• Journal of Radiation Protection and Research
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• 제46권1호
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• pp.1-7
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• 2021

Background: The use of computed tomography (CT) device has increased in the past few decades in Japan. Dose optimization is strongly required in pediatric CT examinations, since there is concern that an unreasonably excessive medical radiation exposure might increase the risk of brain cancer and leukemia. To accelerate the process of dose optimization, continual assessment of the dose levels in actual hospitals and medical facilities is necessary. This study presents organ dose estimation using pediatric cerebral CT scans in the Kyushu region, Japan in 2012 and the web-based calculator, WAZA-ARI (https://waza-ari.nirs.qst.go.jp). Materials and Methods: We collected actual patient information and CT scan parameters from hospitals and medical facilities with more than 200 beds that perform pediatric CT in the Kyushu region, Japan through a questionnaire survey. To estimate the actual organ dose (brain dose, bone marrow dose, thyroid dose, lens dose), we divided the pediatric population into five age groups (0, 1, 5, 10, 15) based on body size, and inputted CT scan parameters into WAZA-ARI. Results and Discussion: Organ doses for each age group were obtained using WAZA-ARI. The brain dose, thyroid dose, and lens dose were the highest in the Age 0 group among the age groups, and the bone marrow and thyroid doses tended to decrease with increasing age groups. All organ doses showed differences among facilities, and this tendency was remarkable in the young group, especially in the Age 0 group. This study confirmed a difference of more than 10-fold in organ doses depending on the facility and CT scan parameters, even when the same CT device was used in the same age group. Conclusion: This study indicated that organ doses varied widely by age group, and also suggested that CT scan parameters are not optimized for children in some hospitals and medical facilities.

• 한국의학물리학회지:의학물리
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• 제26권4호
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• pp.258-266
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• 2015

현대 방사선치료는 고선명 X선 투사영상을 이용하여 환자 및 종양의 위치를 확인하는 기술이 요구되지만, 3차원 영상 촬영을 위한 피폭량 및 영상정보의 급격한 증가는 환자에게 추가적인 부담이 될 수 있다. 본 연구에서는 영상의 구조 정보를 효과적으로 추출할 수 있는 Structural similarity (SSIM) 인자를 도입하여 매일 촬영하는 환자의 2차원 X선 영상간 차이를 자동 분석하여 환자의 위치 정확성의 검증 가능성을 제시하였다. 먼저 종양을 모사하기 위하여 구형 전산 팬텀의 크기와 위치를 변화시키면서 각각의 투사 영상을 시뮬레이션하고, SSIM 인자를 통해 영상 간 차이를 검출하여 분석하였다. 또한 12일간 매일 촬영한 방사선 치료 환자의 2차원 X선 영상들 간 차이를 동일한 방법으로 검출하였다. 그 결과 산출된 팬텀 변화에 따른 SSIM 값은 0.85~1 범위로, 관심영역(ROI)을 영상 전체가 아닌 팬텀으로 한정하였을 때는 0.006~1 범위로 나타나서 ROI 적용 시 민감도가 크게 상승하는 것을 확인하였다. 또한 임상 영상의 SSIM은 0.799~0.853 범위의 값을 나타냈으며 영상 간 차이가 SSIM 분포 상에 검출되는 것을 확인하였다. 본 연구결과는 소요 시간 및 피폭 등의 우려로 매일 사용하기 어려운 3차원 영상기법 대신 간단한 2차원 영상만을 이용하여 객관적이고 정량적인 환자 위치 정확성의 자동 평가 기법을 제공할 수 있을 것으로 기대된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권5호
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• pp.2225-2229
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• 2014

Background: Carcinoma of the tongue is the most common intra-oral malignancy in Western countries. Incidence and mortality rates have increased in recent years, and survival has not improved. This study aimed to determine etiologic factors for tongue cancer with age-sex matched case-control data. Materials and Methods: 47 patients with carcinoma of the tongue referred to our oral medicine clinic between years 2005-2006 were analyzed and compared with control group data. The medical records, including family history of cancer, dental trauma, and history of abuse of alcohol and tobacco products was recorded for all subjects. Chi square comparison tests and linear regression analysis were performed using the SPSS program for statistics. Results: Patient and randomly selected control groups each consisted of 30 male and 17 female subjects with mean ages 53.2 (${\pm}12.6$) and 52.6 (${\pm}11.5$) years respectively. Smoking and alcohol abuse proportions were significantly higher in the patient group (p=0.0001, p<0.0001 respectively). Chronic mechanical trauma was observed in 44.7% of the patients and 17.0% of the control group (p=0.004). Similarly, family history of cancer of any type (for the first degree relatives) was found to be more common in the patient group (p=0.009). On regression analysis, alcohol abuse, family history of cancer, smoking, chronic mechanical traumas appeared as significant etiologic factors (p=0.0001). Conclusions: We believe that field cancerization may become evident in oral and oropharyngeal mucosa with multiple steps of molecular changes starting from the first sign of dysplasia with chronic exposure to etiological factors. Chronic trauma cases need particular attention to search for very early signs of cancer.

• 대한방사선기술학회지:방사선기술과학
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• 제38권2호
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• pp.101-106
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• 2015

최근에 방사선을 이용한 검사들은 환자들이 받는 피폭선량에 대한 관심이 증대하고 있으며, 이러한 방사선을 이용한 방사선사들은 X-선 검사 시 환자에게 조사되는 피폭선량을 인지하여 영상의 질 저하 없이 환자의 피폭선량경감에 대하여 끊임없이 노력해야 한다. 외국의 경우 일반촬영검사들의 피폭선량기준치로 면적선량계와 표면입사선량계에 의하여 선량관리를 하고 있다. 이에 본 논문은 모의팬텀을 이용하여 일반촬영검사들 중 두 개부 전후방 촬영, 흉부 후전방 촬영, 복부 전후방 촬영을 중심으로 면적선량계와 반도체 선량계를 이용하여 면적선량과 표면선량을 비교 측정하였으며, 그 결과 면적선량계와 반도체선량계와의 측정차이는 없었다.

• 대한치과의사협회지
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• 제58권7호
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• pp.388-397
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• 2020

Objective: The purpose of the study was to calculate the effective and absorbed organ doses of cone-beam computed tomography (CBCT) in pediatric patient using personal computer-based Monte Carlo (PCXMC) software and to compare them with those measured using thermoluminescent dosimeters (TLDs) and anthropomorphic phantom. Materials and Methods: Alphard VEGA CBCT scanner was used for this study. A large field of view (FOV) (20.0 cm × 17.9 cm) was selected because it is a commonly used FOV for orthodontic analyses in pediatric patients. Ionization chamber of dose-area product (DAP) meter was located at the tube side of CBCT scanner. With the clinical exposure settings for a 10-year-old patient, DAP value was measured at the scout and main projection of CBCT. Effective and absorbed organ doses of CBCT at scout and main projection were calculated using PCXMC and PCXMCRotation software respectively. Effective dose and absorbed organ doses were compared with those obtained by TLDs and a 10-year-old child anthropomorphic phantom at the same exposure settings. Results: The effective dose of CBCT calculated by PCXMC software was 292.6 μSv, and that measured using TLD and anthropomorphic phantom was 292.5 μSv. The absorbed doses at the organs largely contributing to effective dose showed the small differences between two methods within the range from -18% to 20%. Conclusion: PCXMC software might be used as an alternative to the TLD measurement method for the effective and absorbed organ dose estimation in CBCT of large FOV in pediatric patients.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6429-6436
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• 2014

Poly-ADP-ribosylation (PAR) is a post-translational modification of mainly chromosomal proteins. It is known to be strongly involved in several molecular events, including nucleosome-remodelling and carcinogenesis. In this investigation, it was attempted to evaluate PAR level as a reliable biomarker for early detection of cancer in blood lymphocyte histones. PAR of isolated histone proteins was monitored in normal and dimethylnitrosamine (DMN)-exposed mice tissues using a novel ELISA-based immuno-probe assay developed in our laboratory. An inverse relationship was found between the level of PAR and period of DMN exposure in various histone proteins of blood lymphocytes and spleen cells. With the increase in the DMN exposure period, there was reduction in the PAR level of individual histones in both cases. It was also observed that the decrease in the level of PAR of histones resulted in progressive relaxation of genomic DNA, perhaps triggering activation of genes that are involved in initiation of transformation. The observed effect of carcinogen on the PAR of blood lymphocyte histones provided us with a handy tool for monitoring biochemical or physiological status of individuals exposed to carcinogens without obtaining biopsies of cancerous tissues, which involves several medical and ethical issues. Obtaining blood from any patient and separating blood lymphocytes are routine medical practices involving virtually no medical intervention, post-procedure medical care or trauma to a patient. Moreover, the immuno-probe assay is very simple, sensitive, reliable and cost-effective. Therefore, combined with the ease of preparation of blood lymphocytes and the simplicity of the technique, immuno-probe assay of PAR has the potential to be applied for mass screening of cancer. It appears to be a promising step in the ultimate goal of making cancer detection simple, sensitive and reliable in the near future.

• 한국방사선학회논문지
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• 제13권4호
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• pp.589-596
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• 2019

진단방사선 영상을 획득하기 위해 이용되는 X-ray는 연속적인 에너지 분포를 가지지만 저에너지 광자의 경우에는 영상 형성 보다는 환자피폭에 더 많은 기여를 하는 것으로 알려져 있다. 이러한 저에너지 광자를 제거하기 위해 임상에서는 알루미늄 필터를 적용하고 있으나 이는 빔 경화 현상으로 인한 영상 품질에 악영향을 미칠 가능성이 있다. 이에 본 연구에서는 알루미늄 필터에 의한 산란 선량이 의료 영상의 품질에 미치는 영향에 대하여 고찰하고자 하였다. 또한, 영상의 대조도 저하를 정량적으로 표현하기 위해 상대 표준 편차 및 산란 열화 인자를 평가 지표로서 활용하였다. 연구 결과, 70 kVp 이상의 전압에서 진단 영상을 확보 시 NCRP에 의해 권장되는 2.5 mmAl를 기준에서 전방산란율 분석 결과 0.69 %, 산란 열화 인자 분석 결과는 0.005, NNPS 분석 결과 3.59 mm2의 변화가 나타났다. 이러한 연구 결과를 바탕으로 알루미늄 필터의 두께가 증가함에 따라 발생하는 산란 선량이 의료 영상의 품질을 저하시키는 것을 정량적으로 검증하였다.

• 대한방사선기술학회지:방사선기술과학
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• 제43권6호
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• pp.469-473
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• 2020

Breast cancer is growing rapidly year by year and has the highest incidence since 2001. As a result, the interest in mammography for early detection of breast cancer is increasing. However, mammography is accompanied by radiation exposure and therefore it is necessary to reduce exposure dose through appropriate test conditions. The significance of this study is that breast dose studies, which were limited to ordinary women, were applied to breast implant patient. Using MCNP simulation, the phantom with prosthesis inserted was developed to compare dose by tube voltage by pressure thickness. In addition phantom without prostheses has higher dose than phantom with prostheses. If these results were used as basic data, it would be possible to recommend test condition guideline only for breast implant patients.

• Journal of Radiation Protection and Research
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• 제37권4호
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• pp.231-236
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• 2012

This study derived measures to reduce exposure doses by identifying factors which affect the external radiation dose rate of patients treated with radiopharmaceuticals for PET-CT tests. The external radiation dose rates were measured on three parts of head, thorax and abdomen at a distance of 50cm from the surface of 60 PET-CT patients. It showed there are changes in factors affecting the external radiation dose rate over time after the administration of F-18 FDG. The external radiation dose rate was lower in the patients with more water intake than those with less water intake before the injection of radiopharmaceuticals at all three points: right after the injection of radiopharmaceuticals (average 4.17 mins), after the pre-PEET-CT urination step (average 77.47 mins), and right after the PET-CT test (average 114.15 mins). The study also found there is a need to increase the amount of water intake before the injection of radiopharmaceuticals in order to maintain a low external radiation dose rate in patients. This strategy is only possible under the assumption that the quality of the video has not changed after conducting this study on the relations between the image and quality. This study also found a need to use radiopharmaceuticals with the minimum amount needed for each patient because F-FDG doses affects the external radiation dose rate at the point right after the injection of radiopharmaceuticals. Urination frequency was the most significant factor to affect the external radiation dose rates at the point right after the PET-CT test and the point after the pre-PET-CT urination step. There is a need to realize the strategy to increase the urination frequency of patients to maintain the external radiation dose rate low (average 77.47 mins) before and after the injection of radiopharmaceuticals. In addition, at this point, there is a need to take advantage of personal strategies because the external radiation dose rate is lower if the fasting time is shorter, the contrast medium is used, and the amount of water intake is increased after the administration of radiopharmaceuticals. Finally this study found the need to be able to generalize these findings through an in-depth research on the factors affecting the external radiation dose rate, which includes radiopharmaceutical dose, urination frequency, the amount of water intake, fasting time and the use of contrast medium.

• 한국방사선학회논문지
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• 제10권7호
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• pp.539-543
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• 2016

본 연구는 진단용 X선 발생장치에서 조사야 외부의 산란선량을 감소시켜 환자의 피폭 선량을 감소시키기 위한 방법이다. 자체 제작한 $150{\times}190mm^2$ 납판을 콜리메이터 하단에 부착함으로써 조사야 이외의 부위에 도달하는 산란선량을 감소시키고자 하였다. 납판을 추가로 삽입 후 X선 관축방향인 X-축의 산란선량을 측정한 결과 26 ~ 36% 감소하는 것으로 나타났으며, 관축의 수직 방향인 Y-축 방향에서는 납판의 사용 유무에 따른 산란선량은 큰 변화를 나타내지 않았다. 이러한 결과는 콜리메이터 Shutter에 의해서 발생하는 산란선 보다는 초점 근방에서 발생하는 초점외 X선에 의한 산란선 영향이 크다는 것을 의미한다. 따라서 기존의 콜리메이터 하단에 추가로 납판을 설치하는 것이 조사야 외부의 X-축 산란선량을 감소시키는 방법으로 판단되어진다.