Physical evaluations provide the basis for an objective and quantitative analysis of the image quality. Nonetheless, there are limitations in using physical evaluations to judge the utility of the image quality if the observer's subjectivity plays a key role despite its imprecise and variable nature. This study proposes a new method for objective and quantitative evaluation of image quality to compensate for the demerits of both physical and subjective image quality and combine the merits of them. The images of chest phantom were acquired from four digital radiography systems on clinic sites. The physical image quality was derived from an image analysis algorithm in terms of the contrast-to-noise ratio (CNR) of the low-contrast objects in three regions (lung, heart, and diaphragm) of a digital chest phantom radiograph. For image analysis, various image processing techniques were used such as segmentation, and registration, etc. The subjective image quality was assessed by the ability of the human observer to detect low-contrast objects. Fuzzy integral was used to integrate them. The findings of this study showed that the physical evaluation did not agree with the subjective evaluation. The system with the better performance in physical measurement showed the worse result in subjective evaluation compared to the other system. The proposed protocol is an integral evaluation method of image quality, which includes the properties of both physical and subjective measurement. It may be used as a useful tool in image evaluation of various modalities.

According to improved radiation therapy technology such as IMRT and proton therapy, the accuracy of patient alignment system is more emphasized and IGRT is dominated research field in radiation oncology. We proposed to study the feasibility of cone-beam CT system using simple x-ray imaging systems for image guided proton therapy at National Cancer Center. 180 projection views (2,304×3,200, 14 bit with 127 Ռm pixel pitch) for the geometrical calibration phantom and humanoid phantoms (skull, abdomen) were acquired with 2° step angle using x-ray imaging system of proton therapy gantry room (360° for 1 rotation). The geometrical calibration was performed for misalignments between the x-ray source and the flat-panel detector, such as distances and slanted angle using available algorithm. With the geometrically calibrated projection view, Feldkamp cone-beam algorithm using Ram-Lak filter was implemented for CBCT reconstruction images for skull and abdomen phantom. The distance from x-ray source to the gantry isocenter, the distance from the flat panel to the isocenter were calculated as 1,517.5 mm, 591.12 mm and the rotated angle of flat panel detector around x-ray beam axis was considered as 0.25°. It was observed that the blurring artifacts, originated from the rotation of the detector, in the reconstructed toomographs were significantly reduced after the geometrical calibration. The demonstrated CBCT images for the skull and abdomen phantoms are very promising. We performed the geometrical calibration of the large gantry rotation system with simple x-ray imaging devices for CBCT reconstruction. The CBCT system for proton therapy will be used as a main patient alignment system for image guided proton therapy.

In this study, we have conducted characterization of imaging performance for a flat panel digital X-ray detector using amorphous Selenium and a-Si TFT which was developed by the authors. The procedures for characterization were in concordance with internationally recommended standards such as IEC (international electrotechnical commission). The measures used for imaging performance characterization include response characteristic, modulation transfer function (MTF), detective quantum efficiency (DQE), noise power spectrum (NPS), and quantum limited performance. The measured DQEs at lowest and highest spatial frequencies were 40% and 25% respectively, which was superior to that of commercial products by overseas vendor. The MTF values were significantly superior to that of CR and indirect type DRs. The quantum limited performance showed the detector was limited by quantum noise at the entrance exposure level below 0.023 mR, which is sufficiently low for general X-ray examination.

The purpose of this study was to design and construct an ultrasound phantom for volume calibration and evaluate the volume measurement accuracy of a 2 dimensional ultrasonic system. Ultrasound phantom was designed, constructed and tested. The phantom consisted of a background material and a target. The background was made by mixing agarose gel with water. A target, made with an elastic material, was filled with water to vary its volume and shape and inserted into background material. To evaluate accuracy of a 2 dimensional ultrasonic system (128XP, ACUSON), three different shapes of targets (a sphere, 2 ellipsoids and a triangular prism) were constructed. In case of ellipsoid shape, two targets, one with same size length and width (ellipsoid 1) and another with the length 2 times longer than width (ellipsoid 2) were examined. The target volumes of each shape were varied from 94cc to 450cc and measurement accuracy was examined. The volume difference between the real and measured target of the sphere shape ranged between 6.7 and 11%. For the ellipsoid targets, the differences ranged from 9.2 to 10.5% with ellipsoid 1 and 25.7% with ellipsoid 2. The volume difference of the triangular prism target ranged between 20.8 and 35%. An easy and simple method of constructing an ultrasound phantom was introduced and it was possible to check the volume measurement accuracy of an ultrasound system.

We developed a user-friendly program to independently verify monitor units (MUs) calculated by radiation treatment planning systems (RTPS), as well as to manage beam database in clinic. The off-axis factor, beam hardening effect, inhomogeneity correction, and the different depth correction were incorporated into the program algorithm to improve the accuracy in calculated MUs. A beam database in the program was supposed to use measured data from routine quality assurance (QA) processes for timely update. To enhance user's convenience, a graphic user interface (GUI) was developed by using Visual Basic for Application. In order to evaluate the accuracy of the program for various treatment conditions, the MU comparisons were made for 213 cases of phantom and for 108 cases of 17 patients treated by 3D conformal radiation therapy. The MUs calculated by the program and calculated by the RTPS showed a fair agreement within ±3% for the phantom and ±5% for the patient, except for the cases of extreme inhomogeneity. By using Visual Basic for Application and Microsoft Excel worksheet interface, the program can automatically generate beam data book for clinical reference and the comparison template for the beam data management. The program developed in this study can be used to verify the accuracy of RTPS for various treatment conditions and thus can be used as a tool of routine RTPS QA, as well as independent MU checks. In addition, its beam database management interface can update beam data periodically and thus can be used to monitor multiple beam databases efficiently.

Patient's respiration can have an effect on movement of tumor range and peripheral organs. Therefore, the respiratory signal was acquired by relation between external markers and movement of patient's abdomen during radiational therapy in order to minimize the effect of respiration. Based on this technique, many studies of rational therapy to irradiate at particular part of stable respiratory signals have executed and they have been clinically applied. Nevertheless, the phase-based method is preferred to the amplitude-based method for the rational therapy related to respiration. Because stabilization of the respiratory signal are limited. In this study, a in-house respiratory signal analysis program was developed for the phase reassignment and the analysis of the irregular respiratory signals. Various irregular respiratory patterns was obtained from clinical experimental volunteers. After then, the in-house program analyzed the factors affecting to phase assignment which is directly related to irradiated sector. Subsequently, accuracy of phase assignment was improved with removement of irregular signals by self-developed algorithm. This study is considered to be useful for not only image reconstruction and elevation of irradiating accuracy through phase assignment of RPM system but also analysis of respiratory signals. Moreover, development of 4D CT image is planed with phantom researches or clinical experiments based on this program.

A coded aperture camera has been developed to improve the signal-to-noise ratio (SNR) while keeping the spatial resolution of a pinhole gamma camera. The purpose of this study was to optimize a coded aperture camera and to evaluate its possibility for thyroid imaging by Monte Carlo simulation. A clinical gamma camera, a pinhole collimator with 1.0 mm hole diameter, and a 79×79 modified uniformly redundant array (MURA) mask were designed using GATE (Geant4 Application for Tomographic Emission). The penetration ratio, spatial resolution, integral uniformity and signal-to-noise ratio (SNR) were simulated and evaluated as a function of the mask thickness. The spatial resolution of the coded aperture camera was consistent with the various mask thickness, SNR showed a maximum value at 1.2 mm mask thickness and integral uniformity was improved by increasing mask thickness. Compare to the pinhole gamma camera, the coded aperture camera showed improved SNR by a factor of 30 while keeping almost the same spatial resolution. In this simulation study, the results indicated that high spatial resolution and ultra-high SNR of the thyroid imaging are feasible using a coded aperture camera.

To evaluate the metabolic changes in normal adult brains due to alterations SENSE and NEX (number of excitation) by multi voxel MR Spectroscopy at 3.0 Tesla. The study group was composed of normal volunteers (5 men and 8 women) with a mean (± standard deviation) age of 41 (±11.65). Their ages ranged from 28 to 61 years. MR Spectroscopy was performed with a 3.0T Achieva Release Version 2.0 (Philips Medical System-Netherlands). The 8 channel head coil was employed for MRS acquisition. The 13 volunteers underwent multi voxel spectroscopy (MVS) and single voxel spectroscopy (SVS) on the thalamus area with normally gray matter. Spectral parameters were as follows: 15 mm of thickness; 230 mm of FOV (field of view); 2000 msecs of repetition time (TR); 288 msecs of echo time (TE); 110×110 mm of VOI (view of interest); 15×15×15 mm of voxel size. Multi voxel spectral parameters were made using specially in alteration of SENSE factor (1∼3) and 1∼2 of NEX. All MRS data were processed by the jMRUI 3.0 Version. There was no significant difference in NAA/Cr and Cho/Cr ratio between MVS and SVS likewise the previous results by Ross and coworkers in 1994. In addition, despite the alterations of SENSE factor and NEX in MVS, the metabolite ratios were not changed (F-value : 1.37, D.F : 3, P-value : 0.262). However, line-width of NAA peak in MVS was 3 times bigger than that in SVS. In the present study, we demonstrated that the alterations of SENSE factor and NEX were not critically affective to the result of metabolic ratios in the normal brain tissue.

The application of a respiratory gated radiotherpy method to the lung radiation surgery was evaluated compared with the conventional method in which the whole tumor motion range is considered in the delineation of PTV (Planning target volume). The four dimensional CT simulation images were acquired for the five NSCLC (Non-small cell lung cancer) patients for radiation surgery. The respiratory gated plan was prepared with the 50% phase CT images and the conventional method was planned based on the ITV (Internal target volume) which include all the target volumes created in each phase CT images within a whole respiratory period. The DVH (Dose volume histogram) of OAR (Organ at risk) which calculated in each method was compared for the evaluation of the plan properness. The relative decrease of OARs' DVH were verified in the application of respiratory gated method. The average decrease rate were 16.88±9.97% in the bronchus, 34.13±19.15% in the spinal cord, 28.42±18.49% in the chest wall and 32.48±16.66% in the lung. Based on these results, we can verified the applicability and the effectiveness of the respiratory gated method in the lung radiation surgery.

Although MR imaging is generally applicable to depict knee joint deterioration it, is sometimes occurred to mis-read and mis-diagnose the common knee joint diseases. In this study, we employed magnetization transfer ratio (MTR) method to improve the diagnosis of the various knee joint diseases. Spin-echo (SE) T2-weighted images (TR/TE 3,400-3,500/90–100 ms) were obtained in seven cases of knee joint deterioration, FSE T2-weighted images (TR/TE 4,500-5,000/100–108 ms) were obtained in seven cases of knee joint deterioration, gradient-echo (GRE) T2-weighted images (TR/TE 9/4.56/50° flip angle, NEX 1) were obtained in 3 cases of knee joint deterioration, In six cases of knee joint deterioration, fat suppression was performed using a T2-weighted short T1/tau inverse recovery (STIR) sequence (TR/TE =2,894-3,215 ms/70 ms, NEX 3, ETL 9). Calculation of MTR for individual pixels was performed on registration of unsaturated and saturated images. After processing to make MTR images, the images were displayed in gray color. For improving diagnosis, three-dimensional isotropic volume images, the MR tristimulus color mapping and the MTR map was employed.
MTR images showed diagnostic images quality to assess the patients' pathologies. The intensity difference between MTR images and conventional MRI was seen on the color bar. The profile graph on MTR imaging effect showed a quantitative measure of the relative decrease in signal intensity due to the MT pulse. To diagnose the pathologies of the knee joint, the profile graph data was shown on the image as a small cross. The present study indicated that MTR images in the knee joint were feasible. Investigation of physical change on MTR imaging enables to provide us more insight in the physical and technical basis of MTR imaging. MTR images could be useful for rapid assessment of diseases that we examine unambiguous contrast in MT images of knee disorder patients.