디지털흉부 X 선촬영장치의화질 에양자검출효율 (Detective Quantum Efficiency; 이하 DQE) 을이용한디지털 X 선촬영장치의성능평가를위한기술문서 를발표하였으며, 이는디지털 X 선촬영장치의정량적성능측 정방법으로현재까지널리사용되고있다 (6). 그러나시스

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1 Original Article pissn J Korean Soc Radiol 2011;65(5): The Image Quality of a Digital Chest X-Ray Radiography System: Comparison of Quantitative Image Quality Analysis and Radiologists Visual Scoring 1 디지털흉부 X 선촬영장치의화질 : 정량적화질평가와영상의학과의사의육안평가간의비교연구 1 Hosang Jeon, PhD 1,4, Ji Ho Nam, MD 1, Myung Jin Chung, MD 2, Darl Park, PhD 3, Won Taek Kim, MD 3, Yong Ho Kim, MS 3, Yong Kan Ki, MD 3, Dong Hyun Kim, MD 3, Ju Hye Lee, MD 3, Dong Won Kim, MD 3 1 Department of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan, Korea 2 Department of Radiology, Samsung Medical Center, Seoul, Korea 3 Department of Radiation Oncology, Pusan National University Hospital, Busan, Korea 4 Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea Purpose: To evaluate the performance of imaging devices, which should be periodically monitored to maintain high quality images to the radiologists. Additionally, this evaluation may prevent patients from radiation over-exposure. The most suitable engineering standard for imaging performance evaluation of digital X-ray thoracic imagers was determined. Materials and Methods: IEC standards were used to evaluate the performance of the imagers. In succession, the visibilities of overall image, pneumothorax, and humerus head in anthropomorphic thoracic phantom images were used to evaluate the image qualities by radiologists. Results: The rank correlation coefficient (p) of visual scoring by radiologists with system spatial resolution is not meaningful (p-value, p = 0.295), but is significant with image noise (p-value, p = ). Finally, the noise equivalent quanta (NEQ) presents a high rank correlation for visual scoring of radiologists (p-value, p = ). Conclusion: Image quality evaluation of radiologists were mainly affected by imaging noise. Hence, the engineered standard for evaluating image noise is the most important index to effectively monitor the performance of X-ray imagers. Additionally, the NEQ can be used to evaluate the performance of radiographic systems, because it theoretically corresponds to the synthetic image quality of systems. Index terms Thoracic X-Ray Images Noise Equivalent Quanta Modulation Transfer Function Normalized Noise Power Spectrum Received August 1, 2011; Accepted August 15, 2011 Corresponding author: Myung Jin Chung, MD Department of Radiology, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul , Korea. Tel Fax chungmjmd@gmail.com This study was supported by a 2010 research grant from Pusan National University Yangsan Hospital, and partially supported by National Research Foundation of Korea (NRF) grant (No ). Copyrights 2011 The Korean Society of Radiology 서론 X선영상을이용한흉부촬영및진단은일반건강검진및각종진단목적으로환자뿐만이아니라일반인에이르기까지과거로부터현재까지광범위하게사용되고있는영상진단기법이다. 또한관련기술의발달에따라 X선영상획득및후처리 (postprocessing) 전과정의디지털화가이루어짐으로써효율적인 X 선영상촬영및진단이가능하게됨에따라현재대다수의의료기관에서는디지털방식의 X선흉부촬영기기를도입하여사용 하고있다. 한편디지털 X선촬영기기의주기적인품질검증 (Quality Assurance) 은의사에게고품질의영상을지속적으로제공하고 X 선촬영에따른환자의피폭을최소화하기위해반드시필요한과정이며, 이에따라육안으로화질을평가하는주관적이고정성적인방법대신디지털 X선촬영장치의객관적이고정량적인성능평가방법에대한연구들이활발하게이루어져왔다 (1-6). 특히국제전기표준회의 (International Electrotechnical Commission; 이하 IEC) 에서는여러연구결과들을토대로 2002 년 submit.radiology.or.kr 대한영상의학회지 2011;65(5):

2 디지털흉부 X 선촬영장치의화질 에양자검출효율 (Detective Quantum Efficiency; 이하 DQE) 을이용한디지털 X 선촬영장치의성능평가를위한기술문서 를발표하였으며, 이는디지털 X 선촬영장치의정량적성능측 정방법으로현재까지널리사용되고있다 (6). 그러나시스템에입력되는신호대잡음비 (signal to noise ratio; 이하 SNR) 와그입력에대응하여출력되는 SNR 의상대적 인비율로표현되는 DQE 는그정의상시스템의입사선량과출 력영상을모두고려한종합적인성능을의미하므로의사가평 가하는영상의화질과반드시선형적인관계를가지는것은아 니다 년에 Herrmann 등 (7) 은필름촬영시스템을이용한 흉부 X 선영상의육안평가결과와 DQE 간에대체로선형적인 관계가관찰되지만 CCD 기반촬영시스템의경우에는 DQE 가 육안평가에비해상대적으로낮은값을가지는경향이있음을 보고하였다. 또한 2004 년에 Sund 등 (8) 은형광판기반시스템 (Phosphor-based system) 과 CCD 기반시스템의성능평가를 수행한결과육안평가는후자가더높았으나 DQE 는전자가 더높은현상이발생하였으며, 이는양자포화조건 (Quantumsaturated condition) 과영상후처리등시스템의특성에따른영 향으로보인다는연구결과를발표하였다. 따라서 DQE 는시스 템의설계및제작, 그리고장비의종합성능관리에는유용하 지만, 의사가인지하는화질성능이가장중요한의료현장에서 디지털 X 선촬영장치의화질평가에직접적으로적용하기는어 렵다. 따라서본연구에서는시스템의출력만을평가함으로써 영상의화질을평가할수있는공학적인자인 noise equivalent quanta ( 이하 NEQ) 를도입하고의사육안평가와의상관관계 를분석하였다. 이 NEQ 는시스템에입력되는 SNR 과는무관하 므로디지털 X 선촬영장치의출력영상의화질을평가하는데 적합할것으로기대된다. 또한 NEQ 산출과정에는영상의공 간해상도를나타내는 modulation transfer function ( 이하 MTF) 과영상의잡음특성을보여주는 noise power spectrum ( 이하 NPS) 측정이필수적이므로, 이들과의사육안평가와의상관관 계비교는정량적평가와의사평가간의관계를이해하는데 중요한역할을할것으로생각된다. 본연구결과는정량적영 상평가인자들을이용한진단용디지털 X 선촬영장치의영상 Table 1. Specifications of Digital X-Ray Imaging Devices for Acquisition of Radiographic Thoracic Images Specifications Philips Canon Model Digital Diagnose CXDI-40G Numbers 2 1 Detector material CsI (Tl) Gd 2O 2S Pixel pitch (mm) Array size 3,001 by 3,001 2,688 by 2,688 Imaging size (cm 2 ) 43 by by 41 품질검증결과를이해하고활용하는데매우유용한근거를제공할것이다. 대상과방법 디지털 X선촬영장치및촬영조건흉부 X선영상획득을위하여사용된디지털 X선영상촬영장치들은 Philips 사의 Digital Diagnose (Philips Healthcare, Best, Netherlands) 2대및 Canon 사의 CXDI-40G (Medical Systems Division of Canon USA, Irvine, CA, USA) 1대이며, 각장치들의주요특성들은 Table 1과같다. 또한사용연한은모두 3년이내로사용정도에는큰차이가없다. 영상획득에사용된관전압 (Tube voltage) 은흉부촬영시많이사용하는 120 kvp 이며, 관전류 (Tube current) 는기기별로서로다른 5 개의값을사용하였다. 정량적화질평가인자 NEQ 는이론적으로시스템으로부터출력되는영상의 SNR 을의미하며, MTF 와 NPS 를이용하여식 1과같이계산될수있으며 (9), 이때 f는공간주파수 (spatial frequency) 를의미하며, NNPS 는정규화된 NPS (normalized NPS) 를의미한다. NEQ(f) = MTF2 (f) (1) NNPS(f) 본연구에서는디지털 X선촬영장치들을이용하여얻어지는 X선영상의정량적화질평가를위해일정한촬영조건에서얻어진각영상들의 MTF 와 NNPS 를모두측정한후식 1을이용하여각각의 NEQ 값을산출하였다. MTF 와 NNPS 측정및계산에관한전반적인절차는 IEC 의권고에따랐다 (6). 또한 MTF, NNPS, 그리고피폭선량측정시촬영조건의차이를최소화하기위하여각촬영조건당한개의영상만을이용하여동시에측정하였다 (Fig. 1). 피폭선량측정은 RAD- CHECK TM ion chamber (Fluke, Gresham, OR, USA) 를사용하였으며 MTF 측정은텅스텐재질의 Edge phantom 을제작하여사용하였다. 한편 MTF 와 NNPS, 그리고 NEQ 와같은공학적화질평가인자들을이용한측정결과들은공간주파수에대한함수로획득되기때문에영상의학과의사의육안평가결과와의직접적인비교가어렵다. 따라서본연구에서는식 2와같이육안으로구별할수있는공간주파수영역 (0.5~2.0 line pairs per mm) 에대해 NEQ 값들을적분하는 integrated NEQ ( 이하 ineq) 480 대한영상의학회지 2011;65(5): submit.radiology.or.kr

3 전호상외 인자를도입하여종합적인성능을표현하였으며 (8), 동일한개 념으로 imtf 및 innps 인자도사용하였다. 2.0 ineq = NEQ(f)df (2) 0.5 영상의학과의사의육안평가 1996 년에 European Commission 은흉부방사선촬영에관한가이드라인 (guideline) 을개정및발표하였는데 (10), 이가이드라인에는영상화질의육안평가를위한 10개의평가항목들이제시되어있다 (Table 2). 본연구에서는이가이드라인을이용하여의인화흉부팬텀 (Canadian Scientific Products, London, Canada) 영상의화질을평가할수있도록영상잡음 (Noise) 과기흉 (Pneumothorax) 의명시성, 그리고상완골두 (Humerus head) 의명시성등육안평가를위한세가지기준을설정하고각각 0~5점 (0, 전혀안보임 ; 1, 거의안보임 ; 2, 식별은되나불충분함 ; 3, 진단이가능한정도로보이나통상의임상영상이하 ; 4, 통상의임상에서접하는영상의수준으로잘보임 ; 5, 통상이상으로명확하게보임 ) 의범위에서평가하였으며, 5년이상의경력을가진 2명의영상의학과의사들이각 2회씩영상평가를수행하였다. 이때영상잡음은 Table 2의평가항목들중 3, 4번, 기흉의명시성은 2, 3, 5, 7, 9, 10번, 그리고상완골두의명시성은 2, 7, 8번과연관되며, 팬텀영상의경우 1번과 6번항목의평가는불가능하므로제외하였다. 통계처리촬영조건에따라달라지는 imtf, innps 및 ineq 와같은정량적화질평가결과와영상의학과의사의육안평가결과간의상관관계를규명하기위하여각각의 Spearman s rank correlation 을평가하여비교하였다. 단, 공간해상도와잡음도의개별적평가가가능한공학적화질평가의경우에는세가지인자들을모두결과분석에사용하였으나, 성능항목별로정확히구분된평가를기대하기어려운육안평가의경우에는세가지인자들에의한평가결과의평균값을사용하였다. 결과 피폭선량을변화시키면서획득한정량적화질평가용영상들을분석한결과 의경우피폭선량이 7.03 배증가하였을때 imtf 는소폭향상된것으로관찰되었으나 (9.3%), innps 는대폭향상된것으로 (366.7%) 나타났다. 또한종합적인 SNR 을의미하는 ineq 는 innps 와거의비슷한수준으 Fig. 1. An example of acquired images for MTF and NNPS measurements. Note.-MTF = modulation transfer function, NNPS = normalized noise power spectrum Table 2. Criteria for Quality Evaluation of Radiographs on European Guidelines, Modified in 1996 Number Criteria Description 01 Reproduction of the vascular pattern of the lung 02 Visually sharp reproduction of the trachea and the proximal bronchi, the border of the heart and aorta 03 Visually sharp reproduction of the diaphragm and the costophrenic angles 04 Visualization of the retrocardiac lung and mediastinum 05 Thin linear structure (0.5 2 mm): fissures, peripheral vessels 06 Rounded structures (2-6 mm): vessels seen en face 07 The carina with the main bronchi 08 The thoracic vertebrae 09 The interface mediastinum lung 10 The costopleural junction 로향상되었다. 와 의경우에는피폭선량의 증가에따른 innps 의증가율이각각 460.5% 와 391.8% 이고 ineq 의증가율도 429.6% 와 401.8% 로크게나타난반면, 피 폭선량과 imtf 사이에는뚜렷한상관관계가관찰되지않았 다 (Table 3)(Fig. 3). 다만평균 imtf 는시스템의종류에따 라달라지는것으로나타났는데, 와 B 의평균 imtf 는모두 1.36 이며 의경우에는 1.14 로계산되었다. 한편동일한촬영조건에서획득한흉부팬텀영상들의화질 들을영상의학과의사들이분석한결과, 세가지시스템모두 에서피폭선량이증가하면영상평가의평균점수 (Mean score) 가증가하였으며 (Fig. 4A), 모든평가항목에서피폭선 량의증가에따른점수의증가가관찰되었다 (Table 4). submit.radiology.or.kr 대한영상의학회지 2011;65(5):

4 디지털흉부 X 선촬영장치의화질 A B Fig. 2. (A) An anthropomorphic phantom and (B) its radiographic image. imtf (mm -1 ) innps (mm) 1.4E-4 1.2E-4 E-4 8.0E-5 6.0E-5 4.0E-5 2.0E-5 ineq (mm -2 ) 3.5E+5 3.0E+5 2.5E+5 2.0E+5 1.5E+5 E+5 5.0E E E Exposure (mr) Exposure (mr) Exposure (mr) A B C Fig. 3. Relationships between exposures and (A) imtfs, (B) innpss and (C) ineqs. Note.-iMTF = integrated modulation transfer function, ineq = integrated noise equivalent quanta, innps = integrated normalized noise power spectrum 동일한영상에대한정량적화질평가결과와영상의학과의사의육안평가결과의직접비교를위해상호간의순위상관관계 (Rank correlation) 를분석한결과 innps 와평균점수사이에는유의미한상관관계가관찰되었으며이때의순위상관관계계수 (Spearman s rank correlation coefficient, p) 는 p = (p < 0.001) 이다 (Fig. 4C). 또한 ineq 와 Mean score 의경우에는 p = (p < 0.001) 로유의미한상관관계가관찰되었다 (Fig. 4D). 그러나 imtf 와 사이에는유의미한상관관계가발견되지않았다 (Fig. 4B). 고찰 디지털방식의진단용 X 선촬영기기가소개된이후그에적 합한정량적성능평가방법에관한연구도꾸준히이루어져왔으며 (9, 11-13), 국제적으로통용될만한기술기준들도이미제시되어널리사용되고있다 (5, 6). 그러나이미서론에서언급한바와같이현재의성능평가는철저히정량적평가인자들을이용하여수행되도록되어있으나, 이는실제로현장에서영상을판독하는의사가육안으로평가하는성능과는미묘한차이가있어서결과적으로시스템유지관리의효율성을저해할가능성이크지만그상관관계에관한연구는아직희소하다. 본연구에서는다양한촬영조건에서영상을획득한후정량적화질평가와육안평가결과를이용하여상호간의상관관계를다각도로분석하였다. 일반적으로흉부 X선진단은병변의종류와위치에따라다양한영향을받는것이사실이지만, X선촬영장치의정량적화질평가기준은단순히영상의 482 대한영상의학회지 2011;65(5): submit.radiology.or.kr

5 전호상외 Table 3. Acquired Engineering Factors for the Evaluation of Image Quality Exposure (mr) imtf (mm -1 ) innps (mm) ineq (mm -2 ) E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E + 05 Note. imtf = integrated modulation transfer function, ineq = integrated noise equivalent quanta, innps = integrated normalized noise power spectrum Exposure (mr) Overall Noise Table 4. The Averaged Scores for Image Quality Evaluation by Radiologists Pneumothorax Humerous Head Mean A p = (p = ) Exposure (mr) B imtf (mm -1 ) C p = (p < 0.001) p = (p < 0.001) E E - 05 E E E + 00 E E E E + 05 innps (mm) D ineq (mm -2 ) Fig. 4. Relationships between mean scores by radiologists and (A) exposures, (B) imtfs, (C) innpss, and (D) ineqs. Note.-iMTF = integrated modulation transfer function, ineq = integrated noise equivalent quanta, innps = integrated normalized noise power spectrum submit.radiology.or.kr 대한영상의학회지 2011;65(5):

6 디지털흉부 X 선촬영장치의화질 공간해상도와잡음도이므로본연구에서사용된육안평가의세가지기준은본연구의목적을달성하는데충분하다고할수있다. 모든시스템에서피폭선량의변화에따른 imtf 의변화는크지않았고 ( 평균표준편차 : 5.0%) 둘사이에유의미한상관관계가발견되지않았다 (Fig. 3A). 디지털방식의 X선촬영시공간해상도에주로영향을미치는요인은영상검출기의화소크기 (pixel pitch) 나섬광물질 (Scintillation material) 의두께와같은장비고유의특성들이므로, 공간해상도를나타내는 imtf 는장비를설계하고제작할때이미결정되었다고볼수있을것이다. 시스템의변화에따른평균 imtf 의변화비율 (1.36/1.14) 이최대공간해상도변화비율 (0.16/0.143) 과큰차이가나지않은것도그사실을뒷받침하고있다. 단, 본연구에서는관전압을고정시켰으나본연구에서사용한디지털영상획득장비중 Philips 사의 Digital Diagnose 의경우관전압이변하면공간해상도에약간의변화가나타난다는연구보고가있다 (11). 영상에포함된잡음의양을나타내는 innps 는피폭선량의증가에따라지속적으로감소하다가어느정도지나면수렴하는경향을보이며, 본래잡음특성이좋아 innps 값이전반적으로낮을수록피폭선량의큰증가에따라수렴하는경향이두드러진다 (Fig. 3B). 본연구에서, imtf 와 innps 를이용하여산출한 ineq 는피폭선량의증가에따라함께증가하며매우선형적인관계를가지는것을확인하였다 (Fig. 3C). 이와같은결과는피폭선량을증가시켜입력신호의 SNR 을향상시키면출력영상의 SNR 도향상되는관계를그대로반영하고있으며 ineq 가정량적화질평가에적합한인자임을보여준다. imtf 는영상의학과의사들의육안평가결과인 와뚜렷한상관관계를갖지않는것으로보인다 (Fig. 4B). 와 C의 를서로비교해보면 imtf 의차이가일부나타나는것으로보이나전체적인상관관계가존재한다고보기는어렵다. 반면에 innps 는모든시스템에서공통적으로 와선형적인상관관계를가지고있으며, 특히서로비슷한 innps 를갖는영상들의 가역시비슷한것으로나타났다. 이와같은특징은 의한개영상을제외한모든영상에서공통적으로나타났는데, 이현상은비슷한 imtf 를갖는영상들의 들이서로큰차이를보였던앞의경우와매우대조적이며여기에는두가지이유가있다고생각된다. 첫째는피폭선량이라는실험조건의한계이다. 같은시스템에서얻은영상들은피폭선량의변화에따라 innps 는다양하게변하였으나 imtf 는거의변하지않기때문이다. 그러나서로다른시스템에서얻어진영상들을비교 하면 imtf 가크게변하는동안 가거의변하지않는경우가많으므로 (Fig. 4B) 실험조건의한계에의한영향은극히제한적이라볼수있다. 육안평가와 imtf 의상관관계를보다명확히규명하기위해서는보다다양한화소크기를가지는시스템들에대한연구가필요하지만현재사용되는흉부용디지털 X선촬영기기들의화소크기는모두 0.1~0.2 mm 범위이므로추가적인연구는큰의미를가지지않는다. 두번째생각할수있는이유는육안평가가공간해상도보다잡음정도에더민감하다는것이다. Fig. 4B와 Fig. 4C를비교해보면 의변화는 imtf 보다 innps 의변화에훨씬민감하며, 특히 innps 의수치가서로비슷할경우 Mean score 의수치역시비슷한것은위의두번째이유를뒷받침하는유력한근거가된다. Fig. 4D는 ineq 와 의상관관계가선형적으로유지되다가 ineq 가일정값이상으로증가하면육안평가결과는수렴하는경향을보여주고있는데, 이는출력영상의 SNR 이증가하여화질이향상되면육안으로도그화질의차이를어느정도감지할수있으나어떤한계이상이되면더이상의 SNR 의증가는육안으로감지하기어려움을의미한다. 흉부 X선촬영시영상의화질을향상시키는가장쉬운방법은피폭선량을증가시키는것이다. 그러나일정수준이상으로피폭선량을증가시킬경우공학적인관점에서의화질은향상되지만실제로영상을판독하는의사는그화질의차이를감지할수없을수있으므로, 효율적인진단과환자의피폭을최소화하기위해서는과도하지않은적정수준의피폭선량을결정하는일이필요하며, 본연구에서사용한 ineq 인자는이를위한가장효과적인방법을제공할수있다. 또한시스템의공간해상도보다는영상의잡음정도가의사가경험하는영상화질에지배적인영향을미치므로디지털 X선촬영기기의영상잡음에대한주기적인검사및관리가매우중요하다. 참고문헌 1. Stierstorfer K, Spahn M. Self-normalizing method to measure the detective quantum efficiency of a wide range of x-ray detectors. Med Phys 1999;26: Hillen W, Schiebel U, Zaengel T. Imaging performance of a digital storage phosphor system. Med Phys 1987;14: Cunningham IA. Standard for measurement of noise power spectra. AAPM Report Samei E, Flynn MJ, Reimann DA. A method for measuring 484 대한영상의학회지 2011;65(5): submit.radiology.or.kr

7 전호상외 the presampled MTF of digital radiographic systems using an edge test device. Med Phys 1998;25: ICRU. Medical imaging - the assessment of image quality. ICRU Report 1996;54 6. IEC. Medical electrical equipment - characteristics of digital X-ray imaging devices - determination of the detective quantum efficiency. IEC Herrmann C, Sund P, Tingberg A, Almen A, Mattsson S, Keddache S, et al. Comparison of two methods for evaluating image quality of chest radiographs. Proc SPIE 2000; 251: Sund P, Båth M, Kheddache S, Månsson LG. Comparison of visual grading analysis and determination of detective quantum efficiency for evaluating system performance in digital chest radiography. Eur Radiol 2004;14: Cunningham IA. Metrics of system performance. SPIE PRESS 2000; European Commission. European guidelines on quality criteria for diagnostic radiographic images. EUR 1996; Borasi G, Nitrosi A, Ferrari P, Tassoni D. On site evaluation of three flat panel detectors for digital radiography. Med Phys 2003;30: Samei E, Flynn MJ. An experimental comparison of detector performance for direct and indirect digital radiography systems. Med Phys 2003;30: Ehsan S, Michael JF, Chotas HG, Dobbins JT. DQE of direct and indirect digital radiographic systems. Proc SPIE 2001; 디지털흉부 X 선촬영장치의화질 : 정량적화질평가와영상의학과의사의육안평가간의비교연구 1 전호상 1,4 남지호 1 정명진 2 박달 3 김원택 3 김용호 3 기용간 3 김동현 3 이주혜 3 김동원 3 목적 : 디지털 X선촬영을이용한흉부진단은각종진단목적으로환자및일반인에이르기까지널리사용중인기법이므로, 인체피폭최소화와화질유지를위해서촬영기기의성능관리가중요하다. 본연구에서는공학적인자들을이용한정량적화질평가결과와영상의학과의사의육안화질평가결과를비교연구하여가장적합한화질평가인자를도출하였다. 대상과방법 : 3대의디지털 X선촬영기기들을대상으로정량적화질평가및흉부팬텀영상을이용한영상의학과의사평가를각각실시하고 Spearman 의순위상관계수를이용하여비교평가하였다. 이때정량적화질평가는 IEC 에따랐으며, 의사평가는영상잡음, 기흉명시성, 그리고상완골두명시성의세가지기준을사용하였다. 결과 : 의사의화질평가결과는촬영기기의공간해상도와유의한순위상관관계가발견되지않았으나 (p = ), 영상의잡음도와매우유의한순위상관관계 (p = ) 를보였다. 또한종합적인영상화질을나타내는 noise equivalent quanta ( 이하 NEQ) 와도유의한순위상관관계를나타내었다 (p = ). 결론 : 영상잡음도는공간해상도에비해영상판독에큰영향을미치므로 X선촬영기기의잡음도관리가중요하다. 또한 NEQ 값은이론적으로종합적인화질을의미하므로디지털 X선촬영장치의성능을효과적으로감시할수있다. 1 양산부산대학교병원방사선종양학과, 2 삼성서울병원영상의학과, 3 부산대학교병원방사선종양학과, 4 양산부산대학교병원의생명융합연구소 submit.radiology.or.kr 대한영상의학회지 2011;65(5):

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자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 A B Fig. 1. High-contrast spatial resolution in phantom test. A. Slice 1 with three sets of hole arr Original Article pissn 1738-2637 J Korean Soc Radiol 2012;67(2):129-134 The Survey of Magnetic Resonance Imaging Quality according to in Korea 1 자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 1 Hyun-Hae

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