Objectives: To obtain permeability surface (PS) values using multi-slice helical CT perfusion imaging and to evaluate the spatial distribution correlation between PS values and vascular endothelial growth factor (VEGF) expression in solitary brain metastases. Methods: Imaging was performed on 21 patients, PS values being calculated from the central, border and peripheral parts of tumours. VEGF expression was determined by immunohistochemical staining. Results: Rim enhancement was found in 16 cases, the border of the tumour featuring PS elevation with high VEGF expression in 13 cases. In the 5 cases with nodular enhancement, the border and the central part had high permeability and VEGF expression was high in all cases, the correlation being significant (P<0.01). Conclusion: VEGF expression in brain metastases positively correlates with PS values from CT perfusion imaging, so that the latter can be used in the surveillance of angiogenic activity in brain metastases.
Objective: The purpose of this study was to evaluate computed tomography (CT) virtual non-contrast (VNC) spectral imaging for gastric carcinoma. Materials and Methods: Fifty-two patients with histologically proven gastric carcinomas underwent gemstone spectral imaging (GSI) including non-contrast and contrast-enhanced hepatic arterial, portal venous, and equilibrium phase acquisitions prior to surgery. VNC arterial phase (VNCa), VNC venous phase (VNCv), and VNC equilibrium phase (VNCe) images were obtained by subtracting iodine from iodine/water images. Images were analyzed with respect to image quality, gastric carcinoma-intragastric water contrast-to-noise ratio (CNR), gastric carcinoma-perigastric fat CNR, serosal invasion, and enlarged lymph nodes around the lesions. Results: Carcinoma-water CNR values were significantly higher in VNCa, VNCv, and VNCe images than in normal CT images (2.72, 2.60, 2.61, respectively, vs 2.35, $p{\leq}0.008$). Carcinoma-perigastric fat CNR values were significantly lower in VNCa, VNCv, and VNCe images than in normal CT images (7.63, 7.49, 7.32, respectively, vs 8.48, p< 0.001). There were no significant differences of carcinoma-water CNR and carcinoma-perigastric fat CNR among VNCa, VNCv, and VNCe images. There was no difference in the determination of invasion or enlarged lymph nodes between normal CT and VNCa images. Conclusions: VNC arterial phase images may be a surrogate for conventional non-contrast CT images in gastric carcinoma evaluation.
This paper describes the construction of knowledge data retrieval management system based on medical image CT. The developed system is aimed to improve the efficiency of the hospital by reading the medical images using the intelligent retrieval technology and diagnosing the patient 's disease name. In this study, the medical image DICOM file of PACS is read, the image is processed, and feature values are extracted and stored in the database. We have implemented a system that retrieves similarity by comparing new CT images required for medical treatment with the feature values of other CTs stored in the database. After converting 100 CT dicom provided for academic research into JPEG files, Code Book Library was constructed using SIFT, CS-LBP and K-Mean Clustering algorithms. Through the database optimization, the similarity of the new CT image to the existing data is searched and the result is confirmed, so that it can be utilized for the diagnosis and diagnosis of the patient.
The aim of this study was to evaluate the usability of applied Low dose Computed Tomography(LDCT) protocol in examining urinary calculus using computed tomography. The subjects of this study were urological patients who visited a medical institution located in Busan from June to December 2016 and the protocol used in this study was Adaptive Statistical Iterative Reconstruction: low-dose CT with 50% Adaptive Statistical Iterative Reconstruction (ASIR). As results of quantitative analysis, the mean pixel value and standard deviation within kidney region of image(ROI)of the axial image were $26.21{\pm}7.08$ in abdomen CT pre scan and $20.03{\pm}8.16$ in low-dose CT. Also the mean pixel value and standard deviation within kidney ROI of the coronal image were $22.07{\pm}7.35$ in abdomen CT pre scan and $21.67{\pm}6.11$ in low dose CT. The results of qualitative analysis showed that four raters' mean values of observed kidney artifacts were $19.14{\pm}0.36$ when using abdomen CT protocol and $19.17{\pm}0.43$ in low-dose CT, and the mean value of resolution and contrast was $19.35{\pm}0.70$ when using abdomen CT protocol and $19.29{\pm}0.58$ in low-dose CT. Also the results of a exposure dose analysis showed that the mean values of CTDIvol and DLP in abdomen CT pre scan were 18.02 mGy and $887.51mGy{\cdot}cm$ respectively and the mean values of CTDIvol and DLP when using low-dose CT protocol were 7.412 mGy and $361.22mGy{\cdot}cm$ respectively. The resulting dose reduction rate was 58.82% and 59.29%, respectively.
Yoon, Seok Hwan;Kim, Byung Jin;Moon, Il Sang;Lee, Hong Jae
The Korean Journal of Nuclear Medicine Technology
/
v.22
no.1
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pp.35-42
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2018
Purpose Standardized uptake value(SUV) has been widely used as a quantitative metric of uptake in PET/CT for diagnosis of malignant tumors and evaluation of tumor therapy response. However, the SUV depends on various factor including PET/CT scanner specifications and reconstruction parameter. The purpose of this study is to validate a EQ PET to evaluate SUV across different PET/CT systems. Materials and Methods First, NEMA IEC body phantom data were used to calculate the EQ filter for OSEM3D with PSF and TOF reconstruction from three different PET/CT systems in order to obtain EARL compliant recovery coefficients of each spheres. The Biograph true point 40 PET/CT images were reconstructed with a OSEM3D+PSF reconstruction, images of the Biograph mCT 40 and Biograph mCT 64 PET/CT scanners were reconstructed with a OSEM3D+PSF, OSEM3D+TOF, OSEM3D+PSF+TOF. Post reconstructions, the proprietary EQ filter was applied to the reconstruction data. Recovery coefficient can be estimated by ratio of measured to true activity concentration for spheres of different volume and coefficient variability(CV) value of RC for each sphere was compared. For clinical study, we compared SUVmax applying different reconstruction algorithms in FDG PET images of 61 patients with lung cancer using Biograph mCT 40 PET/CT scanner. Results For the phantom studied, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.05, 0.04, 0.04 and 0.03 respectively for RC. Application of the proprietary EQ filter, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.04, 0.03, 0.03 and 0.02 respectively for RC. Clinical study, there were no statistical significance of the difference applying EQ PET on SUVmax of 61 patients FDG PET image. (p=1.000) Conclusion This study indicates that CV values of RC in phantom were decreased after applying EQ PET for different PET/CT system and The EQ PET reduced reconstruction dependent variation in SUVs for 61 lung cancer patients, Therefore, EQ PET will be expected to provide accurate quantification when the patient is scanned on different PET/CT system.
This study compared DLP values along with phantom entrance surface doses and the image quality of chest CT scans made using a Care Dose 4D+Care kV System, scans that are made using only the Care Dose 4D function, and scans that are made with changes made by applying 80 kVp, 100 kVp, 120 kVp, and 140 kVp to the Care Dose 4D and tube voltage to search for methods to maintain the highest image quality with minimal patient doses. It was shown that DLP values decreased 6.727% when scans were taken with Chest Care Dose 4D + Care kV semi 100 and 6.481% when scans were taken with Chest Care Dose 4D + Care kV. With Chest Non as a standard, skin surface doses decreased 16.519% when scans were taken with Chest Care Dose 4D + Care kV semi 100 and 15.705% when scans were taken with Chest Care Dose 4D + Care kV. With comparisons of image quality, when comparisons were made with Chest Non, comparisons made of SNR values and CNR values in all scanning conditions including Care Dose 4D + Care kV showed that there were no significant differences at P>0.05. Imaging using Chest Care Dose 4D + Care kV in chest CT showed that exposure doses decreased similarly to result values gained from the best conditions through manual adjustments of kV and mAS, and there were no significant differences in image SNR and CNR. If the Chest Care Dose 4D + Care kV function is used, image quality is maintained and patient exposure to radiation can be reduced.
Purpose: Gallium-68 (68Ga) is increasingly used in nuclear medicine imaging for various conditions such as lymphoma and neuroendocrine tumors by labeling tracers like Prostate Specific Membrane Antigen (PSMA) and DOTA-TOC. However, compared to Fluorine-18 (18F) used in conventional nuclear medicine imaging, 68Ga has lower spatial resolution and relatively higher Signal to Background Ratio (SBR). Therefore, this study aimed to investigate the optimized parameters and reconstruction methods for PET/CT imaging using the 68Ga radiotracer through model-based image evaluation. Materials and Methods: Based on clinical images of 68Ga-PSMA PET/CT, a NEMA/IEC 2008 PET phantom model was prepared with a Hot vs Background (H/B) ratio of 10:1. Images were acquired for 9 minutes in list mode using DMIDR (GE, Milwaukee WI, USA). Subsequently, reconstructions were performed for 1 to 8 minutes using OS-EM (Ordered Subset Expectation Maximization) + TOF (Time of Flight) + Sharp IR (VPFX-S), and BSREM (Block Sequential Regularized Expectation Maximization) + TOF + Sharp IR (QCFX-S-400), followed by comparative evaluation. Based on the previous experimental results, images were reconstructed for BSREM + TOF + Sharp IR / 2 minutes (QCFX-S-2min) with varying β-strength values from 100 to 700. The image quality was evaluated using AMIDE (freeware, Ver.1.0.1) and Advanced Workstation (GE, USA). Results: Images reconstructed with QCFX-S-400 showed relatively higher values for SNR (Signal to Noise Ratio), CNR (Contrast to Noise Ratio), count, RC (Recovery Coefficient), and SUV (Standardized Uptake Value) compared to VPFX-S. SNR, CNR, and SUV exhibited the highest values at 2 minutes/bed acquisition time. RC showed the highest values for a 10 mm sphere at 2 minutes/bed acquisition time. For small spheres of 10 mm and 13 mm, an inverse relationship between β-strength increase and count was observed. SNR and CNR peaked at β-strength 400 and then decreased, while SUV and RC exhibited a normal distribution based on sphere size for β-strength values of 400 and above. Conclusion: Based on the experiments, PET/CT imaging using the 68Ga radiotracer yielded the most favorable quantitative and qualitative results with a 2 minutes/bed acquisition time and BSREM reconstruction, particularly when applying β-strength 400. The application of BSREM can enhance accurate quantification and image quality in 68Ga PET/CT imaging, and an optimization process tailored to each institution's imaging objectives appears necessary.
Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.
The Journal of Korean Society for Radiation Therapy
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v.28
no.2
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pp.131-137
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2016
Purpose : The bladder volume change was measured using ultrasonography for helping decrease the side effects and other organ variations in the location of radiation therapy for cervical cancer patients. An experiment was performed targeting patients who were treated with radiation therapy at PNUH within the period from September to December 2015. Materials and Methods : To maintain the bladder volume, each patient was instructed to drink 500 cc water before and after CT simulation, 60 minutes before the dry run. Also, the bladder volume was measured in each patient CT scan, and a 3D conformal therapy plan was designed. The bladder volumes measured before and after the CT simulation, dry run, and radiation treatment planning were compared and analyzed. Results : The average volume and average error of the bladder that were obtained from the measurement based on the CT scan images had the lowest standard deviation in the CT simulation. This means that the values that were obtained before and after the CT simulation were statistically relevant and correlative. Moreover, the bladder volume measured via ultrasonography was larger size, the average volume in the CT scan. But the values that were obtained Dry run and after the CT simulation were not statistically relevant. Conclusion : Drinking a certain amount of water helps a patient maintain his/her bladder volume for a dry run. Even then, it is difficult to maintain the bladder volume for the dry run. Also, whether or not the patients followed the directions for the dry run correctly is important.
The uterus, one of women's reproductive organs, is also closely related to women's health. Among them, hemorrhagic luteal cysts, one of the causes of pelvic pain that women often experience, were observed through CT and ultrasound, and the quality of images was evaluated through quantitative and qualitative evaluations. This study sought to find out whether the test method is more helpful to patients during CT and ultrasound. This study was conducted on 15 adolescent women and 15 adult women(21.31±3.45 average age). The equipment used for filming used EC3-10X (3~10 MHZ) and Philips Mx8000 iCT 256 among Endocavity Probes among Ecube Platinum. After setting a constant ROI on the cyst and the interface as a quantitative analysis method, SNR and CNR values were measured on a 5-point scale based on image quality, lesion clarity, image distortion, clarity of the interface, and motion artifacts (p<0.05). Independent t-test and Mann Whiteny U were performed, and the statistical program used was noted when SPSS (Version 22.0 for windows software package, Chicago, IL, USA) was statistically less than 0.05. Comparing the SNR and CNR values for this experiment, it can be seen that the SNR value was higher in the case of CT images(p<0.05). As a result of the qualitative evaluation, the quality of the image, the clarity of the lesion, the distortion of the image, the clarity of the interface, and the clarity of the boundary were measured on a 5-point scale based on the movement artifact. Comparing each score, CT images scored higher with a finer difference than ultrasound images(p<0.05). In conclusion, both test methods showed excellent results in finding the patient's lesions. However, in quantitative and qualitative evaluations, CT produced higher results in detecting lesions than ultrasound. However, for cyst tests that require continuous observation, ultrasonography, a non-invasive method that is advantageous for patients, will be clinically useful. Therefore, observing the patient's lesions by appropriately distributing these two test methods will provide optimal diagnostic information. These results will be useful for providing clinical basic data and educational materials to CT and US users in the future.
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