• Korean Journal of Radiology
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• v.23 no.12
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• pp.1241-1250
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• 2022

Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammography-detected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74-0.85) to 0.89 (95% CI, 0.85-0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%-44.5%) and 53.9% (95% CI, 50.9%-56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%-95.9%) vs. 92.6% (95% CI, 86.2%-99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%-89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%-96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%-62.9%) to 49.5% (95% CI, 46.5%-52.4%) (p < 0.001). Conclusion: AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.

• Korean Journal of Radiology
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• v.23 no.11
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Korean Journal of Radiology
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• v.22 no.11
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• pp.1786-1796
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• 2021

Objective: To evaluate the prognostic implications of preoperative magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with a focus on those with targetoid appearance based on the Liver Imaging Reporting and Data System (LI-RADS), as well as known microvascular invasion (MVI) features. Materials and Methods: This retrospective study included 242 patients (190 male; mean age, 57.1 years) who underwent surgical resection of a single HCC (≤ 5 cm) as well as preoperative gadoxetic acid-enhanced MRI between January 2012 and March 2015. LI-RADS category was assigned, and the LR-M category was further classified into two groups according to rim arterial-phase hyperenhancement (APHE). The imaging features associated with MVI were also assessed. The overall survival (OS), recurrence-free survival (RFS), and their associated factors were evaluated. Results: Among the 242 HCCs, 190 (78.5%), 25 (10.3%), and 27 (11.2%) were classified as LR-4/5, LR-M with rim APHE, and LR-M without rim APHE, respectively. LR-M with rim APHE (vs. LR-4/5; hazard ratio [HR] for OS, 5.48 [p = 0.002]; HR for RFS, 2.09 [p = 0.042]) and tumor size (per cm increase; HR for OS, 6.04 [p = 0.009]; HR for RFS, 1.77 [p = 0.014]) but not MVI imaging features (p > 0.05) were independent factors associated with OS and RFS. Compared to the 5-year OS and RFS rates in the LR-4/5 group (93.9% and 66.8%, respectively), the LR-M with rim APHE group had significantly lower rates (68.0% and 45.8%, respectively, both p < 0.05), while the LR-M without rim APHE group did not significantly differ in the survival rates (91.3% and 80.2%, respectively, both p > 0.05). Conclusion: Further classification of LR-M according to the presence of rim APHE may help predict the postoperative prognosis of patients with a single HCC.

• Journal of Intelligence and Information Systems
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• v.23 no.1
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• pp.127-141
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• 2017

Advances in Internet technologies and the proliferation of mobile devices enabled consumers to approach a wide range of goods and services, while causing an adverse effect that they have hard time reaching their congenial items even if they devote much time to searching for them. Accordingly, businesses are using the recommender systems to provide tools for consumers to find the desired items more easily. Association Rule Mining (ARM) technology is advantageous to recommender systems in that ARM provides intuitive form of a rule with interestingness measures (support, confidence, and lift) describing the relationship between items. Given an item, its relevant items can be distinguished with the help of the measures that show the strength of relationship between items. Based on the strength, the most pertinent items can be chosen among other items and exposed to a given item's web page. However, the diversity of the measures may confuse which items are more recommendable. Given two rules, for example, one rule's support and confidence may not be concurrently superior to the other rule's. Such discrepancy of the measures in distinguishing one rule's superiority from other rules may cause difficulty in selecting proper items for recommendation. In addition, in an online environment where a web page or mobile screen can provide a limited number of recommendations that attract consumer interest, the prudent selection of items to be included in the list of recommendations is very important. The exposure of items of little interest may lead consumers to ignore the recommendations. Then, such consumers will possibly not pay attention to other forms of marketing activities. Therefore, the measures should be aligned with the probability of consumer's acceptance of recommendations. For this reason, this study proposes a model-based approach to combine those measures into one unified measure that can consistently determine the ranking of recommended items. A regression model was designed to describe how well the measures (independent variables; i.e., support, confidence, and lift) explain consumer's acceptance of recommendations (dependent variables, hit rate of recommended items). The model is intuitive to understand and easy to use in that the equation consists of the commonly used measures for ARM and can be used in the estimation of hit rates. The experiment using transaction data from one of the Korea's largest online shopping malls was conducted to show that the proposed model can improve the hit rates of recommendations. From the top of the list to 13th place, recommended items in the higher rakings from the proposed model show the higher hit rates than those from the competitive model's. The result shows that the proposed model's performance is superior to the competitive model's in online recommendation environment. In a web page, consumers are provided around ten recommendations with which the proposed model outperforms. Moreover, a mobile device cannot expose many items simultaneously due to its limited screen size. Therefore, the result shows that the newly devised recommendation technique is suitable for the mobile recommender systems. While this study has been conducted to cover the cross-selling in online shopping malls that handle merchandise, the proposed method can be expected to be applied in various situations under which association rules apply. For example, this model can be applied to medical diagnostic systems that predict candidate diseases from a patient's symptoms. To increase the efficiency of the model, additional variables will need to be considered for the elaboration of the model in future studies. For example, price can be a good candidate for an explanatory variable because it has a major impact on consumer purchase decisions. If the prices of recommended items are much higher than the items in which a consumer is interested, the consumer may hesitate to accept the recommendations.

• Progress in Medical Physics
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• v.27 no.1
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• pp.31-36
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• 2016

The paper discusses radiation dose of dual energy CT on which copper modulation layer, is mounted in order to improve diagnostic performance of the dual energy CT. The radiation dose is estimated using MCNPX and its results are compared with that of the conventional dual energy CT system. CT X-ray spectra of 80 and 120 kVp, which are usually used for thorax, abdominal, head, and neck CT scans, were generated by the SPEC78 code and were used for the source specification 'SDEF' card for MCNPX dose modeling. The copper modulation layer was located 20 cm away from a source covering half of the X-ray window. The radiation dose was measured as changing its thickness from 0.5 to 2.0 mm at intervals of 0.5 mm. Since the MCNPX tally provides only normalized values to a single particle, the dose conversion coefficients of F6 tally for the modulation layer-based dual energy CBCT should be calculated for matching the modeling results into the actual dose. The dose conversion coefficient is $7.2*10^4cGy/output$ that is obtained from dose calibration curve between F6 tally and experimental results in which GAFCHORMIC EBT3 films were exposed by an already known source. Consequently, the dose of the modulation layer-based dual energy cone beam CT is 33~40% less than that of the single energy CT system. On the basis of the results, it is considered that scattered dose produced by the copper modulation layer is very small. It shows that the modulation layer-based dual energy CBCT system can effectively reduce radiation dose, which is the major disadvantage of established dual energy CT.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.63-74
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• 2009

Purpose : The current nationally representative data on inpatient care are important to make the of the national public health policy because distributions and the prevalence of diseases among children and adolescents represent the socioeconomic status of the society. The prevalence of chronic disease is increasing now in Korea as the socioeconomic condition is improving. We analyzed a part of genitourinary tract disease of the cross-sectional hospital discharge survey data in Korea collected recently to delineate the trend of genitourinary tract diseases. Methods : Korean nationwide hospital discharge survey for pediatric inpatients in the period from 2004 to 2006 was analyzed. Diagnoses in the data were coded using ICD-10 classification. Totally 826,896 cases were collected from the 85 training hospitals. Selected data of genitourinary tract diseases (belonging to N00-N99 by ICD-10) among 826,896 cases of final inpatients data were analyzed for this study. Results : Among total patients of 826,896, diseases of the genitourinary system accounted for 4.1%. and four diagnostic categories accounted for 92.8%. These were other diseases of the urinary system (N30-39), 45.8%, disease of male genital organs (N40-51),19.1%, glomerular diseases (N00-08), 17.3%, renal tubulo-interstitial diseases (N10-16), 10.6%, respectively. Conclusion : Genitourinary tract disease in pediatric inpatient shows decreasing tendency but the prevalence of chronic diseases is increasing in Korea as the socioeconomic condition is improving. For further comprehensive analysis, regular and organized nationwide survey should be performed. Development of a new data collecting system will improve the performance of such nationwide survey.

• Journal of Biomedical Engineering Research
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• v.25 no.5
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• pp.421-430
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• 2004

Clinically, it is almost impossible for a physician to distinguish subtle changes of frequency spectrum by using a stethoscope alone especially in the early stage of thrombus formation. Considering that reliability of mechanical valve is paramount because the failure might end up with patient death, early detection of valve thrombus using noninvasive technique is important. Thus the study was designed to provide a tool for early noninvasive detection of valve thrombus by observing shift of frequency spectrum of acoustic signals with computer aid diagnosis system. A thrombus model was constructed on commercialized mechanical valves using polyurethane or silicon. Polyurethane coating was made on the valve surface, and silicon coating on the sewing ring of the valve. To simulate pannus formation, which is fibrous tissue overgrowth obstructing the valve orifice, the degree of silicone coating on the sewing ring varied from 20％, 40％, 60％ of orifice obstruction. In experiment system, acoustic signals from the valve were measured using microphone and amplifier. The microphone was attached to a coupler to remove environmental noise. Acoustic signals were sampled by an AID converter, frequency spectrum was obtained by the algorithm of spectral analysis. To quantitatively distinguish the frequency peak of the normal valve from that of the thrombosed valves, analysis using a neural network was employed. A return map was applied to evaluate continuous monitoring of valve motion cycle. The in-vivo data also obtained from animals with mechanical valves in circulatory devices as well as patients with mechanical valve replacement for 1 year or longer before. Each spectrum wave showed a primary and secondary peak. The secondary peak showed changes according to the thrombus model. In the mock as well as the animal study, both spectral analysis and 3-layer neural network could differentiate the normal valves from thrombosed valves. In the human study, one of 10 patients showed shift of frequency spectrum, however the presence of valve thrombus was yet to be determined. Conclusively, acoustic signal measurement can be of suggestive as a noninvasive diagnostic tool in early detection of mechanical valve thrombosis.

• Progress in Medical Physics
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• v.14 no.2
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• pp.124-130
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• 2003

Currently, as a consequence of PACS (Picture Archiving Communication System) implementation many hospitals are replacing conventional film-type interpretations of diagnostic medical images with new digital-format interpretations that can also be saved, and retrieve However, the big limitation in PACS is considered to be the lack of mobility. The purpose of this study is to determine the optimal communication packet size. This was done by considering the terms occurred in the wireless communication. After encoding medical image using JPGE2000 image compression method, This method embodied auto-error correction technique preventing the loss of packets occurred during wireless communication. A PC class server, with capabilities to load, collect data, save images, and connect with other network, was installed. Image data were compressed using JPEG2000 algorithm which supports the capability of high energy density and compression ratio, to communicate through a wireless network. Image data were also transmitted in block units coeded by JPEG2000 to prevent the loss of the packets in a wireless network. When JPGE2000 image data were decoded in a PUA (Personal Digital Assistant), it was instantaneous for a MR (Magnetic Resonance) head image of 256${\times}$256 pixels, while it took approximately 5 seconds to decode a CR (Computed Radiography) chest image of 800${\times}$790 pixels. In the transmission of the image data using a CDMA 1X module (Code-Division Multiple Access 1st Generation), 256 byte/sec was considered a stable transmission rate, but packets were lost in the intervals at the transmission rate of 1Kbyte/sec. However, even with a transmission rate above 1 Kbyte/sec, packets were not lost in wireless LAN. Current PACS are not compatible with wireless networks. because it does not have an interface between wired and wireless. Thus, the mobile JPEG2000 image viewing system was developed in order to complement mobility-a limitation in PACS. Moreover, the weak-connections of the wireless network was enhanced by re-transmitting image data within a limitations The results of this study are expected to play an interface role between the current wired-networks PACS and the mobile devices.

• Journal of radiological science and technology
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• v.36 no.1
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• pp.49-55
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• 2013

Currently, commercially available phantom can reproduce and evaluate only a static situation, the study is incomplete research on phantom and system which is can confirmed functional situation in the kidney by time through dynamic phantom and blood flow velocity, various difference according to the amount of radioactive. Therefore, through this study, it has produced the dynamic kidney phantom to reproduce images through the dynamic flow of the kidney, it desires to evaluate the usefulness of nuclear medicine imaging. The production of the kidney phantom was fabricated based on the normal adult kidney, in order to reproduce the dynamic situation based on the fabricated kidney phantom, in this study, it was applied the volume pump that can adjust the speed of blood flow, so it can be integrated continuously radioactive isotopes in the kidney by using $^{99m}Tc$-pertechnate. Used the radioactive isotope was supplied through the two pump. It was confirmed the changes according to the infusion rate, radioactive isotopes and the different injection speeds on the left and right, analysis of the acquired images was done by drawn five times ROI in order to check the reproducibility of each on the front and rear of the kidney and bladder. Depending on the speed of injection, radioisotope was a lot of integrated and emissions up when adjusting the pressure of the pump as 30 stroke, it was the least integrated and emissions up when adjusting as 40 stroke. The integration of the left & right kidney was not reached in the amount of the highest when adjusting as 10 stroke. In the changes according to the amount of the radioactive isotope, 0.6 mCi(22.2 MBq), 0.8 mCi (29.6 MBq)was showed up similar tendency but, in the result of the different injection 0.8 mCi, it was showed up counts close to double of 0.6 mCi. In the result of the differently injection speed of the left & right kidney, as a result of different conditions that injection speed was 20 stroke through left kidney phantom, the injection speed was 30 stroke through right kidney phantom, it was enough difference in the resulting image can be easily distinguished with the naked eye. Through this study, the results showed that the dynamic kidney phantom system is able to similarly reproduce renogram in the actual clinical practice. Especially, the depicted over time for the flow to be excreted through the kidney into the bladder was adequately reproduce, it is expected to be utilized as basic data to check the quality of the dynamic images. In addition, it is considered to help in the field of functional imaging and quality control.

• Journal of Environmental Health Sciences
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• v.43 no.1
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• pp.1-22
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• 2017

'The worstest environment disaster', 'World's first biocide massacre', 'Home-based Sewol ferry disaster' are all phrases attached to the recent humidifier disinfectant disaster. In the spring of 2011, four of 8 pregnant women including 1 adult man passed away at a university hospital in Seoul due to breathing failure. Epidemiologic investigation conducted by the Korean CDC soon revealed the inhalation of humidifier disinfectant, which had been widely used in Korea during the winter, to be responsible for the disease. As well as lung fibrosis hardening of the lungs, other diseases including asthma, rhinitis, skin disease, liver disease, fetal disease or cancers have been researched for their relation with exposure to the products. By February 9, 2017, 5,342 cases had registered for health problems and 1,131 of them were already dead (20.8% mortality rate). Based on studies by government agencies and a telephone survey of the general population by Seoul National University and civic groups, around 20% of the general public of Korea has used these products. Since the market release of the first product by SK Chemical in 1994, over 7.1 million items from around 20 brands were sold up to 2011. Most of the products were manufactured by well-known large conglomerates such as SK, Lotte, Samsung, Shinsegye, LG, and GS, as well as some European companies including UK-based Reckitt Benckiser and TESCO, the German firm Henkel, the Danish firm KeTox, and an Irish company. Even though this disaster was unveiled in 2011 by the Korean government, the issue of the victims was neglected for over five years. In 2016, an unexpected but intensive investigation by prosecutors found that Reckitt Benckiser manipulated and concealed animal tests for its own brand and brought several university experts and company employees to court. The matter was an intense social issue in Korea from May to June with a surge in media coverage. The prosecutor's investigation and a nationwide boycott campaign organized by victims and environmental groups against Reckitt Benckiser, whose product had been used by more than 70% of victims, led to the producer's official apology and a compensation scheme. A legislative investigation organized after the April 2016 national election revealed the producers' faults and the government's responsibility, but failed to meet expectations. A special law for the victims passed the National Assembly in January 2017 and a punitive system together with a massive environmental epidemiology investigation are expected to be the only solutions for this tragedy. Sciences of medicine, toxicology and environmental health have provided decisive evidence so far, but for the remaining problems the perspectives of social sciences such as sociology and jurisprudence are highly necessary, similar to with the Minamata disease and Wonjin Rayon events. It may not be easy to follow this issue using unfamiliar terminology from medical and chemical science and the long, complicated history of the event. For these reasons the author has attempted to write this article in a question and answer format to render it easier to follow. The 17 questions are: Q1 What is humidifier disinfectant? Q2 What kind of health problems are caused by humidifier disinfectant? Q3 How many victims are there? Q4 What is the analysis of the 1,112 cases of death? Q5 What is the problem with the government's diagnostic criteria and the solution? Q6 Who made what brands? Q7 Has there been a recall? What is still on sale? Q8 Was safety not checked by any producers? Q9 What are the government's responsibilities? Q10 Is it true that these products were sold only in Korea? Q11 Why and how was it unveiled only in 2011 after 17 years of sales? Q12 What delayed the resolution of the victim issue? Q13 What is the background of the prosecutor's investigation in early 2016? Q14 Is it possible to report new victim cases without evidence of product purchase? Q15 What is happening with the victim issue? Q16 How does it compare with the cases of Minamata disease and Wonjin Rayon? Q17 Are there prevention measures and lessons?