투시 조영 검사 시 환자 선량 관리를 위한 진단참고선량 구축에 관한 연구 (UGI, Esophagography 기준)

홍선숙,박은성,조준영,성민숙,양한준,Hong, Sun-Suk,Park, Eun-Seong,Cho, Joon-Yeong,Seong, Min-Suk,Yang, Han-Joon 대한디지털의료영상학회 2012 대한디지털의료영상학회논문지 Vol.14 No.1

This round of tests in patients with UGI and Esophagography data collected by national and international reference levels based on the original set of guidelines and fluoroscopy, through the provision of medical radiation exposure reduction and further optimization of Defense to realize that is intended. 359 names in our hospital underwent Esophagography 302 patients who underwent UGI average fluoroscopy time and number of images to calculate the average 21 cm Acryl phantom dose for 10 seconds and 20 seconds, average area dose and the area dose of 1 spot image, 5 spot consecutive images by measuring the patient dose and third quartile of the mean area dose was set seonryangin reference dose. Esophagography average patient dose was set to 30.05 $Gy{\cdot}cm^2$, DRL was set at a 25.37 $Gy{\cdot}cm^2$. Average dose of UGI patients were selected as 45.33 $Gy{\cdot}cm^2$, DRL was set at a 34 $Gy{\cdot}cm^2$. UGI patients with established average dose recommended in the 2008 national recommendation from the UGI examination with a dose of less than 49.7 $Gy{\cdot}cm^2$ seonryangin is evaluated. This Note examines the dose of self-aware through education recognizes the importance of dose reduction and examine if their efforts and further reduce patient dose could achieve optimization of the medical exposure is considered.

이동형 X선 장치 차폐도구 제작을 통한 표면선량 분포 측정

홍선숙,김득용,Hong, Sun-Suk,Kim, Deuk-Yong 대한디지털의료영상학회 2010 대한디지털의료영상학회논문지 Vol.12 No.1

Opened a court in February 10, 2006, a rule of safety management of the diagnosis radiation system was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this rule is to minimize the risk of being exposed to radiation during the process of handling X-ray. For this reason, we manufactured shielding device of mobile X-ray unit collimator for diminution of skin dose. Shielding device is made to a thickness of Pb 0.375mm. For portable chest radiography, we measured skin dose 50cm from center ray to 200cm at intervals of 20cm by Unfors Xi detector. As a result, a rule of safety management of the diagnosis radiation system has been strengthened. But there are exceptions, such as ER, OR, ICU to this rule. So shielding device could contribute to protect unnecessary radiation exposure and improve nation's health.

Digital Radiography System에서 X선 광자 검출 방식에 따른 선량 및 화질 특성에 관한 연구

홍선숙(Sun Suk Hong),김호철(Ho Chul Kim) 대한전자공학회 2013 전자공학회논문지 Vol.50 No.12

본 연구의 목적은 Direct DR(Digital Radiography), Indirect DR, I.I(Image Intensifier) DR에서 X선 광자 검출 방식에 따른 선량측정 및 획득된 영상을 정량적이고 객관적인 측정을 통해 DR System을 비교 평가 하는 것이다. Rando phantom을 사용하여 입사표면선량을 측정하였으며, 측정된 입사표면선량 값을 통해 PCXMC 프로그램을 사용하여 유효선량과 방사선 조사로 인한 위험을 평가하였다. 21cm 아크릴 phantom을 사용하여 SNR(Signal to Noise Ratio), NPS(Noise Power Spectrum), CNR(Contrast to Noise Ratio)을 측정하였으며, 측정값은 통계학적 분석기법을 사용하여 유의성을 평가하였다. 입사표면선량, 주요장기선량, 유효선량 모두 direct DR이 가장 낮게 측정되었으며, direct DR 선량을 기준으로 I.I type DR은 약 1.3배, indirect DR은 약 2.4배 높은 선량 비율로 측정되었다. 방사선량에 따른 위험도 역시 동일한 비율로 측정되었다. SNR 측정 결과 direct DR 측정값을 기준으로 I.I DR은 약 7.25배, indirect DR이 약 1.48배 낮은 비율로 측정되었다. CNR 측정 결과 direct DR 측정값을 기준으로 I.I DR은 약 1.16배 높고, indirect DR이 약 0.87배 낮은 비율로 측정되었다. 따라서 a-selenium 검출소자를 사용하여 X선 광자를 검출하는 방식인 direct DR은 적은 선량으로 우수한 화질의 영상을 구현함으로써 선량에 민감한 소아나 생식선이 포함된 검사 등에 유용할 것으로 사료된다. 또한 많은 진단 정보를 위한 영상 평가가 요구되는 경우에는 indirect DR이 유용할 것으로 판단된다. The purpose is a comparative evaluation in the DR System according to the dosimetry and image quality of the quantitative and objective via Direct digital radiography, Indirect digital radiography, Image intensifier (Charge Coupled Device type) digital radiography. The experimental method used rando phantom and measured the entrance surface dose. And through using the measured entrance surface dose and then using the PCXMC program were evaluated risk due to irradiation and the effective dose. SNR and NPS and CNR were measured and analyzed by using 21cm acryl phantom. Significance of measured value was evaluated by statistics method. Entrance surface dose, major organ dose, effective dose all of them were measured the lowest rated in direct DR when it is on the basis of direct DR dose, high-dose ratio were measured in I.I DR approximately 1.3 times, indirect DR approximately 2.4 times. Risk in accordance with radiation also was measured same as dose ratio. On the conclusion that SNR measurement result based on direct DR SNR measurements, low-SNR ratio were measured in I.I DR approximately 7.25 times, indirect DR approximately 1.48 times. On the conclusion that CNR measurement result based on direct DR CNR measurements, high-dose ratio were measured in I.I type DR approximately 1.16 tims and low-dose ratio were measured in indirect DR approximately 0.87 times. Therefore Direct DR system using a-selenium sensing element to detect x-ray photon is thought effectively at the examination such as infant to sensitive irradiation and the genital gland. Because quality image is built by low dose. Also when it is necessary that image test requiring many diagnosis information, indirect DR system is thought effectively.

Edge Method를 이용한 Channel과 Convolution Algorithm에 따른 CT 장치의 MTF 분석

홍선숙(Sun Suk Hong),허재(Jae Huh) 대한CT영상기술학회 2011 대한CT영상기술학회지 Vol.13 No.1

목 적 MTF는 영상의 형성 능력을 측정하기 위한 응답 함수를 결정하는 것으로 정현파의 입력과 정현파의 출력과의 진폭의 비를 공간주파수의 함수로 표현한 것으로 X선 검출시스템 정보전달 능력과 기록 능력을 평가하는 데 상당한 정확성을 제공한다. 본 연구에서는 channel과 algorithm 에 따른 CT장치의 MTF를 측정, 분석하여 적절한 의료영상 비교, 평가하고자 한다. 대상 및 방법 GE사의 성능평가용 팬텀을 장비의 Center에 일치시키고 각도 가장자리가 1.5~3° 기울어지게 팬텀을 회전시켰다. Edge영상에서 ESF을 구해 미분하여 LSF곡선을 구한 다음 FFT하여 MTF 곡선을 구하였다. 계산은 Mathworks사에서 제공하는 Matlab을 이용하여 CT 장비 channel별, convolution algorithm별로 50%, 10% MTF를 구하였다. 결 과 G사 channel별 50%, 10% MTF는 0.73, 1.13 으로 single channel이 가장 높고, S사 channel별 50%, 10% MTF는 0.8, 1.22로 128 channel이 가장 높게 나타났다. Algorithm별로는 edge enhancement algorithm으로 갈수록 높아졌으며 G사의 경우 edge algoritm의 50%, 10% MTF가 1, 1.73으로 가장 높고, S사의 경우 B60f algorithm의 50%, 10% MTF가 1.35, 1.8로 가장 높았다. 결 론 channel 수의 증가는 cone beam artifact를 증가시켜 공간 분해능의 감소를 가져온다. 또한 새로운 재구성 방법의 도입은 cone beam artifact를 감소시키는 방법이 될 것이다. Algorithm은 edge enhancement algorithm 일수록 G사와 S사의 CT장치 모두 영상의 선예도와 공간 분해능이 증가되었다. 따라서 미세한 질환 판독을 요구하는 CT 검사의 경우 channel 수가 적은 장비 혹은 새로운 재구성 방법이 도입된 장비가 유리하고 edge enhancement algorithm을 사용하여 검사를 한다면 그 효과를 더욱 증대시킬 수 있을 것이다. Ⅰ. Purpose MTF offers fairs accuracy to estimate X-ray detection system information transmission ability and recording ability that express comparison of amplitude with input of sine wave and output of sine wave by function of spatial frequency that decide response function to measure clean bright atmosphere image formation ability. In this study, wish to compare and estimate suitable medical treatment image measuring and analyzes MTF of CT equipment by channel and algorithm. Ⅱ. Materials and Method The phantom in order to evaluate the performance of GE the equipment was centered with an angled of 1.5-3 differentiate ESF in edge image then FFT obtain LSF curved line then obtain MTF cured line. Calculation got 50%, 10% MTF by CT equipment channel, by convolution algorithm using matlab that offer in mathworks company. Ⅲ. Result 50% and 10% MTF by G company channel are the highest single channel by 0.73 and 1.13. 50% and 10% MTF by S company channel appeared 128channels highest by 0.8 and 1.22. As edge algorithm changes, for G company 50% of edge algorithm, 10% MTF were 1, 1.73, there were highest, and for S company also 50% B60f algorithm, 10% MTF were highest, scores are 1.35, 1.8. Ⅳ. Conclusion Increase of channel number brings decrease of spatial resolution increasing cone beam artifact. Also, induction of new reconstruction method may become way that reduce beam artifact. As algorithm is edge enhancement algorithm, sharpness and resolution of CT equipment total reflex of the G company and S company were increased. Therefore, may agument more the effect if examine equipment that channel number is few in occasion of CT examination who require microscopic disease interpretation or equipment that new algorithm is introduced is profitable and uses edge enhancement algorithm.

CT 프로토콜에 따른 3차원 Volume Rendering과 Surface Rendering의 비교 연구

홍선숙(Sun Suk Hong),김민정(Min Jeong Kim) 대한전산화단층기술학회 2012 대한CT영상기술학회지 Vol.14 No.1

목적 의료 영역에서 3차원 재구성은 병소의 해부학적 위치와 그 형태, 치료 방향의 설정 등 진단과 치료 분야에 유용한 역할을 하고 있다. 따라서 병소나 관심 장기의 정확한 볼륨의 측정은 진단과 치료의 정확성과 효율성을 증대시킬 것이다. 이러한 3차원 재구성 방법으로는 volume rendering과 surface rendering 방법이 대표적이며 본 연구에서는 phantom의 제작을 통하여 재구성 방법에 따른 볼륨을 측정하고 정확도를 비교분석하였다. 대상 및 방법 첫번째 phantom은 아세탈 재질의 cylinder 형태인 10개의 phantom, 두번째와 세번째 phantom은 RP system을 통해 waterdrop형태의 10개 phantom으로 각각 제작하였다. 두번째, 세번째 phantom은 그 모양과 볼륨은 동일하고 재질만 다르게 제작하였다. 각각 재질은 Vero White-Fullcure83와 TangoGray-Fullcure950 재질을 사용하였다. GE사의 64MDCT를 사용하여 5가지의 CT 프로토콜 조건으로 scan하였다. Scan data의 volume rendering:과 surface rendering으로 3차원 재구성하여 각각의 볼륨을 측정하고 실제부피와 측정부피의 오차를 비율로서 나타낸 뒤 Minitab을 이용하여 통계분석 처리하였다. 결과 또한 5가지 type 프로토콜 모두 volume rendering이 surface rendering에 비해 정확도가 높게 나타났다. 재질이 다른 Phantom 2와 3은 volume rendering과 surface rendering 모두 통계적으로 유의한 차이가 없는 것으로 분석되었다. 형태가 일정한 phantom1과 곡면 형태가 포함 된 phantom2의 볼륨 측정 결과 volume rendering은 통계적으로 유의한 차이를 나타났으며 형태가 일정한 phantom1의 정확도가 높은 것으로 나타났다. Surface rendering은 통계적으로 유의한 차이가 없는 것으로 나타났다. 결론 전체적으로 volume rendering 방법과 surface rendering 방법은 정확도가 우수하게 평가되었다. Ct 프로토콜에 따른 3차원 재구성 볼륨 측정 결과volume rendering이 surface rendering에 비해 더 높은 정확도를 나타낸다. 그러나 관심영역에 대한 3차원적인 구조물의 측정(부피, 각도, 길이 등)에 대해서 surface rendering은 volume rendering이 측정할 수 없는 부분까지 측정 가능한 특징을 나타냈다. I. Purpose 3Dimention reconstruction method is beneficial to diagnosis and cure that find location of a lesion and check the shape, because accurate measurement using 3dimention reconstruction for lesion or organ could be ringing(incraseing) accuracy and efficiency. There are two typical methods which are Volume rendering and surface rendering. In this study, We measured volume according to reconstruction methods, using a phantom which we made, and analyze its accuracy II. Materials and Method We made 3 type of phantoms which have a little bit different. First phantom is acetyl material and cylinder type. Second phantom is VeroWhite-Fullrure83 material and Waterdrop1 type which is produced by RP system. Third phantom is TangoGray-Fullcure950 material and waterdrop2 type. We used 5 protocols by GE 64MDCT to get a data. We measured each phantom volume which were reconstructed by surface rendering and volume rendering and we analyzed error ratio of sire and measured sire by Minitab III. Result Volume rendering is higher accuracy than surface rendering on 5 types of protocols. There were no statistical difference about volume and surface rendering on phantom number 2 and 3. In other examination, There was statistical difference about volume rendering on phantom 1 which shape is cycle and phantom 2 which shape is curved. On the contrary, in case of Surface rendering, there was no statistical difference IV. Conclusion Both Volume rendering and surface rendering methods have a good accuracy. An accuracy of Volume rendering is higher than that of surface rendering In the result of measuring about 3D reconstruction volume by CT protocol. On the contrary, Surface rendering had a different character with volume rendering. It’s a special ability to detect shaded interested region. In other words, Surface rendering could measure structures of 3dimention these are volume, angle and length

Glass dosimeter와 PCXMC Program을 이용한 소아피폭선량 측정 및 분석

김영은,이정화,홍선숙,이관섭,Kim, Young-Eun,Lee, Jeong-Hwa,Hong, Sun-Suk,Lee, Kwan-Seob 대한디지털의료영상학회 2012 대한디지털의료영상학회논문지 Vol.14 No.2

Exposed dose of young child should be managed necessarily. Young child is more sensitive than adult of a Radioactivity, especially, and lives longer than adult. Must reduce exposed dose which follows The ALARA(As Low As Reasonably Achievable)rule is recommended by ICRP(International Commission on Radiological Protection)within diagnostic useful range. Therefore, We have to prepare Pediatric DRL(Diagnostic Reference Level) in Korea as soon as possible. Consequently, in this study, wish to estimate organ dose and effective dose using PCXMC Program(a PC-Based Monte Carlo Program), and measure ESD(Entrance surface dose)and organ dose using Glass dosimeter, and then compare with DRL which follows EC(European Commission)and NRPB(National Radiological Protection Board). Using glass dosimeter and PCXMC programs conforming to the International Committee for Radioactivity Prevention(ICRP)-103 tissue weighting factor based on the item before the organs contained in the Chest, Skull, Pelvis, Abdomen in the organ doses and effective dose and dose measurements were evaluated convenience. In a straightforward way to RANDO phantom inserted glass dosimeter(GD352M)by using the hospital pediatric protocol, and in a indirect way was PCXMC the program through a virtual simulation of organ doses and effective dose were calculated. The ESD in Chest PA is 0.076mGy which is slightly higher than the DRL of NRPB(UK) is 0.07mGy, and is lower than the DRL of EC(Europe) which is 0.1mGy. The ESD in Chest Lateral is 0.130mGy which is lower than the DRL of EC(Europe) is 0.2mGy. The ESD in Skull PA is 0.423mGy which is 40 percent lower than the DRL of NRPB(UK) is 1.1mGy and is 28 percent lower than the DRL of EC(Europe) is 1.5mGy. The ESD in Skull Lateral is 0.478mGy which is half than the DRL of NRPB(UK) is 0.8mGy, is 40 percent lower than the DRL of EC(Europe) is 1mGy. The ESD in Pelvis AP is 0.293mGy which is half than the DRL of NRPB(UK) is 0.60mGy, is 30 percent lower than the DRL of EC(Europe)is 0.9mGy. Finally, the ESD in Abdomen AP is 0.223mGy which is half than the DRL of NRPB(UK) is 0.5mGy, and is 20 percent lower than the DRL of EC is 1.0mGy. The six kind of diagnostic radiological examination is generally lower than the DRL of NRPB(UK)and EC(Europe) except for Chest PA. Shouldn't overlook the age, body, other factors. Radiological technician must realize organ dose, effective dose, ESD when examining young child in hospital. That's why young child is more sensitive than adult of a Radioactivity.

복부 CT에서 Adaptive Statistical Iterative Reconstruction과 Model-Based Iterative Reconstruction의 사용에 따른 선량 감소 및 화질 평가

손은영(Eun young Son),홍선숙(Sun suk Hong) 대한CT영상기술학회 2013 대한CT영상기술학회지 Vol.15 No.1

목적 본 연구는 복부 CT 검사에서 adaptive statistical iterative reconstruction 기법과 model based iterative reconstruction 기법으로 획득한 이미지를 토대로 복부 장기의 effective dose 변화 및 화질의 정량적인 분석을 통하여 최적의 영상 정보를 제공할 수 있는 iterative reconstruction을 알아보고자 한다. 대상 및 방법 본 연구를 위해 CT 장비는 GE사의 64-slice multidetector-row CT Discovery 750 HD를 사용하였고, 인체 모형 Rando phantom을 사용하였으며, 복부 장기 effective dose 측정을 위하여 유리 선량계를 사용하였다. 장비의 성능 평가를 하기 위하여 ACR phantom을 사용하였고, Image J와 Matlab program을 사용하여 noise, SNR, distortion 및 resolution 측정을 통해 화질을 정량적으로 평가, 분석하였다. 결과 DLP 및 effective dose는 인위적으로 선량을 감소하여 ASIR와 MBIR로 재구성함에 따라 그 비율대로 유사하게 선량이 감소하였다. Noise는 120 mAs-ASIR(ASIR 40%)에서 최소, 100 mAs-ASIR(ASIR 50%)부터 증가하는 것으로 나타났으며, MBIR은 dose를 감소하지 않고 reconstruction하였을 경우 최소로 측정되어 dose가 감소함에 따라 noise는 증가하는 것으로 나타났다. SNR의 경우 180 mAs-ASIR(ASIR 10%)와 140 mAs-MBIR에서 가장 높게 나타났다. 현재 복부 CT에 사용되는 조건의 영상을 기준으로 image의 distortion을 평가했을 때 80 mAs-ASIR(ASIR 70%)까지 PSNR이 30 dB을 넘게 측정되었으며, MBIR은 모두 30 dB 이하로 측정되었다. 해상력과 선예도 측정 결과에서는 100 mAs-MBIR이 100 mAs-ASIR(ASIR 50%)에 비해 sharpness는 20.58%, resolution은 33.19% 높게 측정되었다. ACR phantom을 통한 장비의 성능 평가는 모두 적합한 것으로 나타났다. 결론 본 연구는 복부 CT 검사에서 200 mAs부터 60 mAs까지 10%씩 선량을 감소하여 ASIR와 MBIR로 재구성한 이미지를 토대로 복부 장기의 effective dose 변화 및 화질을 평가하기 위하여 진행하였다. 결과 모두 환자의 선량을 감소시켜 ASIR와 MBIR로 재구성하여도 진단 가치가 있는 것을 확인할 수 있었으며, 이러한 기법을 복부 CT protocol에 적용한 결과 180 mAs-ASIR(ASIR 10%)에서 최적화된 정보를 얻을 수 있었다. MBIR의 경우 ASIR에 비하여 같은 선량에서 약 67%의 많은 noise를 감소하며, 해상력이 높은 것으로 나타났으나 현재 실용화하기 위해서는 고성능의 컴퓨터와 많은 재구성 시간을 요구하는 단점을 가지고 있다. Ⅰ. Purpose The purpose of this study was to assess iterative reconstruction methods that provide optimal image information in abdominal CT exams. It was based on the acquired images by adaptive statistical iterative reconstruction (ASIR) and model- based iterative reconstruction (MBIR). We analyzed the change of effective dose in abdominal organs and image quality quantitatively. Ⅱ. Meterial and Methods CT scans were performed with a 64-slice multidetector-row CT Discovery 750HD and Rando phantom. Glass dosimeters were used to measure effective dose of organs. ACR phantom was used for performance evaluation of the equipment. We quantitatively evaluated and analyzed image quality by measurement of noise, SNR, distortion, and resolution by using Image J and Matlab program. Ⅲ. Result As we gradually lowered radiation dose and reconstructed with ASIR and MBIR, the value of DLP and effective dose also decreased similarly. Noise value was the lowest at 120 mAs-ASIR (ASIR 40%), and got increased from 100 mAs-ASIR (ASIR 50%). SNR value was the highest at 180 mAs-ASIR (ASIR 10%) and 140 mAs-MBIR. In evaluation of distortion of image quality based on abdominal CT protocol, PSNR showed over 30 dB up to 80 mAs-ASIR (ASIR 60%), and below 30 dB at all MBIRs. In measurement of resolution, sharpness and resolving power at 100 mAs-MBIR were respectively 20.58% and 33.19% higher than those at 180 mAs-ASIR (ASIR 10%). All performance evaluation of the equipment through ACR phantom was found to be acceptable. Ⅳ. Conclusions There’s diagnostic value with both iterative reconstruction methods, ASIR and MBIR, while reducing patient dose. In abdominal CT protocol, we can get optimal information at 180 mAs-ASIR (ASIR 10%). MBIR can provide 67% less noise and higher resolution compared to ASIR in the same dose, however, it requires high performance computer and considerable time to reconstruct.

자체 개발한 하악거상 기구를 활용한 소아 REVERS WATER'S View의 유용성

김강환,손순룡,김광수,홍선숙,이관섭,Kim, Kang-Hwan,Son, Soon-Lyong,Kim, Kwang-Soo,Hong, Sun-Suk,Lee, Kwan-Sup 대한디지털의료영상학회 2013 대한디지털의료영상학회논문지 Vol.15 No.2

This study is to provide clinical data when reverse-water's-view was carried out about pediatric who did not communicate by applying self-development jaw lift tool. This study were conducted in a subject of 23 children who examined revers-water's-view from 2013 July 6 to 2013 August 5 at our hospital. Two group time which were carried out revers-water's with tool and without tool were measured. also, Image of two group were evaluated. Evaluation data obtained by measuring the average difference were analyzed by independent-t-test. After apply self-development-jaw-lift-tool, time was reduced by 35.2%(36.6sec). the results indicated significant differences(p< .05). Image evaluation was increase 43.5%(1.03point), It was statistically highly significant difference (p< .01). If apply self-development-jaw-lift-tool in pediatric revers-water's-view, operator can provide fast, convenience, high quality image to pediatric.