Byunggeon Park;Jongmin Park;Jae-Kwang Lim;Kyung Min Shin;Jaehee Lee;Hyewon Seo;Yong Hoon Lee;Jun Heo;Won Kee, Lee;Jin Young Kim;Ki Beom Kim;Sungjun Moon;Sooyoung, Choi
Korean Journal of Radiology
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v.21
no.11
/
pp.1256-1264
/
2020
Objective: Lung segmentation using volumetric quantitative computed tomography (CT) analysis may help predict outcomes of patients with coronavirus disease (COVID-19). The aim of this study was to investigate the relationship between CT volumetric quantitative analysis and prognosis in patients with COVID-19. Materials and Methods: CT images from patients diagnosed with COVID-19 from February 18 to April 15, 2020 were retrospectively analyzed. CT with a negative finding, failure of quantitative analysis, or poor image quality was excluded. CT volumetric quantitative analysis was performed by automated volumetric methods. Patients were stratified into two risk groups according to CURB-65: mild (score of 0-1) and severe (2-5) pneumonia. Outcomes were evaluated according to the critical event-free survival (CEFS). The critical events were defined as mechanical ventilator care, ICU admission, or death. Multivariable Cox proportional hazards analyses were used to evaluate the relationship between the variables and prognosis. Results: Eighty-two patients (mean age, 63.1 ± 14.5 years; 42 females) were included. In the total cohort, male sex (hazard ratio [HR], 9.264; 95% confidence interval [CI], 2.021-42.457; p = 0.004), C-reactive protein (CRP) (HR, 1.080 per mg/dL; 95% CI, 1.010-1.156; p = 0.025), and COVID-affected lung proportion (CALP) (HR, 1.067 per percentage; 95% CI, 1.033-1.101; p < 0.001) were significantly associated with CEFS. CRP (HR, 1.164 per mg/dL; 95% CI, 1.006-1.347; p = 0.041) was independently associated with CEFS in the mild pneumonia group (n = 54). Normally aerated lung proportion (NALP) (HR, 0.872 per percentage; 95% CI, 0.794-0.957; p = 0.004) and NALP volume (NALPV) (HR, 1.002 per mL; 95% CI, 1.000-1.004; p = 0.019) were associated with a lower risk of critical events in the severe pneumonia group (n = 28). Conclusion: CRP in the mild pneumonia group; NALP and NALPV in the severe pneumonia group; and sex, CRP, and CALP in the total cohort were independently associated with CEFS in patients with COVID-19.
Byeong-Uk Jeon;In Kyu Yu;Tae Kun Kim;Ha Youn Kim;Seungbae Hwang
Journal of the Korean Society of Radiology
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v.82
no.1
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pp.99-115
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2021
Various sequences have been developed for MRI to aid in the radiologic diagnosis. Among the various MR sequences, susceptibility-weighted imaging (SWI) is a high-spatial-resolution, three-dimensional gradient-echo MR sequence, which is very sensitive in detecting deoxyhemoglobin, ferritin, hemosiderin, and bone minerals through local magnetic field distortion. In this regard, SWI has been used for the diagnosis and treatment of various neurologic disorders, and the improved image quality has enabled to acquire more useful information for radiologists. Here, we explain the principle of various signals on SWI arising in neurological disorders and provide a retrospective review of many cases of clinically or pathologically proven disease or components with distinctive imaging features of various neurological diseases. Additionally, we outline a short and condensed overview of principles of SWI in relation to neurological disorders and describe various cases with characteristic imaging features on SWI. There are many different types diseases involving the brain parenchyma, and they have distinct SWI features. SWI is an effective imaging tool that provides complementary information for the diagnosis of various diseases.
Purpose: Recently in diagnostics area PET/CT is using a variety of areas including oncology, as well as in cardiology, neurology, etc. While increasing in the importance of PET/CT, there are various researches in the image quality related to reconstruction method. We compared and tested Iterative 2D Reconstruction Method with True X Reconstruction method by Siemens through phantom experiment, so we can see increasing of clinical usefulness of PET/CT. Materials and Methods: We measured contrast ratio and FWHM due to evaluating images on dose and experiment using Biograph 40 True Point PET/CT (Siemens, Germany). Getting a result of contrast ratio and FWHM, we used NEMA IEC PET body phantom (Data Spectrum Corp.) and capillary tube. We used the current TrueX and the previous Iterative 2D algorithm for all images which have 10 minutes long. Also, a clinical suitability of parameter for Iterative 2D and a recommended parameter by Siemens for True X are applied to the experiment. Results: We tested FWHM using capillary tube. As a result, TrueX was less than Iterative 2D. Also, the differences of FWHM get bigger in low dose. On the other hand, we tested contrasts ratio using NEMA IEC PET body phantom. As a result, TrueX was better aspect than Iterative 2D. However, there was no difference in dose. Conclusion: In this experiment, TrueX get higher results of contrast ratio and spatial resolution than Itertive 2D through experiment. Also, in the reconstruction result through TrueX, TrueX had better aspect of resolution than Iterative 2D in low dose. However, contrast ratio had no specific difference. In other words, TrueX reconstruction method in PET/CT had higher clinical value in use because TrueX can reduce exposure of patient and had a better quality of screen.
The marketing environment has become competitive to an extent that requires firms to target their products at markets that span national boundaries. However, competitive clout cannot be achieved in global consumer markets unless firms thoroughly understand and adequately respond to the core values and needs of those consumers. Brand equity is one of the most important assets to a company. Especially in sportswear markets, brand equity is the crucial value added to a product by its brand name. Factors such as country of origin also influence customer's attitude towards brand equity. Therefore, this paper discusses the relationship between country of origin effect and brand equity, and how they influence consumers' loyalty for respective brands. This paper focused on the sports shoes market, because it is an increasing area of opportunity for world manufacturers. The objectives of this study were the following. (1) Test the effect of country of origin on brand equity. (2) Test how brand equity influences consumers' brand loyalty. (3) Find whether there are differences in the effects of country of origin and brand equity among the three countries. (4) Find whether there are differences in the effects of country of origin and brand equity among the different lifestyles. Based on the review of literature results, the hypotheses are concluded as the following: H1-a: Country image has positive influence on country of origin. H1-b: Product perception has positive influence on country of origin. H2-a: Perceived quality has positive effect on brand equity. H2-b: Perceived price has positive effect on brand equity. H3: Country of origin has positive effect on brand equity. H4: Brand equity has a positive impact on brand loyalty. Research model was constructed (see Fig. 1). After data analysis, the following results were concluded: sports shoes purchase behavior showed significant differences among Korean, Chinese, and American consumers for favorite brand, purchased brand, purchased place, information usage, and favorite sports games. The results of this study also extend the research of the relationship among country of origin, brand equity and brand loyalty to the sports shoes market. Brand equity was proven to have a significant relationship with brand loyalty for all countries. The factors which can influence brand equity are different for different countries. The third finding of this paper is that we identified different three lifestyles, adventurer, follower, and laggard, for Korean, Chinese and American consumers. Without the nationality boundary, seeing the emergence of a new group of consumers who have similar preferences and buy similar brands is more important. All of the consumers consider brand equity to keep their brand loyalty. Perceived price is the only factor which can influence brand equity for adventurers; brand is more important for them. The laggards were not influenced by any factor. All of the factors expect perceived price are important for the followers. Marketing managers should consider brand equity when introducing their brand into a new market. Also localization is the basic strategy that all the sports shoes companies should understand. But as a global brand, understanding the same characteristics for each country is more important to build global strategy.
Purpose : To evaluate the usefulness of functional MRI (fMRI) of visual cortex in patients with ischemic infarction in the occipital lobe. Materials and Methods : Four patients with the symptoms and signs of visual cortical ischemia were included. Functional MRI was performed by 2D-FLASH technique with the parameter of 90/56msec TR/TE, $40^{\circ}$ flip angle, $240{\times}240{\;}FOV,{\;}64{\times}128$ matrix number, 8.32 seconds acquisition time, 8mm slice thickness. An axial slice including both visual cortices was selected and alternative activation and resting of the visual cortex was performed using red color photostimulator. all patients undertook visual field test, and vascular abnormality was examined by MRA (n=4) and DSA (n=2). fMRI results were compared with the results of a visual field test, conventional MRI and cerebral angiography. Results : On fMRI, decreased activity of the visual cortex was found in the occipital lobe corresponding to stenosis of the posterior cerebral artery or its branch noted on angiogram. However, 2 of 4 patients showed no abnormal findings on conventional MRI. Visual field defect was noted in 3 patients, one and of whom showed no abnormality on conventional MRI and diffusion-weighted image, but revealed decreased activity in the corresponding visual cortex on fMRI. Conclusion : fMRI may be a sensitive method for detection of the status of decreased blood flow or vascular reserve which other methods can not.
There is a standard shoulder oblique method (Grashey method) available to view the shoulder joint. This method projects AP view of the shoulder joint so that the Humerus head's subuxation or joint degeneration can be easily visualized. However, in this view, the patients, with supine or sitting or erect position, have to keep their body obliquely. Whereas, the patients who are not well or operated, usually feel very uncomfortable to keep their body in this position and hence, we need other persons' help and much efforts will be needed to get the good quality shoulder joint view. Therefore, we thought of examining a method which shows the joint well by angling the tube to Medio-Lateral direction and without keeping the patients' one side upward in supine position. For this study, total 15 subjects with no history of neurological or psychiatric illness, were recruited for examinations. They consisted of 9 males and 6 females. Statistic group analysis was performed with ANOVA test. Scores of the evaluation of the experts were $1.10{\pm}0.54$ at $25^{\circ}$, $2.50{\pm}0.50$ at 30^{\circ}$, $2.85{\pm}0.36$ at $35^{\circ}$ and $2.33{\pm}0.47$ at $40^{\circ}$, respectively, and they were significant(p<0.05, Table 1). Joint space of the Humerus head and Scapula were well distinguished at $35^{\circ}$, $30^{\circ}$ and $40^{\circ}$ with the almost same score. However, the degree of distortion at $40^{\circ}$ was more severe than that at $30^{\circ}$. Ultimately, $30-35^{\circ}$ views were shown to yield good quality shoulder oblique images. In conclusion, this method may be very useful for the patients who are uncomfortable and for the emergency patients. In order to get similar or comparable view, the same X-tube angle is recommended to be used before and after the operation. Therefore, we hope that this new angled method seems to be efficient.
This study aims to conduct the comparative analysis of the radiation dose according to before and after the calibration of the ionization chamber used for measuring radiation dose in the MDCT, as well as of $CTDI_w$ according to temperature and pressure correction factors in the CT room. A comparative analysis was conducted based on the measured MDCT (GE light speed plus 4 slice, USA) data using head and body CT dosimetric phantom, and Model 2026C electrometer (RADICAL 2026C, USA) calibrated on March 21, 2007. As a result, the $CTDI_w$ value which reflected calibration factors, as well as correction factors of temperature and pressure, was found to be the range of $0.479{\sim}3.162mGy$ in effective radiation dose than the uncorrected values. Also, under the routine abdomen routine CT image acquisition conditions used in reference hospitals, patient effective dose was measured to indicate the difference of the maximum of 0.7 mSv between before and after the application of such factors. These results imply that the calibration of the ion chamber, and the correction of temperature and pressure of the CT room are crucial in measuring and calculating patient effective dose. Thus, to measure patient radiation dose accurately, the detailed information should be made available regarding not only the temperature and pressure of the CT room, but also the humidity and recombination factor, characteristics of X-ray beam quality, exposure conditions, scan region, and so forth.
A method to get a size of the radiation isocenter of linear accelerators using star-shot images was presented and a computer program was developed to automate the method. Accuracy of the method was verified. The developed program was used to measure sizes of the radiation isocenters for a Clinac 21EX (Varian, USA) using data of quality assurance (QA) performed from June 2008 to December 2010. To calculated the size of radiation isocenter, positions of two points on each central ray of the star-shot image were found and the equation of the central ray was determined using the positions of two points. Using the equations of central rays the radius of the minimum circle intersecting all the central rays, which is one half of the size of radiation isocenter, was calculated. The program measured x-intercepts and y-intercepts of the central rays within errors of 0.084 mm and sizes of radiation isocenters within 0.053 mm. All the errors were less than the spatial resolution of star-shot images 0.085 mm. The radiation isocenter sizes of Clinac 21EX were $0.33{\pm}0.27mm$, $0.71{\pm}0.36mm$, $0.50{\pm}0.16mm$ for collimator, gantry and couch respectively. During the measurement period all the measured sizes were less than 2.0 mm and within tolerance. The developed program could calculate the size of radiation isocenters and it would be helpful to routine QA.
Purpose: SPECT/CT, a combination of SPECT and CT, is capable of expressing the results of attenuation correction on images biased by automatic program. As a result, this research evaluates the usefulness of images with CT attenuation correction, using various phantoms and images of patients. Materials and Methods: From July of 2012 to September of 2012, this research was conducted on the contrast, spatial resolution, and images of patients. We studied the contrast with IEC body phantom and Jaszczak phantom, while the spatial resolution was evaluated with NEMA triple line phantom. Further, a comparative study was carried out on the quality of the images, on the difference between the images before and after the CT attenuation correction. Results: Compared the differences between the contrast before and after the CT attenuation correction in IEC body phantom. The contrast was improved by 33.6% at minimum, 89.8% at maximum. In case of Jaszczak Phantom, the contrast was enhanced by 9.9% at minimum, 27.8% at maximum. In NEMA Triple line phantom, the resolution was raised by 4.5% in average: 4.4% in horizontal, 4.5% in vertical. In Anthropomorphic Torso Phantom, the perfusion score of the interior wall with the most severe attenuation was measured to be 29.4%. In the experiment carried out on myocardial perfusion SPECT/CT patients, 9% improvement was discovered in the interior wall, where the most dramatic attenuation occurred, after the CT attenuation correction. Conclusion: SPECT/CT proved its clinical usefulness by enabling the acquisition of images with enhanced contrast and spatial resolution compare to the ones resulted from SPECT.
Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.
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