• Korean Journal of Radiology
• /
• v.23 no.7
• /
• pp.720-731
• /
• 2022

Objective: We aimed to develop and test a deep learning algorithm (DLA) for fully automated measurement of the volume and signal intensity (SI) of the liver and spleen using gadoxetic acid-enhanced hepatobiliary phase (HBP)-magnetic resonance imaging (MRI) and to evaluate the clinical utility of DLA-assisted assessment of functional liver capacity. Materials and Methods: The DLA was developed using HBP-MRI data from 1014 patients. Using an independent test dataset (110 internal and 90 external MRI data), the segmentation performance of the DLA was measured using the Dice similarity score (DSS), and the agreement between the DLA and the ground truth for the volume and SI measurements was assessed with a Bland-Altman 95% limit of agreement (LOA). In 276 separate patients (male:female, 191:85; mean age ± standard deviation, 40 ± 15 years) who underwent hepatic resection, we evaluated the correlations between various DLA-based MRI indices, including liver volume normalized by body surface area (LV_BSA), liver-to-spleen SI ratio (LSSR), MRI parameter-adjusted LSSR (aLSSR), LSSR × LV_BSA, and aLSSR × LV_BSA, and the indocyanine green retention rate at 15 minutes (ICG-R15), and determined the diagnostic performance of the DLA-based MRI indices to detect ICG-R15 ≥ 20%. Results: In the test dataset, the mean DSS was 0.977 for liver segmentation and 0.946 for spleen segmentation. The Bland-Altman 95% LOAs were 0.08% ± 3.70% for the liver volume, 0.20% ± 7.89% for the spleen volume, -0.02% ± 1.28% for the liver SI, and -0.01% ± 1.70% for the spleen SI. Among DLA-based MRI indices, aLSSR × LV_BSA showed the strongest correlation with ICG-R15 (r = -0.54, p < 0.001), with area under receiver operating characteristic curve of 0.932 (95% confidence interval, 0.895-0.959) to diagnose ICG-R15 ≥ 20%. Conclusion: Our DLA can accurately measure the volume and SI of the liver and spleen and may be useful for assessing functional liver capacity using gadoxetic acid-enhanced HBP-MRI.

• Korean Journal of Radiology
• /
• v.1 no.1
• /
• pp.25-32
• /
• 2000

Objective: The purpose of our study was to determine the ability of H-1 MR spectroscopy (MRS) to lateralize the lesion in patients with hippocampal sclerosis. Materials and Methods: Twenty healthy volunteers and 25 patients with intractable temporal lobe epilepsy whose MR imaging diagnosis was unilateral hippocampal sclerosis were included. This diagnosis was based on the presence of unilateral atrophy and/or high T2 signal intensity of the hippocampus. Single-voxel H-1 MRS was carried out on a 1.5-T unit using PRESS sequence (TE, 136 msec). Spectra were obtained from hippocampal areas bilaterally with volumes of interest (VOIs) of 6.0 cm³ and 2.25 cm³ in healthy volunteers, and of either 6.0 cm³ (n = 14) or 2.25 cm³ (n = 11) in patients. Metabolite ratios of NAA/Cho and NAA/Cr were calculated from relative peak height measurements. The capability of MRS to lateralize the lesion and to detect bilateral abnormalities was compared with MR imaging diagnosis as a standard of reference. Results: In healthy volunteers, NAA/Cho and NAA/Cr ratios were greater than 0.8 and 1.0, respectively. In patients, the mean values of these ratios were significantly lower on the lesion side than on the contralateral side, and lower than those of healthy volunteers (p < .05). The overall correct lateralization rate of MRS was 72% (18/25); this rate was lower with a VOI of 6.0 cm³ than of 2.25 cm³ (64% versus 82%, p < .05). Bilateral abnormalities on MRS were found in 24% (6/25) of cases. Conclusion: Although its rate of correct lateralization is low, single-voxel H-1 MRS is a useful and promising diagnostic tool in the evaluation of hippocampal sclerosis, particularly for the detection of bilateral abnormalities. To improve the diagnostic accuracy of H-1 MRS, further investigation, including the use of a smaller VOI and measurement of the absolute amount of metabolites, are needed.

• The Journal of Korean Society for Radiation Therapy
• /
• v.26 no.2
• /
• pp.297-303
• /
• 2014

Purpose : The purpose of this study is reproducibility evaluation of deep inspiration breath-hold(DIBH) technique by respiration data and heart position analysis in radiation therapy for Left Breast cancer patients. Materials and Methods : Free breathing(FB) Computed Tomography(CT) images and DIBH CT images of three left breast cancer patients were used to evaluate the heart volume and dose during treatment planing system( Eclipse version 10.0, Varian, USA ). The signal of RPM (Real-time Position Management) Respiratory Gating System (version 1.7.5, Varian, USA) was used to evaluate respiration stability of DIBH during breast radiation therapy. The images for measurement of heart position were acquired by the Electronic portal imaging device(EPID) cine acquisition mode. The distance of heart at the three measuring points(A, B, C) on each image was measured by Offline Review (ARIA 10, Varian, USA). Results : Significant differences were found between the FB and DIBH plans for mean heart dose (6.82 vs. 1.91 Gy), heart $V_{30}$ (68.57 vs. $8.26cm^3$), $V_{20}$ (76.43 vs. $11.34cm^3$). The standard deviation of DIBH signal of each patient was ${\pm}0.07cm$, ${\pm}0.04cm$, ${\pm}0.13cm$, respectively. The Maximum and Minimum heart distance on EPID images were measured as 0.32 cm and 0.00 cm. Conclusion : Consequently, using the DIBH technique with radiation therapy for left breast cancer patients is very useful to establish the treatment plan and to reduce the heart dose. In addition, it is beneficial to using the Cine acquisition mode of EPID for the reproducibility evaluation of DIBH.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.10 no.5
• /
• pp.1082-1090
• /
• 2009

Peak expiratory flow rate(PEF) is a very important diagnostic parameter obtained from the forced vital capacity(FVC) test. The expiratory flow rate increases during the short initial time period and may cause measurement error in PEF particularly due to non-ideal dynamic characteristic of the transducer. The present study evaluated the initial rise slope($S_r$) on the flow rate signal to compensate the transducer output data. The 26 standard signals recommended by the American Thoracic Society(ATS) were generated and flown through the velocity-type respiratory air flow transducer with simultaneously acquiring the transducer output signal. Most PEF and the corresponding output($N_{PEF}$) were well fitted into a quadratic equation with a high enough correlation coefficient of 0.9997. But only two(ATS#2 and 26) signals resulted significant deviation of $N_{PEF}$ with relative errors>10%. The relationship between the relative error in $N_{PEF}$ and $S_r$ was found to be linear, based on which $N_{PEF}$ data were compensated. As a result, the 99% confidence interval of PEF error was turned out to be approximately 2.5%, which was less than a quarter of the upper limit of 10% recommended by ATS. Therefore, the present compensation technique was proved to be very accurate, complying the international standards of ATS, which would be useful to calibrate respiratory air flow transducers.

• Journal of IKEEE
• /
• v.23 no.4
• /
• pp.1461-1464
• /
• 2019

In this paper, we propose the development of embedded board for integrated radiation exposure protection fireman's life-saving alarm capable of location tracking and radiation measurement. The proposed techniques consist of signal processing unit, communication unit, power unit, main control unit. Signal processing units apply shielding design, noise reduction technology and electromagnetic wave subtraction technology. The communication unit is designed to communicate using the wifi method. In the main control unit, power consumption is reduced to a minimum, and a high performance system is formed through small, high density and low heat generation. The proposed techniques are equipment operated by exposure to poor conditions, such as disaster and fire sites, so they are designed and manufactured for external appearance considering waterproof and thermal endurance. The proposed techniques were tested by an authorized testing agency to determine the effectiveness of embedded board. The waterproof grade has achieved the IP67 rating, which can maintain stable performance even when flooded with water at the disaster site due to the nature of the fireman's equipment. The operating temperature was measured in the range of -10℃ to 50℃ to cope with a wide range of environmental changes at the disaster site. The battery life was measured to be available 144 hours after a single charge to cope with emergency disasters such as a collapse accident. The maximum communication distance, including the PCB, was measured to operate at 54.2 meters, a range wider than the existing 50 meters, at a straight line with the command-and-control vehicle in the event of a disaster. Therefore, the effectiveness of embedded board for embedded board for integrated radiation exposure protection fireman's life-saving alarm has been demonstrated.

• Investigative Magnetic Resonance Imaging
• /
• v.12 no.2
• /
• pp.100-106
• /
• 2008

The purpose of this study was to confirm the exactitude of in vitro nuclear magnetic resonance spectroscopy(NMRS) and to complement the defect of in vivo NMRS. It has been difficult to understand the metabolism of a cerebellum using in vivo NMRS owing to the generated inhomogeneity of magnetic fields (B0 and B1 field) by the complexity of the cerebellum structure. Thus, this study tried to more exactly analyze the metabolism of a canine cerebellum using the cell extraction and high resolution NMRS. In order to conduct the absolute metabolic quantification in a canine cerebellum, the spectrum of our phantom included in various brain metabolites (i.e., NAA, Cr, Cho, Ins, Lac, GABA, Glu, Gln, Tau and Ala) was obtained. The canine cerebellum tissue was extracted using the methanol-chloroform water extraction (M/C extraction) and one group was filtered and the other group was not under extract processing. Finally, NMRS of a phantom solution and two extract solution (90% D2O) was progressed using a 500MHz (11.4 T) NMR machine. Filtering a solution of the tissue extract increased the signal to noise ratio (SNR). The metabolic concentrations of a canine cerebellum were more close to rat’s metabolic concentration than human’s metabolic concentration. The present study demonstrates the absolute quantification technique in vitro high resolution NMRS with tissue extraction as the method to accurately measure metabolite concentration.

• Journal of the Korean Society of Radiology
• /
• v.5 no.3
• /
• pp.143-148
• /
• 2011

The purpose of this study was to examine the usefulness of SPIO contrast agent in Magnetic Resonance Cholangiopancreatography (MRCP) by performing a quantitative comparative analysis in patients undergoing MRCP for gallbladder stones with and without oral injection of SPIO (Superparamagnetic iron oxide) contrast agent. The subjects were 36 patients undergoing MRCP for suspected gallbladder stones between January 2009 and February 2010 and they were divided into halves to compare the two groups of with and without SPIO agent. For each subject in both the injected and non-injected group, T2-weighted images on a 1.5T MR scanner were obtained, using both the breath-holding and respiratory-triggered methods, respectively. The following regions were measured; for breath-hold T2-weighted images, the measurement regions were located at the central part of the gallbladder, and the areas 15 mm away from its center, toward the front and back, respectively, which were chosen to include surrounding tissues, while for respiratory-triggered T2-weighted images, at the central part of the gallbladder, and segment 5 and 6 of liver. In a quantitative analysis, average signal to noise ratio (SNR) in each of regions of interest (ROI) for each group were calculated and then average contrast to noise ratio (CNR) in each of ROI were obtained by using the SNR in the gallbladder as the basis to compare and analyze the values between the two groups. The CNR were higher for the injected group in those regions.

• The Korean Journal of Nuclear Medicine
• /
• v.31 no.3
• /
• pp.330-338
• /
• 1997

This study investigated the method to adjust acquisition time(a) and injection dose (i) to make the best basal and subtraction images in consecutive SPECT. Image quality was assumed to be mainly affected by signal to noise ratio(S/N). Basal image was subtracted from the second image consecutively acquired at the same position. We calculated S/N ratio in basal SPECT images($S_1/N_1$) and subtraction SPECT images(Ss/Ns) to find a(time) and i(dose) to maximize S/N of both images at the same time. From phantom images, we drew the relation of image counts and a(time) and i(dose) in our system using fanbeam-high-resolution collimated triple head SPECT. Noise by imaging process depended on Poisson distribution. We took maximum tolerable duration of consecutive acquisition as 30 minutes and maximum injectible dose as 1,850MBq(50 mCi)(sum of two injections) per study. Counts of second-acquired image($S_2$), counts($S_s$) and noise($N_s$) of subtraction SPECT were as follows. $C_1$ was the coefficient of measurement with our system. $$S_2=S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{30-a}{a})+C_1{\cdot}(30-a){\cdot}{\epsilon}{\cdot}(50-i)$$ $$Ss=S_2-\{S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{(30-a)}{a})\}$$ $$Ns={\sqrt{N_2^2+N_1^2{\cdot}\frac{(30-a)^2}{a^2}}={\sqrt{S_2+S_1{\cdot}\frac{(30-a)^2}{a^2}}$$ In case of rest/acetazolamide study, effect(${\epsilon}$) of acetazolamide to increase global brain uptake of Tc-99m-HMPAO could be 1.5 or less. Varying ${\epsilon}$ from 1 to 1.5, a(time) and i(dose) pair to maximize both $S_1/N_l$ and Ss/Ns was determined. 15 mCi/17 min and 35mCi/13min was the best a(time) and i(dose) pair for rest/acetazolamide study(when ${\epsilon}$ were 1.2) and came to be used for our clinical routine after this study. We developed simple method to maximize S/N ratios of basal and subtraction SPECT from consecutive acquisition. This method could be applied to ECD/HMPAO and brain activation studies as well as rest/acetazolamide studies.

• Journal of Biomedical Engineering Research
• /
• v.25 no.5
• /
• pp.421-430
• /
• 2004

Clinically, it is almost impossible for a physician to distinguish subtle changes of frequency spectrum by using a stethoscope alone especially in the early stage of thrombus formation. Considering that reliability of mechanical valve is paramount because the failure might end up with patient death, early detection of valve thrombus using noninvasive technique is important. Thus the study was designed to provide a tool for early noninvasive detection of valve thrombus by observing shift of frequency spectrum of acoustic signals with computer aid diagnosis system. A thrombus model was constructed on commercialized mechanical valves using polyurethane or silicon. Polyurethane coating was made on the valve surface, and silicon coating on the sewing ring of the valve. To simulate pannus formation, which is fibrous tissue overgrowth obstructing the valve orifice, the degree of silicone coating on the sewing ring varied from 20％, 40％, 60％ of orifice obstruction. In experiment system, acoustic signals from the valve were measured using microphone and amplifier. The microphone was attached to a coupler to remove environmental noise. Acoustic signals were sampled by an AID converter, frequency spectrum was obtained by the algorithm of spectral analysis. To quantitatively distinguish the frequency peak of the normal valve from that of the thrombosed valves, analysis using a neural network was employed. A return map was applied to evaluate continuous monitoring of valve motion cycle. The in-vivo data also obtained from animals with mechanical valves in circulatory devices as well as patients with mechanical valve replacement for 1 year or longer before. Each spectrum wave showed a primary and secondary peak. The secondary peak showed changes according to the thrombus model. In the mock as well as the animal study, both spectral analysis and 3-layer neural network could differentiate the normal valves from thrombosed valves. In the human study, one of 10 patients showed shift of frequency spectrum, however the presence of valve thrombus was yet to be determined. Conclusively, acoustic signal measurement can be of suggestive as a noninvasive diagnostic tool in early detection of mechanical valve thrombosis.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.2
• /
• pp.210-220
• /
• 1996

Background : Neutrophils or monocytes separated in vitro by the adherence to plastic surface are known to be activated by surface adherence itself and subsequent experimental data might be altered by surface adherence. In the process of surface adherence, adhesion molecules have a clear role in intracellular signal pathway of cellular activation. Human alveolar macrophages(HAM) are frequently purified by the adherence procedure after bronchoalveolar lavage. But the experimental data of many reports about alveolar macrophages have ignored the possibility of adhesion-induced cellular activation. Method : Bronchoalveolar lavage was performed in the person whose lung of either side was confirmed to be normal by chest CT. With the measurement of hydrogen peroxide release from adherent HAM to plastic surface and non-adherent HAM with or without additional stimulation of phorbol myristate acetate(PMA) or N-formyl-methionyl-leucyl-phenylalanine (fMLP), we observed the effect of the adherence to plastic surface. We also evaluated the effect of various biological surfaces on adhesion-induced activation of HAM. Then, to define the intracellular pathway of signal transduction, pretreatment with cycloheximide, pertussis toxin and anti-CD11/CD18 monoclonal antibody was done and we measured hydrogen peroxide in the culture supernatant of HAM. Results : 1) The adherence itself to plastic surface directly stimulated hydrogen peroxide release from human alveolar macrophages and chemical stimuli such as phorbol myristate acetate(PMA) or N-formyl-methionyl-leucyl-phenylalanine(fMLP) colud not increase hydrogen peroxide release in these adherent macrophages which is already activated. 2) PMA activated human alveolar macrophages irrespective of the state of adhesion. However, fMLP stimulated the release of hydrogen peroxide from the adherent macrophages, but not from the non-adherent macrophages. 3) HAM adherent to A549 cell(type II alveolar epithelium-like human cell line) monolayer released more hydrogen peroxide in response to both PMA and fMLP. This adherence-dependent effect of fMLP was blocked by pretreatment of macrophages with cycloheximide, pertussis toxin and anti-CD18 monoclonal antibody, Conclusion : These results suggest that the stimulatory effect of PMA and fMLP can not be found in adherent macrophage because of the activation of human alveolar macrophage by the adherence to plastic surface and the cells adhered to biologic surface such as alveolar epithelial cells are appropriately responsive to these stimuli. It is also likely that the effect of fMLP on the adherent macrophage requires new protein synthesis via G protein pathway and is dependent on the adhesion between alveolar macrophages and alveolar epithelial cells by virtue of CD11/CD18 adhesion molecules.