Advance of neuroimaging technique has greatly influenced recent brain research field. Among various neuroimaging modalities, positron emission tomography has played a key role in molecular neuroimaging though functional MRI has taken over its role in the cognitive neuroscience. As the analysis technique for PET data is more sophisticated, the complexity of the method is more increasing. Despite the wide usage of the neuroimaging techniques, the assumption and limitation of procedures have not often been dealt with for the clinician and researchers, which might be critical for reliability and interpretation of the results. In the current paper, steps of voxel-based statistical analysis of PET including preprocessing, intensity normalization, spatial normalization, and partial volume correction will be revisited in terms of the principles and limitations. Additionally, new image analysis techniques such as surface-based PET analysis, correlational analysis and multimodal imaging by combining PET and DTI, PET and TMS or EEG will also be discussed.

Quantitative analysis of dynamic brain PET data using a tracer kinetic modeling has played important roles in the investigation of functional and molecular basis of various brain diseases. Parametric imaging of the kinetic parameters (voxel-wise representation of the estimated parameters) has several advantages over the conventional approaches using region of interest (ROI). Therefore, several strategies have been suggested to generate the parametric images with a minimal bias and variability in the parameter estimation. In this paper, we will review the several approaches for parametric imaging with linearized methods which include graphical analysis and mulilinear regression analysis.

Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrahge were reviewed in this paper.

The measurement of pathologically low levels of tissue $pO_2$ is an important diagnostic goal for determining the prognosis of many clinically important diseases including cardiovascular insufficiency, stroke and cancer. The target tissues nowaday have mostly been tumors or the myocardium, with less attention centered on the brain. Radiolabelled nitroimidazole or derivatives may be useful in identifying the hypoxic cells in cerebrovascular disease or traumatic brain injury, and hypoxic-ischemic encephalopathy. In acute stroke, the target of therapy is the severely hypoxic but salvageable tissue. $^{18}F-MISO$ PET and $^{99}mTc-EC-metronidazole$ SPECT in patients with acute ischemic stroke identified hypoxic tissues and ischemic penumbra, and predicted its outcome. A study using $^{123}I-IAZA$ in patient with closed head injury detected the hypoxic tissues after head injury. Up till now these radiopharmaceuticals have drawbacks due to its relatively low concentration with hypoxic tissues associated with/without low blood-brain barrier permeability and the necessity to wait a long time to achieve acceptable target to background ratios for imaging in acute ischemic stroke. It is needed to develop new hypoxic marker exhibiting more rapid localization in the hypoxic region in the brain. And then, the hypoxic brain imaging with imidazoles or non-imidazoles may be very useful in detecting the hypoxic tissues, determining therapeutic strategies and developing therapeutic drugs in several neurological disease, especially, in acute ischemic stroke.

Correct localization of epileptogenic zone is important for the successful epilepsy surgery. Both ictal perfusion single photon emission computed tomography (SPECT) and interictal F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) can provide useful information in the presurgical localization of intractable partial epilepsy. These imaging modalities have excellent diagnostic sensitivity in medial temporal lobe epilepsy and provide good presurgical information in neocortical epilepsy. Also provide functional information about cellular functions to better understand the neurobiology of epilepsy and to better define the ictal onset zone, symptomatogenic zone, propagation pathways, functional deficit zone and surround inhibition zones. Multimodality imaging and developments in analysis methods of ictal perfusion SPECT and new PET ligand other than FDG help to better define the localization.

Dementia is a major burden for many countries including South Korea, where life expectancy is continuously growing and the proportion of aged people is rapidly growing. Neurodegenerative disorders, such as, Alzheimer disease, dementia with Lewy bodies, frontotemporal dementia, Parkinson disease, progressive supranuclear palsy, corticobasal degeneration, Huntington disease, can cause dementia, and cerebrovascular disease also can cause dementia. Depression or hypothyroidism also can cause cognitive deficits, but they are reversible by management of underlying cause unlike the forementioned dementias. Therefore these are called pseudodementia. We are entering an era of dementia care that will be based upon the identification of potentially modifiable risk factors and early disease markers, and the application of new drugs postpone progression of dementias or target specific proteins that cause dementia. Efficient pharmacologic treatment of dementia needs not only to distinguish underlying causes of dementia but also to be installed as soon as possible. Therefore, differential diagnosis and early diagnosis of dementia are utmost importance. F-18 FDG PET is useful for clarifying dementing diseases and is also useful for early detection of the diseases. Purpose of this article is to review the current value of FDG PET for dementing diseases including differential diagnosis of dementia and prediction of evolving dementia.

Imaging distribution of ${\beta}-amyloid$ plaques in Alzheimer's disease is very important for early and accurate diagnosis. Early trial of the ${\beta}-amyloid$ plaques includes using radiolabeled peptides which can be only applied for peripheral ${\beta}-amyloid$ plaques due to limited penetration through the blood brain barrier (BBB). Congo red or Chrysamine G derivatives were labeled with Tc-99m for imaging ${\beta}-amyloid$ plaques of Alzheimer patient's brain without success due to problem with BBB penetration. Thioflavin T derivatives gave breakthrough for ${\beta}-amyloid$ imaging in vivo, and a benzothiazole derivative [C-11]6-OH-BTA-1 brought a great success. Many other benzothiazole, benzoxazole, benzofuran, imidazopyridine, and styrylbenzene derivatives have been labeled with F-18 and I-123 to improve the imaging quality. However, [C-11]6-OH-BTA-1 still remains as the best. However, short half-life of C-11 is a limitation of wide distribution of this agent. So, it is still required to develop an Tc-99m, F-18 or I-123 labeled agent for ${\beta}-amyloid$ imaging agent.

Neurotransmitter imaging with radiopharmaceuticals plays major role for understanding of neurological and psychiatric disorders such as Parkinson's disease and depression. Radiopharmaceuticals for neurotransmitter imaging can be divided to dopamine transporter imaging radiopharmaceuticals and serotonin trnasporter imaging radiopharmaceuticals. Many kinds of new dopamine transporter imaging radiopharmcaeuticals has a tropane ring and they showed different biological properties according to the substituted functional group on tropane ring. After the first clinical trials with $[^{123}I]{\beta}-CIT$, alkyl chain substituent introduced to tropane ring amine to decrease time for imaging acquisition and to increase selectivity. From these results, $[^{123}I]PE2I$, [18F]FE-CNT, $[^{123}I]FP-CIT$ and $[^{18}F]FP-CIT$ were developed and they showed high uptake on the dopamine transporter rich regions and fast peak uptake equilibrium time within 4 hours after injection. $[^{11}C]McN$ 5652 was developed for serotonin trnasporter imaging but this compound showed slow kinetics and high background radioactivity. To overcome these problems, new diarylsulfide backbone derivatives such as ADAM, ODAM, AFM, and DASB were developed. In these candidates, $[^{11}C]AFM$ and $[^{11}C]DASB$ showed high binding affinity to serotonin transporter and fast in vivo kinetics. This paper gives an overview of current status on dopamine and serotonin transporter imaging radiopharmaceuitcals and the development of new lead compounds as potential radiopharmaceuticals by medicinal chemistry.

Parkinson's disease is a common neurodegenerative disorder that is mainly caused by dopaminergic neuron loss in the substantia nigra. Several radiopharmaceutics have been developed to evaluate the integrity of dopaminergic neuronal system. In vivo PET and SPECT imaging of presynaptic dopamine imaing are already applied to Parkinson's disease and other parkinsonism, and can demonstrate the dopaminergic dysfunction. This review summarized the use of the presynaptic dopaminergic imaging in PD as biomarkers in evaluation of disease progression as well as in diagnosis of PD.

파킨슨병은 노년층에 가장 흔한 퇴행성 뇌질환 중의 하나로 진행성핵상마비, 다중계 위축, 루이체 치매 등과 같은 비전형 파킨슨병과 임상적으로 감별이 어려울 수 있다. 파킨슨병과 비전형 파킨슨병의 감별은 치료방침 결정과 예후평가뿐만 아니라 파킨슨병의 원인과 병태생리를 연구하고 새로운 치료법 개발에 있어서도 매우 중요하다. 파킨슨병과 비전형 파킨슨병과 같이 파킨슨 증후군을 유발하는 질환은 선조체내 도파민 신경의 퇴행성 변화를 흔히 동반하지만 병태생리학적으로 서로 다른 뇌피질 및 피질하 구조물에서의 신경세포 소실을 동반하고 있다. 따라서 국소 시냅스 활성도와 신경 및 시냅스의 손상, 그리고 원발병변과 기능적으로 연결된 원격부위의 기능이상 등을 대변하는 뇌포도당 대사를 F-18FDG PET으로 평가하는 것은 파킨슨 병의 감별진단과 병태생리를 평가하는데 유용하다.

Imaging of the dopamine transporter (DAT) provides a marker for the integrity of presynaptic nigrostriatal dopaminergic system. DAT density is reduced in Parkinson disease, multiple system atrophy, and progressive supranuclear palsy. In patients with suspicious parkinsonism, normal DAT imaging suggests an alternative diagnosis such as essential tremor, vascular parkinsonism, or drug-induced parkinsonism. DAT imaging is a useful tool to aid clinician's differential diagnosis in parkinsonism.

Technological advances in molecular imaging made it possible to image synaptic neurotransmitter concentration in living human brain. The dopaminergic system has been most intensively studied because of its importance in neurological as well as psychiatric disorders. This paper provides a brief overview of recent progress in imaging studies of dopamine release induced by pharmacologic and nonpharmacologic stimulations.

GABA is primary an inhibitory neurotransmitter that is localized in inhibitory interneurons. GABA is released from presynaptic terminals and functions by binding to GABA receptors. There are two types of GABA receptors, $GABA_{A}-receptor$ that allows chloride to pass through a ligand gated ion channel and $GABA_{B}-receptor$ that uses G-proteins for signaling. The $GABA_{A}$-receptor has a GABA binding site as well as a benzodiazepine binding sites, which modulate $GABA_{A}$-receptor function. Benzodiazepine GABAA receptor imaging can be accomplished by radiolabeling derivates that activates benzodiazepine binding sites. There has been much research on flumazenil (FMZ) labeled with $^{11}C-FMZ$, a benzodiazepine derivate that is a selective, reversible antagonist to GABAA receptors. Recently, $^{18}F-fluoroflumazenil$ (FFMZ) has been developed to overcome $^{11}C's$ short half-life. $^{18}F-FFMZ$ shows high selective affinity and good pharmacodynamics, and is a promising PET agent with better central benzodiazepine receptor imaging capabilities. In an epileptic focus, because the GABA/benzodiazepine receptor amount is decreased, using $^{11}C-FMZ$ PET instead of $^{18}F-FDG$ PET, restrict the foci better and may also help find lesions better than high resolution MR. $GABA_{A}$ receptors are widely distributed in the cerebral cortex, and can be used as an viable neuronal marker. Therefore it can be used as a neuronal cell viability marker in cerebral ischemia. Also, GABA-receptors decrease in areas where neuronal plasticity develops, therefore, $GAB_{A}$ imaging can be used to evaluate plasticity. Besides these usages, GABA receptors are related with psychological diseases, especially depression and schizophrenia as well as cerebral palsy, a motor-related disorder, so further in-depth studies are needed for these areas.

[ $^{15}O$ ]을 이용한 양전자 방출 단층촬영 기법(Positron emission tomography)은 핵의학 영상 기법 중에서 두뇌의 인지 기능과 연관된 두뇌 활성화를 정상인과 환자들로부터 연구하는데 큰 장점이 있다. $^{15}O-PET$, 특히 $H_2^{15}O$ PET 기법은 두뇌 국소 혈류 변화(rCBF; regional brain flow)를 상대적으로 비침습적이면서 동시에 정량적 측정할 수 있기 때문에 두뇌 기능을 연구하는데 오늘날 존재하는 핵의학 영상기법 중에서 가장 광범위하게 쓰이고 있다. 특히 $^{15}O$은 짧은 반감기로 인하여, 동일한 피험자를 서로 다른 과제 조건에서 반복적으로 측정하는 것이 가능하다. 이 PET기법은 fMRI와 같은 다른 기능 영상 기법에 비하여 기술적 제한이 있는데, 예를 들면 시간과 공간 해상도가 좋지 않다든지, 개인 데이터를 분석하기에 통계적 효율성이 부족하다거나 하는 문제이다. 그러나 최근에 3D 획득방법 같은 기술적인 발전으로 적은 양의 방사능 dose로 좋은 영상을 획득하는 것이 가능하게 되었고, 이는 다시 개개인으로부터 더 많은 수의 PET 스캔을 획득하는 것을 가능하게 하며, 결과적으로 개인 데이터의 분석이 가능한 통계적 효율성을 제공하게 되었다. 그 외에 $^{15}O$ PET 의 스캐너 환경이 소음에서부터 자유롭다던가, 개개 스캔이 각 과제 조건에서 불연속적이지 획득되기 때문에 상태 특정적 두뇌 변화를 연구하기에 유리하다는 PET연구 만의 장점이 있다. 본 종설에서는 정상인들이나 임상적 환자 집단을 사용한 예시적 연구들을 들어 $^{15}O$ PET의 장점과 한계를 논하고, 두뇌 활성화 연구에 효율적인 PET 연구 절차를 고안하기 위해 고려해야 할 사항들에 대하여 논하였다.TEX>$29.9{\pm}1.8%$, DMF: $7.6{\pm}0.5%$이었다. MEK에서 얻은 $[^{11}C]1$의 비방사능은 98 ($GBq/{\mu}mol$)이다. 각 물질의 질량 분석은 1: m/z 257.3 (M+1), 2: 257.3 (M+1), 3: 271.3 (M+1)이었다. 각 생성물질의 표지효율은 MEK에서 $86.0{\pm}5.5%:5.0{\pm}3.4%:1.5{\pm}1.3%$ $([^{11}C]1:[^{11}C]2:[^{11}C]3)$, CHO에서 $59.7{\pm}2.4%:4.7{\pm}3.2%:1.3{\pm}0.5%$, DEK에서 $29.9{\pm}1.8%:2.0{\pm}0.7%:0.3{\pm}0.1%$, DMF에서 $7.6{\pm}0.5%:0.0%:0.0%$이다. 결론: $[^{11}C]1$은 4가지 반응용매 중 MEK 반응용매에서 가장 높은 표지효율을 나타냈다. 부산물인 $[^{11}C]3$은 고성능 액체 크로마토그래피의 자외선, 방사능 검출기와 질량 분석법을 통해 물질을 추정할 수 있었다.의 개선 효과가 있는 것으로 판단되며 지질과산화에 대해서 강한 억제 활성을 나타내는 것을 알 수 있었다. 이러한 결과로 복분자는 생활 습관병의 예방과 개선에 유효한 것으로 사료되었으며, 지질대사와 과산화지표의 검증을 통해 기능성 식품소재로 활용될 수 있음을 보여주었다.로서 역시 CTV 치료계획에서 적게 조사되었다(p=0.005). 기존의 ICRU 치료계획은 잔류종양의 크기가 작은 경우 불필요하게 정상조직에 많은 선량이 투여되기 때문에 CT를 이용한 CTV 치료계획을 적용하여 정상조직에 대한 피폭을 현저히 낮추고 잔류종양에 목표한 선량을 조사할 수 있다.