• Journal of the Korean Society of Radiology
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• v.17 no.6
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• pp.919-927
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• 2023

Elastography utilizes the fact that the tissue of a malignant tumor is harder than that of a benign tumor and increases the specificity of diagnosis according to the elastic modulus of the tumor, helping to reduce unnecessary biopsies. However, the reliability of elastography can be influenced by the equipment used and the examiner's skills. In this study, the researchers analyzed the reproducibility of elastography by evaluating phantom images when measuring the elasticity values repeatedly. Phantoms were created using silicone and gelatin with different levels of stiffness, and they were inserted at varying depths from the surface. The elasticity values were measured using shear wave elastography. The study aimed to determine whether the reproducibility of elasticity values remains consistent depending on the stiffness and depth of the lesions. The experimental results showed that there was no statistically significant correlation between the elasticity values obtained through shear wave elastography and the depth or stiffness of the lesions. However, in the lesions with the lowest stiffness, the elasticity values were statistically significant (p<0.001) and showed a high correlation with the depth of the lesions. Although there were variations in the measured elasticity values based on the differences in lesion stiffness and depth, these differences did not significantly impact the diagnosis. Therefore, shear wave elastography remains a reliable diagnostic method, and it is suggested that it can be helpful in the diagnosis of breast lesions.

• Korean Journal of Radiology
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• v.24 no.11
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• pp.1102-1113
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• 2023

Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm² and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.1-6
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• 2014

Purpose: In order to know the effectiveness of ultrasonographic examination in diagnosis and follow-up evaluation for the frozen shoulder, we compared those with contralateral side in initial and after steroid injection. Materials and Methods: For the 20 unilateral frozen shoulder from July 2012 to July 2013, ultrasonographic examination was tried using reference line 1 (CBT: distance from coracoid process to LHB tendon) and line 2 (CBG: distance from coracoid process to bicipital groove). We tried 1 time steroid injection and compared the improvement in gross motion and reference line with 2 month, 4 month, and 6 month's serial ultrasonographic examination. Results: The differences on CBT line between lesion side and normal side were -5.6 mm, -5.0 mm, and -4.3 mm in neutral (Neut), external rotation (ER) and internal rotation (IR), respectively. The differences on CBG line were -6.1 mm, -4.7 mm, and -5.0 mm respectively (p<0.05). The changes in the reference line after steroid injection were evaluated at 2 month (CBT: -4.8 mm, -3.5 mm, -2.6 mm / CBG: -4.7 mm, -4.0 mm, -3.6 mm), 4 month (CBT: -4.7 mm, -3.2 mm, -1.7 mm / CBG: -4.3 mm, -3.7 mm, -1.2 mm), and 6 month (CBT: -1.1 mm, -2.9 mm, -0.5 mm / CBG: -1.2 mm, -0.7 mm, -0.9 mm). The gross motion was improved at 4 month after injection, from elevation $108^{\circ}$, ER $32^{\circ}$, IR L5 in initial to $133^{\circ}$, $42^{\circ}$, L3 respectively (p<0.05). Pain improved from 7.5 in initial to 3.0 at 2 month on visual analog scale (VAS). Conclusion: The serial examination after steroid injection revealed that the delayed improvement on reference line (6 month) compared with pain (2 month) or gross motion (4 month). Dynamic ultrasonogram was useful in diagnosis and follow-up evaluation of frozen shoulder.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.205-211
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• 2017

There is a need for aggressive diagnosis and treatment in middle-aged and high-risk individuals who are more likely to progress from nonalcoholic fatty liver to hepatitis. In this study, nonalcoholic fatty liver was divided into severe, moderate, and severe, and classified by quantitative method using computer analysis of GLCM algorithm. The purpose of this study was to evaluate the characteristics of ultrasound images in the local fat avoidance region. Normal, mild, moderate, severe fatty liver, and focal fat sparing area, 80 cases, respectively. Among the parameters of the GLCM algorithm, the values of the Autocorrelation, Square of the deviation, Sum of averages and Sum of variances with high recognition rate of the liver ultrasound image were calculated. The average recognition rate of the GLCM algorithm was 97.5%. The result of local fat avoidance image analysis showed the most similar value to the normal parenchyma. Ultrasonography can be easily accessed by primary screening, but there may be differences in the accuracy of the test method or the correspondence of results depending on proficiency. GLCM algorithm was applied to quantitatively classify the degree of fatty liver. Local fat avoidance region was similar to normal parenchyma, so it could be predicted to be homogeneous liver parenchyma without fat deposition. We believe that GLCM computer image analysis will provide important information for differentiating not only fatty liver but also other lesions.

• Journal of radiological science and technology
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• v.40 no.2
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• pp.213-218
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• 2017

Recently, as the number of high-risk pregnancies increases, the use of new techniques such as Doppler, which have higher acoustic power than in the past, has been increasingly used in prenatal diagnosis and guidelines have been set up by various organizations to prevent excessive exposure. Therefore, in this study, we tried to investigate the temperature change of the body surface for each test mode according to the long time ultrasound examination and to examine the exposure time which is not influenced by the thermal effect. B mode, C mode, and PD mode according to time, and the temperature difference between exposed and unexposed sites were compared. As a result, the B mode showed a significant difference in the temperature change from 10 minutes, 50 minutes after exposed, 20 minutes from the C mode, and 30 minutes from the PD mode (p<0.01). In all three modes, the temperature difference was different (p<0.000), and PD mode was the most sensitive to temperature change. Also, it was found that the temperature rise time was shortened with the increase of the ultrasonic exposure time. Therefore, it is recommended that ultrasonography to observe the embryo or fetus should be used only for diagnostic purposes, avoiding excessive test time.

• Journal of Biomedical Engineering Research
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• v.30 no.5
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• pp.401-411
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• 2009

In this paper, we correct pulse wave velocity(PWV) with heart-rate and derive regression equations to estimate intima-media thickness(IMT). Widely used methods for diagnosis of arteriosclerosis are IMT and PWV. Arterial wall stiffness determines the degree of energy absorbed by the elastic aorta and its recoil in diastole but there is not correlation between sclerosis and IMT in an existing study. In this study, we will correct PWV with heart-rate and get regression equation to estimate IMT using heart-rate correction index(HCI). We executed experiments for this study. Made up question of physical condition and measured electrocardiogram(ECG), photoplethysmogram (PPG) of finger-tip and toe-tip and ultrasound image of carotid artery. Calculated PWV and IMT using ECG, PPG and ultrasound image. We found that every p-value between PWV and IMT is not significant(<0.05). But p-value between IMT and HCI which is a corrected PWV using heart-rate is significant(>0.01). We use HCI and various measured parameter for estimating regression equation and apply backward estimation to select parameters for regression analysis. Result of backward estimation, found that only HCI is possible to derive proper regression equation of IMT. Relationship between PWV and IMT is the second order. Result of regression equation of E-H PWV is $R^2$=0.735, adj $R^2$=0.711. This is the best correlation value. We calculate error of its analysis for verification of earlobe PWV regression equation. Its result is RMSEP=0.0328, MAPE(%) = 4.7622. Like this regression analysis, we know that HCI is useful parameter and relationship between PWV, HCI and IMT. In addition, we are able to suggest possibility which is that we can get different parameter of prediction throughout just one measurement.

• The Journal of the Korea Contents Association
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• v.15 no.8
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• pp.389-396
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• 2015

The liver fibrosis is a disease we often see in clinical medicine, and the persistence and repeatition of inflammation and necrosis of liver cells continue for several years, and it is proceeded to cirrhosis. So decrease of death rate and prevalence rate by complications of cirrhosis and hepatocellular carcinoma is main task of clinical medicine by protection of chronic liver ailment patients from proceeding to cirrhosis and hepatocellular carcinoma. So this study tried to represent the ultrasonic image, blood test, the relationship with liver stiffness of diffuse liver ailment patients as numbers. This study was performed with patients from whom the image was taken by ultrasonic and 141 people who were treated by fibroscan, the basic data for blood test was obtained from the test results at the time when ultrasonic image and liver fibroscan was performed. The statistical analysis was performed by One-way analysis of variance(ANOVA) to verify difference between groups. The value of liver stiffness was increased in the order of normal, chronic liver disease and cirrhosis. As a results, ALT and Albumin have no statistical difference between object groups, and there are statistical differences in the results of ultrasonic decoding at age, AST, ALP, Bilirubin, PLT, PT, and kPa, and they are statistically meaningful(p<0.005). And the value of liver stiffness of chronic liver ailment was presented only as over 12.5kPa in other study, but it was represented as numbers for quantitative diagnosis by presenting average kPa threshold value according to disease in this study. And by presenting relationship of diagnosed results, it is considered that it could be used as first tool to diagnose chronic liver ailment patients according to their disease.

• Journal of Korea Multimedia Society
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• v.13 no.7
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• pp.1044-1050
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• 2010

Endoscopic ultrasonography is a medical procedure in endoscopy combined with ultrasound to obtain images of the internal organs. It is useful to have a predictive pathological manifestation since a doctor can observe tumors under mucosa. However, it is often subjective to judge the degree of malignant degeneration of tumors. Thus, in this paper, we propose a feature analysis procedure to make the pathological manifestation more objective so as to improve the accuracy and recall of the diagnosis. In the process, we extract the ultrasound region from the image obtained by endoscopic ultrasonography. It is necessary to standardize the intensity of this region with the intensity of water region as a base since frequently found small intensity difference is only to be inefficient in the analysis. Then, we analyze the spot region with high echo and calcium deposited region by applying LVQ algorithm and bit plane partitioning procedure to tumor regions selected by medical expert. For detailed analysis, features such as intensity value, intensity information included within two random points chosen by medical expert in tumor region, and the slant of outline of tumor region in order to decide the degree of malignant degeneration. Such procedure is proven to be helpful for medical experts in tumor analysis.

• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.390-397
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• 2009

Endoscopic ultrasonography is a medical procedure in endoscopy combined with ultrasound to obtain images of the internal organs. It is useful to have a predictive pathological manifestation since a doctor can observe tumors under mucosa. However, it is often subjective to judge the degree of malignant degeneration of tumors. Thus, in this paper, we propose a feature analysis procedure to make the pathological manifestation more objective so as to improve the accuracy and recall of the diagnosis. In the process, we extract the ultrasound region from the image obtained by endoscopic ultrasonography. It is necessary to standardize the intensity of this region with the intensity of water region as a base since frequently found small intensity difference is only to be inefficient in the analysis. Then, we analyze the spot region with high echo and calcium deposited region by applying LVQ algorithm and bit plane partitioning procedure to tumor regions selected by medical expert. For detailed analysis, features such as intensity value, intensity information included within two random points chosen by medical expert in tumor region, and the slant of outline of tumor region in order to decide the degree of malignant degeneration. Such procedure is proven to be helpful for medical experts in tumor analysis.

• Tuberculosis and Respiratory Diseases
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• v.80 no.3
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• pp.291-295
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• 2017

Background: Since the introduction of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods: The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results: Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion: Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.