• Journal of radiological science and technology
• /
• v.40 no.2
• /
• pp.311-316
• /
• 2017

Generally assessing bone mineral density (BMD) were performed on dual energy X-ray absorptiometry (DEXA) the same as dual energy CT (DECT) with a rapid-kVp switching. The purpose of this study is to compare the different of BMD value between DEXA and DECT method, and evaluate usefulness of DECT method. Using scanner for BMD measurements were GE, Healthcare Discovery 750 HD for DECT and Hologic QDR 4500W for DEXA. For compare BMD value in each method, scanned lumbar spine phantom and subjects visiting Korean National Cancer Center from April 2015 to December 2015, records of 50 patients. This study was approved by the Institutional Review Board. The mean BMD value measures for spine phantom and for subjects in each scanners presented strong correlation (r=0.948 with p<0.05 for phantom; r=0.635 with p<0.05 and Kendall's tau $({\tau})=0.46$ with p<0.05 for subjects) and linear relationship between DECT and conventional DEXA. DECT technique for BMD measurement will provide a very useful methodology without additional radiation dose.

• Hip & pelvis
• /
• v.30 no.4
• /
• pp.233-240
• /
• 2018

Purpose: This study aimed to evaluate the efficacy of simultaneous computed tomography (CT) and quantitative CT (QCT) in patients with osteoporotic hip fracture (OHF) by analyzing the osteoporosis detection rate and physician prescription rate in comparison with those of conventional dual-energy X-ray absorptiometry (DXA). Materials and Methods: This study included consecutive patients older than 65 years who underwent internal fixation or hip arthroplasty for OHF between February and May 2015. The patients were assigned to either the QCT (47 patients) or DXA group (51 patients). The patients in the QCT group underwent QCT with hip CT, whereas those in the DXA group underwent DXA after surgery, before discharge, or in the outpatient clinic. In both groups, the patients received osteoporosis medication according to their QCT or DXA results. The osteoporosis evaluation rate and prescription rate were determined at discharge, postoperative (PO) day 2, PO day 6, and PO week 12 during an outpatient clinic visit. Results: The osteoporosis evaluation rate at PO week 12 was 70.6% (36 of 51 patients) in the DXA group and 100% in the QCT group (P<0.01). The prescription rates of osteoporosis medication at discharge were 70.2% and 29.4% (P<0.001) and the cumulative prescription rates at PO week 12 were 87.2% and 60.8% (P=0.003) in the QCT and DXA groups, respectively. Conclusion: Simultaneous CT and QCT significantly increased the evaluation and prescription rates in patients with OHF and may enable appropriate and consistent prescription of osteoporosis medication, which may eventually lead to patients' medication compliance.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.9
• /
• pp.655-662
• /
• 2016

We investigated on the usefulness of MAR algorithm by making a comparison of the CT value between before and after applying the MAR algorithm in dual energy CT, using the various kinds of medical metals, causing the artifact to lead to the low image quality. As a result, the artifact was reduced in most cases (P<0.05); in particular, the artifact was highly reduced (P<0.05) using high density material, like alloy-stainless (reduced by 78.1%) and platinum, for example GDC coil (reduced by 76.1%). The effect of decreasing the Black hole artifact was outstanding in both the alloy-stainless and alloy-titanium (P<0.05). However, in case of GDC coil-a type platinum, white streak artifact was reduced effectively (P<0.05). Therefore, in case of patients who have medical metals inserted, we think that high-quality image information can be provided by decreasing the artifact caused by high density material through MAR algorithm in dual energy CT.

• Korean Journal of Radiology
• /
• v.23 no.1
• /
• pp.139-149
• /
• 2022

Objective: To compare the effects of bone suppression imaging using deep learning (BSp-DL) based on a generative adversarial network (GAN) and bone subtraction imaging using a dual energy technique (BSt-DE) on radiologists' performance for pulmonary nodule detection on chest radiographs (CXRs). Materials and Methods: A total of 111 adults, including 49 patients with 83 pulmonary nodules, who underwent both CXR using the dual energy technique and chest CT, were enrolled. Using CT as a reference, two independent radiologists evaluated CXR images for the presence or absence of pulmonary nodules in three reading sessions (standard CXR, BSt-DE CXR, and BSp-DL CXR). Person-wise and nodule-wise performances were assessed using receiver-operating characteristic (ROC) and alternative free-response ROC (AFROC) curve analyses, respectively. Subgroup analyses based on nodule size, location, and the presence of overlapping bones were performed. Results: BSt-DE with an area under the AFROC curve (AUAFROC) of 0.996 and 0.976 for readers 1 and 2, respectively, and BSp-DL with AUAFROC of 0.981 and 0.958, respectively, showed better nodule-wise performance than standard CXR (AUAFROC of 0.907 and 0.808, respectively; p ≤ 0.005). In the person-wise analysis, BSp-DL with an area under the ROC curve (AUROC) of 0.984 and 0.931 for readers 1 and 2, respectively, showed better performance than standard CXR (AUROC of 0.915 and 0.798, respectively; p ≤ 0.011) and comparable performance to BSt-DE (AUROC of 0.988 and 0.974; p ≥ 0.064). BSt-DE and BSp-DL were superior to standard CXR for detecting nodules overlapping with bones (p < 0.017) or in the upper/middle lung zone (p < 0.017). BSt-DE was superior (p < 0.017) to BSp-DL in detecting peripheral and sub-centimeter nodules. Conclusion: BSp-DL (GAN-based bone suppression) showed comparable performance to BSt-DE and can improve radiologists' performance in detecting pulmonary nodules on CXRs. Nevertheless, for better delineation of small and peripheral nodules, further technical improvements are required.

• Journal of the Korean Society of Radiology
• /
• v.17 no.2
• /
• pp.207-213
• /
• 2023

Computed tomography (CT) images are used as the basis for proton Bragg peak position estimation and treatment plan simulation. During the Hounsfield Unit (HU) based proton stopping power ratio (SPR) estimation, small differences in the patient's density and elemental composition lead to uncertainty in the Bragg peak positions along the path of the proton beam. In this study, we investigated the potential of dual-energy computed tomography image-based proton SPRs prediction accuracy to reduce the uncertainty of Bragg peak position prediction. Single- and dual-energy images of an electron density phantom (CIRS Model 062M electron density phantom, CIRS Inc., Norfolk, VA, USA) were acquired using a computed tomography system (Somatom Definition AS, Siemens Health Care, Forchheim, Germany) to estimate the SPRs of the proton beam. To validate the method, it was compared to the SPRs estimated from standard data provided by the National Institute of Standards and Technology (NIST). The results show that the dual-energy image-based method has the potential to improve accuracy in predicting the SPRs of proton beams, and it is expected that further improvements in predicting the position of the proton's Bragg peak will be possible if a wider variety of substitutes with different densities and elemental compositions of the human body are used to predict the SPRs.

• Journal of Nutrition and Health
• /
• v.29 no.9
• /
• pp.943-949
• /
• 1996

Bone mineral density depends largely on the status of dietary minerals such as Ca, P, Mg, and F and proteins, physical activities, parathyroid hormone(PTH), calcitonin(CT), and vitamin D. The decrease of bone density often results in bone fractures and osteoporosis which is prevalent among postmenopausal women. This study was intended to examine the role of parathyroid hormone, calcitonin and cholecaliferol in bone density of mice that were fed different dual photon energy beams. We have measured three major parts of the bone : whole body, head and femur. The results are summarized as follows : 1) Bone mineral density (BMD) was more increased by feeding high Ca diet compared to that of the low Ca diet. 2) Both PTH and Vit D3 enhanced BMD in all of the different Ca levels. 3) When the dietary Ca was deequate CT showed a synergistic effect with PTH in boosting bone density, while CT+Vit D3 showed a negative effect. 4) CT tended to inhibit the effect of increasing bone density by PTH and Vit D3 in medium and low Ca groups. 5) The effect of increasing bone density by PTH in the head of mouse increased when dietary Ca was lower : The increment of bone density by PTH in high, medium, and low Ca was 3%, 8%, 19%, respectively. 6) Femur bone density was affected significantly by dietary Ca levels than hormones. The above observations indicate that bone mineral density can be improved by high dietary Ca and hormone injections including PTH, CT and cholecalciferol, and thus proper dietary and hormonal treatment may be used in preventing bone fractures and osteoporosis.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.1
• /
• pp.63-67
• /
• 2012

Although advances in multi-detector computed tomography (CT) technique make it possible to evaluate peripheral subsegmental pulmonary arteries, several studies have reported that small peripheral embolisms may still be missed. Recently, some reports demonstrated that dual-energy CT improved the capability to detect peripheral pulmonary embolism. We report a case of lymphoma presenting as disseminated microvascular pulmonary tumor embolism, detected by perfusion images using dual energy CT.

• Journal of the Korean Society of Radiology
• /
• v.84 no.1
• /
• pp.170-184
• /
• 2023

Purpose To assess the magnitude of differences between attenuation values of the true non-contrast image (TNC) and virtual non-contrast image (VNC) derived from twin-beam dual-energy CT (tbDECT) and dual-source DECT (dsDECT). Materials and Methods This retrospective study included 62 patients who underwent liver dynamic DECT with tbDECT (n = 32) or dsDECT (n = 30). Arterial VNC (AVNC), portal VNC (PVNC), and delayed VNC (DVNC) were reconstructed using multiphasic DECT. Attenuation values of multiple intra-abdominal organs (n = 11) on TNCs were subsequently compared to those on multiphasic VNCs. Further, we investigated the percentage of cases with an absolute difference between TNC and VNC of ≤ 10 Hounsfield units (HU). Results For the mean attenuation values of TNC and VNC, 33 items for each DECT were compared according to the multiphasic VNCs and organs. More than half of the comparison items for each DECT showed significant differences (tbDECT 17/33; dsDECT 19/33; Bonferroni correction p < 0.0167). The percentage of cases with an absolute difference ≤ 10 HU was 56.7%, 69.2%, and 78.6% in AVNC, PVNC, and DVNC in tbDECT, respectively, and 70.5%, 78%, and 78% in dsDECT, respectively. Conclusion VNCs derived from the two DECTs were insufficient to replace TNCs because of the considerable difference in attenuation values.

• Proceedings of the Korea Contents Association Conference
• /
• 2014.11a
• /
• pp.211-212
• /
• 2014

단일에너지 복부 검사에서 사용했던 조영제 양 대비 30%, 40%, 50%, 60%, 70%로 각각 설정하여 영상을 획득한 후 대동맥, 하대정맥, 간문맥, 간실질에 관심영역을 설정하여 조영증강정도(houns -field unit; HU)를 구하여 단일에너지에서 측정된 부위와의 값을 비교 분석하였다. 그 결과 기존대비 60%로 조영제를 설정한 군에서는 대동맥 HU : $210.80{\pm}13.609$, 하대정맥 HU : $190.40{\pm}25.215$, 간문맥 $198.40{\pm}21.232$, 간실질 HU : $119.20{\pm}7.98$로 각각 측정되었으며. 단일에너지 복부 CT 검사는 대동맥 HU : $205.40{\pm}16.426$, 하대정맥 HU : $188.20{\pm}21.476$, 간문맥 HU : $195.40{\pm}22.744$, 간실질 HU : $121.00{\pm}6.595$ 이었다. 따라서 이중에너지를 이용하여 복부 조영 CT검사를 시행할 때 조영제의 양을 60%로 설정한 후 검사하는 것이 각 장기에서의 단일에너지 조영검사시와 비슷한 조영증강정도를 획득할 수 있다.

• Korean Journal of Radiology
• /
• v.22 no.4
• /
• pp.502-512
• /
• 2021

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40-80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z_eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40-50 keV showed increased CNR and SNR_{breast lesion} compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR_{breast lesion}: 40 keV, 21.01; 50 keV, 16.28; vs. PEI, 10.77; p < 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z_eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion: Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.