진단용 엑스선 장치에 있어서 방사선 방어에 대한 일반 요구사항 -IEC 60601-1-3:2008에 근거한 KFDA DRS 1-1-3:2008-

강희두,동경래,권대철,최준구,정재호,정재은,류영환,Kang, Hee-Doo,Dong, Kyung-Rae,Kweon, Dae-Cheol,Choi, Jun-Gu,Jeong, Jae-Ho,Jung, Jae-Eun,Ryu, Young-Hwan 대한디지털의료영상학회 2009 대한디지털의료영상학회논문지 Vol.11 No.2

This study gives an account of the collateral standards in IEC 60601-1-3: 2008 specifying the general requirements for basic safety and essential performance of diagnostic X-ray equipment regarding radiation protection as it pertains to the production of X-rays. The collateral standards establish general requirements for safety regarding ionization radiation in diagnostic radiation systems and describe a verifiable evaluation method of suitable requirements regarding control over the lowest possible dose equivalent for patients, radiologic technologists, and others. The particular standards for each equipment can be determined by the general requirements in the collateral standard and the particular standard is followed in the risk management file. The guidelines for radiation safety of diagnostic radiation systems is written up in ISO 13485, ISO 14971, IEC 60601-1-3(2002)1st edition, medical electric equipment part 1-3, and the general requirements for safety-collateral standards: programmable electrical medical systems. Therefore the diagnostic radiation system protects citizens' health rights with the establishment and revisions of laws and standards for diagnostic radiation systems as a background for the general requirements of radiation safe guards applies, as an international trend, standards regarding the medical radiation safety management. The diagnostic radiation system will also assure competitive power through a conforming evaluation unifying the differing standards, technical specifications, and recognized processes.

PACS Database를 활용한 촬영실명제 정착화 실현

강지연,이래곤,강희두,이화선,황선광,Kang, Ji-Youn,Lee, Lae-Gon,Kang, Doo-Hee,Lee, Hwa-Sun,Hwang, Sun-Gwang 대한디지털의료영상학회 2007 대한디지털의료영상학회논문지 Vol.9 No.2

As developing the medical treatment image portion with the change of these times, PACS, which is able to digitalize image portion data, has a lot of data-based image data. Applying this PACS, we would like to settle down RNSXI(real-name shooting X -ray of inspector) system. We interviewed with P ACS's operators of university hospitals which is using PACS in Seoul about the present conditions whether using of RNSXI or not. And we inquired the RNSXI equipments, applying PACS database, and Interface conditions undertook to do in our hospital. All university hospitals in Seoul are set up the P ACS system. But no hospital use the RNSXI. In our hospital, we can check inspector' name or initials who exposure x-ray with the PACS Viewer by looking over equipments(CR, DR, US, MG, MR, CT) and Interface of the DICOM Header data. However, some equipments like RF and Angio can not check inspector' name or initials. Under the Film/System environment, RNSXI system has been used frequently like that inspector's signature or initial added to a patient data. Though the digital medical treatment was developed, RNSXI system was declined. It is necessary to using RNSXI system in order to improving radiologists' rights, even if it is not under the application of the medical treatment image laws. If RNSXI system use, radiologists should specialize in their major and the Repeat rate should be reduced. In environment of PACS, RNSXI system can be used by linking both the equipments and the Interface with a production enterprise of P ACS. Therefore RNSXI system applying the P ACS datebase should settle down in our medical system for being provided lots of data.

치과 방사선 발생기의 성능평가에 관한 연구

정재은,정재호,강희두,이종웅,나극환,Jung, Jae-Eun,Jung, Jae-Ho,Kang, Hee-Doo,Lee, Jong-Woong,Ra, Keuk-Hwan 대한디지털의료영상학회 2009 대한디지털의료영상학회논문지 Vol.11 No.2

I think this will be valuable reference for assuring consistency and homogeneity of clarity and managing dental radiation equipment by experimentation of dental radiation equipment permanent which based on KS C IEC 61223-3-4 standard and KS C IEC 61223-2-7. Put a dental radiation generator and experiment equipment as source and film(sensor) length within 30 em, place the step-wedge above the film(sensor). Tie up tube voltage 60 kVp, tube current 7 mA and then get an each image through CCD sensor and film by changing the exposure time as 0.12sec, 0.25sec, 0.4sec. Repeat the test 5times as a same method. Measure the concentration of each stage of film image, which gained by experiment, using photometer. And the image that gained by CCD sensor, analyze the pixel value's change by using image J, which is analyzing image program provided by NIH(National Institutes of Health). In case of film, while 0.12sec and 0.25sec show regular rising pattern of density gap as exposure time's increase, 0.4sec shows low rather than 0.12sec and 0.25sec. In case of CCD sensor density test, the result shows opposite pattern of film. This makes me think that pixels of CCD's sensor can have 0~255 value but it becomes saturation if the value is over 255. The way that getting clear reception during decreasing human's exposed radiation is one of maintaining an equipment as a best condition. So we should keeping a dental radiation equipment's condition steadily through cyclic permanent test after factor examination. Even digital equipment doesn't maintain a permanent, it can maintain a clarity by post processing of image so that hard to set it as standard of permanent test. Therefore it would be more increase the accuracy that compare a film as standard image. Thus I consider it will be an important measurement to care for dental radiation equipment and warrant homogeneity, consistency of dental image's clarity through comparing pattern which is the result from factor test against cyclic permanent test.

구강 내 촬영용 센서의 정량적 평가

정재호,정재은,강희두,나극환,Jung, Jae-Ho,Jung, Jae-Eun,Kang, Hee-Doo,Ra, Keuk-Hwan 대한디지털의료영상학회 2009 대한디지털의료영상학회논문지 Vol.11 No.2

Carried out an experiment for quantitative evaluation about intraoral sensor among oral dental imaging equipments in PACS environment. For evaluation, testing environment & evaluation criteria are established that refer to the 'IEC 62220-1-2' and experimented with set up the standard radiation penetration that correspond with RQA-3(IEC 61267). Results of experiments using the image J, derived the ESF(edge spread function), LSF (line spread function) and calculated the MTF(modulation transfer function) finally. As a result, the MTF that 0.1, 0.2sec are 10% about 10 lp/mm and 0.32 sec is the 10% about 9 lp/mm in level represents the value of the MTF. Change of scan condition in dental environmental, according to the MTF value taken note that no changes can be seen enough. However, the dimensions of each other size $1(1200{\times}1600)$, size $2(1440{\times}1920)$ intraoral sensors for 3 lp/mm, respectively 40%, 90% of the note might have been the difference between the value of MTF, in accordance with standard sensors might note differences could be observed.

판독용 모니터 정도관리 항목 및 시행기준안 개발 연구

손기경,성동욱,정해조,정재호,강희두,신진호,이순근,김용환,Son, Gi-Gyeong,Sung, Dong-Wook,Jung, Hae-Jo,Jeong, Jae-Ho,Kang, Hee-Doo,Shin, Jin-Ho,Lee, Sun-Geun,Kim, Yong-Hwan 대한디지털의료영상학회 2007 대한디지털의료영상학회논문지 Vol.9 No.1

PACS has been run at the Kyung Hee University Medical Center(KHMC) since 2001, and the installation and operation of PACS have contributed to automation and quantification of KHMC's medical environment During these five years our greatest concern is how to make our own guiding principle of diagnostic monitor QA which is adapted to international standards. In accordance with the terms of 'KHMC QA Guideline', 'AAPM TG18', 'SMPTE RP133', 'DICOM Part14', 'DIN V 6868-57', 'JESRA X-0093', 'JIS Z4752-2-5' and 'KCARE', concern about quality assurance of medical images are on the increase. With the investigation of acceptance testing and quality control of international standards for medical display devices, and data collection and analysis for recommended guideline, it is reported that acceptance testing(quality control), including geometrical distortion, display reflection, luminance response, luminance uniformity, display resolution, display noise, veiling glare and color chromaticity being adequate and effective to domestic hospital environments for medical display devices and assessment methods according to each performance. Accordingly, KHMC classified the checkpoint items by period, at the time of monitor setting, monthly, quarterly, half-yearly and annually. Periodic classification of checkpoint items for monitor QA makes a good guideline for image QA/QC and useful guideline for persistent good quality of monitor.

CT 조영제 혈관외유출의 방사선학적 고찰

권대철,박창희,정재호,강희두,송은홍,Kweon, Dae-Cheol,Park, Chang-Hee,Jeong, Jae-Ho,Kang, Hui-Doo,Song, Woon-Heung 대한디지털의료영상학회 2008 대한디지털의료영상학회논문지 Vol.10 No.2

Extravasation of contrast material is a not infrequent complication of enhanced imaging studies and large volume extravasation may result in severe damage. Subcutaneous extravasation of the radiographic contrast medium is one of the complications of the contrast medium-enhanced procedures. Automated power injectors enable the contrast material to be delivered at a uniform high-flow-rate and as a nonfragmented bolus, and this is essential for many contrast material enhanced CT(computed tomography) applications. The major risk associated with the use of automated power injectors is the well known complication of contrast material extravasation at the injection site. Automated injection of CT contrast material can produce the compartment syndrome. Selection of the nonionic contrast material after careful evaluation of the intravenous administration site and monitoring of the patient during the use of a mechanical power injector may help minimize or prevent extravasation injuries. Early identification is important and conservative management is effective in most cases. Prevention of these injuries with the education of radiological technologist remains the ultimate aim.

의료영상 압축을 위한 JPEG2000의 효율성 연구

정재호,신진호,손기경,강희두,Jung, Jae-Ho,Shin, Jin-Ho,Son, Gi-Gyeong,Kang, Hee-Doo 대한디지털의료영상학회 2003 대한디지털영상기술학회지 Vol.6 No.1

Purpose : In a PACS(Picture Archiving Communications System) environment, which is a very important component in a digital medical environment, the compression of digital medical images is a necessary and effective feature. In a current system where JPEG is applied to the compression of medical images, this study is to examine effectiveness and suitability when the JPEG2000, a more advanced compression algorithm for still images, is applied to the compression of medical images. In this thesis, we attempt to address the compressibility for effective clinical usage when compressing medical images, applying the objectivization of clinical evaluation as a function of compressibility. In the experiment al method, the compression was applied at a fixed rate using JPEG2000, and the n the result was compared with compressed images by JPEG. Method : For the performance evaluation, we choose SNR(Signal to Noise Ratio) measurement of an objective evaluation of definition and analyze a subjective evaluation by the ROC(Receiver Operating Characteristic) method. The results of the experiment showed that in the case of JPEG2000 there is hardly any distortion of images, even at high compression ratio(100:1), while regarding noise, the SNR remains around about 40dB, which is also relatively high. Before reading by reference to evaluative materials concerning objective compressed images, it is impossible to apply high compression to images : however, after reading, this can be applied to images that have already existed for some time.

DICOM 객체를 활용한 무결성 PACS Data 관리시스템 구현

박범진,정재호,손기경,정영태,강희두,Park, Bum-Jin,Jeong, Jae-Ho,Son, Gi-Gyeong,Jung, Young-Tae,Kang, Hee-Doo 대한디지털의료영상학회 2013 대한디지털의료영상학회논문지 Vol.15 No.1

PACS is one of the most used medical information system and share information from other hospitals through the PACS. Data integrity means zero defects data and this is a prerequisite of information system performance. but I wonder if I can trust these informations that Incorrect information from radiotechnologist's mistakes, anonymous in emergency department, Newborn baby department, modified informations at later. And Modified informations causes defect in integrity of the data. When we import, we use DICOM header not DB data. so error occurs that DB data is deferent with DICOM Header information. This paper discusses to resolve as above problem using DICOM object such as DICOM PR, SR. And propose quality management system that can guarantee the patient information and can manage exam history.

개인정보 보호를 위한 의료영상 발급 표준 업무절차 개발연구

박범진(Bum-Jin Park),유병규(Beong-Gyu Yoo),이종석(Jong-Seok Lee),정재호(Jae-Ho Jeong),손기경(Gi-Gyeong Son),강희두(Hee-Doo Kang) 대한방사선과학회(구 대한방사선기술학회) 2009 방사선기술과학 Vol.32 No.3

목 적 : 기존 필름으로 발급되었던 의료영상은 IT기술의 발달로 디지털화 되어 CD로 발급되고 있다. 그러나 발급 시 신분확인을 하고 있는 의무기록과는 달리 필름을 사용하던 시절부터 의료영상은 별다른 신분확인을 하지 않는 의료기관이 많다. 이에 신청자의 개인의료정보 보호에 대한 인식 실태를 조사하고 여러 의료기관의 CD 또는 DVD 등의 매체를 통한 의료영상 복사 현황을 조사, 정보보안에 관련된 국, 내외 법률 및 권고안을 분석하여 국내 환경에 부합하는 의료영상 복사 발급과 절차를 마련하는 기준을 제시하고자 한다. 대상 및 방법 : 첫째, 2008년 5월 1일부터 7월 31일까지 수도권에 있는 33개 종합병원을 대상으로 의료영상 복사 신청 시 구비서류, 발급절차 등을 전화를 통한 유전 조사를 시행하였다. 신청자에 따른 구비서류를 의료법 제21조 2항에 의거 ① 본인일 경우 신분증 확인, ② 가족일 경우 신청자 신분증, 가족관계 서류(건강보험증, 가족관계증명서, 등보 등), ③ 제3자 대리인일 경우 신분증, 위임장, 인감증명서로 기준을 마련하여 조사하였다. 둘째, 연구기간 동안 위의 기준에 따라 의료영상을 발급해 주고 있는 K 의료원에 복사를 신청하는 신청자들이 준비해온 구비서류 여부를 파악하였다. 셋째, 구비서류의 확인 및 미비 시 조치 등에 대한 발급절차의 기준을 정립하여 프로세스를 개발하였다. 결 과 : 수도권 33개 의료영상 발급현황을 조사한 결과 모든 조건을 충족한 병원은 16곳(49%), 신분증만 있으면 가능한 병원은 4곳(12%), 누구나 신청 가능한 병원 4곳(12%)이었으며 의료영상을 발급하는 부서가 아닌 진료과에서 신청하는 곳이 9곳(27%)으로 구비서류 조건여부는 알 수 없었다. 또한 신청자들이 복사 신청 시 준비해온 구비서류가 조건에 충족한지 3개월간의 조사 결과 모두 준비한 경우(완비)는 629건(49%), 일부만 준비한 경우(일부 미비) 416건(33%), 모두 준비하지 않은 경우(미비) 226건(18%)이였다. 위의 연구결과를 근거로 의료영상 복사 신청 절차에 대한 프로세스를 정립하여 객관적인 응대를 할 수 있도록 하고, 환자와의 마찰을 줄이고 불편을 최소화 하면서 환자의 편의를 도모하고자 세분화된 발급절차 모형도를 작성하였다. 결 론 : 다른 전산 시스템과 달리 의료영상 시스템인 PACS가 의료기기로 분류되어 있는 것은 그만큼 의료정보의 중요성이 크다는 의미이다. 또한 의료영상의 학문적 성격으로 의학교육 및 연구에 많이 쓰이는데 이러한 이유로 쉽게 인용되고 남용 될 수 있다. 따라서 의료영상은 전문적인 교육을 받은 의료영상 관리자에 의해 적절한 발급 기준으로 발급, 관리되어야 할 것이며 이에 관해 개인정보보호와 의료영상에 대한 적극적인 홍보가 필요할 것이다. Purpose : The medical imaging issuance is changed from conventional film method to Digital Compact Disk solution because of development on IT technology. However other medical record department's are undergoing identification check through and through whereas medical imaging department cannot afford to do that. So, we examine present applicant's recognition of private intelligence safeguard, and medical imaging issuance condition by CD & DVD medium toward various medical facility and then preform comparative analysis associated with domestic and foreign law & recommendation, lastly suggest standard for medical imaging issuance and process relate with internal environment. Materials and methods : First, we surveyed issuance process & required documents when situation of medical image issuance in the metropolitan medical facility by wire telephone between 2008.6.1~2008.7.1 in accordance with the medical law Article 21~clause 2, suggested standard through applicant's required documents occasionally - ① in the event of oneself → verifying identification, ② in the event of family → verifying applicant identification & family relations document (health insurance card, attested copy, and so on), ③ third person or representative → verifying applicant identification & letter of attorney & certificate of one's seal impression. Second, also checked required documents of applicant in accordance with upper standard when situation of medical image issuance in Kyung-hee university medical center during 3 month 2008.5.1~2008.7.31 Third, developed a work process by triangular position of issuance procedure for situation when verifying required documents & management of unpreparedness. Result : Look all over the our manufactured output in the hospital - satisfy the all conditions → 4 place(12%), possibly request everyone → 4 place (12%), and apply in the clinic section → 9 place(27%) that does not medical imaging issuance office, so we don't know about required documents condition. and look into whether meet or not the applicant's required documents on upper 3month survey - satisfy the all conditions → 629case(49%),p prepare a one part → 416case(33%), insufficiency of all document →226case(18%). On the authority of upper research result, we are establishing the service model mapping for objective reception when image export situation through triangular position of issuance procedure and reduce of friction with patient and promote the patient convenience. Conclusion : The PACS is classified under medical machinery that mean indicates about higher importance of medical information therefore medical information administrator's who already received professional education & mind, are performer about issuance process only and also have to provide under ID checking process exhaustively.

PACS에서 보안관리 평가기준 연구와 실태조사

정재호(Jae-Ho Jeong),동경래(Kyung-Rae Dong),권대철(Dae-Cheol Kweon),손기경(Gi-Gyeong Son),김현수(Hyun-Soo Kim),강희두(Hee-Doo Kang) 대한방사선과학회(구 대한방사선기술학회) 2008 방사선기술과학 Vol.31 No.4

본 연구는 의료기관 PACS 운영 및 영상정보관리 과정에서의 개인정보보호와 보안 관리에 대한 보안평가 기준 및 보안평가에 따른 등급기준을 마련하고자 하였다. 보안평가기준과 보안평가 등급기준의 지표를 도출 하기 위해 ISO17799(BS 7799), HIPPA(Health Insurance and Portability and Accountability Act of 1996), 국내 의료법 등을 참조하여 정책적 보안, 기술적 보안, 데이터관리 보안, 물리적 보안 등 4가지 항목을 대분류로 선정 후 10개의 세부 평가항목을 선정하여 점수화 하였다. 도출된 보안평가기준과 보안등급의 지표를 가지고 30곳의 의료기관에서 조사를 시행하였다. 대분류의 평가 요소 중 물리적 보안 항목의 전체 의료기관 평균 점수는 20점 만점기준 18.5점(93%)으로 가장 우수한 점수를 나타내었으며, 정책보안항목 30점 기준 18.5점(62%), 데이터관리 보안항목 20점 기준 12점(60%), 기술적 보안항목 30점 기준 17.5점(58%) 순임을 알 수 있었다. 30개 종합병원의 보안평가 점수는 평균 67점으로 4등급 수준을 나타내었다. PACS환경에서 취약한 개인정보보호 및 보안의식에 대한 관리기준 수립이 필요하다. This study is to prepare an evaluation standard about personal information protection and security management of a medical institution and to build up a grade standard of evaluation in PACS environment. We built up evaluation index based on 10 detailed items in four big categories (political security, technical security, data management security and physical security) by referring to ISO17799 (BS 7799), HIPPA (Health Insurance and Portability and Accountability Act of 1996) and domestic medical law. We have investigated at the thirty places where medical facility with the extracted security criteria and security evaluation index. Average score of physical security list, one of the big categories, was 18.5/20 (93%) at all medical institutions. Political security score was 18.5/30 (62%), data management security score was 12/20 (60%) and technical security score was 17.5/30 (58%). Therefore, security evaluation score was average 67 in 30 general hospitals, which was 4th level. The results showed that it is necessary to establish evaluation and management standard about personal information protection and security consciousness which are weak in PACS environment.