• Title/Summary/Keyword: Enhanced CT

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A Study on the Segmentation of Kidney from the Non-Enhanced CT Image (조영제를 사용하지 않은 복보 CT영상에서 신장의 추출에 대한 연구)

  • 김선주;유승화;김종철;노승무;박종원
    • Proceedings of the Korean Information Science Society Conference
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    • 2000.04b
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    • pp.514-516
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    • 2000
  • 본 논문은 조영제를 사용하지 않은 정상인의 신장의 추출에 관한 연구로서 복구 CT 영상의 특성을 파악하고 신장부분을 분석함으로서 신장의 자동적인 추출을 시행하였다. 처리과정에서 기준값에 의한 이진영상에서 각 장기의 서로 다른 화소분포의 특징을 이용하여 장기추출을 시행하였고 템플리트를 이용한 서브트랙션과 채우기 과정을 거쳐 단일 슬라이스에서 신장을 추출한 후 추출된 신장영상의 슬라이스들을 겹친 영상을 생성하여 단일 슬라이스 내에서 제거되지 못한 노이즈들을 제거하였다.

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Imaging Assessment of Visceral Pleural Surface Invasion by Lung Cancer: Comparison of CT and Contrast-Enhanced Radial T1-Weighted Gradient Echo 3-Tesla MRI

  • Yu Zhang;Woocheol Kwon;Ho Yun Lee;Sung Min Ko;Sang-Ha Kim;Won-Yeon Lee;Suk Joong Yong;Soon-Hee Jung;Chun Sung Byun;JunHyeok Lee;Honglei Yang;Junhee Han;Jeanne B. Ackman
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.829-839
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    • 2021
  • Objective: To compare the diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3-tesla (3T) magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of visceral pleural surface invasion (VPSI). Visceral pleural invasion by non-small-cell lung cancer (NSCLC) can be classified into two types: PL1 (without VPSI), invasion of the elastic layer of the visceral pleura without reaching the visceral pleural surface, and PL2 (with VPSI), full invasion of the visceral pleura. Materials and Methods: Thirty-three patients with pathologically confirmed VPSI by NSCLC were retrospectively reviewed. Multidetector CT and contrast-enhanced 3T MRI with a free-breathing radial three-dimensional fat-suppressed volumetric interpolated breath-hold examination (VIBE) pulse sequence were compared in terms of the length of contact, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. Supplemental evaluation of the tumor-pleura interface (smooth versus irregular) could only be performed with MRI (not discernible on CT). Results: At the tumor-pleura interface, radial VIBE MRI revealed a smooth margin in 20 of 21 patients without VPSI and an irregular margin in 10 of 12 patients with VPSI, yielding an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F-score for VPSI detection of 91%, 83%, 95%, 91%, 91%, and 87%, respectively. The McNemar test and receiver operating characteristics curve analysis revealed no significant differences between the diagnostic accuracies of CT and MRI for evaluating the contact length, angle of mass margin, or arch distance-to-maximum tumor diameter ratio as predictors of VPSI. Conclusion: The diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3T MRI and CT were equal in terms of the contact length, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. The advantage of MRI is its clear depiction of the tumor-pleura interface margin, facilitating VPSI detection.

Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better"

  • uz Zaman, Maseeh;Fatima, Nosheen;Zaman, Areeba;Zaman, Unaiza;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3465-3468
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    • 2016
  • Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

Computed Tomography Findings Associated with Treatment Failure after Antibiotic Therapy for Acute Appendicitis

  • Wonju Hong;Min-Jeong Kim;Sang Min Lee;Hong Il Ha;Hyoung-Chul Park;Seung-Gu Yeo
    • Korean Journal of Radiology
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    • v.22 no.1
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    • pp.63-71
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    • 2021
  • Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HUpost) and non-enhanced CT (HUpre). The degree of appendiceal wall enhancement (HUsub) was calculated as the subtracted value between HUpost and HUpre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HUpost (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HUsub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

Development and Performance Evaluation of an Ultra-Compact CT with Auto Calibration of Detector Center Axis (검출기 중심축을 자동 보정하는 초소형 CT 개발 및 성능평가)

  • Byeong-Woo Kwak;Keun-Ho Rew
    • Journal of the Korean Society of Radiology
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    • v.17 no.5
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    • pp.651-662
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    • 2023
  • In this study, we designed and fabricated an ultra-compact CT that automatically calibrates the detector's center axis and verified its performance. The three-dimensional reconstruction performance was evaluated using 3D CAD data and X-ray data acquired by manually calibrating the center axis of the CT detector. The results showed that tilting the center axis by more than 0.25° causes circle break phenomenon, which rapidly degrades the quality of the 3D reconstructed image. By applying the automatic calibration device of a detector center axis, the 3D reconstruction performance was enhanced by calibrating the detector center axis to match the specimen rotation axis.

Evaluation of Inflammatory Disease in the Nasal Cavity and Paranasal Sinuses using CT in Dogs and Cats (개와 고양이에서 컴퓨터단층촬영술을 이용한 비강의 염증성 질병 평가)

  • Choi, Ho-Jung;Lee, Ki-Ja;Park, Seong-Jun;Jeong, Seong-Mok;Song, Kun-Ho;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.42-45
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    • 2010
  • Inflammatory sinonasal disease was diagnosed in five dogs and two cats with clinical signs of nasal discharge and epistaxis. Survey radiography and CT were performed in all of patients. CT scan of the rostral cranium was performed with a thickness of 2 or 5 mm. Nasal cytology and culture from nasal smear were performed immediately after CT examination. Remarkable increase of opacity in the nasal cavities and frontal sinuses was observed in only 3 cases. On CT images, the cavitating lesions were isodense in nasal cavity (7 cases), frontal sinuses (3 cases), and nasopharynx (2 cases) with destruction of the nasal septum (4 cases), maxillary turbinates (5 cases), maxilla (3 cases), and hard palate (3 cases). The lesions were enhanced after intravenous contrast administration in 5 cases and were not enhanced in 2 cases. Inflammatory cells were observed in nasal cytology. Most of the cultures from nasal smear were bacteria. CT is useful to diagnose sinonasal disease and is more accurate in demonstrating the extent and character of lesions of nasal cavity than radiography.

Preoperative Detection of Hepatic Metastases from the colorectal Cancers: Comparison of Dual-phase CT scan, Mn-DPDP enhanced MRI, and combination of CT and MRI (대장암의 간 전이 진단: 이중시기 CT, Mn-DPDP 조영증강 MRI, 그리고 CT-MRI 종합 판독의 비교)

  • Shin, Kyung-Min;Kim, Jong-Yeol;Choi, Gyu-Seok;Kim, Hye-Jeong;Lee, Jong-Min;Chang, Yong-Min;Kim, Yong-Seon;Kang, Duk-Sik;Ryeom, Hun-Kyu
    • Investigative Magnetic Resonance Imaging
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    • v.9 no.2
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    • pp.109-116
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    • 2005
  • Purpose : To determine the usefulness of additional Mn-DPDP MRI for preoperative evaluation of the patients with colorectal cancers by comparison of dual-phase CT scan, Mn-DPDP enhanced MRI and combination of CT and MRI. Materials and Methods : Fifty-three colorectal cancer patients with 92 metastatic nodules underwent dualphase (arterial and portal) helical CT scan and Mn-DPDP MRI prior to surgery. The indication of MRI was presence or suspected of having metastatic lesions at CT scan and/or increased serum carcinoembryonic antigen (CEA) levels (10 ng/mL or more). The diagnosis was established by the combination of findings at surgery, intraoperative ultrasonography, and histopathologic examination. Two radiologists interpreted CT, MRI, and combination of CT-MRI at discrete sessions and evaluated each lesion for location, size, and intrinsic characteristics. The lesions were divided into three groups according to their diameter; 1cm<, 1-2 cm, and >2 cm. Diagnostic accuracy was evaluated using the alternative-free response receiver operating characteristic method. Detection and false positive rate were also evaluated. Results : In the lesions smaller than 1 cm, detection rate of combined CT-MRI was superior to CT or MRI alone (82%, p=0.036). The mean accuracy (Az values) of combined CT and MRI was significantly higher than that of CT in the lesions smaller than 2 cm (1 cm<, p=0.034; 1-2 cm, p=0.045). However, there was no significant difference between MRI and combined CT-MRI. The false positive rate of CT was higher than those of combined CT-MR in the lesions smaller than 1 cm (28%, p=0.023). Conclusion : Additional MRI using Mn-DPDP besides routine CT scan was helpful in differentiating the hepatic lesions (<2 cm) and could improve detection of the small hepatic metastases (<1 cm) from colorectal carcinoma.

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Efficiacy of CT Colonography in the Detection of Colorectal Polypoid Lesions (대장의 폴립양 병변의 발견에 있어 CT 대장조영술의 유용성)

  • Kim, Yun-Gyeong;Lee, Ji-Eun;Lee, Jeong-Gyeong;Baek, Seung-Yeon;Song, Hyeon-Ju;Jeong, Seong-Ae
    • Journal of Korea Association of Health Promotion
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    • v.4 no.1
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    • pp.49-59
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    • 2006
  • "본 논문은 대한영상의학회지 2005년 제52권 제1호에 실렸던 논문으로 대한영상의학회의 승인을 득하고 본 협회지에 게재함. Purpose: We wished to compare CT colonography with conventional colonoscopy for the detection of colorectal poiypoid lesions, and we wanted to evaluate the role of IV contrast-enhanced CT colonography for the differentiation between benign polypoid lesions and malignant polypoid lesions. Materials and Methods: Thirty-four consecutive patients underwent CT colonography prior to conventional colonoscopy, Precontrast prone-position CT images and post contrast supine position CT images were obtained and the virtual colonoscopic images were reconstructed, Axial, sagittal and presence, size and morphologic features of colorectal polypoid lesions, and thor these findings were compared with the colonoscopic findings. The degree of enhancement of colorecralpolypoid lesions was measured by subtracting the attenuation valves obtained with precontrastand postcontrast CT images for the differentiation of benignity and malignancy of the colorectal polypoid lesions. Results. Among 75 colorectal polypoid lesions identified on conventional colonoscopy, 49neoplasms were found on CT coloaographv, and the overall detection rate was 65,3%.Detection rate of lesions smaller than l0mm was 52.1%(24/46), and the detection rate for lesions equal to or larger than 10mm was 86.2%(25/29), Morphologic features of the sessile type lesions on CT colonography were well correlated with those noted on colonoscopy, but the stalks were not identified in 6 of 13 polyps on CT colonography. There was no statistical correlation between benignity and malignancy and the degree of contrast enhancement on CT colonography, Conclusion CT colonography is a useful modality for the detection of colorectal polypoid lesionsequal to or polyps. However, CT colonography cannot differentiate benignity from malignancy.

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The Effect of Intravenous Contrast on SUV Value in $^{18}F$-FDG PET/CT using Diagnostic High Energy CT (진단용 고선량 CT를 이용한 $^{18}F$-FDG PET/CT 촬영시 정맥 조영제가 SUV 값에 미치는 영향)

  • Jeong, Young-Jin;Kang, Do-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.169-176
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    • 2006
  • Purpose: According to the development of CT scanner in PET/CT system, the role of CT unit as a diagnostic tool has been more important. To improve the diagnostic ability of CT scanner, it is a key aspect that CT scanning has to be performed with high dose energy and intravenous (IV) contrast. So we investigated the effect of IV contrast media on the maximum SUV (maxSUV) of normal tissues and pathologic lesions using PET/CT scanner with high dose CT scanning. Materials & Methods: The study enrolled 13 patients who required PET/CT evaluation. At first, the patients were performed whole body non-contrast CT (NCCT-120 kVp, 130 mAs) scan. Then contrast enhanced CT (CECT) scan was performed immediately. Finally PET scan was followed. The PET omission data were reconstructed twice, once with the NCCT and again with the CECT. We measured the maxSUV of 10 different body regions that were considered as normal in ail patients. Also pathologic lesions were investigated. Results: There were not seen focal artifacts in PET images based on CT with IV contrast agent. Firstly, 130 normal regions in 13 patients were evaluated. The maxSUV was significantly different between two PET images (p<0.00)). The maxSUV was $1.1{\pm}0.5$ in PET images with CECT-corrected attenuation and $1.0{\pm}0.5$ in PET images with NCCI-corrected attenuation. The limit of agreement was $0.1{\pm}0.3$ in Bland-Altman analysis. Especially there were significant differences in 6 of 10 regions, apex and base of the right lung, ascending aorta, segment 6 & segment 8 of the liver and spleen (p<0.05). Secondly, 39 pathologic lesions were evaluated. The maxSUV was significantly different between two PET images (p<0.001). The maxSUV was $4.7{\pm}2.0$ in PET images with CECT-corrected attenuation and $4.4{\pm}2.0$ in PET images with NCCT-corrected attenuation. The limit of agreement was $0.4{\pm}0.8$ in Bland-Altman analysis. Conclusion: Although there were increases of maxSUVs in the PET images based on CT with IV contrast agent, it was very narrow in the range of limit of agreement. So there was no significant effect to clinical interpretation for PET images that were corrected attenuation with high dose CT using IV contrast.

F-18 FDG Uptake in an Eosinophilic Liver Abscess Mimicking Hepatic Metastasis on PET/CT Images (PET/CT에서 간전이로 오인되었던 호산구성 간농양의 F-18 FDG 섭취 증가)

  • Sohn, Myung-Hee;Jeong, Hwan-Jeong;Lim, Seok-Tae;Kim, Dong-Wook;Yim, Chang-Yeol
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.253-255
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    • 2008
  • A 61-year-old man had a F-18 FDG PET/CT scan for evaluation of a common bile duct cancer identified on CT. The PET/CT image showed a hypermetabolic mass in the common bile duct, and a focal area of increased F-18 FDG uptake in segment IV of the liver, which corresponded to a hypoattenuated lesion on non-enhanced CT, and was consistent with hepatic metastasis. The patient underwent choledochojejunostomy with hepatic resection, and pathologic findings were compatible with an eosinophilic abscess in the liver. This case demonstrates that F-18 FDG uptake by an eosinophilic abscess can mimic hepatic metastasis in a patient with a malignancy.