• Title/Summary/Keyword: radiologists

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Susceptibility-Weighted MR Imaging for the Detection of Developmental Venous Anomaly: Comparison with T2 and FLAIR Imaging (자화율강조 MR영상을 이용한 뇌정맥 기형의 진단: T2강조영상과 FLAIR영상과의 비교)

  • Cho, Soo Bueum;Choi, Dae Seob;Ryu, Hyeon Gyu;Shin, Hwa Seon;Kim, Ji-Eun;Choi, Hye Young;Park, Mi Jung;Choi, Ho Cheol;Son, Seungnam
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.200-207
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    • 2014
  • Purpose : We evaluated the diagnostic value of susceptibility-weighted imaging (SWI) for the detection of developmental venous anomaly (DVA). Materials and Methods: Retrospective review of 1068 brain MR examinations found 28 DVAs in 28 patients (2.6%) on contrast-enhanced T1-weighted images. SWI, T2, and FLAIR images of 28 patients with DVA and 28 sex- and age-matched control patients without DVA were analyzed by blinded readers on each type of sequences. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. In cases of discrepancy, two reviewers reached a consensus later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each MR sequence for the detection of DVA were determined. Statistical analysis was performed by using the Mcnemar test. The significance level was p < 0.05. Results: The sensitivity, specificity, PPV, and NPV of SWI for the detection of DVA were 85.7%, 92.9%, 92.3%, and 86.7%, respectively. T2 and FLAIR images showed sensitivity of 35.7% and 35.7%, specificity of 92.9% and 96.4%, PPV of 83.3% and 90.9%, and NPV of 59.1% and 60.0%, respectively. On SWI, the sensitivity and NPV for the detection of DVAs were significantly higher than those of T2 and FLAIR images (p < 0.05). Conclusion: SWI was sensitive and specific for the detection of DVA.

High-Resolution Contrast-Enhanced 3D-Spoiled Gradient-Recalled Imaging for Evaluation of Intracranial Vertebral Artery and Posterior Inferior Cerebellar Artery in Lateral Medullary Infarction (고해상도 조영증강 삼차원 회손기울기 회상 영상을 이용한 측면연수경색 환자의 두개내 척추동맥 및 뒤아래소뇌동맥 평가)

  • Yoon, Youngno;Ahn, Sung Jun;Suh, Sang Hyun;Park, Ah Young;Chung, Tae-Sub
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.1
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    • pp.17-24
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    • 2014
  • Purpose : To determine whether high-resolution contrast-enhanced three dimensional imaging with spoiled gradient-recalled sequence (HR-CE 3D-SPGR) plays a meaningful role in the assessment of intracranial vertebral artery (ICVA) and posterior inferior cerebellar artery (PICA) in lateral medullary infarction (LMI). Materials and Methods: Twenty-five patients confirmed with LMI were retrospectively enrolled with approval by the IRB of our institute, and 3T MRI with HR-CE 3D-SPGR and contrast-enhanced magnetic resonance angiography (CE-MRA) were performed. Two radiologists who were blinded to clinical information and other brain MR images including diffusion weighted image independently evaluated arterial lesions in ICVA and PICA. The demographic characteristics, the area of LMI and cerebellar involvement were analyzed and compared between patients with arterial lesion in ICVA only and patients with arterial lesions in both ICVA and PICA on HR-CE 3D-SPGR. Results: Twenty-two of twenty-five LMI patients had arterial lesions in ICVA or PICA on HR-CE 3D SPGR. However twelve arterial lesions in PICA were not shown on CE-MRA. Concurrent cerebellar involvement appeared more in LMI patients with arterial lesion in ICVA and PICA than those with arterial lesion in ICVA alone (p = 0.069). Conclusion: HR-CE 3D-SPGR can help evaluate arterial lesions in ICVA and PICA for LMI patients.

EVALUATION OF RADIOPACITY AND DISCRIMINABILITY OF VARIOUS FIBER REINFORCED COMPOSITE POSTS (수종의 섬유 강화 레진 포스트의 방사선 불투과도와 식별도 평가)

  • Lee, Eun-Hye;Choi, Hang-Moon;Park, Se-Hee;Kim, Jin-Woo;Cho, Kyung-Mo
    • Restorative Dentistry and Endodontics
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    • v.35 no.3
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    • pp.188-197
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    • 2010
  • The purpose of this study was to compare radiopacity and radiographic discriminability of various FRC-Posts. Six FRC-Posts were investigated ; 1) FRC Postec Plus (Ivoclar Vivadent AG, Schaan, Liechtenstein), 2) Snowlight (Carbotech, Lewis center, OH, USA), 3) Dentin Post (Komet Brasseler, Lamgo, Germany), 4) Rely-X Fiber Post (3M ESPE, St.paul, MN, USA), 5) D.T.-Light Post (BISCO, Schaumburg, IL,USA), 6) Luxapost (DMG, Hamburg, Germany) The radiographs of each post with a reference 1 mm / 2 mm aluminum step-wedge was taken using digital sensor. The optical density were calculated by gray value of $10{\times}10$ pixel and compared in mm Al equivalent at five points. Six maxillary incisors of similar radiopacity were used. Radiographs of posts in Mx. incisors of lingual side of dry mandible were taken. We showed radiographs and asked the questionnaire to 3 radiologists, 3 endodontists, 3 general practitioners. The questionnaire was comprised of choices of the highest, lowest radiopaque individual post and the choices of best discriminable post at apical, coronal area. The following results were obtained. 1. Each post system showed various radiopacity. 2. There was change of discriminability between each post and simulated specimens regardless of examiner. Although each post showed various radiopacity, the difference of radiopacity did not affect on discriminability.

Effect of the Space Dose Rate due to Change of X-ray Irradiation Energy and MU Value in Radiation Therapy Room (선형가속기의 엑스선 조사에너지와 MU값의 변화가 치료실 내 공간선량률 변화에 미치는 영향)

  • Kwon, Hyeonghyo;Park, Geonryul;Kim, Minji;Jo, Yeongdan;Kim, Youngjae
    • Journal of the Korean Society of Radiology
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    • v.14 no.2
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    • pp.77-83
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    • 2020
  • This study investigated the radiation protection of therapeutic radiologists. Based on the change in X-ray energy and MU value, the space dose rate in the treatment room after the irradiation was measured. 6MV, 10MV and 15MV photon beams were exposed to radiation inside the treatment room based on 300MU, 600MU and 1000MU using a linear accelerator. And repeated 10 times under the same conditions. As a result of the experiment, 0.1555 μSv/h for 6MV 300MU, 0.157 μSv /h for 300sec, 0.152 μSv/h, 0.156 μSv/h for 600MU, and 0.157 μSv/h 0.152 μSv/h for 1000MU. 300MU of 10MV was 0.49 μSv/h, 0.309 μSv/h, and 0.69 μSv/h, 0.416 μSv/h for 600MU, respectively, and 1000MU was 0.977 μSv/h and 0.478 μSv/h, respectively. The 300MU of 15MV was 3.02 μSv/h, 1.2 μSv/h, 5.459 μSv/h at 600MU, 7.34 μSv/h at 1.836 μSv/h 1000MU, and 2.709 μSv/h. The average spatial dose rate of 6MV was not significantly different from the natural spatial dose rate in the treatment room. High spatial dose rates were measured at 10 MV and 15 MV and were attenuated over time. Therefore, entering the treatment room after a certain period of time (more than 60 seconds) is considered to be effective to prevent the exposure dose of radiation workers.

A Study on the Evaluation of Patient Dose in Interventional Radiology (중재적방사선검사에서 환자 피폭선량에 관한 연구)

  • Park, Hyung-Sin;Lim, Cheong-Hwan;Kang, Byung-Sam;You, In-Gyu;Jung, Hong-Ryang
    • Journal of radiological science and technology
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    • v.35 no.4
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    • pp.299-308
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    • 2012
  • To perform patient dose surveys in major interventional radiography procedures as a mean of inter-institutional comparison and of establishing reference dose levels with the ultimate goal of optimizing patient doses in the field of interventional radiography. We reviewed international patient dose survey data in the literature and measured patient dose in major interventional radiography procedures (TACE, AVF, PTBD, TFCA, GDC embolization). ESD(Entrance Skin Dose) was measured using TLD chips attached to the patient skin and ED(Effective Dose) was calculated using angiography unit-derived DAP. A survey of patient dose in interventional radiography procedures were also performed with a questionnaire for interventional radiologists and we proposed a guideline for optimizing patient doses in the field of interventional radiology. The patient dose survey data in interventional radiography procedures were very rare in literature compared with those in diagnostic radiography procedures. In TACE, the mean ED was 25.43 mSv and the mean ESD was 511.75 mGy. The mean ED of TACE was not high, but the cumulative dose should be checked, due to longer procedure TACE. In TFCA, the mean ED was 22.6 mSv and it was relatively high compared with data of other countries. In GDC embolization, the mean ED was not available, because GDC embolization was performed with old Image-Intensifier-type unit and there has no unit-installed ionization chamber. Also, the mean ESD of GDC embolization was up to 2,264 mGy and further studies are needed to calculate the net ED of GDC embolization. Patient dose occurred during interventional radiography procedures are high related with the difficulty of the procedure, fluoroscopy time, the number of angiographies and the treatment protocol. Therefore, continuous education and efforts should be made to optimize the patient dose in the field of interventional radiology.

A Study on Medical Waste Contaminated by Radioactivity in Nuclear Medicine Department (핵의학과 일반 의료폐기물에서의 방사능 오염에 관한 고찰)

  • Yoo, Jae-Sook;Jang, Jung-Chan;Lee, Dong-Hoon;Cha, Min-Kyeong;Nam, Ki-Pyo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.70-74
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    • 2011
  • Purpose: In the Nuclear Medicine department of Asan Medical Center, radioactive waste has been disposed of by using several disposal boxes designed for nuclear waste. However, some quantity of radioactivity has been detected occasionally due to some radiologists' carelessness not only from radioactive waste, but also from medical waste such as uncontrolled radioactive waste related to patients, poly gloves or saline solution bottles from radiopharmaceuticals laboratory. Thus, this study is going to suggest a solution to maintain the medical wastes made from controlled areas that can be below maximum permissible surface dose limits by finding the cause of radioactive contamination. Materials and methods: This study was taken place in 17 different places-2 medical wastebaskets in the waiting room, 2 medical wastebaskets in the PET room, 5 medical wastebaskets in the in vitro laboratory and 6 medical wastebaskets in the radiopharmaceuticals laboratory of the East building, 2 medical wastebaskets in the waiting room of the New building of Nuclear Medicine Department in Asan Medical Center from April to August 2010. Mean radioactivity and its standard deviation of each place have been found by measuring surface contamination of medical wastebaskets and backgrounds twice a week, totaling 30 times. An independent t-test of SPSS (Ver. 12.0) statistic program has been used for statistical analysis. Swabs, saline solution bottles and poly gloves collected from each place also measured 30 times, respectively. Results: This study analyzed medical waste and the backgrounds of each place by using survey meter detectors that significant differences of five places did not exist, but existed statistically in twelve places (p<0.05). Also, swabs, saline solution bottles and poly gloves collected from each radioactive waste partly exceed the legal dose limit as a result of measuring by a gamma counter. Conclusion: Backgrounds and the surface doses of radioactive disposal box in all 17 places measured by the survey meter did not exceed the legal dose limit; however, it obviously showed that there were prominent differences in 12 places. Assuming that the cause of the differences was swabs, saline solution bottles and gloves, we examined them by gamma counter, and the results showed remarkably high doses of radioactivity. Consequently, swabs and poly gloves which are normally disposed in the general medical waste box should be disposed in the radioactive waste box furnished by radiopharmaceuticals laboratory. Also, saline solution discharged from radioactive pharmaceutical places is considered as radioactive liquid waste so that it should be disposed of by the septic tank specifically designed for radioactive liquid.

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Usefulness in Evaluation of NM Image which It Follows in Onco. Flash Processing Application (Onco. Flash Processing 적용에 따른 핵의학 영상의 유용성 평가)

  • Kim, Jung-Soo;Kim, Byung-Jin;Kim, Jin-Eui;Woo, Jae-Ryong;Kim, Hyun-Joo;Shin, Heui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.1
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    • pp.13-18
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    • 2008
  • Purpose: The image processing method due to the algorism which is various portion nuclear medical image decision is important it makes holds. The purpose of this study is it applies hereupon new image processing method SIEMENS (made by Pixon co.) Onco. flash processing reconstruction and the comparison which use the image control technique of existing the clinical usefulness it analyzes with it evaluates. Materials & Methods: 1. Whole body bone scan-scan speed 20 cm/min, 30 cm/min & 40 cm/min blinding test 2. Bone static spot scan-regional view 200 kcts, 400 kcts for chest, pelvis, foot blinding test 3. 4 quadrant-bar phantom-20000 kcts visual evaluation 4. LSF-FWHM resolution comparison ananysis. Results: 1. Raw data (20 cm/min) & processing data (30 cm/min)-similar level image quality 2. Low count static image-image quality clearly improved at visual evaluation result. 3. Visual evaluation by quadrant bar phantom-rising image quality level 4. Resolution comparison evaluation (FWHM)-same difference from resolution comparison evaluation Conclusion: The study which applies a new method Onco. flash processing reconstruction, it will be able to confirm the image quality improvement which until high level is clearer the case which applies the method of existing better than. The new reconstruction improves the resolution & reduces the noise. This enhances the diagnostic capabilities of such imagery for radiologists and physicians and allows a reduction in radiation dosage for the same image quality. Like this fact, rising of equipment availability & shortening the patient waiting move & from viewpoint of the active defense against radiation currently becomes feed with the fact that it will be the useful result propriety which is sufficient in clinical NM.

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Assessment of the Synovial Inflammation in Rheumatoid Arthritis with $^{99m}Tc$-labelled Polyclonal Human IgG(HIG): Prospective Comparison with Gadolinium Enhanced MRI ($^{99m}Tc$-labelled HIG 스캔을 이용한 류마티스 관절염 환자에서 활막염증의 평가 : 조영증강 자기공명영상과의 전향적인 비교)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Suh, Jin-Suck;Park, Chang-Yun;Jeon, Pyoung;Na, Jae-Beom;Lee, Soo-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.84-91
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    • 1995
  • Many clinical and laboratory tests have been employed to evaluate disease activity in rheumatioid arthritis. $^{99m}Tc$-labelled polyclonal IgG(HIG) has been demonstrated to accumulate in focal sites of infection or inflammation in both animals and human subjects. The purpose of this study was to distinguish arthritis with active inflammation from those without active inflammation and to correlate relative intensities of $^{99m}Tc$-labelled HIG uptake of the rheumatoid arthritis with clinical and MR indices of the joint inflammation. This study included twelve patients with active rheumatoid arthritis, two with ankylosing spondylitis and one with degenerative osteoarthritis without active inflammation. A Whole-body and spot images were obtained 4 hours after intravenous injection of 20mCi of $^{99m}Tc$-labelled HIG. Scintigrams were assessed visually by 3 experienced radiologists, and graded as normal or mildly and markedly increased uptake within the joints, and the degree of uptake was compared with clinical and radiologic severity of synovial inflammation. MRI studies were done on the involved joints consisted of wrist(n = 11), knee(n = 2) and hip joint(n= 2). Active synovitis was defined when marked elevation of ESR and gadolinium enhancement of synovium on MRI were demonstrated. Markedly increased radiotracer uptake was seen in 10 of 11 rheumatoid arthritic patients with active synovitis whereas normal or mildly increased uptakes were noted in others, including rheumatoid arthritic patient(n=1) and non-rheumatoid patients(n = 3) without active synovitis. This study showed that the localization of involved joints in rheumatoid arthritis could be detected with $^{99m}Tc$-labelled HIG and that the degree of uptake correlated well with the degree and activity of inflammation. In conclusion, $^{99m}Tc$-labelled HIG scan is a useful method in the evaluation of active inflammation in rheumatoid arthritis.

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The Comparative Analysis Study and Usability Assessment of Fat Suppressed 3D T2* weighted Technique and Fat Suppressed 3D SPGR Technique when Examining MRI for Knee Joint Cartilage Assesment (슬관절 연골 평가를 위한 자기공명영상 검사 시 지방 신호 억제 3D T2* Weighted 기법과 지방 신호 억제 3D SPGR 기법의 비교 및 유용성 평가)

  • Kang, Sung-Jin
    • Journal of the Korean Magnetics Society
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    • v.26 no.6
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    • pp.219-225
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    • 2016
  • In this study, for assessment of degenerative knee joint cartilage disease we acquired images by fat suppressed 3D spoiled gradient recalled (SPGR) and fat suppressed 3D $T2^*$ weighted imaging techniques. To do a quantitative evaluation, the knee joint cartilage was divided into medial femoral cartilage (MFC), medial tibial cartilage (MTC), lateral femoral cartilage (LFC), lateral femoral cartilage (LFC) and patella cartilage (Pat) to measure their respective signal intensity values, signal-to-noise ratio, and contrast-to-noise ratio. As for the measured values, statistical significance between two techniques was verified by using Mann-Whitney U-Test. To do a qualitative evaluation, two radiologists have examined images by techniques after which image artifact, cartilage surface, tissue contrast, and depiction of lesion distinguishing were evaluated based on 4-point scaling (1: bad, 2: appropriate, 3: good, 4: excellent), and based on the result, statistical significance was verified by using Kappa-value Test. 3.0T MR system and HD T/R 8ch knee array coil were used to acquire images. As a result of a quantitative analysis, based on SNR values measured by using two imaging techniques, MFC, LFC, LTC, and Pat showed statistical significance (p < 0.05), but MTC did not (p > 0.05). As a result of verifying statistical significance for measured CNR value, MFC, LFC, and Pat showed statistical significance (p < 0.05), while MTC and LTC did not show statistical significance (p > 0.05). As a result of a qualitative analysis, by comparing mean values for evaluated image items, 3D $T2^*$ weighted Image has indicated a slightly higher value. As for conformance verification between the two observers by using Kappa-value test, all evaluated items have indicated statistically significant results (p < 0.05). 3D $T2^*$ weighted technique holds a clinical value equal to or superior to 3D SPGR technique with respect to evaluating images, such as distinguishing knee joint cartilages, comparing nearby tissues contrast, and distinguishing lesions.

Actual Condition of Quality Control of X-ray Imaging System in Primary Care Institution: focused on Gwangju Metropolitan City (1차 의료기관의 엑스선 발생장치 정도관리에 관한 현황조사:광주광역시 지역을 중심으로)

  • Dong, Kyung-Rae;Lee, Seun-Joo;Kweon, Dae-Cheol;Goo, Eun-Hoe;Jung, Jae-Eun;Lee, Kyu-Su
    • Journal of Radiation Protection and Research
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    • v.35 no.1
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    • pp.34-42
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    • 2010
  • With the expanded use of radiation in modern medical practices, the most important issue in regards to efforts to reduce individual exposure dose is quality assurance. Therefore in order to study the present condition of quality assurance, the Gwangju Metropolitan City area was divided into five districts each containing ten hospitals. Four experiments were conducted: a reproducibility experiment for kVp, mA, and examination time (sec) intensity of illumination; half-value layer (HVL) measurement; and beam perpendicularity test matching experiment. The tube voltage reproducibility experiment for all fifty hospitals resulted in a 95.33% passing rate and mA and examination time both resulted in a 77.0% passing rate. The passing rate for intensity of illumination was 86.0% and 52.0% for HVL, which was the lowest passing rate of all four factors. For the beam perpendicularity test matching experiment, generally the central flux is matched to within $1.5^{\circ}$. Of all fifty hospitals 30.0% were beyond $3^{\circ}$. The results of the survey showed that 58% responded that they knew about quality assurance cycle. All fifty respondents stated that they have not received any training in regards to quality assurance at their current place of employment. Although quality assurance is making relative progress, the most urgent issue is awareness of the importance of quality assurance. Therefore, the implementation of professional training focusing on safety management and accurate quality assurance of radiation will reduce the exposure to radiation for radiologists and patients and higher quality imaging using less dosage will also be possible.