• Title/Summary/Keyword: standard of diagnosis

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Correction of Artifacts due to Patient Arm Motion in PET/CT: Scatter-Limit Correction (PET/CT 검사에서 움직임에 의한 인공물의 산란제한보정법 적용 영상 평가)

  • Bahn, Young Kag;Lee, Seung Jae;Kim, Jung Yul;Oh, Sin Hyun;Nam-Koong, Hyuk;Park, Hoon-Hee;Kang, Chun Koo;Lim, Han Sang;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.44-48
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    • 2012
  • Purpose : Arm motion can give rise to striking cold artifact on PET/CT. We investigated that evaluation of scatter-limit correction and correct the patient arm motion artifact in Discovery 600 PET/CT. Materials and Methods : To evaluate a radioactivity uptake (Bq/ml) and a standard uptake value (SUV), the scatter limit correction and scatter correction were compared using 1994 NEMA Phantom$^{TM}$ in Discovery 600 PET/CT (GE Healthcare, Mi, We). Arm motion phantom study was involved a central 20 cm diameter cylinder simulating the neck and 2 peripheral 10 cm diameter cylinders simulating arms. The positions of the arms were altered so as to introduce different amounts of misalignment. The evaluation of arm motion phantom study used the radioactivity uptake and SUV in scatter correction and scatter limit correction. Results : The statistical significance of radioactivity uptake and SUV did not show the differences in comparisons of the scatter limit correction and the scatter correction that not show (p<0.05). Radioactivity uptake of the scatter correction was up to 3.1 kBq/ml in the 0.04 kBq/ml. It was approximately 98.7% undervalued in the arm motion phantom study. However, Radioactivity uptake of the scatter limit correction was up to 3.0 kBq/ml in the 2.11 kBq/ml. It was approximately 30% undervalued in arm motion phantom study. SUV of the scatter correction was 1.05 to 0.006 and underestimated about 98%. However, an applying SUV of the scatter limit correction changed the value as 0.67 which is underestimated about 25%. Radioactivity uptake and SUV of the scatter limit correction was increased approximately 60%, or more than the scatter correction. Conclusion : It is considered that if the patient arm motion artifact was occurred the scatter limit correction will be applicable to give an accurate diagnosis.

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Reproducibility of Regional Pulse Wave Velocity in Healthy Subjects

  • Im Jae-Joong;Lee, Nak-Bum;Rhee Moo-Yong;Na Sang-Hun;Kim, Young-Kwon;Lee, Myoung-Mook;Cockcroft John R.
    • International Journal of Vascular Biomedical Engineering
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    • v.4 no.2
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    • pp.19-24
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    • 2006
  • Background: Pulse wave velocity (PWV), which is inversely related to the distensibility of an arterial wall, offers a simple and potentially useful approach for an evaluation of cardiovascular diseases. In spite of the clinical importance and widespread use of PWV, there exist no standard either for pulse sensors or for system requirements for accurate pulse wave measurement. Objective of this study was to assess the reproducibility of PWV values using a newly developed PWV measurement system in healthy subjects prior to a large-scale clinical study. Methods: System used for the study was the PP-1000 (Hanbyul Meditech Co., Korea), which provides regional PWV values based on the measurements of electrocardiography (ECG), phonocardiography (PCG), and pulse waves from four different sites of arteries (carotid, femoral, radial, and dorsalis pedis) simultaneously. Seventeen healthy male subjects with a mean age of 33 years (ranges 22 to 52 years) without any cardiovascular disease were participated for the experiment. Two observers (observer A and B) performed two consecutive measurements from the same subject in a random order. For an evaluation of system reproducibility, two analyses (within-observer and between-observer) were performed, and expressed in terms of mean difference ${\pm}2SD$, as described by Bland and Altman plots. Results: Mean and SD of PWVs for aorta, arm, and leg were $7.07{\pm}1.48m/sec,\;8.43{\pm}1.14m/sec,\;and\;8.09{\pm}0.98m/sec$ measured from observer A and $6.76{\pm}1.00m/sec,\;7.97{\pm}0.80m/sec,\;and\;\7.97{\pm}0.72m/sec$ from observer B, respectively. Between-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.14{\pm\}0.62m/sec,\;0.18{\pm\}0.84m/sec,\;and\;0.07{\pm}0.86m/sec$, and the correlation coefficients were high especially 0.93 for aortic PWV. Within-observer differences ($mean{\pm}2SD$) for aorta, arm, and leg were $0.01{\pm}0.26m/sec,\;0.02{\pm}0.26m/sec,\;and\;0.08{\pm}0.32m/sec$ from observer A and $0.01{\pm}0.24m/sec,\;0.04{\pm}0.28m/sec,\;and\;0.01{\pm}0.20m/sec$ from observer B, respectively. All the measurements showed significantly high correlation coefficients ranges from 0.94 to 0.99. Conclusion: PWV measurement system used for the study offers comfortable and simple operation and provides accurate analysis results with high reproducibility. Since the reproducibility of the measurement is critical for the diagnosis in clinical use, it is necessary to provide an accurate algorithm for the detection of additional features such as flow wave, reflection wave, and dicrotic notch from a pulse waveform. This study will be extended for the comparison of PWV values from patients with various vascular risks for clinical application. Data acquired from the study could be used for the determination of the appropriate sample size for further studies relating various types of arteriosclerosis-related vascular disease.

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A new diagnostic method for diabetic neuropathy using $TcpO_2$ ($TcpO_2$ 이용한 당뇨병성 신경병증 환자의 조기진단)

  • Hong, Hyun-Ki;Kim, Sung-Woo;Nam, Ki-Chang;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.3
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    • pp.1-8
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    • 2007
  • PDiabetic neuropathy is one of the most common diabetes related complications including diabetic nephropathy and retinopahty. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum current of 100mA to nerves causing stress and pain to patients. In this study, as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2$, $TcpCO_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group(p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance(p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient groups showed statistical significance(p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471(p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If the suggested $TcpO_2$ method is used periodically, prevention and early diagnosis of diabetic neuropathy would be possible.

Condylar and Ramal Vertical Asymmetry of Temporomandibular Disorders in Panoramic (파노라마 방사선사진을 이용한 측두하악관절장애 환자의 하악과두와 하악지 비대칭에 관한 연구)

  • Jong, Ji-Woong;Kim, Byung-Gook;Kim, Jae-Hyung
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.239-246
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    • 2005
  • The purpose of this study was to examine the difference of condylar and ramal vertical asymmetric indices on paonramic radiographs between temporomandibular disorder patients and normal group and according to classification of temporomandibular disorders. One hundred and twenty temporomandibular disorder patients and thirty normal individuals were selected. After tracing the panoramic radiographs, measurements for asymmetric indices were identified. The means and standard deviations of the measurement of each group were calculated and compared between two groups. Through the comparison of the measurement between two groups, following results were obtained 1. As a result of comparing condylar and ramal vertical asymmetry indices of the temporomandibular disorder patients with that of normal group, there was significant difference in condylar vertical asymmetry index between two groups and no significant difference in ramal vertical asymmetry index between two groups. 2. Condylar and ramal vertical asymmetry indices of temporomandibular joint disorder and muscle disorder patients showed greater value than normal group, but there was no significant difference between temporomandibular joint disorder patients and muscle disorder patients. 3. Among temporomandibular joint disorder patients, muscle disorder patients, and normal group, there was only significant difference in condylar vertical asymmetry index between temporomandibular joint disorder patients and normal group. 4. Among disc displacement, disc dislocation with reduction, and disc dislocation without reduction, there were no significant difference in condylar and ramal vertical asymmetry indices. 5. There were no correlation between aging and condylar and ramal vertical asymmetry indices. The results of the present study showed that condylar vertical asymmetry index of temporomandibular disorder patients showed greater values than normal group, and this difference could be considered as the features of temporomandibular disorders. Thus measuring the condylar vertical asymmetry index on panoramic radiographs is considered as the important factor for diagnosis and treatment of temporomandibular disorders.

Can the C-14 Urea Breath Test Reflect the Extent and Degree of Ongoing Helicobacter pylori Infection? (C-14 요소호기검사의 정량치가 Helicobacter pylori 감염 정도를 반영할 수 있을까?)

  • Lim, Seok-Tae;Sohn, Myung-Hee;Lee, Seung-Ok;Lee, Soo-Teik;Jeong, Myoung-Ja
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.61-68
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    • 2001
  • Purpose: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). Materials and methods: One hundred fifty patients (M:F=83:67, age $48.6{\pm}11.2$ yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive (${\geq}200dpm$), Intermediate ($50{\sim}199dpm$) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. Results: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were $45{\pm}27$ dpm in grade 0, $707{\pm}584dpm$ in grade 1, $1558{\pm}584dpm$ in grade 2, $1851{\pm}604dpm$ in grade 3, and $2719{\pm}892dpm$ in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. Conclusion: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.

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Measurement of Specific Radioactivity for Clearance of Waste Contaminated with Re-186 for Medical Application (의료용 Re-186 오염폐기물의 규제해제를 위한 방사능측정)

  • Kim, Chang-Bum;Lee, Sang-Kyung;Jang, Seong-Joo;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.40 no.4
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    • pp.633-638
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    • 2017
  • The amount of radioactive waste has been rapidly increased with development of radiation treatment in medical field. Recently, it has been a common practice to use I-131 for thyroid cancer, F-18 for PET/CT and Tc-99m for diagnosis of nuclear medicine. All the wastes concerned have been disposed of by means of the self-disposal method, for example incineration, after storage enough to decay less than clearance level. IAEA proposed criteria for clearance level of waste which depends on the individual ($10{\mu}Sv/y$) and collective dose (1 man-Sv/y), and concentration of each nuclide (IAEA Safety Series No 111-P-1.1, 1992 and IAEA RS-G-1.7, 2004). In this study, specific radioactivity of radioactive waste contaminated with Re-186 was measured to confirm whether it meets the clearance level. Re-186 has long half life of 3.8 days relatively and emits beta and gamma radiation, therefore it can be applied in treatment and imaging purposes. The specific radioactivity of contaminated gloves weared by radiation workers was measured by MCA(Multi-channel Analyzer) which was calibrated by reference materials in accordance with the measuring procedure. As a result, comparison evaluation of decay storage period between the half-life which was calculated by attenuation curve based on real measurement and physical half-life was considered, and it is showed that the physical half-life is longer than induced half-life. Therefore, the storage period of radioactive waste for self-disposal may be curtailed in case of application of induced half-life. The result of this study will be proposed as ISO standard.

CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

Analysis of anthropometric data for premature infants of 26 to 35 weeks of gestation; comparison with the data of 1960's (재태연령 26주 이상 35주 이하 미숙아의 신체계측치의 분석; 1960년대 측정치와의 비교)

  • Aum, Ji A;Jung, Hee Jin;Huh, Jae Won;Son, Sang Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.543-548
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    • 2007
  • Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.

Correlation between 5-Minute $^{99m}Tc-Pertechnetate$ Uptake and 24-Hour $^{131}I$ Uptake in Patients with Thyroid Disease (갑상선환자에서의 5분 $^{99m}Tc-Pertechnetate$ 섭취율과 방사성옥소섭취율의 상관관계)

  • Lee, Chan-Woo;Won, Kyu-Chang;Yoon, Hyun-Dae;Cho, In-Ho;Kim, Tae-Nyeun;Shin, Dong-Gu;Lee, Hyoung-Woo;Shim, Bong-Sup;Lee, Hyun-Woo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.280-289
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    • 1992
  • The 20-minute $^{99m}Tc-pertechnetate$ uptake became readily available for routine use and it replaced $^{131}I$ for thyroid imaging. However measuring thyroid uptake during a 5-minute minimizes pertechnetate uptake by the salivary glands and presence of contaminated saliva from those glands in to the pharynx and esophagus. A study was carried out to determine the suitability of the utility of a S-minute and 20-minute interval from administration of $^{99m}Tc-pertechnetate$ to imaging and uptake measurement as a replacement for the 24 hour standard originally established with $^{131}I$, and to evaluate the relationship between 5-minute $^{99m}Tc-pertechnetate$ uptake and other thyroid functions. A 5-minute and 20-minute uptake of $^{99m}Tc-pertechnetate$ were measured in 70 patients with thyroid disease at Yeungnam University Hospital from March 1, 1991 to Feb. 29, 1992. The results were as follows. 1) The 5-minute $^{99m}Tc-pertechnetate$ uptake in Graves' disease, Hashimoto's thyroiditis, simple goiter, non toxic nodular goiter, subacute thyroiditis and euthyroid were 18.2%, 14.6%, 2.8%, 3.2%, 1.2% and 1.1%, respectively. There was a significant difference between the mean of the euthyroid group and the mean of the Graves' disease. So differenciation between them can be easily made. 2) The 5 minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24 hour $^{131}I$ thyroid uptake (r=0.75, p<0.001). These data provided an equation for estimating the 24 hour uptake of iodide given the 5 minute pertechnetate uptake: Estimated 24-hour $^{131}I$ thyroid Uptake= 7.188*ln (5 minute $^{99m}Tc-pertechnetate$ uptake)+16.94 3) The 20-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with 24-hour $^{131}I$ uptake (r=0.72, p<0.001) and 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake (r=0.96, p<0.001). 4) In the Graves' disease, The 5-minute $^{99m}Tc-pertechnetate$ thyroid uptake was well correlated with serum $T_3-resin$ uptake (r=0.46, p<0.01), serum total $T_3$ (r=0.55, p<0.05), serum total $T_4$ (r=0.46, p<0.05). These results suggest that 5-minute ${99m}Tc-pertechnetate$ thyroid uptake has been found at least as useful as 24-hour $^{131}I$ uptake for diagnostic confirmation at our hospital, the logistical advantages of completing the diagnosis. The exam in 5-minutes led us to abandon the 24-hour study in the majority of patients, but the 24-hour $^{131}I$ uptake is still obtained in patients with planned or potential radioiodine therapy.

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Performance Measurement of Diagnostic X Ray System (진단용 X선 발생장치의 성능 측정)

  • You, Ingyu;Lim, Cheonghwan;Lee, Sangho;Lee, Mankoo
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.447-454
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    • 2012
  • To examine the performance of a diagnostic X-ray system, we tested a linearity, reproducibility, and Half Value Layer(HVL). The linearity was examined 4 times of irradiation with a given condition, and we recorded a level of radiation. We then calculated the mR/mAs. And the measured value should not be more than 0.1. If the measured value was more than 0.1, we could know that the linearity was decreased. The reproducibility was analyzed 10 times of irradiations at 80kVp, 200mA, 20mAs and 120kVp, 300mA, 8mAs. The values from these analyses were integrated into CV equation, and we could get outputs. The reproducibility was good if the output was lower than 0.05. HVL was measured 3 times of irradiation without a filter, and we inserted additional HLV filters with 0, 1, 2, 4 mm of thickness. We tested the values until we get the measured value less than a half of the value measured without additional filter. We tested the linearity, the reproducibility, and HVL of 5 diagnostic X-ray generators in this facilities. The linearity of No. 1 and No. 5 generator didn't satisfy the standard for radiation safety around 300mA~400mA and 100mA~200mA, respectively. HVL of No.1 generator was not satisfied at 80kVp. The outputs were higher in the three-phase equipment than the single-phase equipment. The old generators need to maintain and exchange of components based on the these results. Then, we could contribute to getting more exact diagnosis increasing a quality of the image and decreasing an expose dose of radiation.