT is required to increase the tube current 4.37 times than the original tube current owing to the 77.1% attenuation in the filter.

MR Images of Infarction of Wandering Spleen Associated with Intestinal Non-rotation (장 회전 이상과 함께 발생한 부유비장 경색의 자기공명영상에서의 소견: 증례 보고)

  • Kim, Eugene;Kim, Mi Young;Kim, Yeo Ju;Kim, Youn Jeong;Kim, Woo Chul;Suh, Chang Hae;Choi, Suk Jin;Cho, Jae Sung
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.253-257
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    • 2014
  • Wandering spleen is a rare clinical condition caused by lax splenic suspensory ligaments. The laxity of ligaments causes torsion of splenic vascular pedicle. CT scan of a 7-year-old girl with abdominal pain showed a non-enhancing lobular mass in lower abdomen. Small bowel loops were located at the right-sided abdomen and colonic loops at the left-sided abdomen. MRI scan showed non-enhancing heterogeneous mass with twisted vascular pedicle. To our knowledge, only a few cases have been reported about wandering spleen diagnosed on MRI.

Web-based 3D Face Modeling System for Hairline Modification Surgery (헤어라인 교정 시술을 위한 웹기반 얼굴 3D 모델링)

  • Lee, Sang-Wook;Jang, Yoon-Hee;Jeong, Eun-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.11
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    • pp.91-101
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    • 2011
  • This research aims to suggest web-based 3D face modeling system for hairline modification surgery. As public interests in beauty regarding face escalate with era of wide persoanl mobile smart iCT devices, need for medical information system is urgent and increasing demand. This research attempted to build 3D facing modeling library deploying conventional technology and proprietary software available. Implications from the our experiment found that problems and requirement for developing new web based standard. We suggest new system from our experiment and literature review regarding relevant technologies. Main features of our suggested systems is based on studies regarding hair loss treatment such as medical science, beauty studies and information technology. This system processes input images of 2D frontal and profile pictures of face into 3D face modeling with mesh-data. The mesh data is compatible with web standard technology including SVG and Canvas Tag supported natively by HTML5.

Recurrent Malignant Thymoma Detected by Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA Scan (Tc-99m MIBI, Tc-99m Tetrofosmin, 그리고 Tc-99m (V) DMSA 스캔에 의해 발견된 재발성 악성 흉선종)

  • Seok, Ju-Won;Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.268-273
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    • 2001
  • Thymoma is the most common primary tumor of anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges 8% to 18%. We reported one patient of recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m Tetrofosmin scintigraphies showed an increased uptake in the mediastinal area. Also, Tc-99m (V) DMSA scintigraphy revealed an increased uptake tn the corresponding area. Coronal SPECT images of Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA revealed increased uptake of each radiopharmaceutical in the tumor lesion corresponding to the mediastinal lesion on the chest CT. However, the normal blood pool activities of the heart and great vessels of Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor seeking agent, we recommend Tc-99m MIBI and Tc-99m Tetrofosmin SPECT rather than Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.

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Quantitative Analysis of Regional Cerebral Blood Flow using $^{99m}Tc-HMPAO$ SPECT in Parkinson's Disease (파킨슨병에서 $^{99m}Tc-HMPAO$ SPECT를 이용한 국소뇌혈류의 정량적 분석)

  • Lee, Myung-Chul;Bae, Sang-Kyun;Lee, Myung-Hae;Chung, June-Key;Koh, Chang-Soon;Roh, Jae-Kyu;Myung, Ho-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.251-256
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    • 1992
  • Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using $^{99m}Tc-HMPAO$ SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were $0.082{\pm}0.033$ and $0.108{\pm}0.062$, respectively and PIA were $-0.4{\pm}0.7%$ and $-0.7{\pm}1.0%$, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

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