• 한국콘텐츠학회논문지
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• 제13권6호
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• pp.331-338
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• 2013

간질환을 주소로 추적검사를 위해 내원한 CT(Computer Tomography, 이하 CT) 검사자를 대상으로 체질량 지수와 관전압 변화에 따른 영상의 화질 및 방사선 피폭선량변화에 대하여 알아보고자 하였다. 2010년 3월부터 2011년 6월까지 부산 P대학병원에 복부 CT 를 검사한 환자 중 체질량지수(Body Mass Index, 이하 BMI)가 25이하인 환자를 대상으로 하였고 대상자는 48명이었다. 영상의 질의 객관적 평가로 신호대 잡음비와 유효선량을 비교하였다. 복부 영상의 화질평가는 영상의학과 의사2명이 한국의료영상품질관리원에서 선정한 임상영상 평가의 기준을 근거로 해 1점에서 20점까지 점수를 매겨 평가하였다. 피폭선량분석에서 CTDIvol값은 관전압이 100kVp일 때 120kVp보다 약44.1%가 감소하였다. 그리고 유효선량은 관전압 100kVp일 때 120kVp보다 약43%가 감소하였다. 영상의 화질 평가는 반복적으로 CT검사를 위해 내원한 총48명의 검사자 영상 중 Good 1명, Excellent 47명으로 평가되었다. 추적검사를 시행하는 환자 중 BMI지수가 25이하인 환자들을 대상으로 저관전압을 적용한 복부 CT검사 시 영상의 질적 저하없이 진단 가치가 있는 영상의 획득과 피폭선량 감소효과를 얻을 수 있다고 사료된다.

• Korean Journal of Radiology
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• 제22권5호
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• pp.735-741
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• 2021

Objective: To evaluate circularity as a quantitative shape factor of small renal tumor on computed tomography (CT) in differentiating fat-poor angiomyolipoma (AML) from renal cell carcinoma (RCC). Materials and Methods: In 257 consecutive patients, 257 pathologically confirmed renal tumors (either AML or RCC less than 4 cm), which did not include visible fat on unenhanced CT, were retrospectively evaluated. A radiologist drew the tumor margin to measure the perimeter and area in all the contrast-enhanced axial CT images. In each image, a quantitative shape factor, circularity, was calculated using the following equation: 4 x π x (area ÷ perimeter²). The median circularity (circularity index) was adopted as a representative value in each tumor. The circularity index was compared between fat-poor AML and RCC, and the receiver operating characteristic (ROC) curve analysis was performed. Univariable and multivariable binary logistic regression analysis was performed to determine the independent predictor of fat-poor AML. Results: Of the 257 tumors, 26 were AMLs and 231 were RCCs (184 clear cell RCCs, 25 papillary RCCs, and 22 chromophobe RCCs). The mean circularity index of AML was significantly lower than that of RCC (0.86 ± 0.04 vs. 0.93 ± 0.02, p < 0.001). The mean circularity index was not different between the subtypes of RCCs (0.93 ± 0.02, 0.92 ± 0.02, and 0.92 ± 0.02 for clear cell, papillary, and chromophobe RCCs, respectively, p = 0.210). The area under the ROC curve of circularity index was 0.924 for differentiating fat-poor AML from RCC. The sensitivity and specificity were 88.5% and 90.9%, respectively (cut-off, 0.90). Lower circularity index (≤ 0.9) was an independent predictor (odds ratio, 41.0; p < 0.001) for predicting fat-poor AML on multivariable logistic regression analysis. Conclusion: Circularity is a useful quantitative shape factor of small renal tumor for differentiating fat-poor AML from RCC.

• 대한통합의학회지
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• 제5권3호
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• pp.29-37
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• 2017

Purpose: The purpose of this study was to classify patients with chronic back pain according to the degree of their back pain, and to compare the pain dysfunction index with the qualitative changes in abdominal muscles. Therefore, we aimed to provide a basis for the treatment intervention method for patients with back pain. Methods: Twenty patients with chronic back pain were purposive sample to a group of 10 patients with a back pain index of 60 % or more and a group with less than 60 % of back pain, and the subjects who voluntarily participated in the study After receiving the letter, I conducted the research the dysfunction of back pain was measured by the Korean version of the Oswestry Disability Index (KODI), and the ultrasonic wave (Ultrasound MyLabOne, ESAOTE, Italy) And the white area index, and the abdominal muscle movement was used as the exercise instrument POWER breathe K5 (Hab direct, UK), which strengthens the respiratory muscles through threshold-muscle traction. Result: In this study, patients with chronic back pain were subjected to breathing exercises, which led to the decrease in back pain dysfunction. The ultrasonographic analysis of abdominal muscles revealed that both the white area index and muscle image density in the skeletal muscle and in the outer muscle of the abdomen gradually decreased over time. Conclusion: It is thought that introducing back pain patients to abdominal muscle reinforcement training is effective in improving the functions of the patients' muscles, thus increasing their quality of life.

• 핵의학기술
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• 제24권1호
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• pp.15-19
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• 2020

본 연구는 최근에 활발히 연구되고 있는 딥러닝 기술인 생성적 적대 신경망(GAN)을 핵의학 영상에 적용하여 잠재적으로 유용성이 있는지 확인해보고자 하였다. 본원에서 ¹⁸F-FDG Brain PET/CT검사를 진행한 30명의 환자를 대상으로 하였고 List모드로 15분 검사한 후 이를 1, 2, 3, 4, 5분 초기획득시간 이미지로 재구성하였다. 이 중 25명의 환자를 GAN모델의 학습을 위한 트레이닝 이미지로 사용하고 5명의 환자를 학습된 GAN모델의 검증을 위한 테스트 이미지로 사용하였다. 학습된 GAN모델에 입력으로 1, 2, 3, 4, 5분의 초기획득 이미지를 넣고 출력으로 15분 인공지능 표준획득 이미지를 획득한 후 이를 기존의 15분 표준획득시간 검사 이미지와 비교 평가하였다. 평가에는 정량화된 이미지 평가방법인 평균제곱오차, 최대신호 대 잡음비, 구조적 유사도 지수를 이용하였다. 평가 결과 초기획득시간 이미지에서 1에서 5분으로 갈수록 실제 표준획득시간 이미지에 가까운 평균제곱오차, 최대신호 대 잡음비, 구조적 유사도 지수 수치를 나타내었다. 이러한 연구를 통해 앞으로 인공지능 기술이 핵의학 분야에서 의료영상의 획득시간 단축과 관련하여 중요한 영향을 미칠 수 있을 것으로 사료된다.

• Korean Journal of Radiology
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• 제22권6호
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• pp.983-993
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• 2021

Objective: To investigate the image quality of ultralow-dose CT (ULDCT) of the chest reconstructed using a cycle-consistent generative adversarial network (CycleGAN)-based deep learning method in the evaluation of pulmonary tuberculosis. Materials and Methods: Between June 2019 and November 2019, 103 patients (mean age, 40.8 ± 13.6 years; 61 men and 42 women) with pulmonary tuberculosis were prospectively enrolled to undergo standard-dose CT (120 kVp with automated exposure control), followed immediately by ULDCT (80 kVp and 10 mAs). The images of the two successive scans were used to train the CycleGAN framework for image-to-image translation. The denoising efficacy of the CycleGAN algorithm was compared with that of hybrid and model-based iterative reconstruction. Repeated-measures analysis of variance and Wilcoxon signed-rank test were performed to compare the objective measurements and the subjective image quality scores, respectively. Results: With the optimized CycleGAN denoising model, using the ULDCT images as input, the peak signal-to-noise ratio and structural similarity index improved by 2.0 dB and 0.21, respectively. The CycleGAN-generated denoised ULDCT images typically provided satisfactory image quality for optimal visibility of anatomic structures and pathological findings, with a lower level of image noise (mean ± standard deviation [SD], 19.5 ± 3.0 Hounsfield unit [HU]) than that of the hybrid (66.3 ± 10.5 HU, p < 0.001) and a similar noise level to model-based iterative reconstruction (19.6 ± 2.6 HU, p > 0.908). The CycleGAN-generated images showed the highest contrast-to-noise ratios for the pulmonary lesions, followed by the model-based and hybrid iterative reconstruction. The mean effective radiation dose of ULDCT was 0.12 mSv with a mean 93.9% reduction compared to standard-dose CT. Conclusion: The optimized CycleGAN technique may allow the synthesis of diagnostically acceptable images from ULDCT of the chest for the evaluation of pulmonary tuberculosis.

• 대한의용생체공학회:의공학회지
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• 제42권3호
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• pp.80-85
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• 2021

We developed a model to classify the absence of cervical cancer using deep learning from the cervical image to which the histogram equalization algorithm was applied, and to compare the performance of each model. A total of 4259 images were used for this study, of which 1852 images were normal and 2407 were abnormal. And this paper applied Image Sharpening(IS), Histogram Equalization(HE), and Contrast Limited Adaptive Histogram Equalization(CLAHE) to the original image. Peak Signal-to-Noise Ratio(PSNR) and Structural Similarity index for Measuring image quality(SSIM) were used to assess the quality of images objectively. As a result of assessment, IS showed 81.75dB of PSNR and 0.96 of SSIM, showing the best image quality. CLAHE and HE showed the PSNR of 62.67dB and 62.60dB respectively, while SSIM of CLAHE was shown as 0.86, which is closer to 1 than HE of 0.75. Using ResNet-50 model with transfer learning, digital image-processed images are classified into normal and abnormal each. In conclusion, the classification accuracy of each model is as follows. 90.77% for IS, which shows the highest, 90.26% for CLAHE and 87.60% for HE. As this study shows, applying proper digital image processing which is for cervical images to Computer Aided Diagnosis(CAD) can help both screening and diagnosing.

• 한국방사선학회논문지
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• 제14권6호
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• pp.791-800
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• 2020

태아 심장의 기능을 평가하기 위해 초음파 검사가 널리 이용되고 있으나 주관적이라는 검사의 특성으로 인해 검사자마다 측정 방식에 차이가 있으며 특히 심근 성능 지수는 현재까지 기준치가 없는 실정이다. 이에 본 연구에서는 정상 태아의 펄스 도플러 파형을 분석하여 자동 측정 프로그램을 개발하여 객관적인 측정을 하고자 하였다. 2019년 4월부터 2020년 2월까지 부산에 위치한 W병원에 내원한 산모 133명을 대상으로 태아 심장 초음파검사를 시행하였으며 좌심실의 펄스 도플러 영상을 획득 후 각 심근 성능 지수를 측정하였다. 본 연구에서 구현한 자동 측정 프로그램을 이용한 임신 초기, 중기, 말기의 심장 성능 지수와 기존의 측정 방식을 이용한 심장 성능 지수를 비교한 결과, 두 수치에는 차이가 있었으나 같은 경향성을 보였다.

• 한국병원경영학회지
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• 제23권1호
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• pp.41-50
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• 2018

The purpose of this research is to evaluate Brand Value by using the K-BPI(Korea Brand Power Index) of Korea Management Association which is based on consumer awareness, as well as to identify how Brand Value which is composed of top of awareness, unaided awareness, aided awareness, image, possibility of purchasing, preference, affects on the Market Share perceived by consumers. This research subjects were 10 hospitals with more than 1,000 beds in Seoul and Gyeonggi-do, and survey subjects were 20 or older adults living in the metropolitan area of Korea. Using K-BPI for measuring Brand Value and used calculation of Market Share according to consumer preference model for measuring Market Share. The major results of this research are as follows: First, this research identified that the top 5 hospitals of largest hospitals in metropolitan area measured by using K-BPI and Market Share were same hospitals as Big 4 hospitals of previous research evaluating the comprehensive competitiveness of hospitals and also same as hospitals that appeared recently. Second, Big 5 hospitals ranked first to fifth in both Brand Value and Market Share. To identify the relationship between K-BPI items(top of awareness, unaided awareness, aided awareness, image, availability, preference) and Market Share, multiple linear regression was used by dividing 5 upper and 5 lower group of hospitals per each. The group of 5 upper hospitals had a significant effect on Market Share, with 'top of awareness', 'unaided awareness', 'aided awareness'. The group of 5 lower hospitals had a significant effect on Market Share with 'unaided awareness', 'aided awareness'. The results of this study and hospitals of the first to third hospitals published in the K-BPI press release reported by KMAC in 2017, and the previous studies evaluating the comprehensive competitiveness hospitals, all had one thing in common that Big 4 hospitals ranked high position. This suggests that evaluation of Brand Value also can be a evaluation measure of hospital. A new competitiveness of hospital is expected by managing brand awareness to have a brand competitiveness and by securing intrinsic Market Share of consumer to reach hospital use ultimately.

• Journal of Radiation Protection and Research
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• 제45권4호
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• pp.171-177
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• 2020

Background: This study aims to determine the effective atomic number (Zeff) from dual-energy image sets obtained using a conventional computed tomography (CT) simulator. The estimated Zeff can be used for deriving the stopping power and material decomposition of CT images, thereby improving dose calculations in radiation therapy. Materials and Methods: An electron-density phantom was scanned using Philips Brilliance CT Big Bore at 80 and 140 kVp. The estimated Zeff values were compared with those obtained using the calibration phantom by applying the Rutherford, Schneider, and Joshi methods. The fitting parameters were optimized using the nonlinear least squares regression algorithm. The fitting curve and mass attenuation data were obtained from the National Institute of Standards and Technology. The fitting parameters obtained from stopping power and material decomposition of CT images, were validated by estimating the residual errors between the reference and calculated Zeff values. Next, the calculation accuracy of Zeff was evaluated by comparing the calculated values with the reference Zeff values of insert plugs. The exposure levels of patients under additional CT scanning at 80, 120, and 140 kVp were evaluated by measuring the weighted CT dose index (CTDIw). Results and Discussion: The residual errors of the fitting parameters were lower than 2%. The best and worst Zeff values were obtained using the Schneider and Joshi methods, respectively. The maximum differences between the reference and calculated values were 11.3% (for lung during inhalation), 4.7% (for adipose tissue), and 9.8% (for lung during inhalation) when applying the Rutherford, Schneider, and Joshi methods, respectively. Under dual-energy scanning (80 and 140 kVp), the patient exposure level was approximately twice that in general single-energy scanning (120 kVp). Conclusion: Zeff was calculated from two image sets scanned by conventional single-energy CT simulator. The results obtained using three different methods were compared. The Zeff calculation based on single-energy exhibited appropriate feasibility.

• Korean Journal of Radiology
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• 제25권4호
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• pp.384-394
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• 2024

Objective: To evaluate the image quality of novel dark-blood computed tomography angiography (CTA) imaging combined with deep learning reconstruction (DLR) compared to delayed-phase CTA images with hybrid iterative reconstruction (HIR), to visualize the cervical artery wall in patients with Takayasu arteritis (TAK). Materials and Methods: This prospective study continuously recruited 53 patients with TAK (mean age: 33.8 ± 10.2 years; 49 females) between January and July 2022 who underwent head-neck CTA scans. The arterial- and delayed-phase images were reconstructed using HIR and DLR. Subtracted images of the arterial-phase from the delayed-phase were then added to the original delayed-phase using a denoising filter to generate the final-dark-blood images. Qualitative image quality scores and quantitative parameters were obtained and compared among the three groups of images: Delayed-HIR, Dark-blood-HIR, and Dark-blood-DLR. Results: Compared to Delayed-HIR, Dark-blood-HIR images demonstrated higher qualitative scores in terms of vascular wall visualization and diagnostic confidence index (all P < 0.001). These qualitative scores further improved after applying DLR (Dark-blood-DLR compared to Dark-blood-HIR, all P < 0.001). Dark-blood DLR also showed higher scores for overall image noise than Dark-blood-HIR (P < 0.001). In the quantitative analysis, the contrast-to-noise ratio (CNR) values between the vessel wall and lumen for the bilateral common carotid arteries and brachiocephalic trunk were significantly higher on Dark-blood-HIR images than on Delayed-HIR images (all P < 0.05). The CNR values were significantly higher for Dark-blood-DLR than for Dark-blood-HIR in all cervical arteries (all P < 0.001). Conclusion: Compared with Delayed-HIR CTA, the dark-blood method combined with DLR improved CTA image quality and enhanced visualization of the cervical artery wall in patients with TAK.