• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.911-917
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• 2023

The method of observing nodular changes on the liver surface using clinical ultrasonography is useful for diagnosing cirrhosis. However, the speckle noise that inevitably occurs in ultrasound images makes it difficult to identify changes in the liver surface and echo patterns, which has a negative impact on the diagnosis of cirrhosis. The purpose of this study is to model the median modified Wiener filter (MMWF), which can efficiently reduce noise in cirrhotic ultrasound images, and confirm its applicability. Ultrasound images were acquired using an ACR phantom and an actual cirrhotic patient, and the proposed MMWF algorithm and conventional noise reduction algorithm were applied to each image. Coefficient of variation (COV) and edge rise distance (ERD) were used as quantitative image quality evaluation factors for the acquired ultrasound images. We confirmed that the MMWF algorithm improved both COV and ERD values compared to the conventional noise reduction algorithm in both ACR phantom and real ultrasound images of cirrhotic patients. In conclusion, the proposed MMWF algorithm is expected to contribute to improving the diagnosis rate of cirrhosis patients by reducing the noise level and improving spatial resolution at the same time.

• Journal of radiological science and technology
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• v.46 no.6
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• pp.475-484
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• 2023

This study aimed to compare filters for reducing speckle noise in ultrasound images using clinical liver images. We acquired the clinical liver ultrasound images, and noisy images were obtained by adding 0.01, 0.05, 0.10, and 0.50 intensity levels of speckle noise to the liver images. The Wiener filter, median modified Wiener filter, gamma filter, and Lee filter were designed for the noisy images by setting window sizes at 3×3, 5×5, and 7×7. The coefficient of variation (COV) and contrast to noise ratio (CNR) were calculated to evaluate noise reduction and various filters. Moreover, the filter with the highest image quality was selected and quantitatively compared to a noisy image. As a result, COV and CNR showed the noise improved result when the Lee filter was applied. Furthermore, the Lee filter image with a window size of 7×7 was noted to possess approximately a minimum of 1.28 to a maximum of 3.38 times better COV and a minimum of 2.18 to a maximum of 5.50 times better CNR than the noisy image. In conclusion, we confirmed that the Lee filter was effective in reducing speckle noise and proved that an appropriate window size needs to be set considering blurring.

• Korean Journal of Radiology
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• v.22 no.7
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• pp.1077-1086
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• 2021

Objective: To investigate the diagnostic performance of quantitative ultrasound (US) parameters for the assessment of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD) using magnetic resonance imaging proton density fat fraction (MRI-PDFF) as the reference standard. Materials and Methods: In this single-center prospective study, 120 patients with clinically suspected NAFLD were enrolled between March 2019 and January 2020. The participants underwent US examination for radiofrequency (RF) data acquisition and chemical shift-encoded liver MRI for PDFF measurement. Using the RF data analysis, the attenuation coefficient (AC) based on tissue attenuation imaging (TAI) (AC-TAI) and scatter-distribution coefficient (SC) based on tissue scatter-distribution imaging (TSI) (SC-TSI) were measured. The correlations between the quantitative US parameters (AC and SC) and MRI-PDFF were evaluated using Pearson correlation coefficients. The diagnostic performance of AC-TAI and SC-TSI for detecting hepatic fat contents of ≥ 5% (MRI-PDFF ≥ 5%) and ≥ 10% (MRI-PDFF ≥ 10%) were assessed using receiver operating characteristic (ROC) analysis. The significant clinical or imaging factors associated with AC and SC were analyzed using linear regression analysis. Results: The participants were classified based on MRI-PDFF: < 5% (n = 38), 5-10% (n = 23), and ≥ 10% (n = 59). AC-TAI and SC-TSI were significantly correlated with MRI-PDFF (r = 0.659 and 0.727, p < 0.001 for both). For detecting hepatic fat contents of ≥ 5% and ≥ 10%, the areas under the ROC curves of AC-TAI were 0.861 (95% confidence interval [CI]: 0.786-0.918) and 0.835 (95% CI: 0.757-0.897), and those of SC-TSI were 0.964 (95% CI: 0.913-0.989) and 0.935 (95% CI: 0.875-0.972), respectively. Multivariable linear regression analysis showed that MRI-PDFF was an independent determinant of AC-TAI and SC-TSI. Conclusion: AC-TAI and SC-TSI derived from quantitative US RF data analysis yielded a good correlation with MRI-PDFF and provided good performance for detecting hepatic steatosis and assessing its severity in NAFLD.

• Journal of Biomedical Engineering Research
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• v.5 no.2
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• pp.121-126
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• 1984

A new approach to texture classification for quantitative ultrasound liver diagnosis using run difference matrix was developed. The run difference matrix comprised the gray level difference along with a distances. From this run difference matrix, we defined several vectors and parameters such as DOD, DGD, DAD vector, SHP, SMO, SMG, LDE, LDEL etc.Each parameter values calculated in fatty, cirrhotic, normal and chronic hepatitic liver images were plotted in a plane and we found that RDM method was more sensitive to small structural changes than the conventional run length method and showed improved classification ability between the diseases.

• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.463-472
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• 2021

Demand for examinations using transvaginal transducer with high frequencies is increasing to observe pelvic organs in gynecological ultrasound tests. However, the quality control of the replacement probe in clinical trials is not properly implemented and the evaluation criteria have not been established. Therefore, 58 transvaginal transducers and 20 convex transducers were applied to the ATS-539 ultrasound phantom for 20 ultrasound devices currently in clinical use to obtain their respective images and measure them quantitatively and qualitatively. For quantitative measurements, vertical measurement, horizontal measurement, and focal zone and qualitative measurements, dead zone, axial·lateral resolution, sensitivity, functional resolution, gray scale·dynamic range were performed. Quantitative statistical analysis showed significant differences between the two transducers in the lateral measurement and local area (p<0.05). qualitative comparative analysis showed differences in sensitivity and functional resolution. This occurs due to the difference in frequency between transducers and the transducer's injection geometry. Based on the above experiments, the tolerance for horizontal measurement is raised to 10% (±8 mm), the tolerance for sensitivity is observed up to 6 cm deep, which is 12 cm deep,which is the level of the third quartile (75%). The permissible range of functional resolution is up to 6 (12 cm), 6 (12 cm), 11 (11 cm), 9 (9 cm), 6 (6 cm) target, which is the level of the third quartile (75%). It is considered reasonable to adjust the depth of targets in gray scale·dynamic range to measure at a depth of 2 cm, which is 50% of the depth of 4 cm. As above, the criteria for evaluating the quality of transvaginal transducer for use in the past have been proposed and it is expected that this study will be used as a basic data for the production of phantom exclusively for transvaginal transducer in the future.

• Journal of Veterinary Clinics
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• v.39 no.3
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• pp.114-120
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• 2022

The purpose of this study is to examine the status of quality control using multipurpose phantom of ultrasound equipment used in hospital of veterinary college in South Korea by using ATS-539 multipurpose phantom so as to examine quantitative and objective new image evaluation method. Specialists discussed and analyzed multipurpose phantom images acquired by using convex transducer of 10 ultrasound imaging devices, currently used in 9 veterinary colleges, at 4.0-6.0 MHz. Total 8 items that can be measured with ATS-539 multipurpose phantom including dead zone, vertical and horizontal measurement, axial/lateral resolution, sensitivity, focal zone, functional resolution and gray scale/dynamic range were evaluated. For qualitative evaluation, valid decisions were made based on dead zone, axial/lateral resolution, and gray scale/dynamic range which are resolution index, and coefficient of variation (COV) and blind referenceless image spatial quality evaluator (BRISQUE) were found to increase objectivity. As a result of experiment, all the targeted ultrasonic devices were found appropriate from qualitative evaluation items of dead zone, axial/lateral resolution, and gray scale/dynamic range. In other evaluation items, they were found to be appropriate from focal zone and vertical measurement of quantitative evaluation while inappropriate from horizontal measurement, sensitivity, and functional resolution. COV value was 0.12 ± 0.04, and BRISQUE value was 47.77 ± 2.77, both analysis results show that the noise level of all ultrasonic devices was located within tolerance range. Upon image examination using ATS-539 multipurpose phantom, they were 100% appropriate with inspection standards of dead zone, axial/lateral resolution, and gray scale/dynamic range, and besides, focal zone and functional resolution can be used as evaluation items. In the field of veterinary medicine, 8 standard items using ATS-539 multipurpose phantom and image evaluation items using COV and BRISQUE can be used as standards for quality control of ultrasonography machine.

• Journal of Biomedical Engineering Research
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• v.43 no.4
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• pp.241-250
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• 2022

It is known that chronic pain and injury of upper limb joint tissue in manual wheelchair users is usually caused by muscle imbalance, and the propulsion speed is reported to increase this muscle imbalance. In this study, kinematic variables, electromyography, and ultrasonographic images of the upper limb were measured and analyzed at two different propulsion speeds to provide a quantitative basis for the risk of upper extremity joint injury. Eleven patients with spinal cord injury for the experimental group (G_E) and 27 healthy adults for the control group (G_C) participated in this study. Joint angles and electromyography were measured while subjects performed self-selected comfortable and fast-speed wheelchair propulsion. Ultrasound images were recorded before and after each propulsion task to measure the acromiohumeral distance (AHD). The range of motion of the shoulder (14.35 deg in G_E; 20.24 deg in G_C) and elbow (5.25 deg in G_E; 2.57 deg in G_C) joints were significantly decreased (p<0.001). Muscle activation levels of the anterior deltoid, posterior deltoid, biceps brachii, and triceps brachii increased at fast propulsion. Specifically, triceps brachii showed a significant increase in muscle activation at fast propulsion. AHD decreased at fast propulsion. Moreover, the AHD of G_E was already narrowed by about 60% compared to the G_C from the pre-tests. Increased load on wheelchair propulsion, such as fast propulsion, is considered to cause upper limb joint impingement and soft tissue injury due to overuse of the extensor muscles in a narrow joint space. It is expected that the results of this study can be a quantitative and objective basis for training and rehabilitation for manual wheelchair users to prevent joint pain and damage.

• Childhood Kidney Diseases
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• v.9 no.1
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• pp.21-30
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• 2005

Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

• The Journal of the Acoustical Society of Korea
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• v.27 no.2E
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• pp.45-50
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• 2008

In recent years, quantitative ultrasound (QUS) technologies have played a growing role in the diagnosis of osteoporosis. Most of the commercial bone somometers measure speed of sound (SOS) and/or broadband ultrasonic attenuation (EUA) at peripheral skeletal sites. However, the QUS parameters are purely empirical measures that have not yet been firmly linked to physical parameters such as bone strength or porosity. In the present study, the theoretical models for wave propagation in cancellous bone, such as the Biot model, the stratified model, and the modified Biot-Attenborough (MBA) model, were applied to predict the dependence of phase velocity on porosity in cancellous bone. The optimum values for the input parameters of the three models in cancellous bone were determined by comparing the predictions with the previously published measurements in human cancellous bone in vitro. This modeling effort is relevant to the use of QUS in the diagnosis of osteoporosis because SOS is negatively correlated to the fracture risk of bone, and also advances our understanding of the relationship between phase velocity and porosity in cancellous bone.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.1 no.2
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• pp.11-19
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• 2003

The purpose of this study investigated the anesthetic effects of lidocaine gel by phonophoretic transdermal delivery. The anesthetic effects were evaluated by two aspects as quantitative sensory testing and sensory nerve conduction study. Twelve healthy males(aged $23.25{\pm}2.09$ years) were studied. Exclusion criteria were ; pain, history of sensory disturbances and skin conditions in the areas to be examined. The subjects were divided into two groups; group I(lidocaine gel without ultrasound) and group II(lidocaine gel with ultrasound). The following results were obtained; 1. In changes of tactile threshold and electrical pain threshold, all groups were significantly increased(p<0.05). 2. In changes of electrical pain threshold, it was significantly differenced between the groups(p<0.05). We conclude that the transdermal delivery of lidocaine gel by phonophoresis has a possibility to use for surface anesthesia and the pain control of the superficial tissue.