• Journal of the Korean Society of Radiology
• /
• v.79 no.6
• /
• pp.303-310
• /
• 2018

Purpose: To evaluate the CT features of incidental breast lesions on chest CT and to suggest useful criteria for referral to a specialized breast unit. Materials and Methods: Between May 2009 and April 2014, enhanced chest CT examination reports containing the key word 'breast' were reviewed retrospectively. Patients who had incidental breast lesion and were referred to a specialized breast unit and then underwent pathological confirmation or follow-up over a 1-year period were included. Finally, 86 patients (all female, mean age, $48.9{\pm}12.6years$) were enrolled. Two radiologists evaluated lesion characteristics, including size, shape, margins, and enhancement. The correlations between the CT features and pathologies were evaluated, and the diagnostic accuracy of CT features in various combinations was assessed. Results: Among the CT features, irregular shape, non-circumscribed margin, and high contrast enhancement were different between malignant and benign lesions (p < 0.05). The combination of non-circumscribed margin and high contrast enhancement had the highest accuracy (97.7%). Conclusion: Reliable CT features for incidental malignant breast masses are irregular shape, non-circumscribed margin, and high contrast enhancement. The combination of non-circumscribed margin and high contrast enhancement could help distinguish incidental malignant breast lesions and indicate referral to a specialized breast unit.

• Journal of International Society for Simulation Surgery
• /
• v.1 no.1
• /
• pp.37-40
• /
• 2014

Purpose For living donor liver transplantation, liver segmentation is difficult due to the variability of its shape across patients and similarity of the density of neighbor organs such as heart, stomach, kidney, and spleen. In this paper, we propose an automatic segmentation of the liver using multi-planar anatomy and deformable surface model in portal phase of abdominal contrast-enhanced CT images. Method Our method is composed of four main steps. First, the optimal liver volume is extracted by positional information of pelvis and rib and by separating lungs and heart from CT images. Second, anisotropic diffusing filtering and adaptive thresholding are used to segment the initial liver volume. Third, morphological opening and connected component labeling are applied to multiple planes for removing neighbor organs. Finally, deformable surface model and probability summation map are performed to refine a posterior liver surface and missing left robe in previous step. Results All experimental datasets were acquired on ten living donors using a SIEMENS CT system. Each image had a matrix size of $512{\times}512$ pixels with in-plane resolutions ranging from 0.54 to 0.70 mm. The slice spacing was 2.0 mm and the number of images per scan ranged from 136 to 229. For accuracy evaluation, the average symmetric surface distance (ASD) and the volume overlap error (VE) between automatic segmentation and manual segmentation by two radiologists are calculated. The ASD was $0.26{\pm}0.12mm$ for manual1 versus automatic and $0.24{\pm}0.09mm$ for manual2 versus automatic while that of inter-radiologists was $0.23{\pm}0.05mm$. The VE was $0.86{\pm}0.45%$ for manual1 versus automatic and $0.73{\pm}0.33%$ for manaual2 versus automatic while that of inter-radiologist was $0.76{\pm}0.21%$. Conclusion Our method can be used for the liver volumetry for the pre-surgery planning of living donor liver transplantation.

• Journal of the Korean Society of Radiology
• /
• v.2 no.1
• /
• pp.17-21
• /
• 2008

Because of the reason that the meningioma is enhanced lately, we started the study to maximally enhance the meningioma. we were to know the relation between meningioma and vessels in the skull and compared 3D CT angiography with the conventional angiography. we got the data from 6 patients performed by both 3D CT angiography and there were 5 cases in sphenoidal ridge and 1 case parasagittal sinus. Injecting the contrast media at 3 ml/sec, 120 ml and then the CT number reached 100, we started the study using the medical system Program(smart prep). The scan parameters were HS-Mode(1.25 mm / 7.5 mm) right after being injected all and reconstructed with 0.5 mm interval. We compared the study with the conventional angiography after reconstructing the images required by using 3D-Med software Program(Rapidia). Seeing the consequences, the maximum enhancing time in the menigioma is about 120~180 seconds after injecting the contrast media and we distinguished the relation between vessels and tumors at the time and 1 case showed us the aneurysm with a tumor clearly at the time too. It was very helpful to the operation that the 3D images required by injecting the contrast media to the patients with meningioma distingushed between tumors and vessels dimensionally.

• Korean Journal of Radiology
• /
• v.19 no.6
• /
• pp.1066-1076
• /
• 2018

Objective: The reliability of size measurements of liver metastases from neuroendocrine tumors (NETs) on contrast-enhanced computed tomography (CT) phases made by different readers may be hampered due to transient, variable rim enhancement in arterial phase (AP) or portal venous phase (PVP) images. We aimed to assess the reliability of tumor size measurements in pre- and post-contrast scans. Materials and Methods: The study coordinator selected target lesions according to Response Evaluation Criteria in Solid Tumors 1.1 guidelines in 44 consecutive patients with pathologically confirmed NET liver metastases. Two blinded readers measured the longest diameters of target lesions on pre-contrast, AP, and PVP images twice with a 4-week interval. Inter- and intra-observer agreements were evaluated using Bland-Altman plots and 95% limit of agreement (LOA) calculations. Results: Of the 79 target lesions (approximate mean size of 3 cm), 45 showed rim enhancement. Inter-observer agreement assessed based on LOA was highest in pre-contrast CT images (-6.1-5.7 mm), followed by PVP (-7.9-7.1 mm) and AP (-8.5-7.4 mm) images. Intra-observer agreement showed the same trend: -2.8-2.9 mm and -2.9-2.9 mm for readers 1 and 2, respectively, on pre-contrast CT, -2.8-2.9 mm and -3.0-3.2 mm, respectively, on PVP, and -3.2-4.2 mm and -3.4-3.2 mm, respectively, on AP images. Mean tumor diameters differed significantly among the phases in the following increasing order: pre-contrast CT, PVP, and AP images. Conclusion: There was better inter- and intra-observer agreement in size measurements of NET liver metastases on pre-contrast scans than on AP and PVP scans. Pre-contrast CT may be the optimal for measuring NET liver metastases if its accuracy is proven.

• Journal of Biomedical Engineering Research
• /
• v.25 no.3
• /
• pp.189-194
• /
• 2004

Pixel values of contrast enhanced computed tomography (CE-CT) images are randomly changed. Also, the middle liver part has a problem to segregate the liver structure because of similar gray-level values of a pancreas in the abdomen. In this paper, an automatic liver segmentation method using a partial histogram threshold (PHT) algorithm is proposed for overcoming randomness of CE-CT images and removing the pancreas. After histogram transformation, adaptive multi-modal threshold is used to find the range of gray-level values of the liver structure. Also, the PHT algorithm is performed for removing the pancreas. Then, morphological filtering is processed for removing of unnecessary objects and smoothing of the boundary. Four CE-CT slices of eight patients were selected to evaluate the proposed method. As the average of normalized average area of the automatic segmented method II (ASM II) using the PHT and manual segmented method (MSM) are 0.1671 and 0.1711, these two method shows very small differences. Also, the average area error rate between the ASM II and MSM is 6.8339 ％. From the results of experiments, the proposed method has similar performance as the MSM by medical Doctor.

• Clinical Pain
• /
• v.20 no.2
• /
• pp.86-92
• /
• 2021

Ultrasound imaging in clinical practice is one of the widely used diagnostic methods because there is no radiation risk, more cost- effective compared to MRI or CT, and possible to perform an intervention through fast real-time imaging. In order to increase the diagnostic value, the studies of contrast-enhanced ultrasound (CEUS) using an ultrasound contrast agent have been actively conducted since about 50 years ago and are being used clinically in vascularity and microcirculation of internal organs. Although ultrasound is actively used for the diagnosis and treatment of various diseases in musculoskeletal disorders, there are some limitations in diagnosing mild or small lesions, inflammatory reactions, or abnormalities at the molecular level. In this review, the principles, types, and research, and clinical applications of ultrasound contrast agents have been summarized and introduced. If we understand the characteristics of the ultrasound contrast agents and anatomical knowledge, as well as molecular changes, the ultrasound contrast agents are widely applied in musculoskeletal disorders and have tremendous potential for diagnosis and treatment.

• Journal of the Korean Society of Radiology
• /
• v.82 no.6
• /
• pp.1477-1492
• /
• 2021

Purpose Dedicated breast CT is an emerging volumetric X-ray imaging modality for diagnosis that does not require any painful breast compression. To improve the detection rate of weakly enhanced lesions, an adaptive image rescaling (AIR) technique was proposed. Materials and Methods Two disks containing five identical holes and five holes of different diameters were scanned using 60/100 kVp to obtain single-energy CT (SECT), dual-energy CT (DECT), and AIR images. A piece of pork was also scanned as a subclinical trial. The image quality was evaluated using image contrast and contrast-to-noise ratio (CNR). The difference of imaging performances was confirmed using student's t test. Results Total mean image contrast of AIR (0.70) reached 74.5% of that of DECT (0.94) and was higher than that of SECT (0.22) by 318.2%. Total mean CNR of AIR (5.08) was 35.5% of that of SECT (14.30) and was higher than that of DECT (2.28) by 222.8%. A similar trend was observed in the subclinical study. Conclusion The results demonstrated superior image contrast of AIR over SECT, and its higher overall image quality compared to DECT with half the exposure. Therefore, AIR seems to have the potential to improve the detectability of lesions with dedicated breast CT.

• Progress in Medical Physics
• /
• v.17 no.1
• /
• pp.32-39
• /
• 2006

To assess the ability of an extravasation detection accessory (EDA) system to detect clinically important extravascular injection of iodinated contrast material delivered with an automated power injector. Fifty patients referred for contrast material enhanced body computed tomography studied in a prospective, observation study in which the EDA system was used to identify and interrupt any injection associated with clinically Important extravasation. The presence or absence of extravasation was definitively established with multi-detector CT at the injection site (injection rate, $2.0{\sim}2.5$ mL/sec). There were two true positive, extravasation volumes $22{\sim}25$ mL. The EDA system had sensitivity in the detection of clinically important extravasation. The EDA system is easy to use, safe, and accurate In the monitoring of intravenous injections for extravasation, which may prove especially useful in CT applications.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.17 no.2
• /
• pp.53-58
• /
• 2013

Purpose: To optimize correction method for SPECT/CT, image quality consisting of resolution and contrast was evaluated using three radioisotopes ($^{99m}Tc$, $^{201}Tl$ and $^{131}I$) and three different correction methods; attenuation correction (AC), scatter correction (SC) and both attenuation and scatter correction (ACSC). Materials and Methods: Images were acquired with a SPECT/CT scanner and a conventional CT protocol with an OESM reconstruction algorithm (2 iterations and 10 subsets). For resolution measurement, fixed radioactivity (2.22 kBq) was infused into a spatial resolution phantom and full width at half maximum (FWHM) was measured using a vendor-provided software. For contrast evaluation, radioactive source with a ratio of 1:8 to background was filled in a Flanged Jaszczak phantom and percent contrast (%) were calculated. All the parameters for image quality were compared with non-correction (NC) method. Results: As compared with NC, image resolution of all three isotopes were significantly improved by AC and ACSC, not by SC. In particular, ACSC showed better resolution than AC alone for $^{99m}Tc$ and $^{201}Tl$. Image contrast of all three radioisotopes in a sphere with the largest diameter were enhanced by all correction methods. ACSC showed the highest contrast in all three radioisotopes, which was the most accurate in $^{99m}Tc$ (85.9%). Conclusion: Image quality of SPECT/CT was improved in all the radioisotopes by CT-based attenuation correction methods, except SC alone. SC failed to improve resolution in any radioisotopes, but it was effective in contrast enhancement. ACSC would be the best correction method as it improved resolution in radioisotopes with low energy levels and contrast in radioisotope with low energy levels. However, in radioisotope with high energy level, AC would be better than ACSC for resolution improvement.

• Journal of radiological science and technology
• /
• v.26 no.3
• /
• pp.33-39
• /
• 2003

Purpose : Be aware of clinical possibilities on image quality by comparison of contrast-enhanced dynamic CT and MR imaging applied of MIP technique after the experimentally induced clonorchasis infection in dogs. Materials and Method : Twenty mongrel dogs prepared in zoo-laboratory were followed up with serial CT scans and MR imaging for 13 weeks after the experimental infection in liver. Two-phase helical CT was acquired in the supine position with the following scanning parameters. After the injection of contrast material, the arterial phase was initiated using a bolus-racking method. The portal phase scan was started 15 seconds after the arterial phase scan. CT protocol was determined after single level dynamic scans. MR imaging used the CP body coil and images get a 2D image using HASTE, FLASH, TSE pulse sequence. Bile duct MR imaging were obtained in three plans. Then each image was post processed by using target MIP algorithm. Two experimentation above, as a method of evaluation, one pathologist, three radiologist and five radiological technologist were analyzed visually for evaluation of following findings, enhancement of the bile duct wall, dilatation of bile duct tip, liver parenchyma, background suppression. Results : Five dogs was died of a disease after the infection, the rest one else shows the chronic dilatation of the intrahepatic bile duct with CT and MR imaging. Contrast administration of CT shows the contrast-enhanced of the bile duct walls with live parenchyma. MR imaging calculated of CNR and CR from pulse sequence for comparative evaluation and shows the pattern of the intrahepatic bile duct, dilatation of bile duct tip using MIP technique. CNR of the clonorchiasis, HASTE was $16{\pm}0.83$, TSE $7.06{\pm}3.0$, FLASH $1.19{\pm}0.2$ and CR, HASTE was 73.3%, TSE 62.3%, FLASH 6.4%. Conclusion : CT and MR imaging is very usefulness in diagnosis of dog clonorchiasis.