• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.123-129
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• 2023

The purpose of this study was to analyze differences in imaging quality and dose difference between intra-venous (IV) and intra-arterial (IA) liver dynamic computed tomography (CT). Herein, retrospective, blinded analysis was conducted to analyze signal-to-noise and contrast-to-noise ratios in cases of patients who underwent IV or IA liver dynamic CT for transarterial chemoembolization (TACE), an interventional procedure for hepatocellular carcinoma. The dose length product (DLP) value stored in Picture Archive and Communication System (PACS) was used to calculate the effective dose and thereby compare differences in the dose between the two methods. The mean liver and spleen signal to noise ratio (SNR) was greater in IV-liver dynamic CT than in IA-liver dynamic CT; however, contrast to noise ratio (CNR) was higher in IA-liver dynamic CT than in IV-liver dynamic CT. However, there were no differences in DLP and effective dose between the two methods. In conclusion, our findings showed that IA-liver dynamic CT showed a similar effective dose and superior CNR compared with IV-liver dynamic CT. Further studies must analyze 3D angiography CT of the hepatic artery to clearly distinguish the feeding artery, which is the essential step in interventional procedures for hepatocellular carcinoma.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.2
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• pp.155-167
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• 2023

The aim of this study was to investigate the effects of slow maxillary expansion (SME) on the dentoalveolar, skeletal, upper airway, and maxillary sinus using cone-beam computed tomography (CBCT). Twenty-three orthodontic patients (mean age 8.93 ± 1.61 years) who were treated with maxillary expansion using banded hyrax in the Department of Pediatric Dentistry at Jeonbuk National University Dental Hospital were included. According to the expansion speed applied, they were divided into two groups: SME (12 subjects, mean age 8.92 ± 1.45 years) and rapid maxillary expansion (RME, 11 subjects, mean age 8.94 ± 1.84 years). CBCT were obtained before (T0) and after (T1) the treatment and were analyzed with InVivo5 software (Anatomage, San Jose, CA, USA). Descriptive statistics showed no significant differences between the two groups in age, sex, or skeletal maturity. There were significant increases in maxillary width at the dentoalveolar and skeletal levels for both groups. Upper airway volume revealed a significant increase of 38.59% in the SME group and 28.72% in the RME group. However, there was no significant difference between SME group and RME group in all measurements. This study suggested the efficacy of SME in growing patients. SME was effective in increasing not only dentoalveolar and skeletal measurements but also airway volume. Therefore, pediatric dentists should select an appropriate expansion method considering the physiological aspects of periodontal tissues and discomfort in growing children.

• Economic and Environmental Geology
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• v.55 no.6
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• pp.571-582
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• 2022

In this study, the raw material and tempers of bricks used in three brick tombs built in Gongju, during the Ungjin period of Baekje were investigated. The royal tomb of King Muryeong, the 6th tomb in the royal tombs, and Kyochonri brick tomb remained in Gongju and the bricks of each site had different shape and physical properties despite their similarity in raw materials. As the results of the mineralogical and microstructural analysis, the bricks of the royal tombs were made of refined raw materials, and were infrequently added crushed bricks(grogs) as a tempering material. On the other hand, thick and elongated pores of bricks from the Kyochonri brick tomb were frequently found, and the remains of plant carbonization are observed in their microstructures. Since the pores are mainly distributed in a thickness of 0.3 to 1 mm, it is estimated that bricks were produced by adding a certain size of the plant to refined soil, and grogs also were added as a tempering material. In particular, it was found that adding plants and grogs in raw materials of bricks caused thick pores or cracks in the internal structure. Since the bricks of the Kyochonri brick tomb have internal cracks and low firing temperature, the ultrasonic velocity of the bricks was lower than that of the royal tomb bricks. It means that the mechanical strength of these bricks were relatively low. Accordingly, it is estimated that the tempering materials, firing temperature, and internal structures of bricks can affect durability of the brick, and it can be thought as a difference in the manufacturing technology of brick making.

• Journal of Korean Neurosurgical Society
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• v.66 no.1
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• pp.44-52
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• 2023

Objective : This study aimed to investigate the efficacy of transverse process (TP) hook system at the upper instrumented vertebra (UIV) for preventing screw pullout in adult spinal deformity surgery using the pedicle Hounsfield unit (HU) stratification based on K-means clustering. Methods : We retrospectively reviewed 74 patients who underwent deformity correction surgery between 2011 and 2020 and were followed up for >12 months. Pre- and post-operative data were used to determine the incidence of screw pullout, UIV TP hook implementation, vertebral body HU, pedicle HU, and patient outcomes. Data was then statistically analyzed for assessment of efficacy and risk prediction using stratified HU at UIV level alongside the effect of the TP hook system. Results : The screw pullout rate was 36.4% (27/74). Perioperative radiographic parameters were not significantly different between the pullout and non-pullout groups. The vertebral body HU and pedicle HU were significantly lower in the pullout group. K-means clustering stratified the vertebral body HU ≥205.3, <137.2, and pedicle HU ≥243.43, <156.03. The pullout rate significantly decreases in patients receiving the hook system when the pedicle HU was from ≥156.03 to < 243.43 (p<0.05), but the difference was not statistically significant in the vertebra HU stratified groups and when pedicle HU was ≥243.43 or <156.03. The postoperative clinical outcomes improved significantly with the implementation of the hook system. Conclusion : The UIV hook provides better clinical outcomes and can be considered a preventative strategy for screw-pullout in the certain pedicle HU range.

• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.835-841
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• 2023

The aim of this study is to evaluate the diagnostic ability of dual-energy computed tomography (DECT) for Composition determination of urinary stones in phantom model. Seventeen cases with urinary stones who underwent DECT were enrolled in the study. The composition of the urinary stones was extracted from the seventeen patients were analyzed with DECT in phantom model with fresh pork. The volume scan method using Dual-energy software was used and the scanned image sets were assessed. All 17 urinary stones of the phantom model were analyzed according to the stone composition using DE stone Analysis were divided into uric acid stones (n=6, 35.29%) and non-uric acid stones (n=11, 64.71%). These urinary stones were pathologically confirmed. The mean attenuation values of uric acid stones at 135 kV, 100 kV and 80 kV was 348.87 ± 166.37 HU, 345.33 ± 151.18 HU and 337.94 ± 172.77 HU, respectively. The mean attenuation values of non-uric acid stones at 135 kV, 100 kV and 80 kV was 551.93 ± 297.09 HU, 747.04 ± 351.31 HU and 958.19 ± 424.72 HU, respectively. At 80 kV, uric acid stones and non-uric acid stones showed significant difference in the attenuation values(P<0.05). The attenuation values of DECT could differentiate the compositions of urinary stones between uric acid and non-uric acid stones at 80 kV in phantom model.

• Korean Journal of Radiology
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• v.22 no.12
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• pp.1964-1973
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• 2021

Objective: To investigate the diagnostic performance of CT fractional flow reserve (CT-FFR) for myocardial bridging-related ischemia using dynamic CT myocardial perfusion imaging (CT-MPI) as a reference standard. Materials and Methods: Dynamic CT-MPI and coronary CT angiography (CCTA) data obtained from 498 symptomatic patients were retrospectively reviewed. Seventy-five patients (mean age ± standard deviation, 62.7 ± 13.2 years; 48 males) who showed myocardial bridging in the left anterior descending artery without concomitant obstructive stenosis on the imaging were included. The change in CT-FFR across myocardial bridging (ΔCT-FFR, defined as the difference in CT-FFR values between the proximal and distal ends of the myocardial bridging) in different cardiac phases, as well as other anatomical parameters, were measured to evaluate their performance for diagnosing myocardial bridging-related myocardial ischemia using dynamic CT-MPI as the reference standard (myocardial blood flow < 100 mL/100 mL/min or myocardial blood flow ratio ≤ 0.8). Results: ΔCT-FFR_systolic (ΔCT-FFR calculated in the best systolic phase) was higher in patients with vs. without myocardial bridging-related myocardial ischemia (median [interquartile range], 0.12 [0.08-0.17] vs. 0.04 [0.01-0.07], p < 0.001), while CT-FFR_systolic (CT-FFR distal to the myocardial bridging calculated in the best systolic phase) was lower (0.85 [0.81-0.89] vs. 0.91 [0.88-0.96], p = 0.043). In contrast, ΔCT-FFR_diastolic (ΔCT-FFR calculated in the best diastolic phase) and CT-FFR_diastolic (CT-FFR distal to the myocardial bridging calculated in the best diastolic phase) did not differ significantly. Receiver operating characteristic curve analysis showed that ΔCT-FFR_systolic had largest area under the curve (0.822; 95% confidence interval, 0.717-0.901) for identifying myocardial bridging-related ischemia. ΔCT-FFR_systolic had the highest sensitivity (91.7%) and negative predictive value (NPV) (97.8%). ΔCT-FFR_diastolic had the highest specificity (85.7%) for diagnosing myocardial bridging-related ischemia. The positive predictive values of all CT-related parameters were low. Conclusion: ΔCT-FFR_systolic reliably excluded myocardial bridging-related ischemia with high sensitivity and NPV. Myocardial bridging showing positive CT-FFR results requires further evaluation.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.57-69
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• 2024

Purpose: Quantitative analysis through count measurement in nuclear medicine planar images is limited by analysis techniques that are useful for obtaining various clinical information or by organ overlap or artifacts in actual clinical practice. On the other hand, the use of SPECT tomography images is quantitative analysis using volume rather than planar, which is not only free from problems such as projection overlap, but also has excellent quantitative accuracy. In the use of developing SPECT quantitative analysis technology, this study aims to compare the accuracy of quantitative analysis between ROI of the conventional planar images and VOI of the SPECT tomographic images in evaluating the count change happened by the volume change of the source. Materials and Methods: A ^99mTcO₄^- source(200.17 MBq) was filled with sterilized water in the syringe to create a phantom with an inner diameter volume of 60 cc, and a planar image and a SPECT image were obtained by reducing the volume by 15 cc (25%) respectively. ROI and VOI(threshold: 1~45%, 5% interval) were set for each image obtained to estimate true count and measure the total count, and compared with the preseted volumetric change rate(%). Results: When volume changes of 25%, 50%, and 75% occurred in the initial volume of 60 cc(100%) of the phantom, the average count changes of the measured planar image were 26.8%, 53.2%, 77.5%, and the average count changes of the SPECT image were 24.4%, 50.9%, and 76.8%. In this case, the VOI size(cm³) set showed an average change rate of 25.4%, 51.1%, and 76.6%. The highest threshold value for the accuracy of radioactive concentration by VOI size (average error -1.03%) was 35%, and the VOI size of the same threshold had an error of -17.1% on average compared to the actual volume. Conclusion: On average, the count-based volumetric change rate in nuclear medicine images was able to track changes more accurately using VOI than ROI, but there was no significant difference with relatively similar value. However, the accuracy of radioactive concentration according to individual VOI sizes did not match, but it is considered that a relatively accurate quantitative analysis can be expected when the size of VOI is set smaller than the actual volume.

• Korean Journal of Radiology
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• v.22 no.5
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• pp.697-705
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• 2021

Objective: To investigate the feasibility and the accuracy of the coronary CT angiography (CCTA)-derived Registry of Crossboss and Hybrid procedures in France, the Netherlands, Belgium and United Kingdom (RECHARGE) score (RECHARGECCTA) for the prediction of procedural success and 30-minutes guidewire crossing in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). Materials and Methods: One hundred and twenty-four consecutive patients (mean age, 54 years; 79% male) with 131 CTO lesions who underwent CCTA before catheter angiography (CA) with CTO-PCI were retrospectively enrolled in this study. The RECHARGECCTA scores were calculated and compared with RECHARGECA and other CTA-based prediction scores, including Multicenter CTO Registry of Japan (J-CTO), CT Registry of CTO Revascularisation (CT-RECTOR), and Korean Multicenter CTO CT Registry (KCCT) scores. Results: The procedural success rate of the CTO-PCI procedures was 72%, and 61% of cases achieved the 30-minutes wire crossing. No significant difference was observed between the RECHARGECCTA score and the RECHARGECA score for procedural success (median 2 vs. median 2, p = 0.084). However, the RECHARGECCTA score was higher than the RECHARGECA score for the 30-minutes wire crossing (median 2 vs. median 1.5, p = 0.001). The areas under the curve (AUCs) of the RECHARGECCTA and RECHARGECA scores for predicting procedural success showed no statistical significance (0.718 vs. 0.757, p = 0.655). The sensitivity, specificity, positive predictive value, and the negative predictive value of the RECHARGECCTA scores of ≤ 2 for predictive procedural success were 78%, 60%, 43%, and 87%, respectively. The RECHARGECCTA score showed a discriminative performance that was comparable to those of the other CTA-based prediction scores (AUC = 0.718 vs. 0.665-0.717, all p > 0.05). Conclusion: The non-invasive RECHARGECCTA score performs better than the invasive determination for the prediction of the 30-minutes wire crossing of CTO-PCI. However, the RECHARGECCTA score may not replace other CTA-based prediction scores for predicting CTO-PCI success.

• Journal of Periodontal and Implant Science
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• v.54 no.2
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• pp.96-107
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• 2024

Purpose: Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss^® and Bio-Oss/Collagen^®) and 2 types of synthetic hydroxyapatite (Apaceram-AX^® and Refit^®). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact. Methods: A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption). Results: All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance. Conclusions: Overall, the materials demonstrated varying post-implantation behaviors in vivo. Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.4
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• pp.261-268
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• 2023

[¹⁸F]Fluorocholine is a radiopharmaceutical used non-invasively in positron emission tomography to diagnose parathyroid adenoma, prostate cancer, and hepatocellular carcinoma by evaluating the choline metabolism. In this study, a radiolabeling method for [¹⁸F]fluorocholine was optimized using a solid phase extraction (SPE) cartridge. [¹⁸F]Fluorocholine was labeled in two steps using an automated synthesizer. In the first step, dibromomethane was reacted with [¹⁸F]KF/K2.2.2/K₂CO₃ to obtain the intermediate [¹⁸F]fluorobromomethane. In the second step, [¹⁸F]fluorobromomethane was passed through a Sep-Pak^Ⓡ Silica SPE cartridge to remove the impurities and then reacted with N,N-dimethylaminoethanol (DMAE) in a Sep-Pak^Ⓡ C18 SPE cartridge to label [¹⁸F]fluorocholine. The reaction conditions of [¹⁸F]fluorocholine were optimized. The synthesis yield was confirmed according to the number of silica cartridges and DMAE concentration. No statistically significant difference in the synthesis yield of [¹⁸F]fluorocholine was observed when using four or three silica cartridges (P>0.05). The labeling yield was 11.5±0.5% (N=4) when DMAE was used as its original solution. On the other hand, when diluted to 10% with dimethyl sulfoxide, the radiochemical yield increased significantly to 30.1±5.2% (N=20). In conclusion, [¹⁸F]Fluorocholine for clinical use can be synthesized stably in high yield by applying an optimized synthesis method.