• Title/Summary/Keyword: Clinical CT

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Clinical Implications of Focal Mineral Deposition in the Globus Pallidus on CT and Quantitative Susceptibility Mapping of MRI

  • Hyojin Kim;Jinhee Jang;Junghwa Kang;Seungun Jang;Yoonho Nam;Yangsean Choi;Na-young Shin;Kook-Jin Ahn;Bum-soo Kim
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.742-751
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    • 2022
  • Objective: To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. Materials and Methods: This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GPQSM) and CT (GPCT) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GPQSM and GPCT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results: GPCT and GPQSM were significantly associated (p < 0.001) but were not identical. Higher GPCT and GPQSM grades showed smaller gray matter (p = 0.030 and p = 0.025, respectively) and white matter (p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes (p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GPCT (p = 0.006) and brain atrophy was significantly associated with GPQSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GPCT (p < 0.001) and GPQSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GPCT (p = 0.040) and GPQSM (p = 0.035). Conclusion: Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.

Recent Advances in Nuclear Medicine Imaging Instrumentation (핵의학 영상기기의 최근 진보)

  • Jung, Jin-Ho;Choi, Yong;Hong, Key-Jo;Min, Byung-Jun;Hu, Wei;Kang, Ji-Hoon
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.98-111
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    • 2008
  • This review introduces advances in clinical and pre-clinical single photon emission computed tomography (SPECT) and positron emission tomography (PET) providing noninvasive functional images of biological processes. Development of new collimation techniques such as multi-pinhole and slit-slat collimators permits the improvement of system spatial resolution and sensitivity of SPECT. Application specific SPECT systems using smaller and compact solid-state detector have been customized for myocardial perfusion imaging with higher performance. Combined SPECT/CT providing improved diagnostic and functional capabilities has been introduced. Advances in PET and CT instrumentation have been incorporated in the PET/CT design that provide the metabolic information from PET superimposed on the anatomic information from CT. Improvements in the sensitivity of PET have achieved by the fully 3D acquisition with no septa and the extension of axial field-of-view. With the development of faster scintillation crystals and electronics, time-of-flight (TOF) PET is now commercially available allowing the increase in the signal-to-noise ratio by incorporation of TOF information into the PET reconstruction process. Hybrid PET/SPECT/CT systems has become commercially available for molecular imaging in small animal models. The pre-clinical systems have improved spatial resolution using depth-of-interaction measurement and new collimators. The recent works on solid state detector and dual modality nuclear medicine instrumentations incorporating MRI and optical imagers will also be discussed.

Development of Clinical Terminology System for Human Body : Convergence Research of SNOMED CT (인체 골격의 좌표형 임상용어체계 표준 개발 : SNOMED CT 기반의 융복합 연구)

  • Choi, Byung-Kwan;Choi, Eun-A;Nam, Moon-Hee
    • Journal of Digital Convergence
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    • v.17 no.4
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    • pp.177-185
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    • 2019
  • This is a methodological study to develop standards for human body coordinate clinical terminology system. The Standard was developed through four stages: Stage 1 - research plan was developed through literature review and data collection. Stage 2 - preliminary standard was created. Stage 3 - the standard was revised in accordance with the consultation of experts through seminars. Stage 4 - Final version of the standard was presented after verification of the content level. 2D human body images are expressed as x, y axes, and 3D images are expressed as x, y, z axes. Concepts and definitions of coordinates were preassembled into FSN, synonyms and preferred names of SNOMED CT. The latter combination was defined through 18 relationships. The average index was 4.01 for the content validity of the developed relationship standard. This research suggests that subsequent standards should be developed for other parts of the human body such as the brain, organs, and tissues. Also, it suggests that methodological research should be continued to increase the utilization of the standard in clinical practice.

Assessment of the Severity of Coronavirus Disease: Quantitative Computed Tomography Parameters versus Semiquantitative Visual Score

  • Xi Yin;Xiangde Min;Yan Nan;Zhaoyan Feng;Basen Li;Wei Cai;Xiaoqing Xi;Liang Wang
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.998-1006
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    • 2020
  • Objective: To compare the accuracies of quantitative computed tomography (CT) parameters and semiquantitative visual score in evaluating clinical classification of severity of coronavirus disease (COVID-19). Materials and Methods: We retrospectively enrolled 187 patients with COVID-19 treated at Tongji Hospital of Tongji Medical College from February 15, 2020, to February 29, 2020. Demographic data, imaging characteristics, and clinical data were collected, and based on the clinical classification of severity, patients were divided into groups 1 (mild) and 2 (severe/critical). A semiquantitative visual score was used to estimate the lesion extent. A three-dimensional slicer was used to precisely quantify the volume and CT value of the lung and lesions. Correlation coefficients of the quantitative CT parameters, semiquantitative visual score, and clinical classification were calculated using Spearman's correlation. A receiver operating characteristic curve was used to compare the accuracies of quantitative and semi-quantitative methods. Results: There were 59 patients in group 1 and 128 patients in group 2. The mean age and sex distribution of the two groups were not significantly different. The lesions were primarily located in the subpleural area. Compared to group 1, group 2 had larger values for all volume-dependent parameters (p < 0.001). The percentage of lesions had the strongest correlation with disease severity with a correlation coefficient of 0.495. In comparison, the correlation coefficient of semiquantitative score was 0.349. To classify the severity of COVID-19, area under the curve of the percentage of lesions was the highest (0.807; 95% confidence interval, 0.744-0.861: p < 0.001) and that of the quantitative CT parameters was significantly higher than that of the semiquantitative visual score (p = 0.001). Conclusion: The classification accuracy of quantitative CT parameters was significantly superior to that of semiquantitative visual score in terms of evaluating the severity of COVID-19.

The Virulence Factors of Vibrio spp. (비브리오의 병원성 인자에 관한 연구)

  • Oh, Yang-Hyo;Kim, Yung-Bu;Park, Young-Min;Kim, Min-Jung;Cha, Mi-Sun;Kim, Young-Hee;Lim, Eun-Gyoung
    • The Journal of the Korean Society for Microbiology
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    • v.34 no.6
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    • pp.513-518
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    • 1999
  • A total of 113 Vibrio sp. strains were examined for plasmid content which were subjected to digestion with restriction enzymes. About the 55% Vibrio spp. have the plasmid more than one. Most of these plasmid various derivatives ranged from $2.4\;kb{\sim}23\;kb$, especially two strains of V. mimicus and one strain of V. furnissii carried one high-molecular weight plasmid (molecular weight ranging between $70\;kb{\sim}100\;kb$). Results of restriction analysis for plasmid of this three strains were by no means the rule. For detection of tdh and ctx gene, the virulence factor involved in the pathogenesis, we carried out the TDH and CT assay, PCR amplification, and hybridization. A total 11 strains were produced TDH, involved in 9 strains of V. parahaemolyticus and 1 strain of V. alginolyticus from clinical isolates and 1 strains of V. mimicus from environmental isolates. In the experiments of tdh gene detection, in all, 3 strains of V. parahaemolyticus from clinical isolates and 2 strains from environmental isolates could be successfully amplified in 400 bp by PCR. The PCR results were consistent with DNA hybridization tests. In the experiments of CT assay, in all, 3 strains of V. cholerae from clinical isolate and 1 strain of V. cholerae from environmental isolates were observed CT-producing. These CT-producing strains amplified in 302 bp by PCR for the detection of ctx gene. All CT-producing strains hybridized with digoxigenin-labeled DNA probe, while CT-negative strains did not hybridize. Also hybridization tests results for detection of ctx gene consistent with PCR.

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Clinical Application of Transcatheter Arterial Chemoembolization Combined with Synchronous C-arm Cone-Beam CT Guided Radiofrequency Ablation in treatment of Large Hepatocellular Carcinoma

  • Wang, Zhi-Jun;Wang, Mao-Qiang;Duan, Feng;Song, Peng;Liu, Feng-Yong;Wang, Yan;Yan, Jie-Yu;Li, Kai;Yuan, Kai
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1649-1654
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    • 2013
  • Objective: This work aimed to evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with c-arm cone-beam CT guided synchronous radiofrequency ablation (RFA) in treatment of large hepatocellular carcinoma (HCC). Methods: 21 patients with large HCC were studied from January 2010 to March 2012. TACE combined with synchronous C-arm cone-beam CT guided RFA were performed on a total of 25 lesions. Conventional imaging examination (CEUS, enhanced CT or MRI) and AFP detection were regularly conducted to evaluate the technical success rate of combined treatment, complications, treatment response, time without disease recurrence and survival rate. Results: The technical success rate of combined treatment was 100%, without any significant complication. After 1 month, there were 19 cases with complete response and 2 cases with partial response, with an complete response rate of 90.4% (19/21) and a clinical effective rate of 100% (21/21). The complete response rates of single nodular lesions (100%, 17/17) was significantly higher than that of multiple nodular lesions (50%, 2/4) (P<0. 05). During 2 to 28 months of follow-up, in 19 cases with complete response, the average time without disease recurrence was $10.8{\pm}6$ months. The total survival rates of 6, 12 and 18 months in 21 patients were 100%, respectively. Conclusion: TACE combined with synchronous C-arm CT guided RFA is safe and effective for treatment of large HCC. The treatment efficacy for single nodular lesion is better than that for multiple nodular lesions.

Radiology Residents' Independent Diagnosis of Appendicitis Using 2-mSv Computed Tomography: A Secondary Analysis of a Large Pragmatic Randomized Trial

  • Jungheum Cho;Hae Young Kim;Seungjae Lee;Ji Hoon Park;Kyoung Ho Lee
    • Korean Journal of Radiology
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    • v.24 no.6
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    • pp.529-540
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    • 2023
  • Objective: To compare the diagnostic performance and clinical outcomes of 2-mSv computed tomography (CT) and conventional-dose CT (CDCT), following radiology residents' interpretation of CT examinations for suspected appendicitis. Materials and Methods: Altogether, 3074 patients with suspected appendicitis aged 15-44 years (28 ± 9 years, 1672 females) from 20 hospitals were randomly assigned to the 2-mSv CT (n = 1535) or CDCT (n = 1539) groups in a pragmatic trial from December 2013 and August 2016. Overall, 107 radiology residents participated in the trial as readers in the form of daily practice after online training for 2-mSv CT. They made preliminary CT reports, which were later finalized by attending radiologists via addendum reports, for 640 and 657 patients in the 2-mSv CT and CDCT groups, respectively. We compared the diagnostic performance of the residents, discrepancies between preliminary and addendum reports, and clinical outcomes between the two groups. Results: Patient characteristics were similar between the 640 and 657 patients. Residents' diagnostic performance was not significantly different between the 2-mSv CT and CDCT groups, with a sensitivity of 96.0% and 97.1%, respectively (difference [95% confidence interval {CI}], -1.1% [-4.9%, 2.6%]; P = 0.69) and specificity of 93.2% and 93.1%, respectively (0.1% [-3.6%, 3.7%]; P > 0.99). The 2-mSv CT and CDCT groups did not significantly differ in discrepancies between the preliminary and addendum reports regarding the presence of appendicitis (3.3% vs. 5.2%; -1.9% [-4.2%, 0.4%]; P = 0.12) and alternative diagnosis (5.5% vs. 6.4%; -0.9% [-3.6%, 1.8%]; P = 0.56). The rates of perforated appendicitis (12.0% vs. 12.6%; -0.6% [-4.3%, 3.1%]; P = 0.81) and negative appendectomies (1.9% vs. 1.1%; 0.8% [-0.7%, 2.3%]; P = 0.33) were not significantly different between the two groups. Conclusion: Diagnostic performance and clinical outcomes were not significantly different between the 2-mSv CT and CDCT groups following radiology residents' CT readings for suspected appendicitis.

Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer

  • Kim, Hwan-Ik;Noh, O Kyu;Oh, Young-Taek;Chun, Mison;Kim, Sang-Won;Cho, Oyeon;Heo, Jaesung
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.202-208
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    • 2016
  • Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

Analysis of Attenuation Differences According to Radiolucent and Radiopague Materials : Based on DECT (Dual Energy Computed Tomography) (방사선 투과 및 불투과성 물질에 따른 감약 차이의 분석 : DECT 검사 중심으로)

  • Jang, Hyon-Chol;Kim, Yoon-Shin;Kim, Hyeon-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1584-1589
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    • 2014
  • This study analyzed CT values of radiolucent and radiopaque materials by energy region after selecting radiolucent and radiopaque materials at random using GE's DECT((Dual Energy Com-puted Tomography) at S University Hospital located in Gyeonggi-province from July through August in 2013. Besides, it drew out the most analogous energy region to the value of 120kVp CT, which is applied to existing SECT(Single Energy Computed Tomography), by utilizing the analysis method of CT values and tried to find out the most useful and appropriate materials when contrast was applied within visible area in clinical application. As a result, there was little decrease of CT value after 90KeV in the case of materials with low density and high moisture content such as normal saline, methyl-cellulose and gels used in ultra-sonic waves test; energy does not influence much on materials with extremely low or high density such as air and contrast medium; methyl-cellulose and gels used in ultra-sonic waves test are considered to be the most useful materials for clinical applications.

Development and Radiation Shield effects of Dose Reduction Fiber for Scatter ray in CT Exams (피폭선량저감 섬유의 개발과 CT 검사시 산란선 차폐 효과)

  • Kim, Sunghwan;Kim, Yong Jin;Kwak, Jong Suk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1871-1876
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    • 2013
  • In this study, we developed and characterized the shielding properties of dose reduction fiber (DRF, Buffalo Co.) sheet during brain and chest CT examinations. The DRF sheet was composed of $1{\sim}500{\mu}m$ oxide Bismuth ($Bi_2O_3$) and 5 ~ 50 nm nano-barium sulfate ($BaSO_4$). Phantom and clinical studies were performed for characterization of the DRF shielding properties. In clinical study, we measured doses of eye, chest, abdomen and reproductive system of 60 patients in 3 hospitals during brain and chest CT examinations. We could determined the shielding effect of the DRF by comparing the doses when we used the DRF sheet or not. When we used the sheet during CT examination, the scattered dose were reduced about 20~50%. So, we suggest that the fiber should be used in radiological examinations for reducing patients doses.