• Korean Journal of Radiology
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• 제22권6호
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• pp.901-911
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• 2021

Objective: To evaluate the technical applicability of a semiautomatic three-dimensional (3D) hybrid CT segmentation method for the quantification of right ventricular mass in patients with cardiovascular disease. Materials and Methods: Cardiac CT (270 cardiac phases) was used to quantify right ventricular mass using a semiautomatic 3D hybrid segmentation method in 195 patients with cardiovascular disease. Data from 270 cardiac phases were divided into subgroups based on the extent of the segmentation error (no error; ≤ 10% error; > 10% error [technical failure]), defined as discontinuous areas in the right ventricular myocardium. The reproducibility of the right ventricular mass quantification was assessed. In patients with no error or < 10% error, the right ventricular mass was compared and correlated between paired end-systolic and end-diastolic data. The error rate and right ventricular mass were compared based on right ventricular hypertrophy groups. Results: The quantification of right ventricular mass was technically applicable in 96.3% (260/270) of CT data, with no error in 54.4% (147/270) and ≤ 10% error in 41.9% (113/270) of cases. Technical failure was observed in 3.7% (10/270) of cases. The reproducibility of the quantification was high (intraclass correlation coefficient = 0.999, p < 0.001). The indexed mass was significantly greater at end-systole than at end-diastole (45.9 ± 22.1 g/m² vs. 39.7 ± 20.2 g/m², p < 0.001), and paired values were highly correlated (r = 0.96, p < 0.001). Fewer errors were observed in severe right ventricular hypertrophy and at the end-systolic phase. The indexed right ventricular mass was significantly higher in severe right ventricular hypertrophy (p < 0.02), except in the comparison of the end-diastolic data between no hypertrophy and mild hypertrophy groups (p > 0.1). Conclusion: CT quantification of right ventricular mass using a semiautomatic 3D hybrid segmentation is technically applicable with high reproducibility in most patients with cardiovascular disease.

• Korean Journal of Radiology
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• 제25권6호
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• pp.540-549
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• 2024

Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

• 한국임상수의학회지
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• 제25권2호
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• pp.96-101
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• 2008

흉수량은 흉수천자의 실시 여부 및 진단과 치료에 이용되는 방법의 결정에 영향을 미치므로 흉수량 측정은 중요하다. 본 실험의 목적은 흉수를 정량화하기 위해 흉부 방사선 및 초음파와 컴퓨터단층촬영을 시행하여 그 결과를 비교하고 정확도를 측정하는데 있다. 임상적으로 건강한 6 마리의 비글견을 이용하여 생리식염수를 최종 용량이 60 ml/kg 될 때까지 체중당 10ml씩 흉강에 주입하면서 흉부 방사선 검사, 초음파 검사, CT 검사를 차례로 실시하였다. 흉부 방사선 사진에서 흉수의 유무 평가 및 흉수 정량화를 실시하였으며 초음파 영상에서 흉수량은 폐의 표면과 흉강벽 사이의 최대 수직 거리를 측정하여 평가하였다. CT 영상에서 흉수량은 soft tissue window에서 평가하였으며 최대 흉수량을 나타내는 영상에서 최소 수직거리를 측정하였다. 흉수량과 흉부 방사선 사진 및 초음파 영상에서의 측정치와 통계학적으로 유의적인 결과를 얻지 못했다. 그러나 CT 검사에서의 측정값과 흉수량과의 유의적인 관계를 나타내었다. 특히 흉수의 정량화에서 좌우측 측정치의 평균값이 좌우측 각각의 값보다 더 높은 정확도를 나타내었다. 흉수를 확인하기 위해서는 흉부 방사선 검사 초음파 검사 및 CT 검사가 모두 가능하나 흉수를 정량화하기 위해서는 흉부 방사선 및 초음파 검사보다 CT 검사가 유용함을 확인하였다.

• Korean Journal of Radiology
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• 제22권8호
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• pp.1300-1309
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• 2021

Objective: To assess the feasibility and reproducibility of pancreatic surface lobularity (PSL) quantification derived from abdominal computed tomography (CT) in a population of patients free from pancreatic disease. Materials and Methods: This retrospective study included 265 patients free from pancreatic disease who underwent contrast-enhanced abdominal CT between 2017 and 2019. A maximum of 11 individual PSL measurements were performed by two abdominal radiologists (head [5 measurements], body, and tail [3 measurements each]) using dedicated software. The influence of age, body mass index (BMI), and sex on PSL was assessed using the Pearson correlation and repeated measurements. Inter-reader agreement was assessed using the intraclass correlation coefficient (ICC) and Bland Altman (BA) plots. Results: CT images of 15 (6%) patients could not be analyzed. A total of 2750 measurements were performed in the remaining 250 patients (143 male [57%], mean age 45 years [range, 18-91]), and 2237 (81%) values were obtained in the head 951/1250 (76%), body 609/750 (81%), and tail 677/750 (90%). The mean ± standard deviation PSL was 6.53 ± 1.37. The mean PSL was significantly higher in male than in female (6.89 ± 1.30 vs. 6.06 ± 1.31, respectively, p < 0.001). PSL gradually increased with age (r = 0.32, p < 0.001) and BMI (r = 0.32, p < 0.001). Inter-reader agreement was excellent (ICC 0.82 [95% confidence interval 0.72-0.85], with a BA bias of 0.30 and 95% limits of agreement of -1.29 and 1.89). Conclusion: CT-based PSL quantification is feasible with a high success rate and inter-reader agreement in subjects free from pancreatic disease. Significant variations were observed according to sex, age, and BMI. This study provides a reference for future studies.

• 한국멀티미디어학회논문지
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• 제16권6호
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• pp.700-707
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• 2013

본 논문에서는 시간차 흉부 CT 영상의 폐 실질 비강체 정합을 위하여 영역 이진화 모델링과 지역적 변형 모델을 이용한 정합 기법을 제안한다. 제안 기법은 먼저 폐 혈관과 실질을 분할하고, 영역 이진화 모델링을 수행하여 두 영상 사이의 밝기값의 차이에 따른 정합 오차를 최소화 한다. 다음으로 초기 정합 기법으로 두 폐 표면을 전역적으로 정렬하고, 지역적 변형 변환 모델을 제안하여 비강체 정합을 수행한다. 또한, 정합 후 감산된 시간에 따른 밝기값 차이가 미리 정의된 칼라 맵을 이용하여 가시화 된다. 실험 결과는 제안기법이 10명의 환자에 대하여 최대호흡과 최소호흡 CT 영상에서 폐 실질을 정확하게 정합하였음을 보여주었다. 제안된 비강체 정합 기법은 폐 실질에 대한 정량적 분석 결과의 직관적인 칼라 매핑을 통하여 다양한 폐 질환의 정량적 분석에 유용하게 사용될 수 있다.

• Korean Journal of Radiology
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• 제24권8호
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• pp.807-820
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• 2023

Objective: To assess whether computed tomography (CT) conversion across different scan parameters and manufacturers using a routable generative adversarial network (RouteGAN) can improve the accuracy and variability in quantifying interstitial lung disease (ILD) using a deep learning-based automated software. Materials and Methods: This study included patients with ILD who underwent thin-section CT. Unmatched CT images obtained using scanners from four manufacturers (vendors A-D), standard- or low-radiation doses, and sharp or medium kernels were classified into groups 1-7 according to acquisition conditions. CT images in groups 2-7 were converted into the target CT style (Group 1: vendor A, standard dose, and sharp kernel) using a RouteGAN. ILD was quantified on original and converted CT images using a deep learning-based software (Aview, Coreline Soft). The accuracy of quantification was analyzed using the dice similarity coefficient (DSC) and pixel-wise overlap accuracy metrics against manual quantification by a radiologist. Five radiologists evaluated quantification accuracy using a 10-point visual scoring system. Results: Three hundred and fifty CT slices from 150 patients (mean age: 67.6 ± 10.7 years; 56 females) were included. The overlap accuracies for quantifying total abnormalities in groups 2-7 improved after CT conversion (original vs. converted: 0.63 vs. 0.68 for DSC, 0.66 vs. 0.70 for pixel-wise recall, and 0.68 vs. 0.73 for pixel-wise precision; P < 0.002 for all). The DSCs of fibrosis score, honeycombing, and reticulation significantly increased after CT conversion (0.32 vs. 0.64, 0.19 vs. 0.47, and 0.23 vs. 0.54, P < 0.002 for all), whereas those of ground-glass opacity, consolidation, and emphysema did not change significantly or decreased slightly. The radiologists' scores were significantly higher (P < 0.001) and less variable on converted CT. Conclusion: CT conversion using a RouteGAN can improve the accuracy and variability of CT images obtained using different scan parameters and manufacturers in deep learning-based quantification of ILD.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1077-1088
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• 2018

Objective: To correlate CT parameters on detector-based dual-energy CT enterography (DECTE) with Crohn's disease activity index (CDAI) and externally validate quantitative CT parameters. Materials and Methods: Thirty-nine patients with CD were retrospectively enrolled. Two radiologists reviewed DECTE images by consensus for qualitative and quantitative CT features. CT attenuation and iodine concentration for the diseased bowel were also measured. Univariate statistical tests were used to evaluate whether there was a significant difference in CTE features between remission and active groups, on the basis of the CDAI score. Pearson's correlation test and multiple linear regression analyses were used to assess the correlation between quantitative CT parameters and CDAI. For external validation, an additional 33 consecutive patients were recruited. The correlation and concordance rate were calculated between real and estimated CDAI. Results: There were significant differences between remission and active groups in the bowel enhancement pattern, subjective degree of enhancement, mesenteric fat infiltration, comb sign, and obstruction (p < 0.05). Significant correlations were found between CDAI and quantitative CT parameters, including number of lesions (correlation coefficient, r = 0.573), bowel wall thickness (r = 0.477), iodine concentration (r = 0.744), and relative degree of enhancement (r = 0.541; p < 0.05). Iodine concentration remained the sole independent variable associated with CDAI in multivariate analysis (p = 0.001). The linear regression equation for CDAI (y) and iodine concentration (x) was y = 53.549x + 55.111. For validation patients, a significant correlation (r = 0.925; p < 0.001) and high concordance rate (87.9%, 29/33) were observed between real and estimated CDAIs. Conclusion: Iodine concentration, measured on detector-based DECTE, represents a convenient and reproducible biomarker to monitor disease activity in CD.

• 핵의학기술
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• 제26권2호
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• pp.20-31
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• 2022

Broad Quantification Calibration(B.Q.C)은 SPECT/CT 장비에서 정량적인 평가(Quantitative Analysis)에 사용되는 표준 섭취 계수(Standard Uptake Value; SUV) 측정을 위한 Calibration 이다. Tc-99m, I-123, I-131, Lu-177 네 가지 핵종 별로 B.Q.C 를 시행한 후 SUV 가 정확하게 측정되는지를 검증하기 위해 팬텀 실험을 추가로 시행하였다. SPECT 장비를 위한 국제 기준이 아직까지 명확하게 마련되지 있지 않아 ACR Esser PET phantom을 이용하여 감마카메라 장비에서 사용하는 핵종 별로 SUV 측정을 위한 기반 작업을 수행하고자 하였다. 실험에 사용 된 SPECT/CT 장비는 SIEMENS 사의 Symbia Intevo 16과 Symbia Intevo Bold 두 장비이다. B.Q.C는 point source 를 이용하여 각 detector 에 감도를 인식시켜주는 sensitivity cal. 을 1 차로 시행하고, cylinder phantom 을 이용하여 Volume Sensitivity Factor(VSF)를 산출하는 volume sensitivity cal.을 추가로 시행한다. SUV 측정을 위해 ACR Esser PET phantom을 이용하여 Tc-99m, I-123, I-131, Lu-177 네 가지 핵종 별로 팬텀 영상을 획득하고, 배후방사능(BKG)의 SUV_mean와 네 개의 hot vial(25, 16, 12, 8 mm)에서의 SUV_max를 측정하였다. Intevo 16, Intevo Bold 두 장비간의 SUV 차이를 비교하기 위해 SPSS ver. 21(IBM company, USA)을 이용하여 Mann-Whitney 검정을 시행하였다. B.Q.C 시행에 따른 네 가지 핵종 별로, 각 장비와 Detector 1, 2 에서의 Sensitivity(CPS/MBq) 및 VSF 는 다음과 같다(Intevo 16 D1 sensitivity/D2 sensitivity/VSF, Intevo Bold 순). Tc-99m 에서는 87.7/88.6/1.08, 91.9/91.2/1.07, I-123에서는 79.9/81.9/0.98, 89.4/89.4/0.98, I-131에서는 124.8/128.9/0.69, 130.9, 126.8/0.71, Lu-177 에서는 8.7/8.9/1.02, 9.1/8.9/1.00 이었다. ACR Esser PET 팬텀 실험에서 SUV 결과는 다음과 같다(Intevo 16 BKG SUV_mean/25mmSUV_max/16mm/12mm/ 8mm, IntevoBold순). Tc-99m에서는 1.03/2.95/2.41/1.96/1.84, 1.03/2.91/2.38/1.87/1.82, I-123에서는 0.97/2.91/2.33/ 1.68/1.45, 1.00/2.80/2.23/1.57/1.32, I-131에서는 0.96/1.61/ 1.13/1.02/0.69, 0.94/1.54/1.08/0.98/0.66, Lu-177에서는 1.00/ 6.34/4.67/2.96/2.28, 1.01/6.21/4.49/2.86/2.21 이었다. 두 장비 간의 팬텀 실험 별 SUV 차이를 비교하기 위해 MannWhitney 검정을 시행한 결과, 통계적으로 유의한 차이가 없었다(z=-0.338, p=0.735). 기존 감마카메라는 단면 영상의 육안적인 평가만 가능하였다면, SPECT/CT 영상을 통해 해부학적 정보와 3차원 단층 영상 획득 및 SUV 측정으로 정량 분석이 가능하게 되었다. 주로 사용하는 Tc-99m 뿐만 아니라 I-123, I-131, Lu-177 핵종에 대해서도 Broad Quantification Calibration 을 시행하여 핵종 별로 정량적인 정보를 획득 할 수 있는 기반 작업이 수행 되었고, ACR Esser PET phantom 실험을 통해 SUV 측정의 신뢰도에 대한 검증도 수행 되었다. 장비의 성능 및 정량분석의 재현성을 유지하기 위해 주기적인 장비의 정도관리가 필요할 것이며, 이를 통해 Bone SPECT/CT 뿐만 아니라 기타 다른 SPECT/CT 영상 검사의 추적관찰 및 동위원소 치료 분야에서도 치료반응을 평가하는 등의 많은 도움이 될 것으로 사료된다.

• 대한핵의학회지
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• 제39권2호
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• pp.124-132
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• 2005

Cardiac PET emerged as a powerful tool that allowed in vivo quantification of physiologic processes including myocardial perfusion and metabolism, as well as neuronal and receptor function for more than 25 years. Wow PET imaging has been playing an important role in the clinical evaluation of patients with known or suspected ischemic heart disease. This important clinical role is expected to grow with the availability of PET/CT scanner that allow a true integration of structure and function. The objective of this review is to provide an update on the current and future role of PET in clinical cardiology with a special eye on the great opportunities now offered by PET/CT.

• International Journal of Oral Biology
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• 제38권3호
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• pp.87-92
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• 2013

Periodontal inflammation increases the risk of tooth loss, particularly in cases where there is an associated loss of alveolar bone and periodontal ligament (PDL). Histological and morphometric evaluation of periodontal inflammation is difficult. Especially, the lengths of the periodontal ligament and interdental alveolar bone space have not been quantified. A quantitative imaging procedure applicable to an animal model would be an important clinical study. The purpose of this study was to quantify the loss of alveolar bone and periodontal ligament by evaluation with micro-computed tomography (micro-CT). Another purpose was to investigate differences in infections with systemic E. coli LPS and TNF-${\alpha}$ on E. coli lipopolysaccharide (LPS) in loss of alveolar bone and periodontal ligament model on mice. This study showed that linear measurements of alveolar bone loss were represented with an increasing trend of the periodontal ligament length and interdental alveolar process space. The effects of systemic E. coli LPS and TNF-${\alpha}$ on an E. coli LPS-induced periodontitis mice model were investigated in this research. Loss of periodontal ligament and alveolar bone were evaluated by micro-computed tomography (micro-CT) and calculated by the two- and three dimensional microstructure morphometric parameters. Also, there was a significantly increasing trend of the interdental alveolar process space in E. coli LPS and TNF-${\alpha}$ on E. coli LPS compared to PBS. And E. coli LPS and TNF-${\alpha}$ on E. coli LPS had a slightly increasing trend of the periodontal ligament length. The increasing trend of TNF-${\alpha}$ on the LPS-induced mice model in this experiment supports the previous studies on the contribution of periodontal diseases in the pathogenesis of systemic diseases. Also, our findings offer a unique model for the study of the role of LPS-induced TNF-${\alpha}$ in systemic and chronic local inflammatory processes and inflammatory diseases. In this study, we performed rapidly quantification of the periodontal inflammatory processes and periodontal bone loss using micro-computed tomography (micro-CT) in mice.