• Title/Summary/Keyword: $^{18}FDG$ PET-CT

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Application of MicroPACS Using the Open Source (Open Source를 이용한 MicroPACS의 구성과 활용)

  • You, Yeon-Wook;Kim, Yong-Keun;Kim, Yeong-Seok;Won, Woo-Jae;Kim, Tae-Sung;Kim, Seok-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.51-56
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    • 2009
  • Purpose: Recently, most hospitals are introducing the PACS system and use of the system continues to expand. But small-scaled PACS called MicroPACS has already been in use through open source programs. The aim of this study is to prove utility of operating a MicroPACS, as a substitute back-up device for conventional storage media like CDs and DVDs, in addition to the full-PACS already in use. This study contains the way of setting up a MicroPACS with open source programs and assessment of its storage capability, stability, compatibility and performance of operations such as "retrieve", "query". Materials and Methods: 1. To start with, we searched open source software to correspond with the following standards to establish MicroPACS, (1) It must be available in Windows Operating System. (2) It must be free ware. (3) It must be compatible with PET/CT scanner. (4) It must be easy to use. (5) It must not be limited of storage capacity. (6) It must have DICOM supporting. 2. (1) To evaluate availability of data storage, we compared the time spent to back up data in the open source software with the optical discs (CDs and DVD-RAMs), and we also compared the time needed to retrieve data with the system and with optical discs respectively. (2) To estimate work efficiency, we measured the time spent to find data in CDs, DVD-RAMs and MicroPACS. 7 technologists participated in this study. 3. In order to evaluate stability of the software, we examined whether there is a data loss during the system is maintained for a year. Comparison object; How many errors occurred in randomly selected data of 500 CDs. Result: 1. We chose the Conquest DICOM Server among 11 open source software used MySQL as a database management system. 2. (1) Comparison of back up and retrieval time (min) showed the result of the following: DVD-RAM (5.13,2.26)/Conquest DICOM Server (1.49,1.19) by GE DSTE (p<0.001), CD (6.12,3.61)/Conquest (0.82,2.23) by GE DLS (p<0.001), CD (5.88,3.25)/Conquest (1.05,2.06) by SIEMENS. (2) The wasted time (sec) to find some data is as follows: CD ($156{\pm}46$), DVD-RAM ($115{\pm}21$) and Conquest DICOM Server ($13{\pm}6$). 3. There was no data loss (0%) for a year and it was stored 12741 PET/CT studies in 1.81 TB memory. In case of CDs, On the other hand, 14 errors among 500 CDs (2.8%) is generated. Conclusions: We found that MicroPACS could be set up with the open source software and its performance was excellent. The system built with open source proved more efficient and more robust than back-up process using CDs or DVD-RAMs. We believe that the operation of the MicroPACS would be effective data storage device as long as its operators develop and systematize it.

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The Role of Camera-Based Coincidence Positron Emission Tomography in Nodal Staging of Non-Small Cell Lung Cancer (비소세포폐암의 림프절 병기 결정에서 Coincidence PET의 역할)

  • Lee, Sun-Min;Choi, Young-Hwa;Oh, Yoon-Jung;Cheong, Seong-Cheoll;Park, Kwang-Joo;Hwang, Sung-Chul;Lee, Yi-Hyeong;Park, Chan-H;Hahn, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.5
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    • pp.642-649
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    • 1999
  • Background: It is very important to determine an accurate staging of the non-small cell lung cancer(NSCLC) for an assessment of operability and it's prognosis. However, it is difficult to evaluate tumor involvement of mediastinal lymph nodes accurately utilizing noninvasive imaging modalities. PET is one of the sensitive and specific imaging modality. Unfortunately PET is limited use because of prohibitive cost involved with it's operation. Recently hybrid SPECT/PET(single photon emission computed tomography/positron emission tomography) camera based PET imaging was introduced with relatively low cost. We evaluated the usefulness of coincidence detection(CoDe) PET in the detection of metastasis to the mediastinal lymph nodes in patients with NSCLC. Methods: Twenty one patients with NSCLC were evaluated by CT or MRI and they were considered operable. CoDe PET was performed in all 21 patients prior to surgery. Tomographic slices of axial, coronal and sagittal planes were visually analysed. At surgery, mediastinal lymph nodes were removed and histological diagnosis was performed. CoDe PET findings were correlated with histological findings. Results: Twenty of 21 primary tumor masses were detected by the CoDe PET. Thirteen of 21 patients was correctly diagnosed mediastinal lymph node metastasis by the CoDe PET. Pathological N0 was 14 cases and the specificity of N0 of CoDe PET was 64.3%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of N1 node was 83.3%, 73.3%, 55.6%, 91.7%, and 76.2% respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of N2 node was 60.0%, 87.5%, 60.0%,87.5%, and 90.0% respectively. There were 3 false negative cases but the size of the 3 nodes were less than 1cm. The size of true positive nodes were 1.1cm, 1.0cm, 0.5cm respectively. There were 1 false positive among the 12 lymph nodes which were larger than 1cm. False positive cases consisted of 1 tuberculosis case, 1 pneumoconiosis case and 1 anthracosis case. Conclusion: CoDe PET has relatively high negative predictive value in the enlarged lymph node in staging of mediastinal nodes in patients with NSCLC. Therefore CoDe PET is useful in ruling out metastasis of enlarged N3 nodes. However, further study is needed including more number of patients in the future.

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A Study to Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET/CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Ban, Yung-Kak;Lim, Han-Sang;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Purpose: Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to $^{99m}Tc$ emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radiotechnologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radiotechnologists. Materials and Methods: Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8$ cm and mean weight: $65.9{\pm}1.4$ kg). Radiation were measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150 and 200 cm. Then, all the procedure was given with a portable radiation shielding on the location of head, chest and abdomen at the distance of 100, 150 and 200 cm and transmittance was calculated. Results: In 10 cm, head (105.40 ${\mu}Sv/h$) was the highest and foot (15.85 ${\mu}Sv/h$) was the lowest. In 200 cm, head, chest and abdomen showed similar. On head, the measured dose rates were 9.56 ${\mu}Sv/h$, 5.23 ${\mu}Sv/h$, and 3.40 ${\mu}Sv/h$ in 100, 150 and 200 cm respectively. When using shielder, it shows 2.24 ${\mu}Sv/h$, 1.67 ${\mu}Sv/h$, and 1.27 ${\mu}Sv/h$ in 100, 150 and 200 cm on head. On chest, the measured dose rates were 8.54 ${\mu}Sv/h$, 4.90 ${\mu}Sv/h$, 3.44 ${\mu}Sv/h$ in 100, 150 and 200 cm, respectively. When using shielder, it shows 2.27 ${\mu}Sv/h$, 1.34 ${\mu}Sv/h$, and 1.13 ${\mu}Sv/h$ in 100, 150 and 200 cm on chest. On abdomen, the measured dose rates were 9.83 ${\mu}Sv/h$, 5.15 ${\mu}Sv/h$ and 3.18 ${\mu}Sv/h$ in 100, 150 and 200cm respectively. When using shielder, it shows 2.60 ${\mu}Sv/h$, 1.75 ${\mu}Sv/h$ and 1.23 ${\mu}Sv/h$ in 100, 150 and 200 cm on abdomen. Transmittance was increased as the distance was expanded. Conclusion: As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the radiotechnologists.

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Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Performance Evaluation of Reconstruction Algorithms for DMIDR (DMIDR 장치의 재구성 알고리즘 별 성능 평가)

  • Kwak, In-Suk;Lee, Hyuk;Moon, Seung-Cheol
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.29-37
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    • 2019
  • Purpose DMIDR(Discovery Molecular Imaging Digital Ready, General Electric Healthcare, USA) is a PET/CT scanner designed to allow application of PSF(Point Spread Function), TOF(Time of Flight) and Q.Clear algorithm. Especially, Q.Clear is a reconstruction algorithm which can overcome the limitation of OSEM(Ordered Subset Expectation Maximization) and reduce the image noise based on voxel unit. The aim of this paper is to evaluate the performance of reconstruction algorithms and optimize the algorithm combination to improve the accurate SUV(Standardized Uptake Value) measurement and lesion detectability. Materials and Methods PET phantom was filled with $^{18}F-FDG$ radioactivity concentration ratio of hot to background was in a ratio of 2:1, 4:1 and 8:1. Scan was performed using the NEMA protocols. Scan data was reconstructed using combination of (1)VPFX(VUE point FX(TOF)), (2)VPHD-S(VUE Point HD+PSF), (3)VPFX-S (TOF+PSF), (4)QCHD-S-400((VUE Point HD+Q.Clear(${\beta}-strength$ 400)+PSF), (5)QCFX-S-400(TOF +Q.Clear(${\beta}-strength$ 400)+PSF), (6)QCHD-S-50(VUE Point HD+Q.Clear(${\beta}-strength$ 50)+PSF) and (7)QCFX-S-50(TOF+Q.Clear(${\beta}-strength$ 50)+PSF). CR(Contrast Recovery) and BV(Background Variability) were compared. Also, SNR(Signal to Noise Ratio) and RC(Recovery Coefficient) of counts and SUV were compared respectively. Results VPFX-S showed the highest CR value in sphere size of 10 and 13 mm, and QCFX-S-50 showed the highest value in spheres greater than 17 mm. In comparison of BV and SNR, QCFX-S-400 and QCHD-S-400 showed good results. The results of SUV measurement were proportional to the H/B ratio. RC for SUV is in inverse proportion to the H/B ratio and QCFX-S-50 showed highest value. In addition, reconstruction algorithm of Q.Clear using 400 of ${\beta}-strength$ showed lower value. Conclusion When higher ${\beta}-strength$ was applied Q.Clear showed better image quality by reducing the noise. On the contrary, lower ${\beta}-strength$ was applied Q.Clear showed that sharpness increase and PVE(Partial Volume Effect) decrease, so it is possible to measure SUV based on high RC comparing to conventional reconstruction conditions. An appropriate choice of these reconstruction algorithm can improve the accuracy and lesion detectability. In this reason, it is necessary to optimize the algorithm parameter according to the purpose.