• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.537-543
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• 2022

The purpose of this simulation study was to evaluate the possibility of pancreas detection through effective atomic number information using dual-energy computed tomography(CT). The effective atomic number of 10 tissue-equivalent materials were estimated through stoichiometric calibration. For stoichiometric calibration, HU values at low-energy (80 kV) and high-energy (140 kV) for 10 tissue-equivalent materials were used. Based on this method, the effective atomic number image of the tissue-equivalent material was extracted through an iterative algorithm. According to the results, the attenuation ratio in accordance with the effective atomic number was estimated to have an R² value of 0.9999, and the effective atomic number of Pancreas, Water, Liver, Blood, Spongiosa, and Cortical bone was overall within 1% accuracy compared to the theoretical value. Conventional pancreatic cancer examination uses a contrast medium, so there is a possibility of potential side effects of the contrast medium. In order to solve this problem, it is thought that it will be possible to contribute to an accurate and safe examination by extracting the effective atomic number using dual-energy CT without contrast enhancement. Based on this study, future research will be conducted on the detection of pancreatic cancer using the HU value of pancreatic cancer based on clinical images.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.93-101
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• 2015

Purpose In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. Thus, a wide range of scatter correction(SC) methods have been studied and this study is to evaluate the accuracy of CT based SC(CTSC) used in SPECT/CT as the comparison with existing energy window based SC(EWSC). Materials and Methods SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. In both conditions, Astonish(iterative : 4 subset : 16) reconstruction method and CT attenuation correction were commonly applied and three types of SC methods such as non-scatter correction(NSC), EWSC, CTSC were used in images filled with image. For EWSC, 9 sub-energy windows were set additionally in addition to main(=peak) energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Results Based on the image filled with air, %SF of images filled with water to which each SC method was applied is NSC 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the most scattering counts were removed in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. Conclusion In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

• Nuclear Engineering and Technology
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• v.55 no.4
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• pp.1342-1349
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• 2023

The planning accuracy of charged particle therapy (CPT) is subject to the accuracy of stopping power (SP) estimation. In this study, we propose a method of deriving a pseudo-triple-energy CT (pTECT) that can be achievable in the existing dual-energy CT (DECT) systems for better SP estimation. In order to remove the direct effect of errors in CT values, relative CT values according to three scanning voltage settings were used. CT values of each tissue substitute phantom were measured to show the non-linearity of the values thereby suggesting the absolute difference and ratio of CT values as parameters for SP estimation. Electron density, effective atomic number (EAN), mean excitation energy and SP were calculated based on these parameters. Two of conventional methods were implemented and compared to the proposed pTECT method in terms of residuals, absolute error and root-mean-square-error (RMSE). The proposed method outperformed the comparison methods in every evaluation metrics. Especially, the estimation error for EAN and mean excitation using pTECT were converging to zero. In this proof-of-concept study, we showed the feasibility of using three CT values for accurate SP estimation. Our suggested pTECT method indicates potential clinical utility of spectral CT imaging for CPT planning.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.212-225
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• 2023

Purpose We retrospectively investigated the characteristics of patients with monosodium urate (MSU) deposits of the hand and wrist on dual-energy CT (DECT) compared to those without. We also attempted to determine the pattern of MSU distribution in DECT. Materials and Methods In total, 93 patients were included who had undergone DECT for evaluation of the hand or wrist pain under the clinical impression of gouty arthritis. The total volume of MSU deposits on DECT was calculated and the pattern of MSU distribution on DECT was analyzed. Also, the level of the serum urate at the time of DECT and the highest level of the serum urate of the patients were obtained from their records and the relationship between MSU and serum urate level was evaluated. Results The range of the volume of MSU deposits on DECT was 0.01-16.11 cm³ (average: 1.07 cm³). The average level of serum urate was significantly higher in the MSU positive group than that in the MSU negative group. MSU deposits were most frequently observed in the wrists followed by fingers and digitorum tendons. Conclusion On DECT, MSU deposits were most frequently detected in the wrist and related with high serum urate level.

• Journal of Radiation Protection and Research
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• v.43 no.1
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• pp.1-9
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• 2018

Background: In this study, we investigate the image quality of virtual monochromatic images synthesized from dual-energy computed tomography (DECT) at voltages of 80/140 kV and 100/140 kV. Materials and Methods: Virtual monochromatic images of a phantom are synthesized from DECT scans from 40 to 70 keV in steps of 1 keV under the two combinations of tube voltages. The dose allocation of dual-energy (DE) scan is 50% for both low- and high-energy tubes. The virtual monochromatic images are compared to single-energy (SE) images at the same radiation dose. In the DE images, noise is reduced using the 100/140 kV scan at the optimal monochromatic energy. Virtual monochromatic images are reconstructed from 40 to 70 keV in 1-keV increments and analyzed using two quality indexes: noise and contrast-to-noise ratio (CNR). Results and Discussion: The DE scan mode with the 100/140 kV protocol achieved a better maximum CNR compared to the 80/140 kV protocol for various materials, except for adipose and brain. Image noise is reduced with the 100/140 kV protocol. The CNR values of DE with the 100/140 kV protocol is similar to or higher than that of SE at 120 kV at the same radiation dose. Furthermore, the maximum CNR with the 100/140 kV protocol is similar to or higher than that of the SE scan at 120 kV. Conclusion: It was found that the CNR achieved with the 100/140 kV protocol was better than that with the 80/140 kV protocol at optimal monochromatic energies. Virtual monochromatic imaging using the 100/140 kV protocol could be considered for application in breast, brain, lung, liver, and bone CT in accordance with the CNR results.

• Journal of radiological science and technology
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• v.45 no.2
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• pp.135-143
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• 2022

In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. This study is to evaluate the accuracy of CT based SC(CTSC) and energy window based SC(EWSC) as the comparison with existing Non SC. SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(^99mTc 74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. For EWSC, 9 sub-energy windows were set additionally in addition to main energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Based on the image filled with air, %SF of images filled with water to which each SC method was applied is non scatter correction(NSC) 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the scatter counts were removed the most in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

• Journal of Korean Neurosurgical Society
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• v.54 no.5
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• pp.384-389
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• 2013

Objective : Use of quantitative computed tomography (CT) to evaluate bone mineral density was suggested in the 1970s. Despite its reliability and accuracy, technical shortcomings restricted its usage, and dual-energy X-ray absorptiometry (DXA) became the gold standard evaluation method. Advances in CT technology have reduced its previous limitations, and CT evaluation of bone quality may now be applicable in clinical practice. The aim of this study was to determine if the Hounsfield unit (HU) values obtained from CT correlate with patient age and bone mineral density. Methods : A total of 128 female patients who underwent lumbar CT for back pain were enrolled in the study. Their mean age was 66.4 years. Among them, 70 patients also underwent DXA. The patients were stratified by decade of life, forming five age groups. Lumbar vertebrae L1-4 were analyzed. The HU value of each vertebra was determined by averaging three measurements of the vertebra's trabecular portion, as shown in consecutive axial CT images. The HU values were compared between age groups, and correlations of HU value with bone mineral density and T-scores were determined. Results : The HU values consistently decreased with increasing age with significant differences between age groups (p<0.001). There were significant positive correlations (p<0.001) of HU value with bone mineral density and T-score. Conclusion : The trabecular area HU value consistently decreases with age. Based on the strong positive correlation between HU value and bone mineral density, CT-based HU values might be useful in detecting bone mineral diseases, such as osteoporosis.

• Progress in Medical Physics
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• v.32 no.1
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• pp.1-17
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• 2021

The evolution of X-ray computed tomography (CT) has been based on the discovery of X-rays, the inception of the Radon transform, and the development of X-ray digital data acquisition systems and computer technology. Unlike conventional X-ray imaging (general radiography), CT reconstructs cross-sectional anatomical images of the internal structures according to X-ray attenuation coefficients (approximate tissue density) for almost every region in the body. This article reviews the essential physical principles and technical aspects of the CT scanner, including several notable evolutions in CT technology that resulted in the emergence of helical, multidetector, cone beam, portable, dual-energy, and phase-contrast CT, in integrated imaging modalities, such as positron-emission-tomography-CT and single-photon-emission-computed-tomography-CT, and in clinical applications, including image acquisition parameters, CT angiography, image adjustment, versatile image visualizations, volumetric/surface rendering on a computer workstation, radiation treatment planning, and target localization in radiotherapy. The understanding of CT characteristics will provide more effective and accurate patient care in the fields of diagnostics and radiotherapy, and can lead to the improvement of image quality and the optimization of exposure doses.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.7-11
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• 2012

Purpose : The effect of concomitant use of $^{18}F$-FDG and intravenous contrast agent (CA) on dual-energy X-ray absorptiometry (DXA), was rarely reported. We had investigated these potentially confounding effects. Materials and Methods : Twenty-two patients had undergone DXA before and immediately after $^{18}F$-FDG PET/CT scans. Two DXA and 1 PET/CT scans had performed within one-day. $^{18}F$-FDG PET/CT scans had been performed with CA in 17 patients and without CA in 5 patients. Whole body bone mineral content (BMC), whole body bone mineral density (BMD), total fat mass (TFM), and lean body mass (LBM) were measured by DXA scanner before and after the $^{18}F$-FDG PET/CT scans. Results : BMC, BMD, TFM and LBM had significantly affected by $^{18}F$-FDG PET/CT with CA (BMC, +13.7%, from $2061.3{\pm}393.7$ to $2343.4{\pm}373.3$; BMD, +9.3%, from $1.07{\pm}0.09$ to $1.17{\pm}0.08$; TFM, -34.1%, from $17052.1{\pm}4049.9$ to $11237.1{\pm}2990.3$; LBM, +13.6%, from $45834.5{\pm}5662.1$ to $52094.0{\pm}6335.4$). However, $^{18}F$-FDG PET/CT without CA had no effect on the measurement of DXA (BMC, +2.4%, from $2197.7{\pm}391.6$ to $2251.5{\pm}380.9$; BMD, +1.8%, from $1.13{\pm}0.09$ to $1.15{\pm}0.07$; TFM, -6.8%, from $14585.6{\pm}3455.9$ to $13591.3{\pm}4351.4$; LBM, +2.2%, from $47360.5{\pm}8381.8$ to $48441.1{\pm}8488.1$). Conclusion : The measurements of DXA are affected by using CA. However, DXA scans might be unaffected by the presence of $^{18}F$-FDG administered for PET/CT.

• Journal of Korea Multimedia Society
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• v.19 no.8
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• pp.1248-1259
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• 2016

Classification methods based on dual energy X-ray absorptiometry, ultrasonic waves, and quantitative computed tomography have been proposed. Also, a classification method based on machine learning with bone mineral density and structural indicators extracted from the CT images has been proposed. We propose a method which enhances the performance of existing classification method based on bone mineral density and structural indicators by extending structural indicators and using principal component analysis. Experimental result shows that the proposed method in this paper improves the correctness of osteoporosis classification 2.8% with extended structural indicators only and 4.8% with both extended structural indicators and principal component analysis. In addition, this paper proposes a method of automatic phantom analysis needed to convert the CT values to BMD values. While existing method requires manual operation to mark the bone region within the phantom, the proposed method detects the bone region automatically by detecting circles in the CT image. The proposed method and the existing method gave the same conversion formula for converting CT value to bone mineral density.