• 제목/요약/키워드: Imaging guidelines

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2024 Consensus Statement on Coronary Stenosis and Plaque Evaluation in CT Angiography From the Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT)

  • Cherry Kim;Chul Hwan Park;Bae Young Lee;Chan Ho Park;Eun-Ju Kang;Hyun Jung Koo;Kakuya Kitagawa;Min Jae Cha;Rungroj Krittayaphong;Sang Il Choi;Hwan Seok Yong;Sung Min Ko;Sung Mok Kim;Sung Ho Hwang;Nguyen Ngoc Trang;Whal Lee;Young Jin Kim;Jongmin Lee;Dong Hyun Yang
    • Korean Journal of Radiology
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    • 제25권4호
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    • pp.331-342
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    • 2024
  • The Asian Society of Cardiovascular Imaging-Practical Tutorial (ASCI-PT) is an instructional initiative of the ASCI School designed to enhance educational standards. In 2021, the ASCI-PT was convened with the goal of formulating a consensus statement on the assessment of coronary stenosis and coronary plaque using coronary CT angiography (CCTA). Nineteen experts from four countries conducted thorough reviews of current guidelines and deliberated on eight key issues to refine the process and improve the clarity of reporting CCTA findings. The experts engaged in both online and on-site sessions to establish a unified agreement. This document presents a summary of the ASCI-PT 2021 deliberations and offers a comprehensive consensus statement on the evaluation of coronary stenosis and coronary plaque in CCTA.

전이성 척추 종양의 영상 소견: 고령 환자의 단일병소를 중심으로 한 감별 질환 (Imaging Findings of Spinal Metastases with Differential Diagnosis: Focusing on Solitary Spinal Lesion in Older Patients)

  • 박선영;윤민아;이민희;이상훈;정혜원
    • 대한영상의학회지
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    • 제85권1호
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    • pp.77-94
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    • 2024
  • 고령의 환자에서 척추에 단일 병소의 병변을 만나게 되면 골전이를 가장 먼저 염두하게 된다. 골전이는 어느 부위든 가능하지만 척추체에서 가장 많이 발생한다. 그러나 항상 골전이에 전형적인 영상 소견을 보이지 않을 수도 있고 단일 병소로 발견하게 되면 다른 모방하는 병변과 감별이 어려울 수 있다. 그러면 원발암의 진단 및 치료가 늦어지게 된다. 본 종설에서는 골전이의 영상검사 및 임상지침에 대해서 살펴보고 골전이 외에도 고령 환자에서 척추에 단일 병소로 생길 수 있는 다양한 질환들의 영상 소견 및 감별 포인트에 대해서 알아보고자 한다.

2021 한국 갑상선영상 판독과 자료체계의 임상적용 (Clinical Application of the 2021 Korean Thyroid Imaging Reporting and Data System (K-TIRADS))

  • 나동규
    • 대한영상의학회지
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    • 제84권1호
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    • pp.92-109
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    • 2023
  • 갑상선 결절 환자에서 초음파 검사는 일차적 영상 진단법으로 정립되어 있으며 치료 결정을 위한 핵심적인 진단 역할을 갖는다. Korean Thyroid Imaging Reporting and Data System(이하 K-TIRADS)는 초음파 유형에 기초한 암 위험도 분류체계로서 실시간 초음파 검사를 시행하면서 쉽게 결절 진단이 가능하다는 장점을 갖고 있다. 개정된 2021 K-TIRADS는 결절의 초음파 분류 기준을 보다 명확히 하였고, 고위험 갑상선암의 의심 소견이 없는 환자에서 병리진단검사를 결정하는 결절 크기 기준을 개정하여 불필요한 병리진단검사를 최소화하고 적절한 갑상선암 진단 예민도가 유지되도록 개정하였다. 갑상선영상의학진료는 갑상선 결절 환자의 진단 및 비수술적 치료를 수행하는 중요한 임상적 역할을 가지고 있으며, 적절한 환자 진료를 위해서는 표준적 진료 지침에 근거하여 진료가 수행되어야 한다.

Carpal Tunnel Syndrome Caused by Lipofibromatous Hamartoma of the Median Nerve

  • Roh, Youn-Tae;Song, Seok-Whan;Jeong, Changhoon;Kang, Younghoon;Park, Il-Jung
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.664-670
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    • 2020
  • Lipofibromatous hamartoma (LFH) is a rare tumor of the peripheral nerves, which usually involves the median nerve. The authors reported on two rare cases of carpal tunnel syndrome due to LFH of the median nerve. A 49-year-old female patient complained of the mass and symptoms consistent with LFH. Magnetic resonance imaging (MRI) showed typical LFH findings. The symptoms were successfully ameliorated with carpal tunnel release and external neurolysis. A 37-year-old female patient complained of weakening thumb abduction and the mass where the MRI showed atypical findings. Opponensplasty and debulking operations were performed after which thumb abduction was improved; however, neurological sequelae remained. LFH of the median nerve is managed on a case-by-case basis as treatment guidelines are not very clearly defined yet. However, the less invasive treatment such as carpal tunnel release and external neurolysis than more aggressive surgical treatment should be recommended as a treatment option.

Non-cutoff 조명기구가 설치된 주유소의 조명환경 및 빛공해 평가 (Luminous Environment and Light Pollution in Gas Stations with Non-cutoff Luminaires)

  • 공효주;김정태
    • 조명전기설비학회논문지
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    • 제22권1호
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    • pp.7-16
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    • 2008
  • 주유소 조명은 안전하고 시각적으로 흥미롭게 디자인되어야 한다. 최근 연구에는 빛공해와 에너지 낭비 때문에 non-cutoff 조명기구를 주유소에 이용되면 안 되는 것을 보여주었다. 본 연구에서는 non-cutoff 조명기구를 사용한 주유소의 조명환경을 분석하는 것을 목적으로 한다. CS-100 휘도계와 Radiant Imaging Prometric-1400을 이용하여 건물표면, 캐노피, 천정, 기둥 및 바닥면을 측정하였다. 그 결과 캐노피 조명기구의 개수가 증가할수록 건물전체 표면휘도가 증가하였으며, Non-cutoff 조명기구를 설치한 연구대상 전체 주유소는 빛공해를 유발하였다. 따라서 주유소 옥외조명에 대한 기준이 마련되어야 할 것이다.

Automated radiosynthesis for the routine production of [18F]FPEB for imaging metabotropic glutamate receptor 5 (mGluRS)

  • Kyung Rok Nam;Sang Jin Han;Kyo Chul Lee;Jae Yong Choi
    • 대한방사성의약품학회지
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    • 제8권1호
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    • pp.3-8
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    • 2022
  • Alteration of the mGluR5 density is closely related to various brain diseases including schizophrenia, depression, Parkinson's disease, and Alzheimer's disease. Therefore, mGluR5 is considered as a valuable imaging biomarker for brain disease and many radiopharmaceuticals have been developed so far. Among them, [18F]FPEB has favorable pharmacokinetic characteristics, and this is the most frequently used radiopharmaceutical for preclinical and clinical studies. In the present study, we want to introduce the optimized radiosynthetic method for the routine production of [18F]FPEB using a GE TRACERlabTM FXFN pro module. In addition, the entire process was monitored with a webcam to solve the problems arising from the synthetic process. As a result, [18F]FPEB was prepared by nucleophilic substitution from its nitro- precursor at 120℃ for 20 min in dimethyl sulfoxide. Radiochemical yield was 13.7 ± 5.1% (decay-corrected, n = 91) with the molar activity of 84 ± 17 GBq/µmol at the end of synthesis. The radiochemical purity was determined to be above 96%. The manufactured [18F]FPEB injection for quality controls were carried out in accordance with an KIRAMS approved protocol, as per ICH and USP guidelines.

Management and rehabilitation of moderate-to-severe diabetic foot infection: a narrative review

  • Chi Young An;Seung Lim Baek;Dong-Il Chun
    • Journal of Yeungnam Medical Science
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    • 제40권4호
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    • pp.343-351
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    • 2023
  • Diabetic foot is one of the most devastating consequences of diabetes, resulting in amputation and possibly death. Therefore, early detection and vigorous treatment of infections in patients with diabetic foot are critical. This review seeks to provide guidelines for the therapy and rehabilitation of patients with moderate-to-severe diabetic foot. If a diabetic foot infection is suspected, bacterial cultures should be initially obtained. Numerous imaging studies can be used to identify diabetic foot, and recent research has shown that white blood cell single-photon emission computed tomography/computed tomography has comparable diagnostic specificity and sensitivity to magnetic resonance imaging. Surgery is performed when a diabetic foot ulcer is deep and is accompanied by bone and soft tissue infections. Patients should be taught preoperative rehabilitation before undergoing stressful surgery. During surgical procedures, it is critical to remove all necrotic tissue and drain the inflammatory area. It is critical to treat wounds with suitable dressings after surgery. Wet dressings promote the formation of granulation tissues and new blood vessels. Walking should begin as soon as the patient's general condition allows it, regardless of the wound status or prior walking capacity. Adequate treatment of comorbidities, including hypertension and dyslipidemia, and smoking cessation are necessary. Additionally, broad-spectrum antibiotics are required to treat diabetic foot infections.

간세포암 감시를 위한 단축 자기공명영상의 최신지견 (Recent Updates of Abbreviated MRI for Hepatocellular Carcinoma Screening)

  • 김정우;이창희
    • 대한영상의학회지
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    • 제82권2호
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    • pp.280-297
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    • 2021
  • 간세포암 위험이 있는 환자들에 대해 국제 가이드라인들은 6개월마다 초음파로 감시할 것을 권고하고 있다. 그러나 초음파는 초기 간세포암을 발견하는 데에 낮은 민감도를 보인다. 한편, 자기공명영상(MRI)은 간세포암을 비침습적으로 진단하는 데 중요한 역할을 하지만, 검사 시간이 길고 비용이 높아서 감시 검사로는 적합하지 않다. 따라서 비조영증강 단축 MRI, 역동적 조영증강 단축 MRI, 그리고 간담도기영상을 포함한 단축 MRI 등 다양한 단축 MRI 전략들을 간세포암 감시에 이용한 여러 연구들이 있었다. 이 종설에서는 다양한 단축 MRI 전략들을 살펴보고, 비용-효과적인 측면을 고려하여 간세포암 감시의 앞으로 나아가야 할 방향에 대해 살펴보고자 한다.

Guideline on Acceptance Test and Commissioning of High-Precision External Radiation Therapy Equipment

  • Kim, Juhye;Shin, Dong Oh;Choi, Sang Hyoun;Min, Soonki;Kwon, Nahye;Jung, Unjung;Kim, Dong Wook
    • 한국의학물리학회지:의학물리
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    • 제29권4호
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    • pp.123-136
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    • 2018
  • The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.

Current Practices in Breast Magnetic Resonance Imaging: a Survey Involving the Korean Society of Breast Imaging

  • Yun, Bo La;Kim, Sun Mi;Jang, Mijung;Kang, Bong Joo;Cho, Nariya;Kim, Sung Hun;Koo, Hye Ryoung;Chae, Eun Young;Ko, Eun Sook;Han, Boo-Kyung
    • Investigative Magnetic Resonance Imaging
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    • 제21권4호
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    • pp.233-241
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    • 2017
  • Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.