• Journal of radiological science and technology
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• v.37 no.4
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• pp.239-246
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• 2014

Filter absorbs low-energy X-ray to increase the average energy and reduces patient exposure dose. This study investigates if the materials of Mo and W could be used for the digital imaging device CR by conducting image assessment and dose measurement of SNR, FOM and histogram. In addition, measurement of beam quality was conducted depending on the material of the filter, and at the same time, a proper combination of filters was examined depending on the change in tube voltage (kVp). In regard to entrance skin dose, Mo filter showed the dose reduction by 42~56%, compared to Cu filter. Moreover, Mo filter showed higher transmission dose by around 1.5 times than that of Cu filter. In image assessment, it was found that W was unsuitable to be used as a filter, whereas Mo could be used as a filter to reduce dose without decline in image quality at the tube voltage of 80 kVp or higher. As tube voltage increased, 2.0 mm Al+0.1 mm Mo almost had a similar histogram width to that of 2.0 mm Al+0.2 mm Cu. Therefore, Mo filter can be used at relatively high tube voltage of 80 kVp, 100 kVp and 120 kVp. The SNR of 2.0 mm Al+0.1 mm Mo did not show any significant difference from those of 2.0 mm Al+0.2 mm Cu and 2.0 mm Al+0.1 mm Cu. As a result, if Mo filter is used to replace Cu filter in general radiography, where 80 kVp or higher is used for digital radiation image, patient exposure dose can be reduced significantly without decline in image quality, compared to Cu filter. Therefore, it is believed that Mo filter can be applied to chest X-ray and high tube voltage X-ray in actual clinical practice.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.649-661
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• 1999

The goals of this study were 1) to present pre-surgical naso-alveolar molding (PNAM) appliance for bilateral cleft lip and palate treatment and 2) to evaluate the effects of the PNAM appliance on the alveolar molding of the premaxilla and the lateral segments. Subjects consisted of 8 bilateral cleft lip and palate infants (7 males and 1 female, mean age at first visit = 61.6 days after birth) who were treated with PNAM appliances in Department of Orthodontics, Seoul National University Dental Hospital. Average alveolar cleft gap between the premaxilla and the lateral segment was $8.09{\pm}5.03mm$ and average duration of alveolar molding treatment was $8.8{\pm}3.1$ weeks. These patients' models were obtained at initial visit (T0) and after alveolar molding (T1). 20 linear and 14 angular variables were measured by using photometry and digital caliper, All statistical analyses were performed by Microsoft Excel 97 program. Paired t-test was used to discriminate the effect of alveolar molding by PNAM appliance. 1. Closure of the alveolar cleft gap in bilateral cleft cases by molding therapy was completed successfully, 2. Alveolar molding inhibited outward growth of lateral segments and produced inward bending of lateral segments. 3. By bending the anterior part of the vomer, the premaxilla could be rotated and moved. posteriorly via alveolar molding. Conclusion This appliance can be applied to bilateral cleft lip and palate infants with satisfactory results before cheiloplasty.

• Progress in Medical Physics
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• v.23 no.3
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• pp.154-161
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• 2012

Digital Radiography (DR) has rapidly developed in megavoltage X-ray imaging (MVI). Thus, a very simple and general quality assurance (QA) method is required. The purpose of this study was to evaluate the modulation transfer function (MTF), the noise power spectrum (NPS) and the detective quantum efficiency (DQE) for MVI using general QA method and computed radiography (CR) device. We used tungsten edge block with $19{\times}10{\times}1cm^3$ thickness and 6MV energy. For detector, CR-IP (image plate), CR-IP-lead, the CR-IP-back (lanex TM fast back screen), CR-IP-front (lanex TM fast front screen) were used and pre-sampling MTF was calculated. The MTF of CR-IP-front showed the highest value with 1.10 lp/mm although the CR-IP showed the only 0.70 lp/mm. The best NPS was observed in CR-IP front screen. According to the increase in spatial frequency, our results showed that DQE was approximately 1.0 cycles/mm. The present study demonstrates that the QA method with our home-made edge block can be used to evaluate MTF, NPS and DQE for MVI.

• Journal of the Korean Society of Radiology
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• v.14 no.5
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• pp.603-612
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• 2020

This study has a purpose to look into the effect of the relationship between the Tube current (mA) and SOD(Source to Object Distance), which is a parameter of lower limb angiography examination, and the dilution rate of the contrast medium concentration (300, 320, 350) on the image. To that end, using 3 mm vessel model water phantom, a vessel model custom made in the size of peripheral vessel diameter, this study measured relationships between change of parameters, such as tube current (mA), SOD and varying concentrations (300, 320, 350) of contrast medium dilution into SNR and CNR values while analyzing the coefficients of variance(cv<10). The software used to measure SNR and CNR values was Image J 1.50i from NIH (National Institutes of Health, USA). MPV (mean pixel value) and SD (standard deviation) were used after verifying numerically the image signal for region of interest (ROI) and background on phantom from the DICOM (digital imaging and communications in medicine) 3.0 file transmitted to PACS. As to contrast medium dilution by the change of tube current, when 146 mA and 102 mA were compared, For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 22.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As to contrast medium dilution by concentration for SOD change, when SOD's (32.5 cm and 12.5 cm) were compared,For both SNR and CNR, the coefficient of variation value was less than 10 until the section of CM: N/S dilution (100% ~ 30% : 70%) but CM: N/S dilution rate (20%: 80% ~ 10% : 90%) the coefficient of variation was 10 or more. As a result, set a low tube current value in other tests or procedures including peripheral angiography of the lower extremities in the intervention, and make the table as close as possible to the image receiver, and adjust the contrast agent concentration (300) to CM: N/S dilution (30%: 70%). ) Is suggested as the most efficient way to obtain images with an appropriate concentration while simultaneously reducing the burden on the kidney and the burden on exposure.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.241-247
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• 2006

Recently, interests and utilization on Computed Radiography(CR) and Digital Radiography(DR) tends to increase owing to an introduction of Picture Archiving and Communication System(PACS) and an accuracy control of special medical equipment for a breast imaging examination. This study was intended to compare and analyze a detector's imaging quality by each system to be used for the breast imaging examination by using ACR Phantom used at the accuracy control. As an evaluation method, a significance and reliability of image's value using the ACR Phantom was analyzed by using SPSS program. The results are followed. 1. For the fiber, there was 3.9 score in Screen-Film, 4.2 score in CR($50{\mu}m$), 3.2 score in CR($100{\mu}m$), and 4.2 score in DR. There was the high score in the order of CR($50{\mu}m$), DR, Screen-Film, and CR($100{\mu}m$)(P<0.05). 2. For the calcification, there was 2.7 score in Screen-Film, 2.5 score in CR($50{\mu}m$), 2.0 score in CR($100{\mu}m$), and 2.9 score in DR. There was the high score in the order of DR, Screen-Film, CR($50{\mu}m$), and CR($100{\mu}m$).(0.025(P<0.05). 3. For Mass, there was 3.8 score in Screen-Film, 3.8 score in CR($50{\mu}m$), 3.6 score in CR($100{\mu}m$), and 4.5 score in DR. There was the high score in the order of DR, CR($50{\mu}m$), Screen-Film, and CR($100{\mu}m$) (P<0.1). 4. As the total score, there was 10.4 score in Screen-Film, 10.6 score in CR($50{\mu}m$), 8.7 score in CR($100{\mu}m$), and 11.3 score in DR. There was the high score in the order of DR, $CR(50{\mu}m$), Screen-Film, and $CR(100{\mu}m$). As shown in the above results, it can be known that DR and Screen-Film System has higher image quality than CR. But, DR has unstability caused by element, and Screen-Film has the low image quality caused by artifact as disadvantages. When Dual-Side CR($50{\mu}m$) was used among CR systems which had the problem of low image quality, it was indicated that there was no difference with Screen-Film System. Because the radiation imaging examination tends to become digitalized, each system for the breast imaging examination will need to be developed and supplemented.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.101-106
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• 2000

Purpose : This study was peformed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with modulloblastoma and to define the optimal radiotherapeutic regimen. Materials and Methods : We retrospectively analyzed the records of 43 patients with modulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to U months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received at least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. Results : The overall survival rates at 5 and 7 years for entire group of patients were 57$\%$ and 56$\%$, respectively. Corresponding disease free survival rates were 60$\%$ and 51$\%$, respectively, The rates of disease control in the posterior fossa were 77$\%$ and 67$\%$ at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76$\%$ and 66$\%$, respectively, In contrast, those patients who had biopsy alone had a 5 year survival rate of only 40$\%$. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Conclusion : Craniospinal irradiation for patients with moduiloblastoma is an effective adjuvant treatment without significant treatment related toxicitles. There is room for Improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hypefractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be evolved to improve the tumor control rate at primary site.

• KIPS Transactions on Computer and Communication Systems
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• v.11 no.9
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• pp.317-322
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• 2022

The rapid development of information technology is also bringing about many changes in the medical environment. In particular, it is leading the rapid change of medical image information systems using big data and artificial intelligence (AI). The prescription delivery system (OCS), which consists of an electronic medical record (EMR) and a medical image storage and transmission system (PACS), has rapidly changed the medical environment from analog to digital. When combined with multiple solutions, PACS represents a new direction for advancement in security, interoperability, efficiency and automation. Among them, the combination with artificial intelligence (AI) using big data that can improve the quality of images is actively progressing. In particular, AI PACS, a system that can assist in reading medical images using deep learning technology, was developed in cooperation with universities and industries and is being used in hospitals. As such, in line with the rapid changes in the medical image information system in the medical environment, structural changes in the medical market and changes in medical policies to cope with them are also necessary. On the other hand, medical image information is based on a digital medical image transmission device (DICOM) format method, and is divided into a tomographic volume image, a volume image, and a cross-sectional image, a two-dimensional image, according to a generation method. In addition, recently, many medical institutions are rushing to introduce the next-generation integrated medical information system by promoting smart hospital services. The next-generation integrated medical information system is built as a solution that integrates EMR, electronic consent, big data, AI, precision medicine, and interworking with external institutions. It aims to realize research. Korea's medical image information system is at a world-class level thanks to advanced IT technology and government policies. In particular, the PACS solution is the only field exporting medical information technology to the world. In this study, along with the analysis of the medical image information system using big data, the current trend was grasped based on the historical background of the introduction of the medical image information system in Korea, and the future development direction was predicted. In the future, based on DICOM big data accumulated over 20 years, we plan to conduct research that can increase the image read rate by using AI and deep learning algorithms.

• Journal of the Korean Society of Radiology
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• v.3 no.3
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• pp.5-11
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• 2009

When using Image Guided Radiation Therapy, the patient is placed using skin marker first and after confirming anatomical location using OBI, the couch is moved to correct the set up. Evaluation for the error made at that moment was done. Through comparing $0^{\circ}$ and $270^{\circ}$ direction DRR image and OBI image with 2D-2D matching when therapy planning, comparison between patient's therapy plan setup and actual treatment setup was made to observe the error. Treatment confirmation on important organs such as head, neck and spinal cord was done every time through OBI setup and other organs such as chest, abdomen and pelvis was done 2 ~ 3 times a week. But corrections were all recorded on OIS so that evaluation on accuracy could be made through using skin index which was divided into head, neck, chest and abdomen-pelvis on 160 patients. Average setup error for head and neck patient on each AP, SI, RL direction was $0.2{\pm}0.2cm$, $-0.1{\pm}0.1cm$, $-0.2{\pm}0.0cm$, chest patient was $-0.5{\pm}0.1cm$, $0.3{\pm}0.3cm$, $0.4{\pm}0.2cm$, and abdomen was $0.4{\pm}0.4cm$, $-0.5{\pm}0.1cm$, $-0.4{\pm}0.1cm$. In case of pelvis, it was $0.5{\pm}0.3cm$, $0.8{\pm}0.4cm$, $-0.3{\pm}0.2cm$. In rigid body parts such as head and neck showed lesser setup error compared to chest and abdomen. Error was greater on chest in horizontal axis and in AP direction, abdomen-pelvis showed greater error. Error was greater on chest in horizontal axis because of the curve in patient's body when the setup is made. Error was greater on abdomen in AP direction because of the change in front and back location due to breathing of patient. There was no systematic error on patient setup system. Since OBI confirms the anatomical location, when focus is located on the skin, it is more precise to use skin marker to setup. When compared with 3D-3D conformation, although 2D-2D conformation can't find out the rolling error, it has lesser radiation exposure and shorter setup confirmation time. Therefore, on actual clinic, 2D-2D conformation is more appropriate.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.183-198
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• 2000

Purpose: The purpose of this study was to evaluate alterations of regional cerebral blood flow (CBF) and cerebrovascular reserve (CVR), and correlation between these alternations and cognitive dysfunction in patients with chronic traumatic brain injury (TBI) and normal brain MRI findings. Materials and Methods: Thirty TBI patients and 19 healthy volunteers underwent rest/acetazolamide brain SPECT using Tc-99m HMPAO. Korean-Wechsler Adult Intelligence scale test was also performed in the patient group. Statistical analysis was performed with statistical parametric mapping software (SPM'97) Results: CBF was diminished in the left hemisphere including Wernicke's area in all patients with lower verbal scale scores. In addition, a reduction in CBF in the right frontal, temporal and parietal cortices was related with depressed scores in information, digital span, arithmetic and similarities. In patients with lower performance scale scores, CBF was mainly diminished in the right hemisphere including superior temporal and supramarginal gyri, premotor, primary somatomotor and a part of prefrontal cortices, left frontal lobe and supramarginal gyrus. CVR was diminished in sixty-four Brodmann's areas compared to control. A reduction in CVR was demonstrated bilaterally in the frontal and temporal lobes in patients with lower scores in both verbal and performance tests, and in addition, both inferior parietal and occipital lobes in information subset. Conclusion: Alterations of CBF and CVR were demonstrated in the symptomatic TBI patients with normal MRI finding. These alterations were correlated with the change of intelligence, of which the complex functions are subserved by multiple interconnected cortical structures.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.166-176
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• 2010

Purpose: To determine the appropriate prostate planning target volume (PTV) margins for 3-dimensitional (3D) conformal radiotherapy (CRT) and intensity-modulated radiation therapy (IMRT) patients treated with an endorectal balloon (ERB) under our institutional treatment condition. Materials and Methods: Patients were treated in the supine position. An ERB was inserted into the rectum with 70 cc air prior to planning a CT scan and then each treatment fraction. Electronic portal images (EPIs) and digital reconstructed radiographs (DRR) of planning CT images were used to evaluate inter-fractional patient's setup and ERB errors. To register both image sets, we developed an in-house program written in visual $C^{++}$. A new method to determine prostate PTV margins with an ERB was developed by using the common method. Results: The mean value of patient setup errors was within 1 mm in all directions. The ERB inter-fractional errors in the superior-inferior (SI) and anterior-posterior (AP) directions were larger than in the left-right (LR) direction. The calculated 1D symmetric PTV margins were 3.0 mm, 8.2 mm, and 8.5 mm for 3D CRT and 4.1 mm, 7.9 mm, and 10.3 mm for IMRT in LR, SI, and AP, respectively according to the new method including ERB random errors. Conclusion: The ERB random error contributes to the deformation of the prostate, which affects the original treatment planning. Thus, a new PTV margin method includes dose blurring effects of ERB. The correction of ERB systematic error is a prerequisite since the new method only accounts for ERB random error.