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18F-FDG PET/CT 검사에서 정량분석에 관한 CT와 MRI 조영제의 효과

The Effectiveness of CT and MRI Contrast Agent for SUV in 18F-FDG PET/CT Scanning

  • 차상영 (동신대학교 방사선학과) ;
  • 조용귀 (인하대학병원 핵의학과) ;
  • 이용기 (가천대학교 뇌과학연구소) ;
  • 송종남 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과)
  • Cha, Sangyoung (Department of Radiological Science, Dongshin University) ;
  • Cho, Yonggwi (Department of Nuclear Medicine, Inha University Hospital) ;
  • Lee, Yongki (Department of Neuroscience Research Institute Gachon University) ;
  • Song, Jongnam (Department of Radiological Science, Dongshin University) ;
  • Choi, Namgil (Department of Radiological Science, Dongshin University)
  • 투고 : 2016.03.18
  • 심사 : 2016.06.30
  • 발행 : 2016.06.30

초록

PET/CT 촬영에서 정량분석에 영향을 주는 다양한 인자 중 현재 상품화된 CT 조영제와 MRI 조영제의 종류별 각 성분의 특성에 따른 SUV의 변화를 비교 분석하고자 하였다. 실험장비는 Discovery 690 PET/CT(Ge)와 NEMA NU2-1994 PET phantom를 이용하였고, 팬텀에 증류수 2/3를 채워 넣은 후 방사성동위원소(18F-FDG 37 MBq)와 각각의 CT와 MRI 조영제를 순차적으로 주입하여 팬텀을 고르게 교반하고 다시 증류수를 가득 채운 후 기포가 생기지 않게 하였다. 방출스캔은 FDG 또는 FDG와 혼합한 조영제를 넣고 40분에 15분 동안 스캔하였으며, 투과스캔은 CT로 관전압 120 kVp, 관전류 40 mA, 회전시간 0.5 sec, 단면두께 3.27 mm, DFOV 30 cm의 조건으로 스캔하였다. 분석방법으로 정량분석은 각각 10, 15, 20, 25, 30번째 slice에서 region of interest (ROI)를 설정하여 각각 SUVmean, SUVmax를 구하였다. 결과적으로 순수 FDG 영상과 비교에서 MRI 조영제를 혼합한 3종류의 영상 모두에서 SUVmean가 높게 측정되었으나 통계적 유의성은 없었고, SUVmax 에서는 유의한 결과를 얻었다. 또한 4종류의 CT 조영제 영상은 SUVmean, SUVmax 모두 유의한 결과를 얻었다. PET/CT는 영상의 정확도를 위해 감쇠 보정은 다양한 방법으로 시행되고 있지만 CT와 MRI 조영제는 감쇠보정 시 영상의 왜곡에 의한 진단적 가치를 저하시킬 수 있다. 이러한 이유로 진료 당일 여러 종류의 검사를 시행하기 전 반드시 선행되어야 할 검사를 선별하여 서로 영향을 주지 않도록 함으로서 고객에게 차별화된 양질의 의료서비스를 제공해야 한다.

In this study, among various factors having influence on SUV, we intended to compare and analyze the change of SUV using CT(4 type) and MRI(3 type) contrast agents which are commercialized now. We used Discovery 690 PET/CT(GE) and NEMA NU2 - 1994 PET phantom as experimental equipment. We have conducted a study as follows; first, we filled distilled water to phantom about two-thirds and injected radioisotope(18F-FDG 37 MBq), contrast agent. Second, we mixed CT contrast agent with distilled water and MRI contrast agent with that water separately. And then, we stirred the fluid and filled distilled water fully not to make air bubble. In emission scan, we had 15minutes scanning time after 40 minutes mixing contrast agent with distilled water. In transmission scan, we used CT scanning and its measurement conditions were tube voltage 120 kVp, tube current 40 mA, rotation time 0.5 sec, slice thickness 3.27 mm, DFOV 30 cm. Analyzing results, we set up some ROIs in 10th, 15th, 20th, 25th, 30th slice and measured SUVmean, SUVmax. Consequently, all images mixed 3 types of MRI contrast agent with distilled water have high SUVmean as compared with pure FDG image but there was no statistical significance. In SUVmax, they have high score and there was statistical significance. And other 4 images mixed 4 types of CT contrast agent with distilled water have significance in both SUVmean and SUVmax. Attenuation correction in PET/CT has been executed through various methods to make high quality image. But we figured out that using CT and MRI contrast agents before PET/CT scanning could make distortion of image and decrease diagnostic value. In that reason, we have to sort out the priority of examination in hospital not to disturb other examination's results. Through this process, we will be able to give superior medical service to our customers.

키워드

참고문헌

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피인용 문헌

  1. 요오드 조영제 사용이 감마카메라 영상에 미치는 영향 vol.39, pp.4, 2016, https://doi.org/10.17946/jrst.2016.39.4.10
  2. 99mTc에서 방출되는 감마선이 CT 영상에 미치는 영향 vol.13, pp.2, 2019, https://doi.org/10.7742/jksr.2019.13.2.169
  3. CT 촬영 조건에 따른 PET 영상의 변화 vol.13, pp.3, 2019, https://doi.org/10.7742/jksr.2019.13.3.473
  4. CT 촬영 조건에 따른 PET 영상의 변화 vol.13, pp.3, 2019, https://doi.org/10.7742/jksr.2019.13.3.473