Showing papers in "Journal of the Korean Society of Radiology in 2019"
TL;DR: This paper examines in detail the kinds of principles and methods of adversarial attacks made to deep learning models dealing with medical images, the problems that can arise, and the preventive measures that can be taken against them.
Abstract: Due to rapid developments in the deep learning model, artificial intelligence (AI) models are expected to enhance clinical diagnostic ability and work efficiency by assisting physicians. Therefore, many hospitals and private companies are competing to develop AI-based automatic diagnostic systems using medical images. In the near future, many deep learning-based automatic diagnostic systems would be used clinically. However, the possibility of adversarial attacks exploiting certain vulnerabilities of the deep learning algorithm is a major obstacle to deploying deep learning-based systems in clinical practice. In this paper, we will examine in detail the kinds of principles and methods of adversarial attacks that can be made to deep learning models dealing with medical images, the problems that can arise, and the preventive measures that can be taken against them.
24 citations
8 citations
TL;DR: The stages of deep learning algorithm development in the field of medical imaging, namely topic selection, data collection, data exploration and refinement, algorithm development, algorithm evaluation, and clinical application, are explained.
Abstract: Recently, considerable progress has been made in interpreting perceptual information through artificial intelligence, allowing better interpretation of highly complex data by machines. Furthermore, the applications of artificial intelligence, represented by deep learning technology, to the fields of medical and biomedical research are increasing exponentially. In this article, we will explain the stages of deep learning algorithm development in the field of medical imaging, namely topic selection, data collection, data exploration and refinement, algorithm development, algorithm evaluation, and clinical application; we will also discuss the latest trends for each stage.
8 citations
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5 citations
TL;DR: The ESD of TFCA was statistically significantly lower than that of CCTA, and also the used contrast usage was significantly tiny than the amount of contrast agent used in C CTA.
Abstract: A typical cerebrovascular disease among cerebrovascular diseases is vascular diseases such as cerebral infarction, cerebral hemorrhage, cerebral aneurysm, cerebrovascular stenosis. If the disease occurs and causes cerebral damage, it may be difficult to recover completely. So that, Must continue to perform health care through examination early. In particular, Because most cerebrovascular disease examining use radiation equipment and Thus this study was to find out how to select about the optimal examining method and X-ray dose decrease method among different examining method though comparison and analysis for the entrance surface dose (ESD) on cerebrovascular examining with Trance Femoral Cerebral angiography (TFCA) and Cerebral Computed Tomographic Angiography (CCTA). Also, want to find out how to select about the optimal examining method for worried patient that contrast medium side effect though measuring and evaluating for contrast usage. Data were collected from 70 patients (43 males and 27 females) who underwent CCTA at Yeosoo region hospital from June 2018 to December 2018 and 61 patients (34 males and 27 females) who underwent TFCA at Pyeongtaek region hospital from June 2018 to November 2018. ESD analysis method collected retrospective data though M-view and PACS PLUS program, Used contrast usage measuring method did reality measuring method. In the analysis using SPSS, the ESD of TFCA was 245.74 ± 71.91, which was 32.05 ± 7.74 lower than the dose of 277.79 ± 79.65 of CCTA ESD, and statistically significant at t = 3.249, p = 0.017 (p <0.05). As a result of the comparison of the total amount of contrast agent, the mean contrast agent used in TFCA was 55.05 ± 17.68 ml, which was about 14.95 smaller than the amount of contrast agent used in CCTA, and statistically significant t = -4.548, p <0.001. In conclusion, the ESD of TFCA was statistically significantly lower than that of CCTA, and also the used contrast usage was significantly tiny than that of CCTA. Therefore, Select the method to increase the utilization of TFCA for cerebral disease examining, we can consider X-ray dose decrease method at the same time as to decrease side effect of contrast medium.
5 citations
TL;DR: A 72-year-old male with histologically confirmed primary UPS arising from the ileum is described, focusing on both CT and magnetic resonance enterography findings.
Abstract: Gastrointestinal tract involvement in undifferentiated pleomorphic sarcoma (UPS) is extremely rare. To the authors’ knowledge, only 21 cases of primary small bowel UPS have been reported in the literature available in English. Reported CT findings in primary small bowel UPS have been nonspecific, and MRI findings have been reported in only one case. The present article describes a case involving a 72-year-old male with histologically confirmed primary UPS arising from the ileum, focusing on both CT and magnetic resonance enterography findings. On CT, primary small bowel UPS was noted as a heterogeneously enhanced small bowel mass without obstruction. Magnetic resonance enterography revealed heterogeneous intermediate T1 and T2 signal intensity, with hemorrhagic or necrotic foci within the mass and heterogeneous enhancement. The differential diagnosis included malignant gastrointestinal tumor; however, the prognosis of UPS is worse, with higher incidences of extra-abdominal metastasis.
4 citations
TL;DR: 3D printing technology, with additive manufacturing, can aid in the production of various kinds of patient-specific medical devices and implants in medical fields, which cannot be covered by mass production systems for producing conventional devices/implants.
Abstract: Three-dimensional (3D) printing technology, with additive manufacturing, can aid in the production of various kinds of patient-specific medical devices and implants in medical fields, which cannot be covered by mass production systems for producing conventional devices/implants. The simulator-based medical image demonstrates the anatomical structure of the disease, which can be used for education, diagnosis, preparation of treatment plan and preoperative surgical guide, etc. The surgical guide is used as a patient-specific medical device for guiding incision, resection, insertion, and marking. As 3D printers can output materials that can be inserted into the human body, the patient-specific implant device that reflects the patient’s anatomy and surgical plan could be of relevance. In addition, patient-specific aids, including gibs, splints, prostheses, and epitheses, could be used for a better outcome. Finally, bio-printing is also used to cultivate cells to produce functional artificial tissues.
4 citations
TL;DR: UAE using NBCA is safe and effective for the patients with PPH showing extravasation or pseudoaneurysm, and one patient died from multi-organ failure eight days after UAE.
Abstract: Purpose To evaluate the clinical efficacy and safety of uterine artery embolization (UAE) using N-butyl-2-cyanoacrylate (NBCA) in patients with postpartum hemorrhage (PPH). Materials and Methods From February 2010 to May 2018, 14 patients (age: 28–39 years; mean: 33 years) underwent UAE using NBCA among 82 patients with PPH. Medical records were retrospectively reviewed to evaluate the patients characteristics, cause of PPH, embolization procedure, and outcomes. Results Angiograms revealed extravasation (n = 10) or pseudoaneurysm (n = 4) in all patients. The causes of PPH were hysterotomy or hysterectomy related arterial injury (n = 11), cervical laceration (n = 2), and abnormal placentation (n = 1). UAE was performed with NBCA in all patients. Additional UAE with gelatin sponge particles was performed in two patients. Additional non-uterine artery embolization was performed in three patients. Coagulopathy was found in five (35.7%) patients. The technical and clinical success rates were 92.9% and 85.7%, respectively. One patient died from multi-organ failure eight days after UAE. One patient with abnormal placentation had pelvic organ ischemia due to multiple pelvic artery embolization. Conclusion UAE using NBCA is safe and effective for the patients with PPH showing extravasation or pseudoaneurysm.
4 citations
4 citations
TL;DR: This paper aims to provide a history of Radiology in South Korea and some of the techniques used in the development of nuclear medicine and its applications in the treatment of cancer.
Abstract: 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea 2Department of Radiology, Eulji University College of Medicine, Daejeon, Korea 3Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea 4Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea 5Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea
4 citations
TL;DR: The imaging features of intrahepatic and perihilar cholangiocarcinoma and the considerations for interpretation of these features are described.
TL;DR: This review article draws attention to imaging informatics as a vehicle to open a new horizon and to drive to the future path for radiology in the AI and big data era.
Abstract: We are witnessing the big wave of Industrial Revolution 4.0, enabled by artificial intelligence (AI) and big data, which has shaken the entire industry and day-to-day life as well as rapidly changed the landscapes of related academic disciplines. After the introduction of genome sequencing and analysis technology, biology and medical sciences have been rapidly transforming into data science. Radiology is facing a challenging period of transformation into a data science. This review article draws attention to imaging informatics as a vehicle to open a new horizon and to drive to the future path for radiology in the AI and big data era. We introduce the basic concepts of imaging informatics and consider the informatics features of picture archiving and communication system and digital imaging and communications in medicine. We discuss the concepts and differences of radiogenomics and radiomics, which are important specialties of imaging informatics. We introduce the basics of AI and its recent applications in radiology as well as requirements for the successful construction of big data for imaging informatics. We conclude by discussing unresolved issues, potential solutions, and directions for future developments.
TL;DR: The appearance and closure of the TRC and PA ossification centers show predictable patterns of development, appearance and merger earlier in females than in males, and it is suggested that development and morphogenesis of both T RC and PA OSSification centers can be adequately assessed by 3-dimensional body CT.
Abstract: Purpose This study attempts to evaluate the skeletal maturation patterns of the triradiate cartilage (TRC) and the posterior acetabular wall (PA), which can be easily assessed on body computerized tomography (CT). It also examines the effect of gender and age on ossification of both TRC and PA. Materials and Methods This retrospective study included a total of 1324 CT scans for children between the ages of 6 and 16 years. Depending on the extent of ossification in each right or left aspect, determined by the consensus of two observers, the TRC and PA scans were categorized into Grades 4 and 3, respectively. Results The TRC for boys began to ossify at age 10 and closed completely at 14, while the PA for boys started ossification at age 11 and entirely fused at 13. The ages of ossification center appearance and complete fusion in both TRC and PA for girls were exactly two years earlier than boys. The TRC fused within one year after the closure of the PA. Conclusion The appearance and closure of the TRC and PA ossification centers show predictable patterns of development, appearance and merger earlier in females than in males. The suggestion is that development and morphogenesis of both TRC and PA ossification centers can be adequately assessed by using 3-dimensional body CT.
TL;DR: G gadoxetate-enhanced MRI is used to comprehensively review the HCC enhancement patterns and the associated histopathologic findings with their prognostic factors to thoroughly understand these patterns.
Abstract: In patients at high risk of hepatocellular carcinoma (HCC), such as those with chronic hepatitis or cirrhosis, the confirmative diagnosis of HCC can be made solely from characteristic imaging findings on contrast-enhanced CT or MR scans. However, in daily practice, HCCs showing atypical imaging features are frequently encountered. Since the criteria for diagnosis of HCC is based on dynamic contrast enhancement patterns, it is essential to thoroughly understand these patterns. In this article, we aim to use gadoxetate-enhanced MRI to comprehensively review the HCC enhancement patterns and the associated histopathologic findings with their prognostic factors.
TL;DR: The authors reviewed the considerations when performing CT for evaluating abdominal trauma and described the important imaging findings and pitfalls when diagnosing blunt trauma in various intra-abdominal organs.
Abstract: Owing to the developments in imaging modalities, imaging has become an essential element in the early evaluation of and decision-making algorithm for patients with trauma. In particular, CT technology has developed over the past decades, resulting in faster image acquisition and higher image quality. Currently, CT is the key imaging modality for triaging surgical and non-surgical treatment in patients with abdominal trauma and plays an important role in increasing the frequency and success rate of non-surgical treatment. Because rapid and accurate diagnosis of injury in patients with trauma can improve the patients’ prognosis, radiologists should be familiar with the imaging findings, especially the CT findings, in patients with trauma. In this article, the authors reviewed the considerations when performing CT for evaluating abdominal trauma. In addition, they described the important imaging findings and pitfalls when diagnosing blunt trauma in various intra-abdominal organs.
TL;DR: The results showed that the CNR value was the highest and the COV the lowest when applying the TV algorithm, and the algorithm can acquire superior CNR and COV results with 0 mm Al in all algorithm cases.
Abstract: Images using X-rays are essential to diagnosis, but noise is inevitable in the image. To compensate for this, a total variation (TV) algorithm was presented to reduce the patient's exposure dose while increasing the quality of the images. The purpose of this study is to verify the effect on the image quality in radiographic imaging according to the thickness of the additional filtration plate through simulation, and to evaluate the usefulness of the TV algorithm. By using the Geant4 Application for Tomographic Emissions (GATE) simulation image, the actual size, shape and material of the Polymethylmethacrylate (PMMA) phantom were identical, the contrast to noise ratio (CNR) and coefficient of variation (COV) were compared. The results showed that the CNR value was the highest and the COV the lowest when applying the TV algorithm. In addition, we can acquire superior CNR and COV results with 0 mm Al in all algorithm cases.
TL;DR: A survey on the actual condition of teleradiology in Korea was necessary to prepare a guideline and questionnaires were administered to training hospitals.
Abstract: Purpose Teleradiology has been widely used nationwide in various ways. In order to prepare a guideline, it was recognized that a survey on the actual condition of teleradiology in Korea was necessary. Materials and Methods The questionnaires were administered to training hospitals. Interviews were a...
TL;DR: The purpose of this study was to survey and analyze the effects of organizational culture, leadership and organizational commitment on organizational satisfaction among radiological technologist working in hospitals in Busan and showed that organizational commitment had the highest impact on job satisfaction of rad biological technologist.
Abstract: The purpose of this study was to survey and analyze the effects of organizational culture, leadership and organizational commitment on organizational satisfaction among radiological technologist working in hospitals in Busan. As a result, the scores of organizational culture, organizational commitment and job satisfaction of the tertiary university hospital were significantly higher (p<0.05, p<0.001). In the group with no turnover experience, the organizational commitment, job satisfaction, and organizational effectiveness scores were significantly higher (p<0.05). Job satisfaction scores of the department of nuclear medicine were significantly higher (p<0.05). Hierarchical regression analysis showed that organizational commitment had the highest impact on job satisfaction of radiological technologist (β=0.564, p<0.001). radiological technologist play a large part in hospital tissues in the diagnosis of disease. Therefore, based on the results of this study, it is helpful to analyze the relationship between the radiological history, organizational culture, leadership and organizational commitment in order to improve the job satisfaction of radiological technologists.
TL;DR: Comparison of image quality by differences of added filter through simulation image and actual radiation image found out that filter makes not only decreasing total dose by absorbing low energy of X-ray, but also increasing average energy of
Abstract: X-선 영상에서 필터를 통한 여과의 역할은 영상 형성에 유용한 광자를 이용해 환자의 피폭량을 낮춤과 동시에 영상의 대조도를 높이는 것이다. 영상을 형성하는 데 있어서 저에너지 X-선은 환자 조직의 최초 몇 cm 부위에서 흡수되고 고에너지 부분만을 통과하여 형성되므로, 방사선 여과는 여과물질을 삽입하여 저에너지 X-선을 여과물질로 하여금 흡수시켜 환자의...
TL;DR: It is necessary to classify the patient transporter as a frequent visitor in order to measure and manage the exposure dose, increase the knowledge of protection against radiation through education and training, and prevent radiation trouble through medical examination.
Abstract: The medical institutions use radiation generating devices and radioactive isotopes to diagnose and treat patients. The patient transporter performs work in an environment that is more likely to be exposed to radiation when compared with the general public, such as inevitably entering the radiation management area for patient transfer, or transferring the isotope-administered patient at a short distance. For this reason, we conducted a study to determine the degree of exposure of the patient transporter. The 12 patient transporters working at Incheon A General Hospital are eligible. From April 1, 2019 to April 30, 2019, the dosimeter was used in the chest for one month and the accumulated dose was measured. The dosimeter used was a Optically Stimulated Luminescence Dosimetry(OSLD) and the dose reading was OSLD Microstar Reading System. As a result of cumulative dose measurement for one month, the average of the deep dose was 0.13 mSv and the surface dose was 0.13 mSv, and the cumulative dose for one month was multiplied by 12 to estimate the cumulative dose expectation As a result, the average of the deep dose and the surface dose were 1.52 mSv and 1.51 mSv, respectively. It is necessary to classify the patient transporter as a frequent visitor in order to measure and manage the exposure dose, increase the knowledge of protection against radiation through education and training, and prevent radiation trouble through medical examination.
TL;DR: These guidelines ultimately aim to increase the cure rate by surgical resection and reduce the likelihood of unnecessary surgery by early and efficient screening of high-risk cases.
Abstract: Incidental pancreatic cysts may show various clinical courses, from benign to invasive malignant lesions. To adequately treat asymptomatic pancreatic cystic tumors, accurate diagnosis is needed. However, in many cases, clinical and imaging findings do not provide a definitive diagnosis. Therefore, if there is any evidence suggestive of a malignant lesion, the lesion should be removed surgically. If not, follow-up should be done continuously. To date, several academic societies have issued guidelines that suggest malignant features and follow-up strategies for incidental pancreatic cysts. These guidelines ultimately aim to increase the cure rate by surgical resection and reduce the likelihood of unnecessary surgery by early and efficient screening of high-risk cases. The purpose of this study is to review the relevant findings for the definitive diagnosis of relatively common pancreatic cystic neoplasms and to discuss guidelines for the management of incidental pancreatic cystic neoplasms.
TL;DR: A literature review is provided and the efficacy and clinical significance of intervention for urologic trauma is discussed, which may increase the use of interventional procedures for patients with renal injury.
Abstract: Urinary tract injuries occur in up to 10% of patients with abdominal trauma, and the kidney is the most commonly injured structure of the urinary system. The kidney is the third most common abdominal organ to be injured by trauma, following the spleen and liver, in that order. The American Association for the Surgery of Trauma kidney injury scale is the most commonly used classification system for blunt renal injuries, which grades renal injury based on the size of laceration and its proximity to the renal hilum on CT. CT aids in delineating the most important features of urological injury that affect the diagnosis and management, including interventions. The major renal injuries are usually surgical emergencies. The current trend toward a more conservative management of renal trauma and advances in interventional radiology in the field of trauma may increase the use of interventional procedures for patients with renal injury. Urethral injuries can be anterior or posterior depending on the injury site, and interventional urethral realignment plays an important role in the treatment of urethral injury and surgical repair or endoscopic urethral realignment. Therefore, in this paper, we provide a literature review and discuss the efficacy and clinical significance of intervention for urologic trauma.
TL;DR: In this paper, shielding analysis of material and thickness of 3D printer filaments was performed for the manufacture of custom shielding by radiation workers during outdoor radiographic test, and the shielding was attached to the ICRU Slab Phantom after selecting the voxel source 192Ir and 75Se through simulation using MCNPX.
Abstract: In this study, shielding analysis of material and thickness of 3D printer filaments was performed for the manufacture of custom shielding by radiation workers during outdoor radiographic test. The shielding was attached to the ICRU Slab Phantom after selecting the voxel source 192Ir and 75Se through simulation using MCNPX, and the distance between the source and the slab Phantom was set at 100 cm. The 12 shielding materials were divided into 5 mm units up to 200 mm from the absence of shielding materials to evaluate the energy absorbed per unit mass of each shielding material. The results showed that the shielding effect was high in the order of ABS + Tungsten, ABS + Bismuth, PLA + Copper, PLA + Iron from all sources of radiographic test. However, compared to lead, the shielding effect was somewhat lower. Based on this study in the future, further study of the atomic number and the high density filament material is necessary.
TL;DR: Evaluating the feasibility of comprehensive left ventricle (LV) functional parameters on routine coronary computed tomographic angiography (CCTA) based on two-dimensional echocardiography (2DE) found moderate to strong correlations between CCTA and 2DE.
Abstract: Purpose To evaluate the feasibility of comprehensive left ventricle (LV) functional parameters on routine coronary computed tomographic angiography (CCTA) based on two-dimensional echocardiography (2DE). Materials and Methods Ninety-nine patients who underwent CCTA accompanied by 2DE were included in the study. The volumetric LV systolic functional parameters were acquired from 10-phase reconstruction of CCTA data. By differentiating the time-LV volume curve by time domain and measuring mitral valvular orifice areas, transmitral time-velocity curves were drawn and the early (E) to late (A) mitral inflow peak velocities ratio (E/A ratio) was acquired. By measuring a longitudinal jerking velocity of the mitral valvular annulus on a four-chamber view, the mitral peak velocity of early filling (E) to early diastolic mitral annular velocity (E') ratio (E/E' ratio) was evaluated. All functional parameters were compared with the 2DE results. Results The LV end diastolic volume, LV end systolic volume, ejection fraction, stroke volume, cardiac output, and LV myocardial mass measured by CCTA and 2DE showed moderate to strong correlations (r = 0.732, 0.821, 0.416, 0.394, 0.328, and 0.764, respectively; p < 0.05). The E/A and E/E’ ratios showed strong correlation between CCTA and echocardiography (r = 0.807 and 0.751, respectively; p < 0.05). Received May 28, 2018 Revised July 4, 2018 Accepted August 2, 2018
TL;DR: Evaluate the differences in opinion among radiologists working in different types of medical institutions in Korea, through questionnaires, to find out if there are any differences between the opinions of board-certified radiologists.
Abstract: Purpose To evaluate the differences in opinion among radiologists working in different types of medical institutions in Korea, through questionnaires. Materials and Methods Korean board-certified radiologists who participated in the survey in 2017. Results Of the 316 radiologists who responded to th...
TL;DR: Two cases of benign HA and HAC arising from benign HA with characteristic ultrasonography and computed tomography imaging features are presented.
Abstract: Clear cell hidradenoma (HA) is a rare tumor of sweat glands. Although this tumor is benign, local recurrence often occurs when the resection margin is insufficiently obtained. The common imaging finding of HA is a mixed solid and cystic mass with or without increased vascularity in the solid portion. Malignant transformation of the tumor is also recognized. Hidradenocarcinoma (HAC), which is a malignant counterpart of benign HA, can develop de novo or arise from benign HA. However, imaging findings of HAC are not well established because these tumors are rare and they are commonly excised without imaging study. We present two cases of benign HA and HAC arising from benign HA with characteristic ultrasonography and computed tomography imaging features.