• Title/Summary/Keyword: Enhanced CT

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Dynamic Contrast-Enhanced Ultrasound of Gastric Cancer: Correlation with Perfusion CT and Histopathology

  • Ijin Joo;Se Hyung Kim;Dong Ho Lee;Joon Koo Han
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.781-790
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    • 2019
  • Objective: To assess the relationship between contrast-enhanced ultrasound (CEUS) parameters and perfusion CT (PCT) parameters of gastric cancers and their correlation with histologic features. Materials and Methods: This prospective study was approved by our Institutional Review Board. We included 43 patients with pathologically-proven gastric cancers undergoing CEUS using SonoVue® (Bracco) and PCT on the same day. Correlation between the CEUS parameters (peak intensity [PI], area under the curve [AUC], rise time [RT] from 10% to 90% of PI, time to peak [TTPUS], and mean transit time [MTTUS]) and PCT parameters (blood flow, blood volume, TTPCT, MTTCT, and permeability surface product) of gastric cancers were analyzed using Spearman's rank correlation test. In cases of surgical resection, the CEUS and PCT parameters were compared according to histologic features using Mann-Whitney test. Results: CEUS studies were of diagnostic quality in 88.4% (38/43) of patients. Among the CEUS parameters of gastric cancers, RT and TTPUS showed significant positive correlations with TTPCT (rho = 0.327 and 0.374, p = 0.045 and 0.021, respectively); PI and AUC were significantly higher in well-differentiated or moderately-differentiated tumors (n = 4) than poorly-differentiated tumors (n = 18) (p = 0.026 and 0.033, respectively), whereas MTTCT showed significant differences according to histologic types (poorly cohesive carcinoma [PCC] vs. non-PCC), T-staging (≤ T2 vs. ≥ T3), N-staging (N0 vs. N-positive), and epidermal growth factor receptor expression (≤ faint vs. ≥ moderate staining) (p values < 0.05). Conclusion: In patients with gastric cancers, CEUS is technically feasible for the quantification of tumor perfusion and may provide correlative and complementary information to that of PCT, which may allow prediction of histologic features.

Contrast-Enhanced CT and Ultrasonography Features of Intracholecystic Papillary Neoplasm with or without associated Invasive Carcinoma

  • Jae Hyun Kim;Jung Hoon Kim;Hyo-Jin Kang;Jae Seok Bae
    • Korean Journal of Radiology
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    • v.24 no.1
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    • pp.39-50
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    • 2023
  • Objective: To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC). Materials and Methods: In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with DP (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC). Results: For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1-1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3-23.4) on CT were independently associated with ICPN-IC. Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6-10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3-15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0-1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676; p = 0.002). Conclusion: ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP.

Invisible Parotid Gland Pleomorphic Adenoma on Contrast Enhanced-Computed Tomography (조영증강 전산화단층촬영검사에서 보이지 않는 이하선의 다형선종)

  • Heo, Jae Hyung;Kim, Da Mi;Koo, Bon Seok;Chang, Jae Won
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.85-89
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    • 2016
  • Pleomorphic adenomas is the most common tumor of parotid gland and usually located and confined in superficial lobe of parotid gland. Computed tomography (CT) is commonly used to initially evaluate salivary gland lesion, but contrast-enhanced CT may sometimes fail to reveal lesions in spite of a high clinical suspicion. For this reason, ultrasonography (US) can be used as the first-line image work-up in some cases of parotid gland benign tumors. We experienced a case of a 60-year-old woman without underlying disease presenting a palpable parotid mass in which the initial CT examination was reported as 'no obvious mass detected'. However, the lesion was revealed in US and histologically confirmed as pleomorphic adenoma. The patient underwent superficial parotidectomy through modified facelift incision. To the best of our knowledge, this is the first report of invisible major salivary gland tumor on CT in the Korean literature.

Synthesis of contrast CT image using deep learning network (딥러닝 네트워크를 이용한 조영증강 CT 영상 생성)

  • Woo, Sang-Keun
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2019.01a
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    • pp.465-467
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    • 2019
  • 본 논문에서는 영상생성이 가능한 딥러닝 네트워크를 이용하여 조영증강 CT 영상을 획득하는 연구를 수행하였다. CT는 고해상도 영상을 바탕으로 환자의 질병 및 암 세포 진단에 사용되는 의료영상 기법 중 하나이다. 특히, 조영제를 투여한 다음 CT 영상을 획득되는 영상을 조영증강 CT 영상이라 한다. 조영증강된 CT 영상은 물질의 구성 성분의 영상대비를 강조하여 임상의로 하여금 진단 및 치료반응 평가의 정확성을 향상시켜준다. 하지많은 수의 환자들이 조영제 부작용을 갖기 때문에 이에 해당되는 환자의 경우 조영증강 CT 영상 획득이 불가능해진다. 따라서 본 연구에서는 조영증강 영상을 얻지 못하는 환자 및 일반 환자의 불필요한 방사선의 노출을 최소화 하기 위하여 영상생성 딥러닝 기법을 이용하여 CT 영상에서 조영증강 CT 영상을 생성하는 연구를 진행하였다. 영상생성 딥러닝 네트워크는 generative adversarial network (GAN) 모델을 사용하였다. 연구결과 아무런 전처리도 거치지 않은 CT 영상을 이용하여 영상을 생성하는 것 보다 히스토그램 균일화 과정을 거친 영상이 더 좋은 결과를 나타냈으며 생성영상이 기존의 실제 영상과 영상의 구조적 유사도가 높음을 확인할 수 있다. 본 연구결과 딥러닝 영상생성 모델을 이용하여 조영증강 CT 영상을 생성할 수 있었으며, 이를 통하여 환자의 불필요한 방사선 피폭을 최소하며, 생성된 조영증강 CT 영상을 바탕으로 정확한 진단 및 치료반응 평가에 기여할 수 있을거라 기대된다.

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Development of Activity Enhanced Zero Valent Metals for Permeable Reactive Barrier (침투성 반응벽체를 위한 고활성 영가금속 개발)

  • Kim, Young-Hun;Kim, Myung-Chul
    • Journal of Environmental Science International
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    • v.12 no.2
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    • pp.201-205
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    • 2003
  • The dechlorination of chlorinated methanes by iron powder and palladium coated iron (Pd/Fe) was studied in batch experiments. Iron powder dechlorinated carbon tetrachloride (CT) with a half-life of 4 days. Three chloromethane was found as major product and less chlorinated daughters. Mass balance found was to be about 93-99%. Pd/Fe showed very enhanced reactivity for CT in comparing with plain iron. The major dechlorination products of CT were also less chlorinated methanes with Pd/Fe. Pd/Fe also degrade the produced less chlorinated compounds. Sequential reactions were occurred on Pd/Fe. As the Pd/Fe content increased, the reaction rate was increased linearly.

Automatic Liver Segmentation of a Contrast Enhanced CT Image Using an Improved Partial Histogram Threshold Algorithm

  • Seo Kyung-Sik;Park Seung-Jin
    • Journal of Biomedical Engineering Research
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    • v.26 no.3
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    • pp.171-176
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    • 2005
  • This paper proposes an automatic liver segmentation method using improved partial histogram threshold (PHT) algorithms. This method removes neighboring abdominal organs regardless of random pixel variation of contrast enhanced CT images. Adaptive multi-modal threshold is first performed to extract a region of interest (ROI). A left PHT (LPHT) algorithm is processed to remove the pancreas, spleen, and left kidney. Then a right PHT (RPHT) algorithm is performed for eliminating the right kidney from the ROI. Finally, binary morphological filtering is processed for removing of unnecessary objects and smoothing of the ROI boundary. Ten CT slices of six patients (60 slices) were selected to evaluate the proposed method. As evaluation measures, an average normalized area and area error rate were used. From the experimental results, the proposed automatic liver segmentation method has strong similarity performance as the MSM by medical Doctor.

Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography

  • Lee, Sang-Kwon;Jeong, Wooram;Choi, Jihye
    • Korean Journal of Veterinary Research
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    • v.59 no.2
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    • pp.105-108
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    • 2019
  • A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

A Restructuring Method for Search Results of SNOMED CT Browser (SNOMED CT 브라우저에서 검색 결과의 재구성 기법)

  • Ryu, Wooseok
    • IEMEK Journal of Embedded Systems and Applications
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    • v.10 no.3
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    • pp.165-170
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    • 2015
  • SNOMED CT browser is a browsing tool for searching clinical terms in SNOMED CT which is a standard terminology set used worldwide. The search result view of previous browsers merely list up candidate terminologies. The problem is that most of users become confused about how to select an appropriate term from the list. This leads serious waste of medical recoding cost. This paper discusses characteristics of SNOMED CT dataset and proposes a novel design of enhanced result view by restructuring the results using relationships of SNOMED CT concepts. Using the proposed scheme, medical doctors or officers can select appropriate terms more efficiently and can reduce overall recording time.

Diagnostic Value of Computed Tomography in Crohn's Disease Patients Presenting with Acute Severe Lower Gastrointestinal Bleeding

  • Lee, Sunyoung;Ye, Byong Duk;Park, Seong Ho;Lee, Kyung Jin;Kim, Ah Young;Lee, Jong Seok;Kim, Hyun Jin;Yang, Suk-Kyun
    • Korean Journal of Radiology
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    • v.19 no.6
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    • pp.1089-1098
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    • 2018
  • Objective: To investigate the diagnostic yield of contrast-enhanced computed tomography (CT) in Crohn's disease (CD) patients presenting with acute severe lower gastrointestinal bleeding (LGIB), and the role of CT in predicting the risk of rebleeding. Materials and Methods: A consecutive series of 110 CD patients presenting with acute severe LGIB between 2005 and 2016 were analyzed. Among them, 86 patients who had undergone contrast-enhanced CT constituted the study cohort. The diagnostic yield of CT for detecting contrast extravasation was obtained for the entire cohort and compared between different CT techniques. In a subgroup of 62 patients who had undergone CT enterography (CTE) and showed a negative result for extravasation on CTE, the association between various clinical and CTE parameters and the risk of rebleeding during subsequent follow-up was investigated using Cox regression analysis. Results: The diagnostic yield of CT was 10.5% (9 of 86 patients). The yield did not significantly differ between single-phase and multiphase examinations (p > 0.999), or between non-enterographic CT and CTE (p = 0.388). Extensive CD (adjusted hazard ratio [HR], 3.27; 95% confidence interval [CI], 1.09-9.80; p = 0.034) and bowel wall-to-artery enhancement ratio (adjusted HR, 2.81; 95% CI, 1.21-6.54; p = 0.016) were significantly independently associated with increased rebleeding risks, whereas anti-tumor necrosis factor-${\alpha}$ therapy after the bleeding independently decreased the risk of rebleeding (adjusted HR, 0.26; 95% CI, 0.07-0.95; p = 0.041). Conclusion: The diagnostic yield of contrast-enhanced CT was not high in CD patients presenting with acute severe LGIB. Nevertheless, even a negative CTE may be beneficial as it can help predict the risk of later rebleeding.