• 대한디지털의료영상학회논문지
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• 제13권4호
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• pp.165-169
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• 2011

The purpose of this study is to compare the measurement result of radiation dose by using standard thoracic phantom and ionization chamber to advice proposal in the shooting condition of chest PA projection at hospitals recently. And to understand the change between radiation dose and resolution in different conditions. The period this study was from August 2010 to September 2010 and the subjects of the study was 3 general hospitals, 4 personal hospitals and 1 laboratory at the college. Finally we study with 6 DR, 1 CR, and 4 F/S equipments. Most hospitals met advice proposal, but some of the hospitals exceed advice dose from the result of our study. We can lower radiation dose about 25% when kVp is lowered about 20% in DR equipment. And we can lower radiation dose about 50% when mAs is lowered about 35%. The image quality was similar to the original in the study. Most hospitals which exceed advice dose were personal hospitals. The reason why it happened is that radiation dose for chest PA projection at personal hospitals is higher than general hospitals and the personal hospitals' equipments are older than general hospitals' equipments. We guess that patients' radiation dose of chest PA projection can be lowered from the result.

• 대한의용생체공학회:의공학회지
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• 제44권3호
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• pp.167-175
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• 2023

Chest PA is the basic examination of radiographic imaging. Moreover, Chest PA's demands are constantly increasing because of the Increase in respiratory diseases. However, it is not meeting the demand due to problems such as a shortage of radiological technologist, sexual shame caused by patient contact, and the spread of infectious diseases. There have been many cases of using artificial intelligence to solve this problem. Therefore, the purpose of this research is to build an artificial intelligence dataset of Chest PA and to find a posture evaluation method. To construct the posture dataset, the posture image is acquired during actual and simulated examination and classified correct and incorrect posture of the patient. And to evaluate the artificial intelligence posture method, a posture estimation algorithm is used to preprocess the dataset and an artificial intelligence classification algorithm is applied. As a result, Chest PA posture dataset is validated with in over 95% accuracy in all artificial intelligence classification and the accuracy is improved through the Top-Down posture estimation algorithm AlphaPose and the classification InceptionV3 algorithm. Based on this, it will be possible to build a non-face-to-face automatic Chest PA examination system using artificial intelligence.

• 대한디지털의료영상학회논문지
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• 제12권2호
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• pp.119-125
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• 2010

In order to demonstrate the value of long-distance radiography, we have studied how distance affects images in chest frontal radiography and compared short-distance and long-distance images in chest lateral radiography. Cardiothoracic ratio(CTR %) of 50 patients with no disease in the chest(10 each at the age of 20~60) were evaluated in Supine AP(100 cm), Sitting AP(100 cm), Sitting AP(180 cm), and Erect PA(180 cm). In lateral radiography, we evaluated and compared left lateral radiography(100 cm and 180 cm) of the patients based on the horizontal maximum of the heart. The average value of CTR(%) were 0.48 in Erect PA(180 cm), 0.52 in Supine AP(100 cm), 0.50 in Sitting AP(100 cm), 0.49 in Sitting AP(180 cm), which were Supine AP(100 cm) > Sitting AP(100 cm) > Sitting AP(180 cm) > Erect PA(180 cm). The average value of Maximum transverse diameter of left of the cardiac(MLD), which showed how much axis of spine was slanted to the left, was 90.67 mm in Erect PA(180 cm), 103.92 mm in Supine AP(100 cm), 93.54 mm in Sitting(100 cm), 89.84 mm in Sitting AP(180 cm), 58.11 mm in the minimum value and 118.79 mm in the maximum value. The average value of Maximum transverse diameter of right side of the cardiac(MRD), which suggested how much axis of spine was slanted to the right, was 47.18 mm in Erect PA(180 cm), 48.12 mm in Supine AP(100 cm), 44.98 mm in Sitting AP(180 cm), and the minimum value 26.84 mm and the maximum value 65.30 mm. There was no standard method to calculate; therefore, the horizontal maximum of the heart was used for lateral radiography. The average value was 121.07 mm in 100 cm and 109.76 mm in 180 cm. Sitting AP(180 cm) among the types was closest to C-PA(180 cm). As a result, during C-AP radiography, long-distance radiography lessened shadow of the heart more than that of short distance, Sitting position more than Supine position.

• 대한디지털의료영상학회논문지
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• 제11권1호
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• pp.15-20
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• 2009

Far reducing medical radiation exposure and managing patient doses, Entrance surface doses(ESDs) were measured at Diagnostic Radiology Department in ASAN medical center, also we determined and compared with the Diagnostic Reference Level(DRL) of some other countries. ESDs were measured far the most common types of X-ray procedures, such as chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA. ESDs were measured by Glass dosimeter and Unfors Xi meter. Those were applied collimation center of phantom's entrance skin surface. The results of ESDs were compared Glass dosimeter with Unfors Xi meter. Those were measured within 5% statistical difference. It seemed well agreement at two devices. In most cases ESDs measured far the different types of X ray procedures were found to be lower than the DRL of IAEA, but ESDs on chest PA, lumbar spine AP, lumbar spine lateral, Pelvis AP, Skull PA were proximity ar excesses at DRL of advanced country. Through this study, we need an investigation and improvement at present diagnostic radiology exam system. Also, radiologists make an effort to reduce patient dose and having a technical skill.

• Journal of Chest Surgery
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• 제49권5호
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• pp.392-396
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• 2016

We report a case of aortic dissection masquerading as acute ischemic stroke followed by intravenous thrombolysis. A 59-year-old man presented with dizziness. After examination, the patient had a seizure with bilateral Babinski signs. Soon after identifying multiple acute infarctions in both hemispheres on diffusion-weighted brain magnetic resonance (MR) imaging, tissue plasminogen activator (t-PA) was administered. Both common carotid arteries were invisible on MR angiography, and subsequent chest computed tomography revealed an aortic dissection. The emergency operation was delayed for 13 hours due to t-PA administration. The patient died of massive bleeding.

• 한국방사선학회논문지
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• 제11권1호
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• pp.55-61
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• 2017

Chest PA 검사 시 디지털 촬영에 대한 검사 조건 권고안은 마련되어 있지 않다. 각 기기 회사들도 이전의 아날로그 촬영에 적용되었던 고관전압 촬영 조건을 권고하고 있다. 디지털 흉부 X-선 촬영시 관전압, 관전류, 부가여과 필터 변화에 따른 피폭선량을 비교하기 위해 Philips 사에서 권고하는 적정 노출지수( Expos ure Index ) 값인 200 ~ 800사이 값을 만족하는 검사조건을 선별하였다. 유효선량을 평가하기 위해 몬테카를로 시뮬레이션을 시행하였으며 SNR과 CNR을 측정하여 영상평가를 시행하였다. 관전압과 관전류, 부가여과 필터를 조절하여 유효 선량을 최대 77% 까지 감소시킬 수 있었다. 검사조건별로 다소간의 차이는 있으나 영상평가 결과 비슷한 품질의 영상을 얻을 수 있었다.

• 대한디지털의료영상학회논문지
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• 제14권2호
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• pp.9-14
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• 2012

Exposed dose of young child should be managed necessarily. Young child is more sensitive than adult of a Radioactivity, especially, and lives longer than adult. Must reduce exposed dose which follows The ALARA(As Low As Reasonably Achievable)rule is recommended by ICRP(International Commission on Radiological Protection)within diagnostic useful range. Therefore, We have to prepare Pediatric DRL(Diagnostic Reference Level) in Korea as soon as possible. Consequently, in this study, wish to estimate organ dose and effective dose using PCXMC Program(a PC-Based Monte Carlo Program), and measure ESD(Entrance surface dose)and organ dose using Glass dosimeter, and then compare with DRL which follows EC(European Commission)and NRPB(National Radiological Protection Board). Using glass dosimeter and PCXMC programs conforming to the International Committee for Radioactivity Prevention(ICRP)-103 tissue weighting factor based on the item before the organs contained in the Chest, Skull, Pelvis, Abdomen in the organ doses and effective dose and dose measurements were evaluated convenience. In a straightforward way to RANDO phantom inserted glass dosimeter(GD352M)by using the hospital pediatric protocol, and in a indirect way was PCXMC the program through a virtual simulation of organ doses and effective dose were calculated. The ESD in Chest PA is 0.076mGy which is slightly higher than the DRL of NRPB(UK) is 0.07mGy, and is lower than the DRL of EC(Europe) which is 0.1mGy. The ESD in Chest Lateral is 0.130mGy which is lower than the DRL of EC(Europe) is 0.2mGy. The ESD in Skull PA is 0.423mGy which is 40 percent lower than the DRL of NRPB(UK) is 1.1mGy and is 28 percent lower than the DRL of EC(Europe) is 1.5mGy. The ESD in Skull Lateral is 0.478mGy which is half than the DRL of NRPB(UK) is 0.8mGy, is 40 percent lower than the DRL of EC(Europe) is 1mGy. The ESD in Pelvis AP is 0.293mGy which is half than the DRL of NRPB(UK) is 0.60mGy, is 30 percent lower than the DRL of EC(Europe)is 0.9mGy. Finally, the ESD in Abdomen AP is 0.223mGy which is half than the DRL of NRPB(UK) is 0.5mGy, and is 20 percent lower than the DRL of EC is 1.0mGy. The six kind of diagnostic radiological examination is generally lower than the DRL of NRPB(UK)and EC(Europe) except for Chest PA. Shouldn't overlook the age, body, other factors. Radiological technician must realize organ dose, effective dose, ESD when examining young child in hospital. That's why young child is more sensitive than adult of a Radioactivity.

• 대한방사선기술학회지:방사선기술과학
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• 제33권3호
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• pp.173-178
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• 2010

방사선 일반촬영은 크게 두 가지 유형으로 구분할 수 있는데 디지털 영상 시스템인 CR(Computed Radiography)과 DR(Digital Radiography)이 주로 활용되고 있다. 이 둘의 차이는 선량과 영상의 질 관점에서 정의할 수 있다. 본 연구에는 피부입사선량(Entrance Skin Dose, ESD)의 관점에서 환자에게 투여된 선량을 계산하고 비교하여 CR과 DR 간의 선량 차이를 연구하기 위해 8가지의 표준 영상의학적 검사(Skull AP, Skull LAT, Chest PA, Chest LAT, Abdomen AP, L-spine AP, L-spine LAT, Pelvis AP)가 고려되었다. 영상화질에 대한 평가는 진단방사선학적 영상을 위한 화질 기준에 부합하는지를 보증하기 위해 영상의학과 전문의에 의해 시행되었다. DR의 ESD는 CR의 ESD보다 낮다는 것이 확인되었다. 방사선 촬영을 담당한 방사선사가 동일인 이었고 CR과 DR의 영상 화질이 유사하거나 DR에서 조금 더 우수했기 때문에 본 연구는 고려된 검사 내에서 DR이 CR보다 선량 절감 차원에서 볼 때 더 우수한 기기라는 것을 보여준다.

• 한국방사선학회논문지
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• 제4권1호
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• pp.25-30
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• 2010

이 연구 목적은 흉부영상의 진단에 적절한 해상력과 음영에 대한 적절한 평가를 위해서다. 해상력을 비교하기 위해서, linear 해상력 팬텀을 사용하여 film/screen(선생님이 원하시는 conventional radiography : film/screen), CR, DR, 촬영했다. 해상력을 비교하기 위해 2명의 영상의학과 전문의와 3명의 방사선사가 블라인드 테스트를 통하여 평가했다. DR 은 3.95 필름/ 스크린은 3.58, CR은 3.48의 평가가 나왔다. 음영에 대해 분석은, CR, DR의 film/screen의 정상적인 흉부영상 50장을 선택했다. 이 흉부영상에서 7부위(폐야, 폐야 윤곽, 종격동 I, 종격동 II, 심장 음영 I, 심장음영 II, 횡격막)을 정하여 덴시토미터(농도계)을 사용하여 음영을 평가했다. 우리의 분석 방법은 낮은 영상(음영)을 0에서부터 가장 우수한 영상(음영) 2를 정한 일본의 흉부 x-ray 평가 방법을 적용했다. DR의 경우 종격동 1, 종격동2, 심장 1, 심장2, 횡격막에서 2점을 기록하여 우수했다. 이와 반대로 CR에서는 폐부위와 폐음영 부위에서 2점으로 우수했다. 결론적으로, 해상력과 음영에 비교하면 후처리 알고리즘과 작은 픽셀 사이즈에 의한 DR은 CR과 film/screen 보다 우수하다고 도출하였다.

• 대한방사선기술학회지:방사선기술과학
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• 제32권1호
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• pp.33-38
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• 2009

연구목적 : 흉부 단순촬영 상에서 발견되는 대동맥 궁 석회화가 폐쇄성 관상동맥질환과 관련성이 있는지 알아보고자 하였다. 연구방법 : 관상동맥 조영술을 시행한 사람을 대상으로 흉부 단순촬영 영상을 확인하는 후향적 연구이다. 흉부 단순촬영상은 영상의학과 전문의와 방사선사에 의해 대동맥 궁 석회화 유무를 확인하였고, 관상동맥 조영술 결과와 비교하였다. 또한 대동맥 궁 석회화의 크기를 10 mm 미만군과 이상군으로 나누어 비교하였다. 연구결과 : 총 846명의 대상자 중 폐쇄성 관상동맥 질환을 가진 사람은 남자 417명(88.3%)이었고, 여자 312명(83.4%)으로 남자가 많았다. 대동맥 궁 석회화가 있는 사람 중 폐쇄성 관상동맥 질환을 가질 확률을 나타내는 양성예측도는 91.4%이었고, 대동맥 궁 석회화를 가지고 있는 군이 석회화가 없는 군에 비해 폐쇄성 관상동맥 질환을 가질 위험을 나타내는 상대위험도는 1.10배였다. 대동맥 궁 석회화의 크기가 10 mm 이상인 사람 중 폐쇄성 관상동맥 질환을 가질 확률을 나타내는 양성예측도는 91.9%이었고, 대동맥 궁 석회화의 크기가 10 mm 이상인 군이 10 mm 미만인 군에 비해 폐쇄성 관상질환을 가질 위험을 나타내는 상대위험도는 1.04배였다. 결 론 : 흉부 단순촬영에서 발견되는 대동맥 궁 석회화와 관상동맥 조영술의 결과 폐쇄성 관상동맥 질환이 서로 밀접한 관련성이 있음을 확인하였고, 대동맥 궁 석회화가 있는 사람이 없는 사람보다 폐쇄성관상동맥 질환을 가질 위험이 더 높고, 대동맥 궁 석회화의 크기가 클수록 상대위험도는 높았다. 따라서 흉부 단순촬영 시 대동맥 궁 석회화가 발견되면 폐쇄성 관상동맥 질환의 발생 가능성이 높음을 인지하여 반드시 전문의와 상담을 하여야 한다.