• Progress in Medical Physics
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• v.16 no.1
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• pp.10-15
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• 2005

IAEA's guidance levels have been provided for western people to the end. Guidance levels lower than the IAEA'S will be necessary in view of Korean people's proportions. Therefore, we need to develope the standard doses for Korean people. And we conducted a nationwide survey of patient dose from x-ray examinations in Korea. In this study, the 278 institutions were selected from Members Book of Korean Hospital Association. The valid response rate was approximately 57.9%. Doses were calculated from the questionnaires by NDD method. We obtained the results were as follows; 1) General radiographic equipments were distributed for 42.0%, fluoroscopic equipments 29.4%, dental equipments 13.2%, CT units 8.1 % and mamographic units 7.2%. 2) According to classification by rectification, three-phase equipments were 29.9%, inverter-type generators 29.5%, single-phase equipments 25.5%, constant voltage units 9.0% and unknown units 6.0%. 3) According to classification by receptor system, film-screen types were 46.8%, CR types 26.8%, DR types 17.7% and unknown types 8.9%. 4) The number of examinations were chest 49.2%, spine 16.8% and abdomen 12.7%. 5) Patient doses were head AP 3.44 mGy, abdomen AP 4.25 mGy and chest PA 0.39 mGy.

• Progress in Medical Physics
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• v.21 no.2
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• pp.192-200
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• 2010

Cyberknife with small field size is more difficult and complex for dosimetry compared with conventional radiotherapy due to electronic disequilibrium, steep dose gradients and spectrum change of photons and electrons. The purpose of this study demonstrate the usefulness of Geant4 as verification tool of measurement dose for delivering accurate dose by comparing measurement data using the diode detector with results by Geant4 simulation. The development of Monte Carlo Model for Cyberknife was done through the two-step process. In the first step, the treatment head was simulated and Bremsstrahlung spectrum was calculated. Secondly, percent depth dose (PDD) was calculated for six cones with different size, i.e., 5 mm, 10 mm, 20 mm, 30 mm, 50 mm and 60 mm in the model of water phantom. The relative output factor was calculated about 12 fields from 5 mm to 60 mm and then it compared with measurement data by the diode detector. The beam profiles and depth profiles were calculated about different six cones and about each depth of 1.5 cm, 10 cm and 20 cm, respectively. The results about PDD were shown the error the less than 2% which means acceptable in clinical setting. For comparison of relative output factors, the difference was less than 3% in the cones lager than 7.5 mm. However, there was the difference of 6.91% in the 5 mm cone. Although beam profiles were shown the difference less than 2% in the cones larger than 20 mm, there was the error less than 3.5% in the cones smaller than 20 mm. From results, we could demonstrate the usefulness of Geant4 as dose verification tool.

• Journal of the Korean Society of Radiology
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• v.9 no.2
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• pp.101-107
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• 2015

In anteroposterior radiation test for cervical vertebra, it is general that the incidence angle of X-ray is $15^{\circ}$ to $20^{\circ}$ degrees to head regardless of position. So this study suggests appropriate incidence angle of cervical vertebra depended on the position. From 1 January 2013 to 31 December 2013, cervical spine radiographys and magnetic resonance imaging was performed in 107 people who visited P Hospital located in Pusan. Among them, 39 people(men 24, women 15) were below 80 above 20 years old(average age 54 years) with normal cervical lordosis(normal $40^{\circ}{\pm}5^{\circ}$). In erect position, the incidence angle of cervical vertebra is measured from lateral radiographic images. And in supine position, it measured from MRI sagittal images. Results based on gender, the incidence angle of cervical vertebra in erect position was $25.9^{\circ}$ for men, women was $23.1^{\circ}$, showed statistically significant (p<0.05). And the angle in supine was $11.6^{\circ}$ for men, women was $12.6^{\circ}$, showed not statistically significant (p>0.05) An analysis of age group shows, the incidence angle of cervical vertebra in erect position was $24.6^{\circ}$ under 50, and $25.0^{\circ}$ over 50. The angle in supine was $12.0^{\circ}$ under 50, and $11.9^{\circ}$ over 50. And all of them showed not statistically significant (p>0.05). At all ages, the average of incidence angles in erect position were $24.8^{\circ}$, and the angle in supine was $12.0^{\circ}$, showed statistically significant (p<0.05). The cervical vertebra incidence angle for X-ray was $15^{\circ}$ to $20^{\circ}$ degrees to head in general. But, through the results, it is recommended that the angle is $24.8^{\circ}$ in erect and $12.0^{\circ}$ in supine position. It could be shown true anteroposterior(AP) view of cervical vertebra and accurate intervertebral fusion fixing devices.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.43-48
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• 2017

Measurement of bone marrow measurements may occur if bone marrow examination performed with bone marrow examination (bone marrow examination) and bone density (bone scan) are performed together recently. Thus, it was examined in clinical aspects that $^{99m}Tc-MDP$ compounds were affected by bone mineral density measurements. The average age of the participants in the experiment was $35.17{\pm}9.45$ and the patient fractures of the lumbar vertebrae that could affect the metabolic disease and bone density measurements affecting the metabolic disease of the 17 subjects. 6 patients with normal bone mineral density T-scores>-1.0 in 12 patients were analyzed before and after the administration of $^{99m}Tc-MDP$. In the lumbar spine, the average of $0.975{\pm}0.084g/cm^2$ and $0.966{\pm}0.078g/cm^2$ were increased by $0.009g/cm^2$. respectively In the right proximal femur, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.086g/cm^2$. In the right proximal thigh, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.08 g/cm^2$, respectively, which decreased by $0.004g/cm^2$. In the left side proximal femur, mean $0.887{\pm}0.099g/cm^2$ and $0.881{\pm}0.103g/cm^2$, respectively, increased by $0.007g/cm^2$. Therefore, the BMD changes in the lumbar region were larger than that in the proximal thigh. In addition, $^{99m}Tc-MDP$ did not affect the BMD. And a bone scan test using a technetium-labeled compound emitting a gamma-ray energy of 140 keV did not significantly affect bone density measurements. However, if the nuclear medical examination and the osteoporosis test are to be performed together, the examination should be carried out at intervals considering the exposures of the patient.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.517-526
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• 2016

This study analyzed the correlation between BMD (bone mineral density) value calculated in the MDCT (multidetector computed tomography) and lifestyle, physical features and social characteristics. From July 15 2015 to June 6 2016, we converted from HU (hounsfield unit) value measured by using MDCT to T-score for BMD of 141 patients (male: 63, female: 78) in W medical center. We measured the 2nd, 3rd and 4th lumbar spine and analyzed the correlation between gender differences in BMD and lifestyle, physical features and social characteristics. Statistical significance was validated using independent sample T test with one way Anova. Gender BMD was confirmed that a statistically significant difference (p<0.05). BMD values decreased with increasing age but for the statistically men, there was no significant difference from 20s to 50s, it only showed a significant difference in 20s and 60s (p<0.001). For the statistically women, there was no significant difference from 20s to 40s. but since 50s BMD was decreased rapidly, which showed a significant difference (p<0.001). women showed significant differences for the menstruation and menopause, childbirth, alcohol, cereals and greasy food in bone mineral density (p<0.05) but there were no significant differences in men. The bone mineral density values calculated by the MDCT and lifestyle, physical features and social characteristics correlation analysis method is considered to be used as a basis for estimating the state in BMD and osteoporosis management.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.3-9
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• 2011

Purpose: Generally dual energy X-ray absorptiometry has been used for the purpose of evaluation of osteoporosis and treatment. Recently the interest of obesity came to be high and body percent fat test is increasing. Existing measure of body fat have to scan the whole body can be evaluated, but only lumbar spine and hip measurements was assumed to be whole body fat as well as improving the software. It tries to check whether the part measured value not being whole body measurement has the validity or not compared with the value calculated with the method that it is different, it forgives through a correlation with a (BIA) and (BMI). Materials and Methods: In 2010, the body percent fat was measured among the examinee coming to the Asan Medical Center public health care center from March till August against 90 females more than 40 years old through (DXA) and BIA. BMI utilized the value which wrote an hight and weight measured through the body measuring instrument in the examinee information and is automatically calculated. In addition, it classified as the low weight ($13-18.5kg/m^2$), normal ($18.5-25kg/m^2$), and corpulence ($25-30kg/m^2$) based on BMI and so that it could check whether there was the difference according to the weight or not BMI and BIA and correlation between DXA were analyzed in each group. The statistical program for the analysis used SPSS 12.0. Results: The comparison of DXA at 3 which it divides into the low weight and normal and corpulence groups and BIA did not show the difference noted statistically in all groups and the between group comparison was exposed to do not have a meaning. The body percent fat measured by the correlation analysis result DXA at the state that it doesn't divide into the group showed the high correlation (r=0.908, p0.01) noted statistically compared with BMI and showed the high correlation noted statistically in a comparison with BIA (r=0.927, p0.01). Conclusion: It confirmed that the whole body percent fat presumed from the part bone density measurement showed the excel correlation compared with BIA and BMI and information is high. There is still no clear standard about the presumed whole body percent fat and it is difficult to evaluate the fat evaluation by the bone mineral density measurement. However, it is determined that the information offering which is more objective through the comparative study with the body percent fat which is very efficient and in that it can obtain till the information about a fat as well as diagnosis of the osteoporosis through the bone density checkup is measured by the afterward telegraph bone density checkup and is clinically useful is possible.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.43-50
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• 2004

Background : Steroid-induced osteoporosis(SIO) is one of the serious complications of long-term steroid therapy, especially in growing children. Recently bisphosphonates have been used to treat or prevent SIO in adult, which is rare in children with glomerular diseases. We studied the effect of pamidronate on SIO using dual energy X-ray absorptiometry and biochemical markers of bone turnover. Methods : Forty four children receiving moderate-to-high doses of steroids were enrolled. They had no history of bone, liver, or endocrine disease. Patients were stratified by their baseline bone mineral density(BMD) findings. All patients received corticosteroids for 3 month and oral calcium supplementation(500 mg/day) daily. Among them, 28 patients were treated with placebo and 16 were treated with pamidronate(125 mg) for 3 months. Blood chemistry and bone mineral density(BMD) were measured at baseline, and 3months. In addition, parathyroid hormone(PTH), serum osteocalcin, and urinary dipyridinoline levels were evaluated. Results : In overall population, the mean lumbar spine BMD decreased from $0.754{\pm}0.211(g/cm^2)$ to $0.728{\pm}0.208(g/cm^2)$ in the placebo group(P<0.05) and increased from $0.652{\pm}0.194(g/cm^2)$ to $0.658{\pm}0.226(g/cm^2)$ in the pamidronate group(P>0.05). Conclusion : Pamidronate appears to be effective in preventing SIO in children with glomerular diseases requiring long-term steroids therapy. Further careful observation and follow-up might be needed for children receiving bisphosphonates such as pamidronate.

• Journal of radiological science and technology
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• v.33 no.1
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• pp.19-24
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• 2010

The aim of this study was to evaluate the change of bone mineral density according to distal radius rotation and the correlations of the lowest BMD measured by DXA at the lumba versus distal radius. The eleven males were projected distal radius by DR X-ray and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 21 males. The healthy 11 and 21 volunteers without any history of operations, anomalies, or trauma were enrolled. The experiment was performed by two methods. First, The DR X-ray was measured distal radius of 11 males in pronation and supination with three, six and nine degrees, including a neutral position. The ROI was measured by the m-view program on the PACS monitor. Second, The DXA was measured distal radius of 21 males in pronation and supination with five and ten degrees, including a neutral position to evaluate the changes of BMD according to the rotation. A correlation of the BMD in the distal radius with BMD that lumbar spine was performed, along with analysis of the data by SPSS 12.0v. The mean rotation angle of the distal radius about eleven males DR X-ray measured $7^{\circ}$ of pronation (82%, n = 9), $6^{\circ}$ of supination and $0^{\circ}$ of neutral of (9%, n = 1), The total average rotation angle in 11 male was $5.1^{\circ}$ of pronation. The rotation angle of the distal radius about twenty one males on DXA measured $7.2^{\circ}$ of pronation (43%, n = 9), $7^{\circ}$ of supination (24%, n = 5), and $0^{\circ}$ of neutral (33%, n = 7), The total average rotation angle in 21 people was $4.1^{\circ}$ of pronation. The correlation of the analysis of lumba and distal radius were r = 3.0, p = 0.18. consequently, The correlation was not significance. Because BMD of lumba was not coverd for BMD of the distal radius, with a neutral position, Pronation is needed for BMD in the distal radius with the rotation angle measuring at the lowest BMD. the rotation angle about five degrees of pronation of the distal radius is recommended.

• The Korean Journal of Nuclear Medicine
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• v.32 no.4
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• pp.354-364
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• 1998

Purpose: Simple X-ray study and bone scan have limitations for early diagnosis of bone or bone marrow lesions in multiple myeloma. The purpose of this study was to evaluate the diagnostic usefulness of bone marrow immunoscintigraphy using anti-granulocyte monoclonal antibody for the evaluation of bone involvement in multiple myeloma. Materials and Methods: In 22 patients (Male: 15, Female: 7) with multiple myeloma, we performed whole-body immunoscintigraphy using $^{99m}Tc$-labelled antigranulocyte antibody (BW 250/183, Scintimum $Granulozyt^{(R)}$ CIS, France) and compared the findings with those of simple bone radiography and $^{99m}Tc$-MDP bone scan. Abnormal findings in bone marrow scintigraphy were, considered to be present in case of expansion of peripheral bone marrow or focal photon defect in axial bones. Results: Marrow expansion was noted in 15 of 22 patients (68%). Focal photon defects were found in 18 patients (82%). While one (33%) of 3 patients with Stage II disease showed focal defects in bone marrow scan, abnormal focal defects were observed in 17 of 19 (90%) patients with Stage III. Among 124 focal abnormal sites which were observed in bone marrow scan, bone scan or simple bone radiography, bone marrow scan detected 92 sites (74%), whereas 82 sites (66%) were observed in simple bone radiography(58 sites, 47%) or bone scan(40 sites, 32%). Fifty-one (41%) out of 124 bone lesions were detected by bone marrow scan only, and located mostly in thoracolumbar spine. Conclusion: Bone marrow scan using $^{99m}Tc$-labelled antigranulocyte antibody seems to be a more sensitive procedure for the detection of pathologic bone lesions than simple bone X-ray or bone scan in patients with multiple myeloma.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.524-531
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• 1996

Purpose : To evaluate the pattern- of skeletal metastases and to classify the pattern of renal uptakes on bone scans in renal cell carcinoma. Materials and Methods : We reviewed the bone scans of 158 patients with RCC established pathologically. In order to identify individual scan lesion as a bone metastasis, we reviewed all available correlative radiological studies, follow-up bone scans, and biopsies for each lesion. The metastatic bone lesions were divided into seven anatomic regions; skull, spine, shoulder girdle, sternum, ribs, pelvis, and long bones of extremities. The individual scan lesions were divided into two groups as the pattern of uptakes, hot and cold lesion. In addition, the contours and uptakes of kidneys with RCC were classified into 6 groups ; normal uptake, photon-deficient lesion, faint up-take with enlargement, uneven uptake with enlargement, lateralization with crescentic shape, and increased uptake. Results : Twenty out of 158(12.7%) patients with RCC at varying stages showed 71 metastatic bone lesions at presentation and on follow- up bone scans. Nearly 80% of all metastatic lesions were in the axial skeleton with predominantly increased uptake of the radioactivity However a considerable number(22.5%) showed cold lesions on bone scan. A half of bone scans revealed abnormal uptake of involved kidney and much more(82.4%) in case of bone metastases. Two common patterns of abnormal renal uptake were photon-deficient lesion (50%) and faint uptake with enlargement(24.3%). In four patients with bone pain or pathologic fracture, bone scans were useful for the serendipitious localization of previously unrecognized primary lesion of RCC as well as for the detection of bone metastases from RCC. Conclusion : The understanding of the pat-terns of skeletal metastases and renal uptakes on bone scans in RCC is important for the useful information about primary lesion(RCC) as well as detection of bone metastases.