• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.1-9
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• 2023

For optimal image quality of computer tomography angiography (CTA), different iodine concentrations and scan parameters were applied to quantitatively evaluate the image quality characteristics of filtered back projection (FBP), hybrid-iterative reconstruction (hybrid-IR), and deep learning reconstruction (DLR). A 320-row-detector CT scanner scanned a phantom with various iodine concentrations (1.2, 2.9, 4.9, 6.9, 10.4, 14.3, 18.4, and 25.9 mg/mL) located at the edge of a cylindrical water phantom with a diameter of 19 cm. Data obtained using each reconstruction technique was analyzed through noise, coefficient of variation (COV), and root mean square error (RMSE). As the iodine concentration increased, the CT number value increased, but the noise change did not show any special characteristics. COV decreased with increasing iodine concentration for FBP, adaptive iterative dose reduction (AIDR) 3D, and advanced intelligent clear-IQ engine (AiCE) at various tube voltages and tube currents. In addition, when the iodine concentration was low, there was a slight difference in COV between the reconstitution techniques, but there was little difference as the iodine concentration increased. AiCE showed the characteristic that RMSE decreased as the iodine concentration increased but rather increased after a specific concentration (4.9 mg/mL). Therefore, the user will have to consider the characteristics of scan parameters such as tube current and tube voltage as well as iodine concentration according to the reconstruction technique for optimal CTA image acquisition.

• Journal of the Korean Society of Radiology
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• v.16 no.7
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• pp.835-842
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• 2022

This study is aimed to evaluate the effects of a synthetic MR technique in reducing metal artifacts. In the experiment, the in-plane and through-plane images were acquired by applying a synthetic MR technique and a high-speed spin echo technique to a phantom manufactured with screw for spinal surgery. The area of the metal artifact was compared. The metal artifacts were measured by dividing the signal-loss and the signal pile-up areas, and the area of the final artifact was calculated through the sum of the two. As a result, the metal artifacts were relatively reduced when the synthetic MR techniques were applied to both in-plane and through-plane. Comparing by sequence, the in-plane T1 images decreased by 23.45%, T2 images by 20.85%, PD images by 19.67%, and FLAIR images by 22.12%. Also, in the case of the through-plane, the T1 image decreased by 62.95%, the T2 image decreased by 73.93%, the PD image decreased by 74.68%, and the FLAIR image decreased by 66.43%. The cause of this result is that when the synthetic MR technique is applied, the distortion is due to the signal pile-up and does not occur and the size of the entire metal artifact is reduced. Therefore, synthetic MR technique can very effectively reduce metal artifacts, which can help to increase the diagnostic value of images.

• Journal of the Korea Convergence Society
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• v.13 no.5
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• pp.333-346
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• 2022

This study proposes a strategy to attract visitors by analyzing the justification for hosting the 2027 Summer World University Games in Chungcheong, Korea, as well as by assessing the internal and external factors to promote regional development. Using Environmental Analysis as the diagnostic approach, we focus on strength/opportunity (SO), strength/threat (ST), weakness/opportunity (WO), and weakness/threat (WT) analyses. SO analysis show that a matching strategy of mid- to long-term cooperation among the four cities and provinces in Chungcheong and development of local sports by promoting its linkages to science, and industry offer best strategic use-value. ST analysis shows that optimal infrastructure development and establishment of competition management strategies in preparation for non-face-to-face engagement make balanced regional development possible. WO analysis shows the need for rearrangement and renovation of outdated sports facilities, development of programs linked to convergence sports tourism products, efficient and strategic attraction activities, and promoting sustainable development of bed town cities. WT analysis suggests that the imbalance in regional development due to expansion of sports facilities, insufficient cultural contents in tourism, and tourism demand fluctuation are potential problems. Follow-up studies can focus on deeper analysis of the possibility and attractiveness of hosting the Summer World University Games in Chungcheong, Korea using qualitative methods such as focus group interviews and in-depth interviews with stakeholders and local residents.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.3
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• pp.263-276
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• 2023

The purpose of this study was to evaluate the performance of a model using You Only Look Once (YOLO) for object detection of proximal caries in periapical radiographs of children. A total of 2016 periapical radiographs in primary dentition were selected from the M6 database as a learning material group, of which 1143 were labeled as proximal caries by an experienced dentist using an annotation tool. After converting the annotations into a training dataset, YOLO was trained on the dataset using a single convolutional neural network (CNN) model. Accuracy, recall, specificity, precision, negative predictive value (NPV), F1-score, Precision-Recall curve, and AP (area under curve) were calculated for evaluation of the object detection model's performance in the 187 test datasets. The results showed that the CNN-based object detection model performed well in detecting proximal caries, with a diagnostic accuracy of 0.95, a recall of 0.94, a specificity of 0.97, a precision of 0.82, a NPV of 0.96, and an F1-score of 0.81. The AP was 0.83. This model could be a valuable tool for dentists in detecting carious lesions in periapical radiographs.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.48-51
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• 2013

We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.320-329
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• 2023

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.801-808
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• 2023

In order to minimize radiation exposure and secure diagnostic value images during CT examination of the head of children, the usefulness of volume axial mode is evaluated through comparison and analysis of exposure dose and images of volume axial mode, high pitch mode, and helical mode. Image evaluation and dose evaluation were performed in CT high pitch mode, helical mode, and volume axial mode for infants under the age of 1 according to the voltages of 70, 80, and 100 kVp tubes. The image evaluation was conducted by comparing image quality by setting ROI for each image, calculating SNR and CNR, using ONE-WAY (ANOVA) to evaluated statistical significance, and cross-examining the dose evaluation using DLP values displayed in the Dose Report. When inspected using volume axial mode, DLP values were generally low, and SNR and CNR values differed by ROI and kVp. When volume axial mode evaluated the quality of the image compared to other scan modes, the difference is not uniform. For the reason, certain modes are not considered excellent, but the exposure dose was reduced the most in terms of dose. In addition, the point that the volume axial mode can be examined at its original location, short scanning time and needless of table movement is useful for CT tests for children under 1 year of age with high radiation sensitivity.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1185-1193
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• 2021

Objective: Clear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms' tumor and to assess the features with diagnostic value for identifying CCSK. Materials and Methods: We reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3-10 years), 7 with CCSK, and 51 with Wilms' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher's exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed. Results: The age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770-104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337-25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively. Conclusion: Perinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms' tumor in children aged below 10 years.

• Journal of the Korean Society of Radiology
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• v.18 no.2
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• pp.135-144
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• 2024

Ultrasonography examination has limitations in quantifying hepatic fat quantification. Therefore, this study aimed to experimentally demonstrate whether changes in signal attenuation during ultrasound imaging can be quantified using simulated hepatic phantoms to assess hepatic fat content. Additionally, we aimed to evaluate the potential of ultrasound imaging for diagnosing hepatic fatty liver by analyzing the relationship between hepatic fat content and signal intensity in ultrasound images. In this study, we developed a total of five stimulated hepatic phantoms by homogeneously mixing water and oil. We confirmed the fat content of the phantoms using magnetic resonance imaging (MRI) and ultrasound imaging, and measured signal intensity according to distance in ultrasound images to analyze the correlation and mean comparison between fat content and signal intensity. We observed that as the fat content increased, the ultrasound penetration intensity decreased, confirming the potential for quantifying hepatic fat content using ultrasound. Additionally, the analysis of the correlation between the measured fat content using MRI and the signal intensity measured in ultrasound images showed a high correlation. Statistical analysis in our study confirmed that as the fat content increased, the slope representing signal during ultrasound imaging (US-GRE) decreased. In this study, it was statistically confirmed that the US-GRE value of ultrasound images gradually decreases as the fat content increases, and it is believed that US-GRE can serve as a biomarker expressing fatty liver content.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.620-631
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• 2022

Purpose This study aimed to investigate the diagnostic performance of features suggestive of nodal metastasis on preoperative MRI in patients with invasive breast cancer. Materials and Methods We retrospectively reviewed the preoperative breast MRI of 192 consecutive patients with surgically proven invasive breast cancer. We analyzed MRI findings of axillary lymph nodes with regard to the size, long/short ratio, cortical thickness, shape and margin of the cortex, loss of hilum, asymmetry, signal intensity (SI) on T2-weighted images (T2WI), degree of enhancement in the early phase, and enhancement kinetics. Receiver operating characteristic (ROC) analysis, chi-square test, t test, and McNemar's test were used for statistical analysis. Results Increased shorter diameter, uneven cortical shape, increased cortical thickness, loss of hilum, asymmetry, irregular cortical margin, and low SI on T2WI were significantly suggestive of metastasis. ROC analysis revealed the cutoff value for the shorter diameter and cortical thickness as 8.05 mm and 2.75 mm, respectively. Increased cortical thickness (> 2.75 mm) and uneven cortical shape showed significantly higher sensitivity than other findings in McNemar's test. Irregular cortical margins showed the highest specificity (100%). Conclusion Cortical thickness > 2.75 mm and uneven cortical shape are more sensitive parameters than other findings, and an irregular cortical margin is the most specific parameter for predicting axillary metastasis in patients with invasive breast cancer.