• Journal of Korean Neurosurgical Society
• /
• v.64 no.5
• /
• pp.784-790
• /
• 2021

Objective : The purpose of this study was to investigate the correlations among various radiological parameters used to determine cervical alignment from cervical spine radiographs (X-CS) and cervical spine computed tomography (CT-CS), both within and between modalities. Methods : This study included 168 patients (≤60 years old) without a definite whole spine deformity who underwent CT-CS and X-CS. We measured occipital slope (O-s), C1 slope, C2 slope, C7 slope, sella turcica - C7 sagittal vertical axis (StC7-SVA), spino-cranial angle, T1 slope, and C27-SVA. We calculated the O-C2 angle, O-C7 angle, and C2-7 angle from the measured parameters and conducted correlation analyses among multiple parameters. Results : The intrinsic correlation features among multiple cervical parameters were very similar for both X-CS and CT-CS. The two SVA parameters (C27-SVA and StC7-SVA) were mainly influenced by the upper cervical slope parameters (r=|0.13-0.74|) rather than the lower slope cervical parameters (r=|0.08-0.13|). The correlation between X-CS and CT-CS for each radiological parameter was statistically significant (r=0.26-0.44) except for O-s (r=0.10) and StC7-SVA (r=0.11). Conclusion : The correlation patterns within X-CS and CT-CS were very similar in this study. The correlation between X-ray and CT was statistically significant for most radiological parameters, and the correlation score increased when the horizontal gaze was consistently maintained. The lower cervical parameters were not statistically associated with translation-related parameters (C2-7 SVA and StC7-SVA). Therefore, the upper cervical segment may be a better predictor for determining head and neck translation.

• Journal of radiological science and technology
• /
• v.45 no.6
• /
• pp.483-489
• /
• 2022

This study proposes a new skull lateral examination, and provides an improved examination environment for patients and radiologists. The study was divided into three groups. One group was divided into the SID (source to image receptor distance) 110 ㎝ and 180 ㎝ in the skull lateral posture, the other group The other group was divided into an position in contact with the detector and an position without contact with the detector, and the other group was divided into male and female groups, considering that the difference in shoulder width between adult males and females would affect the dose and image quality. For dose evaluation, the ESD (entrance surface dose) was measured at the EAM (external auditory meatus), and the conditions were applied equally at 70 ㎸p, 200 ㎃, and 10 ㎃s. For image quality evaluation, SNR (signal to noise ratio) and CNR (contrast to noise ratio) were measured in frontal sinus, EAM, and sella turcica. As a result of ESD comparison, when sid 110 ㎝ to sid 180 ㎝ was changed among the three groups, ESD values decreased the most to 729.18±4.62 μ㏉ and 224.18±0.74 μ㏉ at 180 ㎝ (p<0.01). The values of SNR and CNR were statistically significant (p<0.01), but there was no qualitative difference. This shows that when the SID is 180 ㎝, it is possible to reduce the dose without lowering the image quality. So, It is suggested that the SID 180 ㎝ is used without contacting the detector when examining the skull lateral.

• Radiation Oncology Journal
• /
• v.9 no.2
• /
• pp.185-195
• /
• 1991

Seventy four patients with pituitary adenoma received radiation therapy (RT) on the pituitary area using 6 MV linear accelerator during the past 7 years at the Division of Radiation Therapy, Kangnam St. Mary's Hospital, Catholic University Medical College. Thirty nine were men and 35 were women. The age ranged from 7 to 65 years with the mean being 37 years. Sixty five ($88\%$) patients were treated postoperatively and 9 ($12\%$) primary RT, To evaluate the effects of RT, we analyzed the series of endocrinologic studies with prolactin (PRL), growth hormone (GH), adrenocorticotrophic hormone (ACTH), leuteinizing hormone (LH), follicular stimulating hormone (FSH) and thyroid stimulating hormone (TSH) etc after RT. All but one with Nelson's syndrome showed abnormal neuroradiologic changes in the sella turcica with invasive tumor mass around supra- and/or parasella area. The patients were classified as 23 ($29\%$) prolactinomas and 20 ($26\%$) growth hormone (GH) secreting tumors, and 6 ($8\%$ ACTH secreting ones consisting of 4 Cushing's disease and 2 Nelson's syndrome. Twentynine ($37\%$) had nonfunctioning tumor and four ($5\%$) of those secreting pituitary tumors were mixed PRL-GH secreting tumors. The hormonal level in 15 ($65\%$) of 23 PRL and 3 ($15\%$) of 20 GH secreting tumors returned to normal by 2 to 3 years after RT, but five PRL and five GH secreting tumors showed high hormonal level requiring bromocriptine medication. Endocrinologic insufficiency developed by 3 years after RT in 5 of 7 panhypopituitarisms, 4 of seven hypothyroidisms and one of two hypogonadisms, respectively. Fifteen ($20\%$) patients were lost to follow up after RT.

• Journal of the Korean Society of Radiology
• /
• v.16 no.7
• /
• pp.897-904
• /
• 2022

The purpose of this study is to compare the difference in dose and image quality when applying the diagnostic reference level (DRL) test conditions for head radiography in a digital radiation environment and the test conditions currently applied in clinical practice. I would like to review the conditions of radiographic examination. In this study, the head model phantom was targeted, and the investigation conditions were divided into clinical conditions (Clinic), DRL value (DRL₇₅), and DRL average value (DRL_mean). For dose, Enterance surface dose (ESD) was measured, and for image quality, signal-to-noise ratio and contrast-to-noise ratio were measured and analyzed for comparison. The average values of skull anterior posterior(AP) ESD according to the changes in test conditions were Clinic 1214.03±4.21 µGy, DRL₇₅ 3017.83±8.14 µGy, DRL_mean 2283.50±7.09 µGy, and skull lateral (Lat). The average value of ESD was statistically significant with Clinic 762.79±3.54 µGy, DRL₇₅ 2168.57±10.83 µGy, and DRL_mean 1654.43±6.48 µGy (p<0.01). The average values of SNR and CNR measured in the orbital, maxillary sinus, frontal sinus, and sella turcica were statistically significant (p<0.01). As a result of this study, compared to DRL, the conditions used in clinical practice showed lower dose levels of about 58% for AP and about 70% for Lat., and there was no qualitative difference in terms of image quality. Through this study, it is necessary to consider a new diagnostic reference level suitable for the digital radiation environment, and it is considered that the dose should be reduced accordingly.