• Journal of the Korean Society of Radiology
• /
• v.14 no.7
• /
• pp.1003-1011
• /
• 2020

This study aims to compare and evaluate the image differences between single and dual sources in applying a technique to reduce metal artifacts using dual energy CT. Discovery CT 256 (GE, USA) as a single source device and Somatom Definition Flash (Siemens Health Care, Forchheim, Germany) as a dual source device. The self-made phantom (pigs with medical titanium screws inserted) was quantitative and qualitatively evaluated under the same conditions by varying the dose under the same conditions using a dual energy CT. The evaluation method was compared by measuring SNR for metal artifacts (scattering, stripe) generated by metal inserts, divided around bones and around tissues. There was a difference in images in the method of reducing metal artifacts between single-source and dual-source devices. In a single source device, the linearized prosthesis by metal implantation showed a greater decrease than the image obtained from a double source device, and the surrounding tissue was well observed without interference from the artifact. In dual-source devices, scattering and stripe artifacts caused by metal inserts decreased more than on a single source device, and signals from adjacent tissues surrounding the metal implant were well observed without diminishing. If the examination is conducted separately between single source and dual source devices depending on whether the area to which the patient is intended to be viewed during the examination is adjacent to the metal insert or the total tissue surrounding the metal insert, it is believed that diagnostic helpful images can be obtained.

• The korean journal of orthodontics
• /
• v.52 no.4
• /
• pp.287-297
• /
• 2022

Objective: To investigate the pattern of accuracy change in artificial intelligence-assisted landmark identification (LI) using a convolutional neural network (CNN) algorithm in serial lateral cephalograms (Lat-cephs) of Class III (C-III) patients who underwent two-jaw orthognathic surgery. Methods: A total of 3,188 Lat-cephs of C-III patients were allocated into the training and validation sets (3,004 Lat-cephs of 751 patients) and test set (184 Lat-cephs of 46 patients; subdivided into the genioplasty and non-genioplasty groups, n = 23 per group) for LI. Each C-III patient in the test set had four Lat-cephs: initial (T0), pre-surgery (T1, presence of orthodontic brackets [OBs]), post-surgery (T2, presence of OBs and surgical plates and screws [S-PS]), and debonding (T3, presence of S-PS and fixed retainers [FR]). After mean errors of 20 landmarks between human gold standard and the CNN model were calculated, statistical analysis was performed. Results: The total mean error was 1.17 mm without significant difference among the four time-points (T0, 1.20 mm; T1, 1.14 mm; T2, 1.18 mm; T3, 1.15 mm). In comparison of two time-points ([T0, T1] vs. [T2, T3]), ANS, A point, and B point showed an increase in error (p < 0.01, 0.05, 0.01, respectively), while Mx6D and Md6D showeda decrease in error (all p < 0.01). No difference in errors existed at B point, Pogonion, Menton, Md1C, and Md1R between the genioplasty and non-genioplasty groups. Conclusions: The CNN model can be used for LI in serial Lat-cephs despite the presence of OB, S-PS, FR, genioplasty, and bone remodeling.

• Journal of the Korean Society of Radiology
• /
• v.17 no.7
• /
• pp.1115-1122
• /
• 2023

This study aimed to present reasonable reception bandwidth application standards for the purpose of suppressing metal objects during MRI examinations. For this purpose, T2 contrast images were acquired using high-speed spin echo technology on a phantom made of screws for spinal surgery, and metal objects were detected. In addition, images were obtained by increasing the reception bandwidth from 100 Hz/PX to 800 Hz/PX by 100 Hz/PX. The metal artifacts were determined as the sum of the areas of the signal attenuation area and the signal accumulation area. In addition, Pearson correlation analysis was performed to analyze the pattern of metal artifacts according to imaging variables. As a result, the signal accumulation area did not change significantly as the reception bandwidth increased (p>0.05), but the signal loss area and the area of metal artifacts decreased as the reception bandwidth increased (p<0.05). Interestingly, the area of metal objects decreased to a maximum in the section where the reception bandwidth was increased from 100 Hz/PX to 200 Hz/PX, consistent with the section where the echo spacing was reduced to a maximum due to the increase in reception bandwidth. In addition, the correlation analysis results also showed that the eco spacing was more related to the signal attenuation area and the area of metal objects than to the reception bandwidth. Therefore, if the reception bandwidth is increased for the purpose of reducing metal objects, it is reasonable to set it based on a value that minimizes the echo spacing in consideration of image quality factors.

• Journal of the Korean Society of Radiology
• /
• v.17 no.7
• /
• pp.1123-1131
• /
• 2023

This study aimed to present a method to effectively suppress metal artifacts caused by spinal fusion surgery during spinal MRI study. For this purpose, a phantom made of spinal surgery screws was created to reproduce the metal artifact. Then, images were acquired with 1.5T and 3.0T MRI to evaluate changes in metal artifacts according to magnetic field strength. In addition, metal artifacts were evaluated by increasing the receive bandwidth to 200, 400 and 800 Hz/PX. As a result, metal artifacts occurring in images obtained from the 1.5T MRI decreased by approximately 52.2% compared to images obtained from the 3.0T MRI, showing a significant difference (p<0.05). In particular, the signal loss and signal pile up areas were reduced by approximately 52.81% and 42.71%, respectively, showing a significant effect in suppressing metal artifacts. On the other hand, when images were acquired while increasing the receive bandwidth from 200 to 800 Hz/PX, there was no significant effect, with a decrease of up to 8.93% for the 1.5T MRI and up to 10.98% for the 3.0T MRI (p>0.05). As a result of this study, increasing the receive bandwidth reduced signal loss and reduced some metal artifacts, but did not have a significant effect because it did not suppress signal pile up. However, when the magnetic field strength was reduced from 3.0T to 1.5T, signal loss and signal pile up were greatly reduced, effectively improving the metal artifact. Therefore, in order to suppress metal artifacts caused by spinal fusion surgery, study using a low magnetic field MRI can be said to be the most effective method.

• The Journal of Korean Academy of Prosthodontics
• /
• v.51 no.4
• /
• pp.276-283
• /
• 2013

Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

• The korean journal of orthodontics
• /
• v.33 no.2 s.97
• /
• pp.91-102
• /
• 2003

This study was performed to investigate the effect of immediate orthodontic force on soft md hard tissues surrounding C-Palatal $Plate^{TM}$ in beagle Dog. Immediately after this appliance was implanted on the midpalate of 4 adult beagle Dogs, 400gm continuous orthodontic force was applied. Experimental animals were euthanized at 8weeks, 18weeks, and 22weeks (including post-removal healing time of 4weeks), and a control animal was euthanized at 8weeks after implantation without orthodontic force application. The appliance and the surrounding tissue were studied radiographically, macroscopically, and histologically. The results were as follows: 1. The lateral radiographs taken after euthanasia showed very slight displacement of the vortical plate in the experimental animals, compared with the control animal. Mobility test of all animals confirmed primary stability without any increase of mobility during experimental period. 2. No pathologic changes were found in the healing condition of covering soft tissue and bone-screw interface in experimental animals as well as a control animal. 3. Osseointegration was achieved in the bone-screw interface in 8weeks after implantation and the amount of osseointegration increased in 18weeks. There was little difference of osseointegration between the compression side and the tension side. 4. In the marginal bone area, slight bone apposition and resorption were found regardless of compression and tension side, while there was no change in the control animal. 5. Both 8week-animal and 18week-animal showed the new bone apposition along the surface of screws which were perforated into the nasal cavity, while the control animal showed no change. 6. After 4weeks of plate removal, the covering epithelium was repaired intactly, while the connective tissue showed loose and irregular rearrangement and the connective tissue capsule remained. The C-Palatal $Plate^{TM}$ manifested sufficient anchorage capacity in the context of histological study as well as clinical outcomes, when immediate orthodontic force was applied after implantation.

• Progress in Medical Physics
• /
• v.10 no.2
• /
• pp.63-71
• /
• 1999

For the purpose of utilization in 3-D conformal radiotherapy and whole body radiosurgery, the Whole Body 3-Dimensional Topographic Radiation Therapy System has been developed. Whole body frame was constructed in order to be installed on the couch. Radiopaque catheters were engraved on it for the dedicated coordinate system and a MeV-Green immobilizer was used for the patient setup by the help of side panels and plastic rods. By designing and constructing the whole body frame in this way, geometrical limitation to the gantry rotation in 3-D conformal radiotherapy could be minimized and problem which radiation transmission may be altered in particular incident angles was solved. By analyzing CT images containing information of patient setup with respect to the whole body frame, localization and coordination of the target is performed so that patient setup error may be eliminated between simulation and treatment. For the verification of setup, the change of patient positioning is detected and adjusted in order to minimize the setup error by means of comparison of the body outlines using 3 CCTV cameras. To enhance efficiency of treatment procedure, this work can be done in real time by watching the change of patient setup through the monitor. The method of image subtraction in IDL (Interactive Data Language) was used to visualize the change of patient setup. Rotating X-ray system was constructed for detecting target movement due to internal organ motion. Landmark screws were implanted either on the bones around target or inside target, and variation of target location with respect to markers may be visualized in order to minimize internal setup error through the anterior and the lateral image information taken from rotating X-ray system. For CT simulation, simulation software was developed using IDL on GUI(Graphic User Interface) basis for PC and includes functions of graphic handling, editing and data acquisition of images of internal organs as well as target for the preparation of treatment planning.

• Journal of Korean Foot and Ankle Society
• /
• v.9 no.2
• /
• pp.146-150
• /
• 2005

Purpose: We made a radiological comparison between $60^{\circ}$ distal Chevron osteotomy with short armed two parts and $40^{\circ}$ distal Chevron osteotomy with long armed one part performing operation in cases of hallux valgus angle of less than $40^{\circ}$, intermetatarsal angle of less than $15^{\circ}$. Materials and Methods: 12 cases with $60^{\circ}$ distal Chevron osteotomy and 12 cases with $40^{\circ}$ distal Chevron osteotomy were selected from October 2000 to March 2005. We have analysed the hallux valgus angle, 1-2 intermetatarsal angle, metatarsal length, distal metartarsal articular angle and angulation at osteotomy site on lateral view in each radiological films taken at preoperative, postoperative and 3 months after operation presuming bone union. All cases were women, both sides were 9 cases and average age was 52.3 years old. Results: Data taken at preoperative, postoperative and 3 months follow up films in $60^{\circ}$ distal Chevron osteotomy were as follows; the hallux valgus angles were $32.1^{\circ}$, $10.9^{\circ}$, $13.8^{\circ}$, the 1-2 intermetatarsal angles were $13.6^{\circ}$, $8.5^{\circ}$, $8.4^{\circ}$, the metatarsal length were 60.6 mm, 58.8 mm, 58 mm, the distal metartarsal articular angles were $13^{\circ}$, $6^{\circ}$, $6.6^{\circ}$ and 3 cases were over $3^{\circ}$ angulation at lateral view. In $40^{\circ}$ distal Chevron osteotomy, the hallux valgus angles were $34.5^{\circ}$, $11.6^{\circ}$, $15.3^{\circ}$, the 1-2 intermetatarsal angles were $12.7^{\circ}$, $8.2^{\circ}$, $7.8^{\circ}$, the metatarsal length were 59.2 mm, 56.9 mm, 55.9 mm, the distal metartarsal articular angles were $12^{\circ}$, $7.3^{\circ}$, $7.3^{\circ}$ and there were no case with angulation over $3^{\circ}$ at lateral view. Conclusion: In comparison between $60^{\circ}$ distal Chevron osteotomy and $40^{\circ}$ distal Chevron osteotomy measuring at postoperative and follow up, most of all data were similar, but 3 cases over $3^{\circ}$ angulation at lateral view happened in $60^{\circ}$ Chevron osteotomy. This result showed that $40^{\circ}$ distal Chevron osteotomy fixing with screws through long armed one part may have benefit than $60^{\circ}$ distal Chevron osteotomy fixing with K-wires through short armed two parts in making rigid fixation, even though there is a personal difference of technigue.

• Clinics in Shoulder and Elbow
• /
• v.15 no.2
• /
• pp.123-129
• /
• 2012

Objective: To evaluate if acromial locking in hook plate is necessary for surgical treatment of acromioclavicular dislocation by compare Wolter plate and AO hook plate. Methods: Seventy one patients who have Rockwood type III to V acromioclavicular joint dislocation treated with AO hook plate and Wolter plate were involved. Among them, 39 patients were treated with Wolter hook plate and 32 patients with AO hook plate. The Constant-Murley score and the range of motion of shoulder joint were measured on postoperative 1st ,$3^{rd}$, $6^{th}$ and $12^{th}$ months, and the radiological complications involving plate and bone were investigated. Results: Constant-Murley score of postoperative one year were $83.2{\pm}6.8$ in AO hook plate group and $85.2{\pm}5.3$ in Wolter plate group without statistical difference (p<0.05). Faster recover of forward elevation and external rotation were examined in Wolter plate group at first and third months after surgery than those of AO hook plate group, but there were no significant difference between after six months or later after surgery. Four cases of loosen or broken screws and one case of pull-out of plate were found in Wolter plate group. Seven cases of subacromial bony erosion and one periprosthetic fracture were found in AO hook plate group. Conclusion: Although clinical outcomes of both two methods were same, no matter if acromial locking system was or not. More radiological complication of plate and bone were found in AO hook plate than that of Wolter plate. However also had disadvantage like larger incision during surgery.

• Journal of Korean Neurosurgical Society
• /
• v.50 no.3
• /
• pp.166-172
• /
• 2011

Objective : The intralaminar screw (ILS) fixation technique offers an alternative to pedicle screw (PS) and lateral mass screw (LMS) fixation in the C7 spine. Although cadaveric studies have described the anatomy of the pedicles, laminae, and lateral masses at C7, 3-dimensional computed tomography (CT) imaging is the modality of choice for pre-surgical planning. In this study, the goal was to determine the anatomical parameter and optimal screw trajectory for ILS placement at C7, and to compare this information to PS and LMS placement in the C7 spine as determined by CT evaluation. Methods : A total of 120 patients (60 men and 60 women) with an average age of $51.7{\pm}13.6$ years were selected by retrospective review of a trauma registry database over a 2-year period. Patients were included in the study if they were older than 15 years of age, had standardized axial bone-window CT imaging at C7, and had no evidence of spinal trauma. For each lamina and pedicle, width (outer cortical and inner cancellous), maximal screw length, and optimal screw trajectory were measured, and the maximal screw length of the lateral mass were measured using m-view 5.4 software. Statistical analysis was performed using Student's t-test. Results : At C7, the maximal PS length was significantly greater than the ILS and LMS length (PS, $33.9{\pm}3.1$ mm; ILS, $30.8{\pm}3.1$ mm; LMS, $10.6{\pm}1.3$; p<0.01). When the outer cortical and inner cancellous width was compared between the pedicle and lamina, the mean pedicle outer cortical width at C7 was wider than the lamina by an average of 0.6 mm (pedicle, $6.8{\pm}1.2$ mm; lamina, $6.2{\pm}1.2$ mm; p<0.01). At C7, 95.8% of the laminae measured accepted a 4.0-mm screw with a 1.0 mm of clearance, compared with 99.2% of pedicle. Of the laminae measured, 99.2% accepted a 3.5-mm screw with a 1.0 mm clearance, compared with 100% of the pedicle. When the outer cortical and inner cancellous height was compared between pedicle and lamina, the mean lamina outer cortical height at C7 was wider than the pedicle by an average of 9.9 mm (lamina, $18.6{\pm}2.0$ mm; pedicle, $8.7{\pm}1.3$ mm; p<0.01). The ideal screw trajectory at C7 was also measured ($47.8{\pm}4.8^{\circ}$ for ILS and $35.1{\pm}8.1^{\circ}$ for PS). Conclusion : Although pedicle screw fixation is the most ideal instrumentation method for C7 fixation with respect to length and cortical diameter, anatomical aspect of C7 lamina is affordable to place screw. Therefore, the C7 intralaminar screw could be an alternative fixation technique with few anatomic limitations in the cases when C7 pedicle screw fixation is not favorable. However, anatomical variations in the length and width must be considered when placing an intralaminar or pedicle screw at C7.