• Title/Summary/Keyword: CT Scanning

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Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better"

  • uz Zaman, Maseeh;Fatima, Nosheen;Zaman, Areeba;Zaman, Unaiza;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3465-3468
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    • 2016
  • Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

Detection and Analysis of the Liver Area and Liver Tumors in CT Scans (CT 영상에서의 간 영역과 간 종양 추출 및 분석)

  • Kim, Kwang-Baek
    • Journal of Intelligence and Information Systems
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    • v.13 no.1
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    • pp.15-27
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    • 2007
  • In Korea, hepatoma is the thirdly frequent cause of death from cancer occupying 17.2% among the whole deaths from cancer and the rate of death from hepatoma comes to about 21's persons per one-hundred thousand ones. This paper proposes an automatic method for the extraction of areas being suspicious as hepatoma from a CT scan and evaluates the availability as an auxiliary tool for the diagnosis of hepatoma. For detecting tumors in the internal of the liver from CT scans, first, an area of the liver is extracted from about $45{\sim}50's$ CT scans obtained by scanning in 2.5-mm intervals starting from the lower part of the chest. In the extraction of an area of the liver, after unconcerned areas outside of the ribs being removed, areas of the internal organs are separated and enlarged by using intensity information of the CT scan. The area of the liver is extracted among separated areas by using information on position and morphology of the liver. Since hepatoma is a hypervascular turner, the area corresponding to hepatoma appears more brightly than the surroundings in contrast-enhancement CT scans, and when hepatoma shows expansile growth, the area has a spherical shape. So, for the extraction of areas of hepatoma, areas being brighter than the surroundings and globe-shaped are selected as candidate ones in an area of the liver, and then, areas appearing at the same position in successive CT scans among the candidates are discriminated as hepatoma. For the performance evaluation of the proposed method, experiment results obtained by applying the proposed method to CT scans were compared with the diagnoses by radiologists. The evaluation results showed that all areas of the liver and liver tumors were extracted exactly and the proposed method has a high availability as an auxiliary diagnosis tools for the discrimination of liver tumors.

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ACCURACY TESTS OF 3D RAPID PROTOTYPING (RP) MEDICAL MODELS: ITS POTENTIAL AND CLINICAL APPLICATIONS (Rapid Prototyping으로 제작한 3D Medical Model의 오차 측정에 관한 연구 (임상 적용 가능성 및 사례))

  • Choi, Jin-Young;Choi, Jung-Ho;Kim, Nam-Kuk;Lee, Jong-Ki;Kim, Myeng-Ki;Kim, Myung-Jin;Kim, Yeong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.25 no.4
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    • pp.295-303
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    • 1999
  • Presented in this paper are the experimental results that measure rapid prototyping (RP) errors in 3D medical models. We identified various factors that can cause dimensional errors when producing RP models, specifically in maxillofacial areas. For the experiment, we used a human dry skull. A number of linear measurements based on landmarks were first obtained on the skull. This was followed by CT scanning, 3D model reconstruction, and RP model fabrication. The landmarks were measured again on both the reconstructed models and the physical RP models, and these were compared with those on dry skull. We focused on major sources of errors, such as CT scanning, conversion from CT data to STL models, and RP model fabrication. The results show that the overall error from skull to RP is $0.64{\times}0.36mm(0.71{\times}0.66%)$ in absolute value. This indicates that the RP technology can be acceptable in the real clinical applications. A clinical case that has applied RP models successfully for treatment planning and surgical rehearsal is presented. Although the use of RP models is rare in the medical area yet, we believe RP is promising in that it has a great potential in developing new tools which can aid diagnosis, treatment planning, surgical rehearsal, education, and so on.

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Automated Detection and Volume Calculation of Nodular Lung Cancer on CT Scans (CT 영상에서 결절성 폐암의 자동추출 및 체적계산)

  • Kim, Do-Yeon;Kim, Jin-Hwan;Noh, Seung-Moo;Park, Jong-Won
    • Journal of KIISE:Computing Practices and Letters
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    • v.7 no.5
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    • pp.451-457
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    • 2001
  • This paper describes automated methods for the detection of lung nodules and their volume calculation on CT scans. Gray-level threshold methods were used to segment the thorax from the background and then the lung parenchymes from the thoracic wall and mediastinum. A scanning-ball algorithm was applied to more accurately delineate the lung boundaries, thereby incorporating peripheral nodules contiguous to pleural surface within the segmented lung parenchymes. The lesions which have the high gray value were extracted from the segmented lung parenchymes. The selected lesions include nodules, blood vessels and partial volume effects. The discriminating features such as size, solid-shape, average, standard deviation and correlation coefficient of selected lesions were used to distinguish true nodules from pseudo-lesions. Volume and circularity calculation were performed for each identified nodules. The identified nodules were sorted in descending order of the volume. These method were applied to 621 image slices of 19 cases. The sensitivity was 95% and there was no false-positive result.

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Accuracy and reliability of measurements performed using two different software programs on digital models generated using laser and computed tomography plaster model scanners

  • Camardella, Leonardo T.;Ongkosuwito, Edwin M.;Penning, E. Willemijn;Kuijpers-Jagtman, Anne Marie;Vilella, Oswaldo V.;Breuning, K. Hero
    • The korean journal of orthodontics
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    • v.50 no.1
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    • pp.13-25
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    • 2020
  • Objective: The aim of this study was to compare the accuracy and reliability of measurements performed using two different software programs on digital models generated using two types of plaster model scanners (a laser scanner and a computed tomography [CT] scanner). Methods: Thirty plaster models were scanned with a 3Shape laser scanner and with a Flash CT scanner. Two examiners performed measurements on plaster models by using digital calipers and on digital models by using Ortho Analyzer (3Shape) and Digimodel® (OrthoProof) software programs. Forty-two measurements, including tooth diameter, crown height, overjet, overbite, intercanine and intermolar distances, and sagittal relationship, were obtained. Results: Statistically significant differences were not found between the plaster and digital model measurements (ANOVA); however, some discrepancies were clinically relevant. Plaster and digital model measurements made using the two scanning methods showed high intraclass coefficient correlation values and acceptable 95% limits of agreement in the Bland-Altman analysis. The software used did not influence the accuracy of measurements. Conclusions: Digital models generated from plaster casts by using laser and CT scanning and measured using two different software programs are accurate, and the measurements are reliable. Therefore, both fabrication methods and software could be used interchangeably.

A Case of The Reduction of Symptoms, But No Change on The CT Scanning in HNP by Oriental Medical Treatment Added Mori cortex-Bee Venom Acupuncture (상백피봉약침요법(桑白皮蜂藥鍼療法)을 포함한 한방치료(韓方治療)로 증상(症狀)은 소실(消失)되었으나 CT추적관찰상(追跡觀察上) 변화(變化)가 없는 요추(腰椎) 추간판(椎間板) 탈출증(脫出症) 1예(例))

  • Lee, Byung-Hoon;Kim, Cheol-Hong;Seo, Jung-Chul;Youn, Hyoun-Min;Song, Choon-Ho;Ahn, Chang-Beohm;Jang, Kyung-Jeon
    • Journal of Pharmacopuncture
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    • v.4 no.2
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    • pp.17-25
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    • 2001
  • By process of treatment for a case which diagnosed as HNP of left posterolateral aspect of L4/5 disc and treated from the 10th, May 2001 to the 23rd, Jun 2001, the results are as follows. Method & Results : This patient was medicated Hwallaktang-gami, taken acupuncture, phototherapy, TENS, electric acupuncture, exercises, Mori Cortex-bee venom acupuncture. As a result, the patient's clinical symptom were improved but a computed tomagraphy confirmed L4/5 and L5/S1 HNP was not changed as seen on repeated CT scanning. Conclusion : These results suggest that among conservative therapies the oriental medical treatments including Mori Cortex-bee venom acupuncture improve clinical symptom effectively. But in this case, the structure of herniated disc was not changed.

Determination of Early Graft Patency Using CT Angiography after Coronary Artery Bypass Surgery (관상동맥우회술 후 CT 조영술을 이용한 이식편의 조기 열림의 판정)

  • 이미경;류대웅;최순호;최종범
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.570-577
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    • 2004
  • CT angiography is now available to evaluate the early graft patency after coronary bypass surgery. We investigated whether patency or occlusion of the bypass grafts can be visualized by CT angiography and what factors effect the visuality. Material and Method: Fifty patients underwent scanning with a 4-slice computed tomographic scanner (Somatom Volume ZoomTM; Siemens, Germany) before being discharged after coronary artery bypass grafting. To evaluate graft patency and relationship between the quality of graft image and the characteristics of the diseased coronary vessels, 50 internal thoracic artery grafts, 18 radial artery grafts, and 56 vein grafts were included in this study. Result: All vein grafts (24 grafts; 32 anastomoses) to left coronary artery system were well visualized, but 3 grafts (4.7%) of 30 vein grafts (35 anastomoses) to right coronary artery system were not visualized. The latter was also occluded in invasive coronary angiographic study. Thirty-nine (78%) internal thoracic artery grafts were well visualized, 8 (16%) faintly visualized, and 3 (6%) not visualized, but all the internal artery grafts were well patent in invasive coronary angiographic study. Conclusion: Unvisualized vein grafts in CT angiography means occlusion of the grafts, but unvisualized arterial grafts in CT angiography may not mean occlusion of the graft but result from competitive flow between the graft and coronary artery. To confirm patency of the unvisualized arterial grafts, invasive coronary angiography is needed.

Feasibility of Shrinking Field Radiation Therapy through 18F-FDG PET/CT after 40 Gy for Stage III Non-Small Cell Lung Cancers

  • Ding, Xiu-Ping;Zhang, Jian;Li, Bao-Sheng;Li, Hong-Sheng;Wang, Zhong-Tang;Yi, Yan;Sun, Hong-Fu;Wang, Dong-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.319-323
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    • 2012
  • Objective: To explore the feasibility of shrinking field technique after 40 Gy radiation through 18F-FDG PET/CT during treatment for patients with stage III non-small cell lung cancer (NSCLC). Methods: In 66 consecutive patients with local-advanced NSCLC, 18F-FDG PET/CT scanning was performed prior to treatment and repeated after 40 Gy. Conventionally fractionated IMRT or CRT plans to a median total dose of 66Gy (range, 60-78Gy) were generated. The target volumes were delineated in composite images of CT and PET. Plan 1 was designed for 40 Gy to the initial planning target volume (PTV) with a subsequent 20-28 Gy-boost to the shrunken PTV. Plan 2 was delivering the same dose to the initial PTV without shrinking field. Accumulated doses of normal tissues were calculated using deformable image registration during the treatment course. Results: The median GTV and PTV reduction were 35% and 30% after 40 Gy treatment. Target volume reduction was correlated with chemotherapy and sex. In plan 2, delivering the same dose to the initial PTV could have only been achieved in 10 (15.2%) patients. Significant differences (p<0.05) were observed regarding doses to the lung, spinal cord, esophagus and heart. Conclusions: Radiotherapy adaptive to tumor shrinkage determined by repeated 18F-FDG PET/CT after 40 Gy during treatment course might be feasible to spare more normal tissues, and has the potential to allow dose escalation and increased local control.

A Study of the Mechanical Properties of Human Trabecular Bone by Spherical Indentation Test (구형압입시험을 통한 망상골의 기계적 물성 연구)

  • 배태수;김정규;이태수;최귀원
    • Journal of Biomedical Engineering Research
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    • v.22 no.5
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    • pp.419-424
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    • 2001
  • We intended to evaluate the Young's modulus of trabecular bone of a human distal femur by spherical Indentation test and CT images and to quantify relationships between the direction of load, density. and Young's modulus. The specimens were scanned at 1 mm intervals on CT scanner After scanning the bones were sectioned with diamond saw. producing 8mm cubes of trabecular bone. The tubes were mechanically tested in inferior-superior(IS), anterior-posterior(AP). and medial-lateral(ML) direction with custom-made device. After testing, the real apparent density of specimens were measured. The results of this study showed that the IS modulus was significant1y greater than both the AP and ML modulus and the AP modulus was also greater than ML modulus significantly(p〈0.01) A significant Power relationship between the apparent density and the modulus was also found.

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Descending Necrotizing Mediastinitis Secondary to Peritonsillar Abscess -A Case Report- (편도주위농양에 합병된 하행 괴사성 종격동염 -치험 1례-)

  • 최필조;이용훈;우종수;이기남;손춘희;박헌수;이인규
    • Journal of Chest Surgery
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    • v.32 no.7
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    • pp.686-689
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    • 1999
  • Descending necrotizing mediastinitis(DNM) is a rare complication of the oropharyngeal and cervical infection. Descending necrotizing mediastinitis requires an early and aggressive surgical approach to reduce the high morbidity and mortality associated with this disease. A 39-year-old man complained of odynophagia, neck swelling, and disturbance of swallowing with dyspnea. CT scans of the neck suggested a peritonsillar abscess and retropharyngeal and peripharyngeal abscess. He underwent cervical drainage. He remained febrile and complained of severe both pain in both shoulders. On postoperative day 5, a follow-up CT scan confirmed a mediastinal abscess. Reexploration of the neck and right thoracotomy for debridement and drainage of the mediastinal abscess were performed.. A large amount of pus was drained from the anterior and posterior mediastinum and its necrotic tissue was debrided. The patient's condition and radiologic findings gradually improved. Cultures of the drain fluid revealed Klebsiella pneumoniae. He was discharged on the 85th hospital day. In our experience, both transcervical drainage and aggressive mediastinal exploration via thoracotomy can lead to an improvement in the survival of the patient with descending necrotizing mediastinitis. CT scanning is useful for early diagnosis of mediastinitis and for follow up.

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