• 대한방사선기술학회지:방사선기술과학
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• 제46권5호
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• pp.401-408
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• 2023

Thyroid uptake measurements can be subject to measurement errors due to the scoping and positioning of the thyroid gland. To compensate for these limitations, the clinical utility of the thyroid simultaneous counting method as an alternative to thyroid uptake measurement was analyzed and evaluated experimentally through quantitative analysis of images acquired after thyroid scanning. Experimental data were obtained using a Gamma camera (GE infinia), a thyroid uptake system (KOROID 1), and a thyroid neck phantom. Based on the thyroid uptake rate of 1-5% according to the protocol of thyroid scan test (^99mTcO₄ - , 370 MBq) in normal results, ^99mTcO₄ - was set in the range of 3.7-18.5 MBq (Matrix: 256×256, Scan time: 1 min, collimator: pin hole, phantom-collimator distances: 7 cm). The acquired images were corrected for the attenuation of isotopes due to the set-up time and half-life by applying the Auto Region of interest (ROI) drawing system, and the significance of the experimental results was evaluated by Multiple linear regression analysis (SPSS, ver. 22, IBM). The thyroid uptake rate showed a significant correlation between the dose and the measured counts when using the thyroid uptake system equipment. Meanwhile, the quantitative analysis counts of phantom images using Gamma camera also showed a significant correlation. Thus confirmed that the correlation between these two experiments was statistically significant (P<0.05). The simultaneous counting protocol, which indirectly measures thyroid uptake from thyroid scans, is likely to be clinically relevant if complemented by additional studies with different variables in patients with thyroid disease.

• Journal of Yeungnam Medical Science
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• 제40권1호
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• pp.12-22
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• 2023

Graves disease (GD) is the most common cause of hyperthyroidism, accounting for more than 90% of cases in Korea. Patients with GD are treated with any of the following: antithyroid drugs (ATDs), radioactive iodine (RAI) therapy, or thyroidectomy. Most patients begin treatment with ATDs, and clinical guidelines suggest that the appropriate treatment period is 12 to 18 months. While RAI treatment and surgery manage thyrotoxicosis by destroying or removing thyroid tissue, ATDs control thyrotoxicosis by inhibiting thyroid hormone synthesis and preserving the thyroid gland. Although ATDs efficiently control thyrotoxicosis symptoms, they do not correct the main etiology of GD; therefore, frequent relapses can follow. Recently, a large amount of data has been collected on long-term ATDs for GD, and low-dose methimazole (MMZ) is expected to be a good option for remission. For the long-term management of recurrent GD, it is important to induce remission by evaluating the patient's drug response, stopping ATDs at an appropriate time, and actively switching to surgery or RAI therapy, if indicated. Continuing drug treatment for an extended time is now encouraged in patients with a high possibility of remission with low-dose MMZ. It is also important to pay attention to the quality of life of the patients. This review aimed to summarize the appropriate treatment methods and timing of treatment transition in patients who relapsed several times while receiving treatment for GD.

• Radiation Oncology Journal
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• 제12권1호
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• pp.59-66
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• 1994

1986년 9월부터 1992년 10월까지 경북대학교병원 치료방사선과에서 방사선치료 단독요법이나 수술 흑은 화학요법과의 병합요법으로 치료받은 두경부종양 환자 75명을 대상으로 경부 방사선조사가 갑상선기능에 미치는 영향을 평가하기 위하여 전향적 조사를 실시하였다. 모든 환자는 방사선치료전 및 방사선치료후에 정기적으로 임상검사 및 갑상선 기능검사를 시행하였다. 갑상선조사선량은 35Gy에서 60Gy였고 그 중앙값은 50Gy였으며 추적관찰기간은 11개월에서 85개월로 중앙추적기간은 30개월 이었다. 결과를 보면 갑상선 기능이상의 빈도는 40$ \% $(30명)이었다. 45명(60$ \% $)은 갑상선 기능이 정상이었으며 2명(3$ \% $)은 임상적 갑상선 기능저하증 이었고 27명(36$ \% $)은 준임상적 갑상선 기능저하증 이었다. 갑상선 기능항진증이 1명(1$ \% $)에서 발견되었으며 갑상선 결절이나 악성종양은 발견되지 알았다. 수술 및 방사선치료군에서 갑상선 기능이상이 다른 치료군에서보다 일찍 발생하였다(p=0.0013). 다변량분석에 따르면 방사선치료후 갑상선 기능이상의 발생빈도에 영향을 주는 위험인자는 여성(p=0.0293) 및 전후두절제술과 방사선치료의 병합요법(p=0.0045)였다. 결론적으로 방사선치료후 정확한 시기에 갑상선 기능이상을 발견하기 위하여 방사선 치료전 및 방사선 치료후에 정기적인 갑상선 기능검사가 필요하며 갑상선 기능이상이 발견되면 즉시 갑상선 호르몬제재 치료를 하여야 하겠다.

• 치과방사선
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• 제20권1호
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• pp.103-112
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• 1990

The purpose of this study was to estimate absorbed dose of each important anatomic site of phantom (RT-2l0 Head & Neck Section/sup R/, Humanoid Systems Co., U.S.A.) head in occlusal radiography. X-radiation dosimetry at 12 anatomic sites in maxillary anterior topography, maxillary posterior topography, mandibular anterior cross-section, mandibular posterior cross-section, mandibular anterior topographic, mandibular posterior topographic occlusal projection was performed with calcium sulfate thermoluminescent dosimeters under 70Kvp and 15mA, 1/4 second (8 inch cone) and 1 second (16 inch cone) exposure time. The results obtained were as follows: Skin surface produced highest absorbed dose ranged between 3264 mrad and 4073 mrad but there was little difference between projections. In maxillary anterior topographic occlusal radiography, eyeballs, maxillary sinuses, and pituitary gland sites produced higher absorbed doses than those of other sites. In maxillary posterior topographic occlusal radiography, exposed eyeball site and exposed maxillary sinus site produced high absorbed doses. In mandibular anterior cross-sectional occlusal radiography, all sites were produced relatively low absorbed dose except eyeball sites. In mandibular posterior cross-sectional occlusal radiography, exposed eyeball site and exposed maxillary sinus site were produced relatively higher absorbed doses than other sites. In mandibular anterior topographic occlusal radiography, maxillary sinuses, submandibular glands, and thyroid gland sites produced high absorbed doses than other sites. In mandibular posterior topographic occlusal radiography, submandibular gland site of the exposed side produced high absorbed dose than other sites and eyeball site of the opposite side produced relatively high absorbed dose.

• 치과방사선
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• 제25권2호
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• pp.297-308
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• 1995

This study was designed to measure the absorbed dose to organs of special interest from full mouth with intraoral film(l4 films) and to compare the five periapical techniques. Thermoluminescent crystals(TLD-100 chip) were located in brain, orbit, bone marrow of mandibular ramus, bone marrow of mandibular body, bone marrow of 4th cervical spine, parotid gland, submandibular gland and thyroid gland. X -ray machine was operated at 70kVp and round collimating film holding device(XCP) and rectangular collimating film holding device(Precision Instrument) were used. The distance from the X-ray focus to the open end of the collimator was 8 inch, 12 inch and 16 inch. The results were as follows : 1. The absorbed dose was the highest in bone marrow of mandibular body(5.656mGy) and the lowest in brain (0.050mGy). 2. Generally, the lowest absorbed dose was measured from 16 inch cylinder, rectangular collimating film holding device with paralleling technique. But, in bone marrow of mandibular body and the floor of mouth, the highest absorbed dose was measured from 12 inch cylinder, rectangular collimating film holding device with paralleling techniques. 3. Comparing of five intraoral radiographic techniques, it was appeared statistically significant reduction of the absorbed doses measured with rectangular collimating film holding device compared to XCP film holding device (P<0.05). 4. No statistically significant reduction in the absorbed dose was found as cylinder length was changed(P>0.05).

• 대한방사선기술학회지:방사선기술과학
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• 제45권1호
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• pp.69-76
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• 2022

This study, the method of reducing the exposure dose by changing the geometrical requirements among the preceding studies and the method of directly wearing a protector on the patient were used to expose the patient. A comparative experiment was conducted on the method of reducing the dose and the most effective method for reducing the exposure dose was investigated. Using the phantom, the dose of the lens, thyroid gland, and gonad gland in the 5 views most used in coronary angiography and intervention accumulated 5 times for 10 seconds at 60~70 kV, 200~250 mA as an automatic controller of the angiography system, and measured by Optically Stimulated Luminescent Dosimeter(OSLD). SID 100 cm and Cine 15 f/s as a control group the experiment was conducted by dividing the experimental group into 3 groups: a group lowered to Cine 7.5 f/s, a phantom protector, and a group lowered to 95 cm SID. As a result of the experiment, showing decrease in exposure dose compared to the control group. Lowering the cine frame may be the simplest and most effective method to reduce the exposure dose, but there is a limit that it cannot be applied if the operator judges that the diagnostic value is small or feels uncomfortable with the procedure. Conclusion as fallow reducing the exposure dose by directly wearing protector is the next best solution, and it is hoped that the conclusions obtained through this study will help reduce the exposure dose to unnecessary organ.

• 치과방사선
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• 제25권1호
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• pp.27-38
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• 1995

The organ or tissue doses were determined with head and neck phantom measurement for multiple axial scans (36 slices), multiple coronal scans (13 slices), 3 types of single axial scans(orbit, maxillary sinus and mandibular canal) and single coronal scan (maxillary sinus). For each scan sequence 30 TLDs were placed in selected sites(16 internal sites and 14 external sites) in a tissue-equivalent phantom. The exposure was made at 120kVp, 500mAs with 5 mm slice width. The results were as follows : 1. In multiple axial scans, the greatest effective dose recorded was that delivered to the thyroid glands(2.77 mSv) and the least was that received by the skin(0.05 mSv). From these data, stochastic effects were 202.2x10/sup -6/ and 3.7×10/sup -6/, respectively. 2. In multiple coronal scans, the greatest effective dose recorded was that delivered to the salivary glands(0.58 mSv) and the least was that received by the skin(0.01 mSv). From these data, stochastic effects were 42.2×10/sup -6/ and 0.7×10/sup -6/, repectively. 3. Among single axial scans, the greatest effective dose recorded was that delivered to the salivary gland(0.38 mSv) in maxillary sinus scan. From this data, stochastic effect was 27.7×10/sup -6/. 4. In single coronal scan, the greatest effective dose recorded was that delivered to the salivary gland(0.01 mSv). From this data, stochastic effect was 1.0×10/sup -6/. 5. The equivalent dose measured that delivered to the lens of the eyes was 69.64 mSv in multiple axial scan, 39.32 mSv in multiple coronal scan and 36.77 mSv in single axial scan(orbit).

• 대한방사선기술학회지:방사선기술과학
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• 제42권4호
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• pp.279-284
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• 2019

The purpose of this study was to find the best protocol for balance of image quality and dose in brain CT scan. Images were acquired using dual-source CT and AAPM water phantom, noise and dose were measured, and effective dose was calculated using computer simulation program ALARA(S/W). In order to determine the ratio of image quality and dose by each protocol, FOM (figure of merits) equation with normalized DLP was presented and the result was calculated. judged that the ratio of image quality and dose was excellent when the FOM maximized. Experimental results showed that protocol No. 21(120 kVp, 10 mm, 1.5 pitch) was the best, the organ with the highest effective dose was the brain(33.61 mGy). Among organs with high radiosensitivity, the thyroid gland was 0.78 mGy and breast 0.05 mGy. In conclusion, the optimal parameters and the organ dose in the protocol were also presented from the experiment, It may be helpful to clinicians who want to know the protocol about the optimum state of image quality and dose.

• 대한핵의학회지
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• 제23권1호
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• pp.7-12
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• 1989

The pain, swelling of salivary glands and dry mouth are not infrequent complication of the high dose radioiodine treatment in the patients with differentiated thyroid cancer. The purpose of this study was, by the dynamic salivary scintigraphy, to observe the change of the salivary function after the high dose $(150\sim200mci)$ radioiodine treatment. From May 1987 to April 1988, the dynamic salivary scintigraphy with 5mci of $^{99m}Tc-pertechnetate$ and gamma camera was performed before and 7 days after the radiolodine treatment in 7 patients with differentiated thyroid cancer. Just after the dynamic scintigraphy, the stimulation test with vitamin C solution of pH3.0 and poststirnulation scintigraphy were done, and the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were calculated for each gland. There was positive correlation between the radioactivity uptake index and excretion fraction after the stimulation. The salivary clearance after the stimulation was $18.96{\pm}8.95ml/min$ in the pretreatment state, and $14.37{\pm}7.7ml/min$ after the radioioine treatment. After the radioiodine treatment, the radioactivity uptake index, excretion fraction and salivary clearance after the stimulation were significantly reduced in the parotid glands, but only the excretion fraction was reduced in the submandibular glands. The more the pretreatment salivary clearance after the stimulation was, the % change after the treatment was smaller. Further studies on the relation between the radiation dose in the salivary glands and the change of their function, and the long-term observation for the recovery of function are expected.

• 대한방사선기술학회지:방사선기술과학
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• 제34권2호
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• pp.105-116
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• 2011

두경부(Head & Neck) CT(Computed Tomography)검사에서 환자가 받는 피폭선량 측정을 위하여 인체등가물질로 만든 Rando phantom과 유리선량계를 이용하여 두경부 검사에 따른 환자의 흡수선량의 변화를 실험을 통하여 연구하였다. 인체두부모형을 안와신경(optic nerve), 교뇌(pons), 소뇌(cerebellum), 갑상선(thyroid)으로 나누어, 두경부(Head & Neck) 부위의 검사를 단독검사(Brain, 3D Facial, Temporal, Brain Angiography, 3D Cervical Spine)와 복합검사(Brain+Brain Angiography, Brain+3D Facial, Brain+Temporal, Brain+3D Cervical spine, Brain+3D Facial+Temporal, Brain+3D Cervical Spin+Angiography)로 구분하여 유효선량의 변화를 실험한 후 결과를 측정하였다. 단순 Brain검사와 Brain Angio검사에는 optic nerve에 유효 선량이 높게 분석되었으며, 또한 Temporal검사에는 Pons에, 3D facial 검사와 3D Cervical Spin검사에는 thyroid의 유효선량 값이 높게 나타났다. 복합적으로 이루어는 검사 중 두경부의 Brain+Brain Angio의 검사는 cerebellum의 부위, Brain+3D facial 검사와 Brain+3D Cervical Spin의 복합검사는 thyroid의 부위, Brain+Temporal의 검사에는 pon's 부위 유효 선량 값이 높게 나타났다. Brain +3D facial +Temporal의 복합검사와 Brain+3D Cervical Spin+Angio의 복합검사는 thyroid의 부위에 유효 선량 값이 높게 분석 되었다. 본 연구 결과 Brain+3D Cervical Spin+Brain Angio 복합검사인 경우의 유효 선량은 2.51858 mSv로 일반인의 연간 유효선량한도 1 mSv의 피폭을 초과하는 결과가 나왔다. 또한, Brain 단순 검사 시 optic nerve는 0.31312 mSv의 유효선량으로 향후 방사선학 검사가 이루어질 경우, 두경부의 일반인의 연간 유효선량을 훨씬 초과할 것이라 사료된다. 따라서 진료의 필요성에 의해서 시행되는 CT검사일지라도 질환 병변의 특성에 맞게 CT촬영조건 변화를 주면서 환자의 피폭선량을 최소한으로 할 수 있는 다양한 검사방법의 연구가 필요하다고 사료된다.