• Title/Summary/Keyword: Diagnostic Errors

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Respiratory air flow transducer calibration technique for forced vital capacity test (노력성 폐활량검사시 호흡기류센서의 보정기법)

  • Cha, Eun-Jong;Lee, In-Kwang;Jang, Jong-Chan;Kim, Seong-Sik;Lee, Su-Ok;Jung, Jae-Kwan;Park, Kyung-Soon;Kim, Kyung-Ah
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.5
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    • pp.1082-1090
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    • 2009
  • Peak expiratory flow rate(PEF) is a very important diagnostic parameter obtained from the forced vital capacity(FVC) test. The expiratory flow rate increases during the short initial time period and may cause measurement error in PEF particularly due to non-ideal dynamic characteristic of the transducer. The present study evaluated the initial rise slope($S_r$) on the flow rate signal to compensate the transducer output data. The 26 standard signals recommended by the American Thoracic Society(ATS) were generated and flown through the velocity-type respiratory air flow transducer with simultaneously acquiring the transducer output signal. Most PEF and the corresponding output($N_{PEF}$) were well fitted into a quadratic equation with a high enough correlation coefficient of 0.9997. But only two(ATS#2 and 26) signals resulted significant deviation of $N_{PEF}$ with relative errors>10%. The relationship between the relative error in $N_{PEF}$ and $S_r$ was found to be linear, based on which $N_{PEF}$ data were compensated. As a result, the 99% confidence interval of PEF error was turned out to be approximately 2.5%, which was less than a quarter of the upper limit of 10% recommended by ATS. Therefore, the present compensation technique was proved to be very accurate, complying the international standards of ATS, which would be useful to calibrate respiratory air flow transducers.

The Effectiveness Evaluation of Reconstruction Method Using DFOV Position Changes for Reduction of Artifact Around Hotspot in PET/CT Images (PET/CT 검사에서 열소 주변 인공물 감소를 위한 DFOV 위치 변화 재구성 방법의 유용성 평가)

  • Han, Dong Chan;Hong, Gun Chul;Choi, Choon ki;Lee, Hyeok;Choi, Seong Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.2
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    • pp.90-94
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    • 2013
  • Purpose: In the PET/CT images, various artifacts cause degradation of the quantitative assessment. Most hotspot generated by radiopharmaceutical injection errors cause an artifact and degrade the quality of the images as well as the accuracy of the quantitative evaluation. The purpose of this study is to assess effectiveness of the elimination of the hotspot at the injection sites using shifting the center of DFOV (Display Field of View, DFOV) method and evaluate the quantitative evaluation of result. Materials and Methods: GE Discovery STE 16 (GE Healthcare, Milwaukee, USA) and 1994 NEMA phantom were used for imaging acquisition. Phantom was filled with 0.005 MBq/mL of $^{18}F-FDG$. A hotspot was artificially placed on the outside of the phantom. The ratio of hotspot area activity to background area activity was regulated as 200:1. After image acquisition with routine protocol, all of the images were reconstructed using the shifting the center of DFOV method that wasn't overlapped with hotspot. Those images obtained before and after applying the shifting reconstruction method were compared. ROIs (Region Of Interests) were set in the hotspot areas, meanSUVs and standard deviations were calculated. Percentage differences were calculated with those meanSUVs and standard deviations. The evaluation on the effects of the shifting reconstruction method was done by comparison of the meanSUVs and the standard deviations, which were calculated for background areas unaffected by hotspot. Results: In the areas of unaffected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.67{\pm}0.06g/mL$ and $0.65{\pm}0.06g/mL$, respectively. In the artifact areas affected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.32{\pm}0.08g/mL$ and $0.56{\pm}0.12g/mL$, respectively. The percentage differences of the area adjacent to the hotspot and the area distant from the hotspot were 65.3% and 97.4%, respectively. Conclusion: In the PET/CT images, meanSUV was improved by 32.1% when the effect of artifact was removed with application of the shifting the center of DFOV methode. In other areas unaffected by artifacts, meanSUVs were not significantly different after applying DFOV center shift method. As shown in the result, adverse effects of hotspot made by swelling in the injection site can be reduced by applying DFOV center shift method. Therefore, DFOV center shift method can be applied for the more precise quantitative evaluation, and contribute to the increase of the diagnostic value of the images.

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The Study of Technical Error Analysis on BMD Using DEXA (이중 에너지 X선 흡수 계측법을 이용한 BMD 검사 시 발생할 수 있는 기술적인 오류 분석)

  • Kang, Yeong-Han;Jo, Gwang-Ho
    • Journal of radiological science and technology
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    • v.29 no.4
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    • pp.229-236
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    • 2006
  • Purpose: This study was conducted to search for the type of technical error in DEXA(dual-energy X-ray absorptiometry) and the effect of error to measurement of BMD. Materials and Methods: The changes of BMD($g/cm^2$, T-score) by patients information(Age, Weight, Height, Manopause age) input error and Confirming ROI error were investigated. Using spine phantom, we canned 10 times by age(5, 10), weight(10, 20 kg), height(5, 10 cm), manopause age(5, 10) increase & decrease respectively. Scanning region(L-spine, femur, Forearm) of 10 patients was calculated by changing ROI respectively. Analysis of difference for mean(precision 1%) were carried out. Results: The error of patient information(Age, Weight, Height, Manopause age) was not changed differently. In confirming ROI, the BMD and T-score of L-spine involving T-12 was decreased to $0.063\;g/cm^2$, 0.3 and involving L-5 increased to $0.077\;g/cm^2$, 0.5. In narrowing 1 cm of vertical line of ROI, the BMD and T-score decreased to $0.006\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.15, each. In hip ROI, Upper and left shift(0.5 cm) of line was not influenced BMD and T-score. In 0.5 cm lower shift(lesser trochanter below), the BMD and T-score increased $0.031\;g/cm^2$, 0.3 and in 1 cm $0.094\;g/cm^2$, 0.65, each. In forearm ROI, the BMD and T-score decreased $0.042\;g/cm^2$, 0.9 involving 1 cm lower wrist. And expanding 1 cm of vertical line, the BMD and T-score decreased $0.008\;g/cm^2$, 0.1 and in 2 cm, $0.021\;g/cm^2$, 0.3, each. The L-spine, hip, forearm ROI error was changed differently. Conclusion: There are so many kinds of technical error in BMD processing. Errors according to age, weight, height, manopause age did not influent to $BMD(g/cm^2)$ and T-score. There are mean differences BMD and T-score in confirming ROI. For the precision exam, in L-spine processing, L1-4 have to confirmed without shift of ROI vertical line. In hip processing, the ROI have to included greater trochanter, femur head and lesser trochanter. In forearm processing, the ROI have to included wrist, radius and ulnar.

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Adoption and Efficacy of ISO 15189 in Medical Laboratories for Diagnostic and Research (메디컬시험기관에서 ISO 15189 도입의 필요성과 시행의 효용성)

  • Yang, Man-Gil;Lee, Won Ho;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.158-167
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    • 2016
  • The requirements for medical laboratories ISO 15189 is examined in organization and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Medical services are provided from the areas of resource management, and pre-examination, examination and post-examination processes. The main goal of ISO 15189 accreditation is to improve the quality of laboratory services provided for patients and clinical users not only through compliance with consensually developed and harmonized requirements but also by adopting the philosophy of continual improvement using the Plan-Do-Check-Act cycle. Laboratory quality should be evaluated and improved in all steps of the testing process as the state-of-the art indicates that the pre- and post-analytical phases are more vulnerable to errors than the intra-analytical phase. The Korea Laboratory Accreditation Scheme (KOLAS), a national accreditation body, provides medical laboratory accreditations for appropriate approaches to evaluating the competence of a medical laboratory in providing effective services to its customers and clinical users. Adoption of ISO 15189 in 2010s as a government policy has been delayed, and only 5 laboratories have been accredited to date in Korea. The medical laboratories should seek the adoption of ISO 15189 with a positive attitude for quality improvement and strengthening of international competitiveness.

The Comparison of DVH between Multiple arc FSRT and Conformal FSRT (Multiple arc FSRT와 Conformal FSRT의 DVH 비교)

  • Kim Ki-Hwan;Kim Jun-Sang;Jang JiYoung;Kim Jae-Sung;Kim Seong-Ho;Song Chang-Joon;Park Min-Kyu;Cho Moon-June
    • Radiation Oncology Journal
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    • v.17 no.3
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    • pp.261-267
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    • 1999
  • Purpose : In FSRT (Fractionated stereotactic radiotherapy) planning, we studied the usefulness between multiple arc FSRT and conformal FSRT by comparing tumor shape and DVH (dose volume histogram). Materials and Methods In Chungnam Univ. hospital, we had treated the sixteen patients with FSRT from Aug. 1997 to Dec. 1998. In choosing multiple arc FSRT or conformal FSRT, we had considered If (irregular factor) after calculating tumor volume and surface area. We had considered multiple arc FSRT if tumor shape was similar to sphere or the value of If was less than 1.25, conformal FSRT if tumor shape was very irregular or If was more than 1.3. For evaluation of treatment planning, we had considered the appropriate DVH for tumor volume and for critical organs. Results : The errors between reference point and the coordinates point on AP, Lat radiography were less than 1 mm before treatment. We had planned $3\~$5 arcs for multiple arc FSRT, $5\~6$ports for conformal FSRT. The mean dose distribution of tumor volume of cumulative DVH between multiple arc FSRT and conformal FSRT was 90.6, 85%, respectively. The dose of critical organs irradiated was less than $5\%$ maximum dose of cumulative DVH. Conclusion : We had obtained the similar value between multiple arc FSRT and conformal FSRT, so that we had appropriate treatment planning of FSRT for multiple arc FSRT and conformal FSRT according to tumor shape and size.

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The Research to Correct Overestimation in TOF-MRA for Severity of Cerebrovascular Stenosis (3D-SPACE T2 기법에 의한 TOF-MRA검사 시 발생하는 혈관 내 협착 정도의 측정 오류 개선에 관한 연구)

  • Han, Yong Su;Kim, Ho Chul;Lee, Dong Young;Lee, Su Cheol;Ha, Seung Han;Kim, Min Gi
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.12
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    • pp.180-188
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    • 2014
  • It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

Quantitative Analysis of Digital Radiography Pixel Values to absorbed Energy of Detector based on the X-Ray Energy Spectrum Model (X선 스펙트럼 모델을 이용한 DR 화소값과 디텍터 흡수에너지의 관계에 대한 정량적 분석)

  • Kim Do-Il;Kim Sung-Hyun;Ho Dong-Su;Choe Bo-young;Suh Tae-Suk;Lee Jae-Mun;Lee Hyoung-Koo
    • Progress in Medical Physics
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    • v.15 no.4
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    • pp.202-209
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    • 2004
  • Flat panel based digital radiography (DR) systems have recently become useful and important in the field of diagnostic radiology. For DRs with amorphous silicon photosensors, CsI(TI) is normally used as the scintillator, which produces visible light corresponding to the absorbed radiation energy. The visible light photons are converted into electric signal in the amorphous silicon photodiodes which constitute a two dimensional array. In order to produce good quality images, detailed behaviors of DR detectors to radiation must be studied. The relationship between air exposure and the DR outputs has been investigated in many studies. But this relationship was investigated under the condition of the fixed tube voltage. In this study, we investigated the relationship between the DR outputs and X-ray in terms of the absorbed energy in the detector rather than the air exposure using SPEC-l8, an X-ray energy spectrum model. Measured exposure was compared with calculated exposure for obtaining the inherent filtration that is a important input variable of SPEC-l8. The absorbed energy in the detector was calculated using algorithm of calculating the absorbed energy in the material and pixel values of real images under various conditions was obtained. The characteristic curve was obtained using the relationship of two parameter and the results were verified using phantoms made of water and aluminum. The pixel values of the phantom image were estimated and compared with the characteristic curve under various conditions. It was found that the relationship between the DR outputs and the absorbed energy in the detector was almost linear. In a experiment using the phantoms, the estimated pixel values agreed with the characteristic curve, although the effect of scattered photons introduced some errors. However, effect of a scattered X-ray must be studied because it was not included in the calculation algorithm. The result of this study can provide useful information about a pre-processing of digital radiography.

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STANDARDIZATION OF WORD/NONWORD READING TEST AND LETTER-SYMBOL DISCRIMINATION TASK FOR THE DIAGNOSIS OF DEVELOPMENTAL READING DISABILITY (발달성 읽기 장애 진단을 위한 단어/비단어 읽기 검사와 글자기호감별검사의 표준화 연구)

  • Cho, Soo-Churl;Lee, Jung-Bun;Chungh, Dong-Seon;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.81-94
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    • 2003
  • Objectives:Developmental reading disorder is a condition which manifests significant developmenttal delay in reading ability or persistent errors. About 3-7% of school-age children have this condition. The purpose of the present study was to validate the diagnostic values of Word/Nonword Reading Test and Letter-Symbol Discrimination Task for the purpose of overcoming the caveats of Basic Learning Skills Test. Methods:Sixty-three reading-disordered patients(mean age 10.48 years old) and sex, age-matched 77 normal children(mean age 10.33 years old) were selected by clinical evaluation and DSM-IV criteria. Reading I and II of Basic Learning Skills Test, Word/Nonword Reading Test, and Letter-Symbol Discrimination Task were carried out to them. Word/Nonword Reading Test:One hundred usual highfrequency words and one hundred meaningless nonwords were presented to the subjects within 1.2 and 2.4 seconds, respectively. Through these results, automatized phonological processing ability and conscious letter-sound matching ability were estimated. Letter-Symbol Discrimination Task:mirror image letters which reading-disordered patients are apt to confuse were used. Reliability, concurrent validity, construct validity, and discriminant validity tests were conducted. Results:Word/Nonword Reading Test:the reliability(alpha) was 0.96, and concurrent validity with Basic Learning Skills test was 0.94. The patients with developmental reading disorders differed significantly from normal children in Word/Nonword Reading Test performances. Through discriminant analysis, 83.0% of original cases were correctly classified by this test. Letter-Symbol Discrimination Task:the reliability(alpha) was 0.86, and concurrent validity with Basic Learning Skills test was 0.86. There were significant differences in scores between the patients and normal children. Factor analysis revealed that this test were composed of saccadic mirror image processing, global accuracy, mirror image processing deficit, static image processing, global vigilance deficit, and inattention-impulsivity factors. By discriminant analysis, 87.3% of the patients and normal children were correctly classified. Conclusion:The patients with developmental reading disorders had deficits in automatized visuallexical route, morpheme-phoneme conversion mechanism, and visual information processing. These deficits were reliably and validly evaluated by Word/Nonword Reading Test and Letter-Symbol Discrimination Task.

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