• 대한한방내과학회지
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• 제44권3호
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• pp.578-584
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• 2023

Objectives: This is a five-year survival and complete response (CR) report on rectal cancer treated with western medicine and Korean traditional medicine. Method: A 25-year-old woman diagnosed with rectal cancer visited ⃝⃝ Korean traditional medicine hospital after neoadjuvant concurrent chemoradiation therapy, chemotherapy, and low anterior resection with regional lymph node dissection. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from January 2018 to February 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on March 11, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for rectal cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for rectal cancer.

• Imaging Science in Dentistry
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• 제53권4호
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• pp.325-333
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• 2023

Purpose: The objective of this study was to evaluate and compare the accuracy and image quality of root surface area (RSA) measurements obtained with various cone-beam computed tomography (CBCT) protocols, relative to the gold standard of micro-computed tomography (CT), in an in vitro setting. Materials and Methods: Four dry human skulls were scanned using 8 different protocols, with voxel sizes of 0.15 mm, 0.3 mm, and 0.4 mm. Three-dimensional models of the selected teeth were constructed using CBCT and microCT protocols, and the RSA was automatically measured by the image-processing software. The absolute difference in the percentage of the RSA(%ΔRSA) was calculated and compared across the 8 CBCT protocols using repeatedmeasures analysis of variance. Finally, image quality scores of the RSA measurements were computed and reported in terms of percent distribution. Results: No significant differences were observed in the %ΔRSA across the 8 protocols (P>0.05). The deviation in %ΔRSA ranged from 1.51% to 4.30%, with an increase corresponding to voxel size. As the voxel size increased, the image quality deteriorated. This decline in quality was particularly noticeable at the apical level of the root, where the distribution of poorer scores was most concentrated. Conclusion: Relative to CBCT protocols with voxel sizes of 0.15mm and 0.3mm, the protocols with a voxel size of 0.4 mm demonstrated inferior image quality at the apical levels. In spite of this, no significant discrepancies were observed in RSA measurements across the different CBCT protocols.

• Anatomy and Cell Biology
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• 제56권1호
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• pp.86-93
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• 2023

Age at death estimation has always been a crucial yet challenging part of identification process in forensic field. The use of human skeletons have long been explored using the principle of macro and micro-architecture change in correlation with increasing age. The clavicle is recommended as the best candidate for accurate age estimation because of its accessibility, time to maturation and minimal effect from weight. Our study applies pre-trained convolutional neural network in order to achieve the most accurate and cost effective age estimation model using clavicular bone. The total of 988 clavicles of Thai population with known age and sex were radiographed using Kodak 9000 Extra-oral Imaging System. The radiographs then went through preprocessing protocol which include region of interest selection and quality assessment. Additional samples were generated using generative adversarial network. The total clavicular images used in this study were 3,999 which were then separated into training and test set, and the test set were subsequently categorized into 7 age groups. GoogLeNet was modified at two layers and fine tuned the parameters. The highest validation accuracy was 89.02% but the test set achieved only 30% accuracy. Our results show that the use of medial clavicular radiographs has a potential in the field of age at death estimation, thus, further study is recommended.

• Imaging Science in Dentistry
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• 제54권2호
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• pp.159-169
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• 2024

Purpose: The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose while maintaining image quality. Materials and Methods: The effective dose emitted by a CBCT device was calculated using thermoluminescent dosimeters placed in a Rando Alderson phantom. Image quality was assessed by 3 experienced evaluators. The relationship between image quality and confidence was evaluated using the Fisher exact test, and the agreement among raters was assessed using the kappa test. Multiple linear regression analysis was performed to investigate whether the technical parameters could predict the effective dose. P-values<0.05 were considered to indicate statistical significance. Results: The optimized protocol (3 mA, 99 kVp, and 450 projection images) demonstrated good image quality and a lower effective dose for radiation-sensitive organs. Image quality and confidence had consistent values for all structures (P<0.05). Multiple linear regression analysis resulted in a statistically significant model. The milliamperage (b=0.504; t=3.406; P=0.027), kilovoltage peak (b=0.589; t=3.979; P=0.016) and number of projection images (b=0.557; t=3.762; P=0.020) were predictors of the effective dose. Conclusion: Optimized CBCT acquisition protocols can significantly reduce the effective radiation dose while maintaining acceptable image quality by adjusting the milliamperage and projection images.

• Nuclear Medicine and Molecular Imaging
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• 제40권6호
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• pp.322-326
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• 2006

목적: 갑상선암 방사성요오드 치료를 위한 전처치로 1주${\sim}$2주간 저요오드식이를 시행하는 것이 국제 권고안에서 권고되고 있으나 각 병원마다 저요오드식이를 자체적인 교육방법에 따라 시행하고 있으며 저요오드식이를 통해 체내 요오드량을 효과적으로 낮추었는지에 대한 측정도 대부분의 병원에서 시행되지 않고 있어, 연구자들의 병원에 의뢰된 환자들의 소변 내 I/Cr비를 측정하여 고전적인 엄격한 저요오드식 이를 1주일간 시 행하는 방법과 덜 엄격한 저요오드식이를 2주일간 시행하는 방법을 비교하여 그 적절성을 평가하고자 하였다. 대상 및 방법: 2006년 4월 10일부터 6월 19일까지 본원에 의뢰된 27명의 환자를 대상으로 제한 및 허용식품 목록, 영양사 교육 유무, 예시 식단 유무, 저요오드식이 기간을 비교하여 가장 빈도가 높은 2가지 방법, 즉 관용적인 기준을 채택하는 군과 엄격한 제한식품을 설명한 군으로 나누어 두 군의 아침 소변을 채집, iodide selective electrode method를 사용하여 소변 내 요오드량을 측정하고 이를 소변 내 크레아티닌으로 나누어 I/Cr비를 구하였다. 두 군의 결과는 t-test를 이용하여 검정하였다. 결과: 두 군간의 특성에는 유의한 차이가 없었으며 각 군에서의 소변 내 I/Cr 비는 2주간 덜 엄격한 저요오드식이 군에서 $289.75{\pm}188.24{\mu}g/g$, 1주간 엄격한 저요오드식이를 시행한 군에서는 $127.87{\pm}78.52{\mu}g/g$으로 측정되었으며 1주간 엄격하게 시행한 군에서 유의하게 낮았다 (p=0.008). 2주간 덜 엄격한 저요오드식이를 시행한 군에서는 14명중 3명(21.42%), 1주간 엄격한 저요오드식이를 시행한 군에서는 13명중 6명(46.15%)이 방사성요오드치료를 위한 적정한 수준으로 제시된 소변 내 요오드배설량 $100{\mu}g/g$이하를 만족했다. 결론: 2주간 덜 엄격한 저요오드식이를 시행한 군에서 1주간 엄격한 교육을 시행한 군보다 높은 소변 내 I/Cr비가 나온 것을 볼 때 교육 방법을 엄격하게 시행하지 않고 간단하게 변형된 방법을 사용할 경우 기간을 길게 하더라도 치료에 필요한 적정 수준의 체내 요오드량 감소를 달성하기 어려울 것으로 판단된다. 그러나 1주간 엄격한 저요오드식이를 시행한 군에서도 체내 요오드량의 감소가 충분히 감소하는 비율이 여전히 낮기 때문에 엄격한 저요오드식이 방법을 2주간 시행하는 것이 더바람직하리라 기대된다.

• 대한방사선치료학회지
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• 제33권
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• pp.99-108
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• 2021

목 적: 사이버나이프를 이용한 정위적 부분유방방사선치료(Stereotactic Partial Breast Irradiation) 시 기존의 침습적인 위치표지자(Fiducial Marker) 삽입 방식이 아닌 비침습방식에 대한 유용성을 평가 하고자 한다. 대상 및 방법: 본 연구를 위한 영상 중심(Imaging Center)의 일치도는 2D모의치료기와 사이버나이프의 양사방향(Both oblique, 45 °, 315 °) 영상 획득 후 다이스 유사 계수를 통해 정량적으로 평가하였다. 표면위치표지자의 위치 재현성은 본원 프로토콜을 기반으로 ATOM Phantom 표면에 금 재질의 위치표지자 8개를 부착하고 2D모의치료와 치료계획, 사이버나이프 영상을 분석하여 평가 하였다. 결 과: 영상 중심의 일치도 평가결과는 양사방향(45 °, 315 °)에서 각각 0.87, 0.9 였다. 표면위치표지자의 재현성 평가 결과 좌측 유방은 수평수직방향 Superior/Inferior 0.3 mm, Left/Right -0.3 mm, Anterior/Posterior 0.4 mm, 회전 방향 Roll 0.3 °, Pitch 0.2 °, Yaw 0.4 ° 로 나타났다. 우측 유방은 수평수직방향 Superior/Inferior -0.1 mm, Left/Right -0.1 mm, Anterior/Posterior -0.1 mm 회전 방향 Roll 0.2 °, Pitch 0.1 °, Yaw 0.1 ° 로 나타났다. 결 론: 사이버나이프를 이용한 정위적 부분유방암방사선치료 시 표면위치표지자의 비침습 트로토콜을 기반으로 통증 및 감염 등의 예방과 전처치 시간을 줄이고 환자의 경제적 부담을 경감 할 수 있었으며, 영상 중심의 높은 일치도 및 위치표지자의 재현성을 바탕으로 치료에 유용할 것으로 사료된다.

• Nuclear Medicine and Molecular Imaging
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• 제40권1호
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• pp.23-27
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• 2006

목적: 일측성 성대마비 환자의 FDG-PET에서 영상 판독에 오류를 일으킬 수 있는 성대의 비대칭 섭취가 여러 차례 보고되었다. 저자들은 일측 성대마비 환자와 정상인에서 발성시와 침묵시의 성대근육의 활동정도를 FDG의 섭취로 비교하여 보았다. 방법 : 11명의 일측 성대마비 환자와(원인:thyroidectomy=7, lung cancer=1, others=3) 12 명의 정상인을 대상으로 FDG-PET 을 시행하였다. 이들을 각각 두그룹으로 나누어 발성군은 FDG 주사후 20분간 책을 읽고 비발성군은 평소 검사와 같이 발성을 금하였다. 성대근육을 5부위로 나누어 SUV를 측정하였고 이를 위해 최근 시행한 CT와 융합 영상을 만들었다. 결과: 일측성대마비환자는 건측 갑상피열근에 높은 섭취를 보였으며 발성군은($SUV=5.88{\pm}2.65$) 비발성군에 비하여($SUV=2.30{\pm}0.39$) 유의하게 높은 섭취를 보였다. 정상군에서는 발성시 외윤상피열근에 대칭적인 FDG 섭취증가를 보였고 후위의 피열간근이 가장 높은 섭취($SUV=3.68{\pm}0.96$)를 보였다. 결론: 발성시 FDG-PET 검사를 하면 일측 성대마비환자와 정상인은 각각 서로 다른 후두근육에 FDG 섭취를 보였다. PET-CT 영상 융합을 사용하여 일측 성대마비 환자의 보상에 관여하는 후두근육의 비대칭적인 FDG섭취를 이해하는 것이 영상 판독에 도움을 줄 수 있을 것이다.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.95-101
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• 2000

Purpose : The purpose of this study was to evaluate the efficacy of oblique coronal MR images, oblique axial images of neutral, internal rotation and external rotation positions in the diagnosis of SLAP Ⅱ lesion. Materials and Methods: MR arthrography of the glenohumeral joint was evaluated retrospectively in 16 patients(16 shoulders) who underwent arthroscopic surgery(mean age; 38 years old, Male; 13, Female; 3). Oblique coronal fat-suppressed Tl-weighted spin echo images were performed with each shoulder in the neutral position of the arm and oblique axial images were performed in neutral, internal and external rotations of the arm respectively. The preoperative findings of MR were classified as definite tear, possible tear and no tear. Arthroscopic findings were correlated with MR findings of several different position of the arm. Results: Arthroscopic surgery revealed 8 SLAP Ⅱ lesion, 2 SLAP I lesion, and 6 normal superior labrum respectively. The accuracy of diagnosis in the 8 SLAP Ⅱ lesion were high on oblique axial image in external rotation which were interpreted as 8 definite tear, to compare with oblique axial images in neutral position which were interpreted as 4 definite tear, 3 possible tear, 1 no tear. The 6 normal superior labrum lesion were interpreted as no tear in all three position. The 2 SLAP I lesion were interpreted as 1 definite tear, 1 no tear on oblique axial image in neutral position and 1 definite tear, 1 possible tear on oblique axial image in external rotation. Conclusion: This study showed that axial MR images in external rotation of the arm combined with oblique coronal images have proved to be effective to detect SLAP Ⅱ lesion, and should be considered in imaging protocol for MR arthrography of the SLAP Ⅱ lesion.

• 한국의학물리학회지:의학물리
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• 제23권1호
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• pp.54-61
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• 2012

중합체 겔 선량계를 제작하여 사이버나이프의 광자선의 소조사면에서의 3차원적 선량측정 실험을 수행하였다. 겔 선량계는 아크릴로 제작된 두경부 팬텀내에 설치하여 선량측정에 사용하였다. 두경부 팬텀의 영상은 사이버나이프의 두경부 환자 치료를 위해 사용하는 전산화단층촬영장치(CT)의 프로토콜을 사용하여 획득하였고 치료계획 시스템에 전달되었다. 겔 선량계에 치료계획에서 수립한 방사선을 조사하였으며, 24시간 경과 후에 선량분석을 위하여 3.0T 자기공명영상장치(MRI)로 영상을 획득하였다. 측정된 겔 팬텀의 선량분포는 MATLAB을 이용하여 분석하였고 측정된 결과를 치료계획에서의 계산값과 비교하였다. 선량분포는 축상(axial) 방향의 등선량곡선의 80% 고선량 영역에서 치료계획 선량곡선과 측정된 선량곡선과의 차이가 0.76 mm이었으며, 40% 저선량 영역에서는 차이가 1.29 mm로 저선량 영역보다 고 선량영역에서 잘 일치함을 알 수 있었다. 본 연구에서 중합체 겔 선량계와 자기공명영상을 이용하여 소조사면에 대해 3차원적으로 선량을 분석할 수 있을 뿐 아니라 치료방사선 정도관리에도 활용될 수 있는 가능성을 확인하였다.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.7-13
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• 2009

Purpose: Endoscopic transnasal correction of the medial orbital fractures cannot be enable to confirm the reduction degree of orbital volume without imaging modalities. We have intended through this study to make a quantative analysis of preoperative orbital volume increment and the reduction degree of that after ethmoidal sinus packing by using CT scan. Methods: In this retrospective study, 22 patients were selected to evaluate the postoperative volume reduction, who took 2 CT scans which are pre- and postoperative under the same protocol. The postoperative CT scan was carried out in about 5 days after the operation with the packing inserted into ethmoidal sinus. The length of bony defect on each section was measured by PACS program and the area of defect was calculated by summing lengths on each section multiplied by the thickness of the section. When the outline of orbit on the slice is drawn manually with a cursor, PACS program measures the area automatically. Orbital volume was calculated from the sum of the area multiplied by the section thickness. Results: The mean dimension of fractured walls was $2.86{\pm}0.99cm^2$. The mean orbital volume of the unaffected orbits was $22.89{\pm}2.15cm^3$ and that of the affected orbits was $25.62{\pm}2.82cm^3$. The mean orbital volume increment of the affected orbits was $2.73{\pm}1.13cm^3$. After surgery, the mean orbital volume of the unaffected orbits was $22.46{\pm}2.73cm^3$ and the mean orbital volume decrease on the surgical side was $2.98{\pm}1.07cm^3$. The estimated correction rate was 118.30%. Conclusion: The orbital volume increment in fractured orbit showed linear correlation with the dimension of fractured area. The orbital volume changes after ethmoidal sinus packing also showed linear correlation with orbital volume increment in fractured orbit. This study showed the regressive linear correlation between the increment of orbital volume and the correction rate. To evaluate the maintenance of reduction state, we think that the further study should be done for comparative analysis of orbital volume change after removal of packing.