• Archives of Plastic Surgery
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• v.34 no.4
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• pp.535-537
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• 2007

Purpose: We experienced a patient with posttraumatic duplication of the sternoclavicular joint causing a protruding deformity, whose major complaint was aesthetic. The patients history, radiologic findings, and surgical treatment are reported. Methods: A 41-year-old bus driver complained a bony prominence at the left medial clavicle, which had developed after a fracture. The patient was annoyed by the protrusion, which was even visible, when he was wearing a pullover. A three dimensional CT scan showed that the medial head was split into two portions, of which the anterior portion was protruding. In general anesthesia the anterior portion of the medial head was excised. Results: The bony prominence was corrected successfully. Follow up three dimensional CT scans showed that the anterior cortex of the clavicle had regenerated completely at the resection line one year after the operation. Conclusion: Surgical interventions for complications after clavicular fracture are usually carried out, only if there is a limitation of function or if it is painful. We report of a patient with posttraumatic bifurcation of the medial clavicular head, most probably caused by malunion. Upon the patient's request, the deformity causing protrusion of the medial clavicular area was successfully resected for cosmetic reasons.

• Archives of Craniofacial Surgery
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• v.20 no.1
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• pp.31-36
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• 2019

Background: After closed reduction, patients are sometimes concerned that their external nasal shapes have changed. The aim of this study was to investigate and explain changes in nasal shape after surgery through objective photogrammetric anthropometry measurements taken through three-dimensional (3D) reformed computed tomography (CT) images. Methods: Our study included 100 Korean patients who underwent closed reduction of isolated nasal bone fracture from January 2016 to June 2017. Using the ruler tool in Adobe Photoshop CS3, we measured preoperative and postoperative nasal base heights, long nostril axis lengths, both nasal alar angles, and amount of nasal deviation through the 3D reformation of soft tissue via CT scans. We then compared the dimension of nose. Results: The amount of postoperative correction for nasal base height was 1.192 mm. The differences in nostril length between each side were found to be 0.333 mm preoperatively and 0.323 mm postoperatively. The differences in the nasal alar angle between each side was $1.382^{\circ}$ preoperatively and $1.043^{\circ}$ postoperatively. The amount of nasal deviation was found to be 5.248 mm preoperatively and 1.024 mm in postoperatively. Conclusion: After the reduction of nasal bone fractures, changes in nasal dimensions were noticeable in terms of nasal deviation but less significant in nasal tips, except for changes in nasal alar angles, which were notable.

• Kosin Medical Journal
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• v.33 no.3
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• pp.454-462
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• 2018

A 54-year-old man, suffering from severe headache and ophthalmoplegia after undergoing endoscopic sinus surgery was referred to a tertiary hospital. Computed tomography (CT) revealed soft tissue density lesions in the left sphenoid sinus. The internal carotid artery was shown to be occluded in brain magnetic resonance imaging (MRI) scans without any other cerebral lesion. Endoscopic view of left nasal cavity shows whitish hyphae in the ethmoid and the sphenoid sinuses. We diagnosed him with cavernous sinus syndrome caused by mucormycosis and conducted endoscopic sinus surgery to remove remaining lesions and decompress orbit and optic nerves. After the revision surgery the patient's headache and ophthalmoplegia were improved. However, multifocal cerebral infarctions were newly discovered in a postoperative CT scan. We experienced a case of mucormycosis of sphenoid sinus resulting in occlusion of internal carotid artery and multifocal cerebral infarction, and report it with a brief review of these disease entities.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.765-773
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• 2023

Objective: This long-term case report details a case of pancreatic cancer with lung metastasis suppressed by integrative cancer medicine (IMT). Methods: A 64-year-old woman diagnosed with pancreatic cancer visited a Korean medicine hospital complaining about the side effects of chemotherapy for lung metastasis. She received IMT involving Korean traditional medicine and Western immunotherapy from May 2017 to June 2023. Tumor dimensions were assessed through computed tomography (CT) and positron-emission tomography/CT scans, while tumor markers and safety were monitored by laboratory tests. Results: IMT suppressed the progression of cancer, as observed by imaging and laboratory tests. The patient achieved 5-year survival, even after discontinuing chemotherapy. Conclusion: This case presents a potential therapeutic alternative for patients who are ineligible for chemotherapy or surgical interventions.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.166-171
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• 2010

Purpose: The SPECT/CT is able to acquire diagnostic information resolved the difficult problems that discriminate regions of focals by intergrating functional images and anatomical images. We introduce the usefulness of "Volumetrix Suite" which can describe 3D images by the convergence of the SPECT/CT images and reference CT images. Materials and Methods: We applied Volumetrix Suite program (Volumetrix IR, Volumetrix 3D) to patients, Bone, Venography, Parathyroid, WBC, taken diagnostic CT examination which have same regions of focal in Seoul Metropolitan Government Seoul National University Boramae Medical Center. After acquiring SPECT/CT images and reference CT images, we fused a couple of scans applying for this programs. The CT scan of Infinia Hawkeye 4 shows limitation of anatomical information. For this reason, we tried to transfer CT images that have lots of diagnostic informations as the form of Dicom file in PACS, and changed from 2D images to 3D images after image registering in Xeleris Workstaion of Hawkeye 4. Results & Conclusion: By using Volumetrix Suite program, we're able to acquire more accurate anatomical informations with 3D rendering which can distinguish both location and range of focals in Infinia Hawkeye 4. Thus, the result of utilizing this program indicate that nuclear medicine anatomical images can be improved by providing more diagnostic imformations produced by its program.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.81-86
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• 2012

Purpose : Combined MR/PET scanners that use the MRI for PET AC face the challenge of absent surface coils in MR images and thus cannot directly account for attenuation in the coils. To make up for the weak point of MR attenuation correction, Three Modality System (PET/CT +MR) were used in Severance hospital. The goal of this work was to investigate the effects of MR Torso Coil on CT attenuation correction for PET. Materials and Methods : PET artifacts were evaluated when the MR Torso Coil was present of CTAC data with changing various kV and mA in uniformity water phantom and 1994 NEMA cylinderical phantom. They evaluated and compared the following two scenarios: (1) The uniform cylinder phantom and the MR Torso Coil scanned and reconstructed using CT-AC; (2) 1994 NEMA cylinderical phantom and the MR Torso Coil scanned and reconstructed using CT-AC. Results : Streak artifacts were present in CT images containing the MR Torso Coil due to metal components. These artifacts persisted after the CT images were converted for PET-AC. CT scans tended to over-estimate the linear attenuation coefficient when the kV and mA is increasing of the metal components when using conventional methods for converting from CT number. Conclusion : The presence of MR coils during PET/CT scanning can cause subtle artifacts and potentially important quantification errors. Alternative CT techniques that mitigate artifacts should be used to improve AC accuracy. When possible, removing segments of an MR coil prior to the PET/CT exam is recommended. Further, MR coils could be redesigned to reduce artifacts by rearranging placement of the most attenuating materials.

• Journal of Radiation Protection and Research
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• v.35 no.4
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• pp.135-141
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• 2010

Purpose : The patients who visited this department for pulmonary disease and need CT scans for Follow-up to observe change of CT value, evaluation of image quality and decrease of radiation dose as change of kVp. Subjects and Methods : Subjects were the patients of 20 persons visited this department for pulmonary disease and Somatom Sensation 16(Semens, Enlarge, Germany) was used. Measurement of CT value as change of kVp was done by setting up ROI diameter of 1cm at the height of thyroid, aortic arch, right pulmonary artery in arterial phase image using 100 kVp, measuring 3 times, and recorded the average. CT value of phantom was measured by scanning phantoms which means contrast media diluted by normal saline by various ratio with tube voltage of 80 kVp, 100 kVp, 120 kVp, 140 kVp and recorded the average of 3 CT values of center of phantom image. In analysing radiation dose, CTDIVOL values of the latest arterial phase image of 120 kVp and as this research set that of 100 kVp were analyzed comparatively. 2 observers graded quality of chest images by 5 degrees (Unacceptable, Suboptimal, Adequate, Good, Excellent). Results : CT value of chest image increased at 100 kVp by 14.06%~27.26% in each ROI than 120 kVp. CT value of phantom increased as tube voltage lowered at various concentration of contrast media. CTDIVOL decreased at 100 kVp(5.00 mGy) by 36% than 120 kVp(7.80 mGy) in radiation dose analysis. here were 0 Unacceptable, 1 Suboptimal, 3 Adequate, 10 Good, 6 Excellent in totally 20 persons. Conclusion : Chest CT scanning with low kilo-voltage for patients who need CT scan repeatedly can bring images valuable for diagnose, and decrease radiation dose against patients.

• The Korean Journal of Nuclear Medicine
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• v.39 no.3
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• pp.174-181
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• 2005

Purpose: Reduction of respiratory motion artifacts in PET images was studied using respiratory-gated PET (RGPET) with moving phantom. Especially a method of generating simulated helical CT images from 4D-CT datasets was developed and applied to a respiratory specific RGPET images for more accurate attenuation correction. Materials and Methods: Using a motion phantom with periodicity of 6 seconds and linear motion amplitude of 26 mm, PET/CT (Discovery ST: GEMS) scans with and without respiratory gating were obtained for one syringe and two vials with each volume of 3, 10, and 30 ml respectively. RPM (Real-Time Position Management, Varian) was used for tracking motion during PET/CT scanning. Ten datasets of RGPET and 4D-CT corresponding to every 10% phase intervals were acquired. from the positions, sizes, and uptake values of each subject on the resultant phase specific PET and CT datasets, the correlations between motion artifacts in PET and CT images and the size of motion relative to the size of subject were analyzed. Results: The center positions of three vials in RGPET and 4D-CT agree well with the actual position within the estimated error. However, volumes of subjects in non-gated PET images increase proportional to relative motion size and were overestimated as much as 250% when the motion amplitude was increased two times larger than the size of the subject. On the contrary, the corresponding maximal uptake value was reduced to about 50%. Conclusion: RGPET is demonstrated to remove respiratory motion artifacts in PET imaging, and moreover, more precise image fusion and more accurate attenuation correction is possible by combining with 4D-CT.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.992-999
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• 1998

Background: To correlate the emphysema score for quantification of the overall extent of emphysema in both lungs by CT with physiologic fingings and to get more objective and simple method to assess the extent of emphysema. Method: Thin-section CT and pulmonary function test(PFT) were performed in 17 patients with emphysema (all males, mean age, 62 years). Emphysema score was obtained as percentage of emphysematous lung area, dividing the total area of the emphysema(voxels with attenuation value less than -880, -900, -920HU, respectively) by the overall area of both lungs(voxels with attenuation value less than -400HU) with highlighting voxels using "Density mask" program. Emphysema score was calculated from whole lung(ESV) and 5 representative scans(ESR) using "Density mask", Visual emphysema score(ESV) was obtained by visual assessment from 5 representative scans. Correlation of these emphysema scores(ESW, ESR, ESV) and physiologic findings were performed, comparing the ESW with ESR and ESV. Results: ESW had correlation with DLCO(r=0.53-0.64) and $FEV_1/FVC$(r=0.42-0.57) among PFT parameters. ESR had good correlation with ESW and with PFT parameters as well. ESV did not correlate with PFT parameters except DLCO. Conclusion: CT quantification of emphysema using "density mask" correlated well with physiologic findings. To assess the severity of emphysema, both ESW and ESR are more reliable than ESV, and ESR is recommended in routine practice as it is objective, simple and reliable.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.369-374
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• 2008

Purpose: F-18 FDG PET/CT has excellent sensitivity and specificity for staging non-Hodgkin lymphomas, but to the author's knowledge few studies to date have evaluated FDG PET/CT in peripheral T cell lymphoma. We evaluated the usefulness of F-18 FDG PET/CT in staging of patients with peripheral T cell lymphoma, especially indolent cutaneous T cell lymphomas. Materials and Methods: Twenty five patients (M:F=17:8, age $53.7{\pm}14.8$ yrs) with biopsy-proven indolent cutaneous T cell (CL) or noncutaneous T cell lymphomas (NCL) underwent PET/CT scans for staging at baseline. Peak standardized uptake values (p-SUV) of all abnormal foci were measured and compared between cutaneous and noncutaneous lesions. F-18 FDG PET/CT was performed on 6 patients with indolent CL and on 19 patients with NCL. Results: All 6 patients with indolent CL had no significant FDG avidity in the skin despite histologically positive cutaneous lesions. However, FDG avidity appeared in extracutaneous lesions (lymph nodes) in two patients with CL where CT imaging suggested lymphoma involvement (mean p-SUV $4.26{\pm}0.37$ in noncutaneous lesions in CL). In NCL, FDG avidity was demonstrated in all lesions where CT imaging suggested lymphoma involvement (mean p-SUV, $8.52{\pm}5.00$ in noncutaneous lesions in NCL). Conclusion: F-18 FDG PET/CT has the limitation of usefulness for the evaluation of the skin in indolent CL. In contrast, F-18 FDG PET/CT is sensitive in staging evaluation of extracutaneous lesions regardless of CL or NCL.