• Korean Journal of Digital Imaging in Medicine
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• v.15 no.2
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• pp.55-61
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• 2013

The purpose of this study is to evaluate image blurring according to variation of the ETL and propose the clinically appropriate ETL range. SIEMENS MAGNETOM Skyra 3.0T and 20 channel head coil were used for the study. MRI phantom was kept the lines horizontally to three direction(X,Y,Z) of the coil and T1, T2 weighted images that used the fast spin echo technique acquired. The ETL with increase of 10 was applied from 10 to 80. In addition, the ETL with increase of 1 was applied in the interval statistically significant differences occurred. And T1, T2 weighted images that used the conventional spin echo technique acquired to compare image blurring of the images that used the fast spin echo technique. The slope of lattice in the images was measured using Image J 1.47v program to evaluate image blurring. And image blurring was determined by the degree of the slope. The statistical significance of both techniques was evaluated by the Kruskal-Wallis test of the SPSS 17.0v. And the correlation of the ETL and image blurring was evaluated quantitatively by regression analysis. The slope of the T1, T2 weighted images that used fast spin echo technique decreased as contrasted with conventional spin echo technique. In the result of the Kruskal-Wallis test, the T1, T2 weighted images that used fast spin echo technique made a significant difference with conventional spin echo technique. Particularly, in the Tomhane' T2 test, the T1, T2 weighted images made a significant difference from ETL 22 and 31 respectively. In the result of the regression analysis, the R-squared of the T1, T2 weighted images are 0.762 and 0.793. It is difficult to apply the long ETL in the T1 weighted image caused by the short TR and multi-slices study. Therefore, clinical impact according to variation of the ETL is very slight in the T1 weighted images. But the application of the proper ETL is demanded in T2 weighted images using the fast spin echo technique in order to prevent image blurring.

• Progress in Medical Physics
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• v.32 no.4
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• pp.172-178
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• 2021

Purpose: This study aimed to develop a deep learning architecture combining two task models to generate synthetic computed tomography (sCT) images from low-tesla magnetic resonance (MR) images to improve metallic marker visibility. Methods: Twenty-three patients with cervical cancer treated with intracavitary radiotherapy (ICR) were retrospectively enrolled, and images were acquired using both a computed tomography (CT) scanner and a low-tesla MR machine. The CT images were aligned to the corresponding MR images using a deformable registration, and the metallic dummy source markers were delineated using threshold-based segmentation followed by manual modification. The deformed CT (dCT), MR, and segmentation mask pairs were used for training and testing. The sCT generation model has a cascaded three-dimensional (3D) U-Net-based architecture that converts MR images to CT images and segments the metallic marker. The performance of the model was evaluated with intensity-based comparison metrics. Results: The proposed model with segmentation loss outperformed the 3D U-Net in terms of errors between the sCT and dCT. The structural similarity score difference was not significant. Conclusions: Our study shows the two-task-based deep learning models for generating the sCT images using low-tesla MR images for 3D ICR. This approach will be useful to the MR-only workflow in high-dose-rate brachytherapy.

• The Journal of Korean Society for Radiation Therapy
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• v.29 no.2
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• pp.9-17
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• 2017

Purpose: The tissue description and electron density indicated by the Computed Tomography(CT) number (also known as Hounsfield Unit) in radiotherapy are important in ensuring the accuracy of CT-based computerized radiotherapy planning. The internal metal implants, however, not only reduce the accuracy of CT number but also introduce uncertainty into tissue description, leading to development of many clinical algorithms for reducing metal artifacts. The purpose of this study was, therefore, to investigate the accuracy and the clinical applicability by analyzing date from SMART MAR (GE) used in our institution. Methode: and material: For assessment of images, the original images were obtained after forming ROIs with identical volumes by using CIRS ED phantom and inserting rods of six tissues and then non-SMART MAR and SMART MAR images were obtained and compared in terms of CT number and SD value. For determination of the difference in dose by the changes in CT number due to metal artifacts, the original images were obtained by forming PTV at two sites of CIRS ED phantom CT images with Computerized Treatment Planning (CTP system), the identical treatment plans were established for non-SMART MAR and SMART MAR images by obtaining unilateral and bilateral titanium insertion images, and mean doses, Homogeneity Index(HI), and Conformity Index(CI) for both PTVs were compared. The absorbed doses at both sites were measured by calculating the dose conversion constant (cCy/nC) from ylinder acrylic phantom, 0.125cc ionchamber, and electrometer and obtaining non-SMART MAR and SMART MAR images from images resulting from insertions of unilateral and bilateral titanium rods, and compared with point doses from CTP. Result: The results of image assessment showed that the CT number of SMART MAR images compared to those of non-SMART MAR images were more close to those of original images, and the SD decreased more in SMART compared to non-SMART ones. The results of dose determinations showed that the mean doses, HI and CI of non-SMART MAR images compared to those of SMART MAR images were more close to those of original images, however the differences did not reach statistical significance. The results of absorbed dose measurement showed that the difference between actual absorbed dose and point dose on CTP in absorbed dose were 2.69 and 3.63 % in non-SMRT MAR images, however decreased to 0.56 and 0.68 %, respectively in SMART MAR images. Conclusion: The application of SMART MAR in CT images from patients with metal implants improved quality of images, being demonstrated by improvement in accuracy of CT number and decrease in SD, therefore it is considered that this method is useful in dose calculation and forming contour between tumor and normal tissues.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.12
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• pp.138-145
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• 2009

Custom medical treatment is being widely adapted to lots of medical applications. A technology for 3D modeling is strongly required to fabricate medical implants for individual patient. Needs on true 3D CAD data of a patient is strongly required for tissue engineering and human body simulations. Medical imaging devices show human inner section and 3D volume rendering images of human organs. CT or MRI is one of the popular imaging devices for that use. However, those image data is not sufficient to use for medical fabrication or simulation. This paper mainly deals how to generate 3D geometry data from those medical images. A new image processing technology is introduced to reconstruct 3D geometry of a human body vacancy from the medical images. Then a surface geometry data is reconstructed by using Marching cube algorithm. Resulting CAD data is a custom 3D geometry data of human vacancy. This paper introduces a novel 3D reconstruction process and shows some typical examples with implemented software.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.166-171
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• 2010

Purpose: The SPECT/CT is able to acquire diagnostic information resolved the difficult problems that discriminate regions of focals by intergrating functional images and anatomical images. We introduce the usefulness of "Volumetrix Suite" which can describe 3D images by the convergence of the SPECT/CT images and reference CT images. Materials and Methods: We applied Volumetrix Suite program (Volumetrix IR, Volumetrix 3D) to patients, Bone, Venography, Parathyroid, WBC, taken diagnostic CT examination which have same regions of focal in Seoul Metropolitan Government Seoul National University Boramae Medical Center. After acquiring SPECT/CT images and reference CT images, we fused a couple of scans applying for this programs. The CT scan of Infinia Hawkeye 4 shows limitation of anatomical information. For this reason, we tried to transfer CT images that have lots of diagnostic informations as the form of Dicom file in PACS, and changed from 2D images to 3D images after image registering in Xeleris Workstaion of Hawkeye 4. Results & Conclusion: By using Volumetrix Suite program, we're able to acquire more accurate anatomical informations with 3D rendering which can distinguish both location and range of focals in Infinia Hawkeye 4. Thus, the result of utilizing this program indicate that nuclear medicine anatomical images can be improved by providing more diagnostic imformations produced by its program.

• Progress in Medical Physics
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• v.24 no.1
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• pp.76-83
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• 2013

Previous studies about effect of respiratory motion on diagnostic imaging and radiation therapy have been performed by monitoring external motions but these can not reflect internal organ motion well. The aim of this study was to develope the artificial pulmonary nodule able to perform non-invasive implantation to dogs in the thorax and to evaluate applicability of the model to respiratory motion studies on PET image acquisition and radiation delivery by phantom studies. Artificial pulmonary nodule was developed on the basis of 8 Fr disposable gastric feeding tube. Four anesthetized dogs underwent implantation of the models via trachea and implanted locations of the models were confirmed by fluoroscopic images. Artificial pulmonary nodule models for PET injected $^{18}F$-FDG and mounted on the respiratory motion phantom. PET images of those acquired under static, 10-rpm- and 15-rpm-longitudinal round motion status. Artificial pulmonary nodule models for radiation delivery inserted glass dosemeter and mounted on the respiratory motion phantom. Radiation delivery was performed at 1 Gy under static, 10-rpm- and 15-rpm-longitudinal round motion status. Fluoroscpic images showed that all models implanted in the proximal caudal bronchiole and location of models changed as respiratory cycle. Artificial pulmonary nodule model showed motion artifact as respiratory motion on PET images. SNR of respiratory gated images was 7.21. which was decreased when compared with that of reference images 10.15. However, counts of respiratory images on profiles showed similar pattern with those of reference images when compared with those of static images, and it is assured that reconstruction of images using by respiratory gating improved image quality. Delivery dose to glass dosemeter inserted in the models were same under static and 10-rpm-longitudinal motion status with 0.91 Gy, but dose delivered under 15-rpm-longitudinal motion status was decreased with 0.90 Gy. Mild decrease of delivered radiation dose confirmed by electrometer. The model implanted in the proximal caudal bronchiole with high feasibility and reflected pulmonary internal motion on fluoroscopic images. Motion artifact could show on PET images and respiratory motion resulted in mild blurring during radiation delivery. So, the artificial pulmonary nodule model will be useful tools for study about evaluation of motion on diagnostic imaging and radiation therapy using laboratory animals.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.516-523
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• 1996

The purpose of this study was to evaluate the clinical usefulness of I-123 MIBG scintigraphy with early planar and SPECT image in the diagnosis of neuroendocrine tumors. We reviewed I-123 MIBG scintigraphies of 21 patients who had been suspected to have neuroendocrine tumors by CT or MRI findings. Early 4 hour planar and SPECT images were obtained in all patients and delayed (13-24 hour) planar images were performed in 17 patients. Final diagnoses were made by surgery, biopsy, or clinical follow up. Twelve patients were confirmed to have neuroendocrine tumors. With 4 hour planar and SPECT images, there were 9 true positives(6 pheochromocytomas, 1 paraganglioma, 1 neuroblastoma, and 1 medullary cancer of the thyroid), 8 true negatives(1 adrenal cortical adenoma, 1 malignant fibrous histiocytoma, 1 adenoma in colon and 5 benign nonfunctioning adrenal tumors), 1 false positive(hepatocellular carcinoma) and 3 false negatives(1 recurred medullary cancer of the thyroid, 1 liver metastasis of carcinoid tumor and 1 ganglioneuroma). The sensitivity and specificity of I-123 MIBG scintigraphy were 75% and 89%, respectively. SPECT images provided good anatomical correlation with CT or MRI. Delayed images showed increased tumor to background ratio in 5 out of 8 true positive patients, but did not change the diagnosis. In conclusion, early 4 hour images with I-123 MIBG is clinically convenient and useful method in the detection of neuroendocrine tumors, and SPECT images can provide good anatomical correlation with CT or MRI.

• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.107-113
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• 2014

Background: Sonoelastography (SE) is a new technique that can assess differences in tissue stiffness, the purpose of this study was to evaluate the ability of SE to assess the long head of biceps tendon alteration. Methods: Forty shoulders of 36 consecutively registered patients with clinical symptoms and conventional ultrasonography findings of biceps tendinitis or tendinosis, and 40 asymptomatic shoulders of 20 healthy volunteers were assessed with SE. Transverse and longitudinal images of long head of biceps tendon were obtained using SE. SE images were performed by one orthopedic surgeon and evaluated by two orthopedic surgeons using an experimentally proven color grading system. Results: The transverse images of SE showed a sensitivity of 87.5%, a specificity of 95.0% and a accuracy of 91.3%, the longitudinal images of SE showed a sensitivity of 92.5%, a specificity of 90.0% and a accuracy of 91.3%. Inter-observer reliability of SE was in 'almost perfect agreement' with a weighted kappa coefficient of 0.83. Conclusions: SE is valuable in the detection of the intratendinous and peritendinous alterations of biceps tendon, and has excellent accuracy and excellent correlation with conventional ultrasound findings.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.265-267
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• 2008

Angiolipomas in the lumbar spinal region are extremely rare. The present report describes the identification of such a tumor and its removal, and discusses the tumor characteristics and prognosis. A 74-year-old woman was presented with a 5-month history of lower back pain. Severe radiculopathy was experienced in the left leg for 5 days prior to the presentation, and there were no neurological deficits. Magnetic resonance (MR) images showed an approximately 3.5 cm heterogeneously enhanced and elongated mass at the left L5-S1 level. A portion of the mass appeared with high signal intensity on T2-weighted MR images, with low signal intensity on T1-weighted images, and with high signal intensity on T1 fat suppression enhancement images. Resection of the tumor was approached via an L5 and S1 laminectomy. A fibrous sticky yellowish hypervascular tumor was identified. Histological study revealed the tumor as an angiolipoma. Symptoms were relieved after tumor excision, and there were no neurological sequelae. Although extremely rare, lumbar epidural angiolipoma should be considered in the differential diagnosis of lumbar spinal epidural lesions. The prognosis after surgical management of this lesion is favorable.

• Journal of Korea Multimedia Society
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• v.11 no.5
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• pp.588-596
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• 2008

For the patients' privacy, secure access control of medical images is essentially necessary. In this paper, two types of Region of Interest (ROI)-based selective encryption schemes are proposed, which concentrate on the security of crucial parts in medical images. The first scheme randomly inverts the most significant bits of ROI coefficients in several high frequency subbands in the transform domain, which only incurs little loss on compression efficiency. The second scheme employs a symmetric key encryption to encrypt selectively the ROI data in the final code-stream, which provides sufficient confidentiality. Both of two schemes are backward compatible so as to ensure a standard bitstream compliant decoder so the encrypted images can be reconstructed without any crash.