• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.71-79
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• 2024

Purpose: This study aims to identify SUV, SNR, spatial resolution, and axial uniformity under the same reconstruction conditions and to find out the differences between equipment models. Materials and Methods: The equipment was GE's Discovery 600, 710, IQ, MI(GE Healthcare, USA), and the Phantom used ACR(American College of Radiology) Flangeless Esser Phantom and PET/SPECT Performance Phantom. The PET/SPECT Performance Phantom injected 18F-FDG at a concentration of 3.8 kBq/mL, and the ACR Flangeless Esser Phantom made the conditions for Hot Spot and Background activity for 4 : 1. Image evaluation was compared and evaluated for SUV, SNR, spatial resolution, and axial uniformity with the same reconstruction that added SharpIR of VPHD. Results: The SUV_max showed a difference up to 4.6% with an average of 2.71, 2.35, 1.89, and 1.43 from Hot Spot 1 to 4, and the SUV_mean showed a difference up to 4.7% with 2.06, 1.75, 1.49, and 1.27. There was a difference up to 5% between equipment, and there was no significant difference between both SUV_max and SUV_mean. SNR showed a difference up to 0.04 with an average of 0.37, 0.26, 0.18, and 0.11. FWHM showed a difference up to 0.27. Lastly, COV of axial uniformity was up to 0.018. Conclusion: SUV showed differences within 5% between equipment and showed no significant difference. This is considered to be used as basic data that can be used for the development and replacement of equipment because it has the advantage of being able to observe with a large number of equipment.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10171-10174
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• 2015

Background: The purpose of this study was to determine the prognostic significance of the maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose (FDG)-positron emission tomography (PET) in patients undergoing surgical treatment for non-small cell lung cancer. Materials and Methods: Seventy-eight consecutive patients (58 with adenocarcinomas, 20 with squamous cell carcinomas) treated with potentially curative surgery were retrospectively reviewed. Results: The SUVmax was significantly higher in the patients with recurrent than with non-recurrent adenocarcinoma (p<0.01). However, among the patients with squamous cell carcinoma, there were no differences with or without recurrence (p=0.69). Multivariate analysis indicated that the SUVmax of adenocarcinoma lesions was a significant predictor of disease-free survival (p=0.04). In addition, an SUVmax of 6.19, the cut-off point based on ROC curve analysis of the patients with pathological IB or more advanced stage adenocarcinomas, was found to be a significant predictor of disease-free survival (p<0.01). Conclusions: SUVmax is a useful predictor of disease-free survival in patients with resected adenocarcinoma, but not squamous cell carcinoma. Patients with adenocarcinoma exhibiting an SUVmax above 6.19 are candidates for more intensive adjuvant therapy.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.110-116
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• 2010

Purpose: The X-ray attenuation coefficient based on CT images is used for attenuation correction in PET/CT. The polychromatic X-ray beam can introduce beam-hardening artifact on CT images. The aims of the study were to evaluate the effect of dental metal prostheses in phantom and patients on apparent tracer activity measured with PET/CT when using CT attenuation correction. Materials and Methods: 40 normal patients (mean age $54{\pm}12$) was scanned between Jan and Feb 2010. NEMA(National Electrical Manufactures Association) PET $Phantom^{TM}$ (NU2-1994) was filled with $^{18}F$-FDG injected into the water that insert implant and metal prostheses dental cast. Region of interest were drawn in non-artifact region, bright steak artifact region and dark streak artifact region on the same transaxial CT and PET slices. Patients and phantom with dental metal prostheses and dental implant were evaluated the change rate of CT Number and $SUV_{mean}$ in PET/CT. A paired t-test was performed to compare the ratio and the difference of the calculated values. Results: In patients with dental metal prostheses, $SUV_{mean}$ was reduced 19.64% (p<0.05) in the non-steak artifact region than the brightstreak artifact region whereas was increased 90.1% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental metal prostheses, $SUV_{mean}$ was reduced 18.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 18.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In patients with dental implant, $SUV_{mean}$ was increased 19.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 96.62% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental implant, $SUV_{mean}$ was increased 14.4% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 7.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. Conclusion: When CT is used for attenuation correction in patients with dental metal prostheses, 19.1% reduced $SUV_{mean}$ is anticipated in the dark streak artifact region on CT images. The dark streak artifacts of CT by dental metal prostheses may cause false negative finding in PET/CT. We recommend that the non-attenuation corrected PET images also be evaluated for clinical use.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.38-43
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• 2012

Purpose: Patients injected with FDG use the bathroom that Measured surface contamination level and spatial dose rate. This study about the effect that result affects workers in same part. Materials and Methods: Group1 is St. Vincent' s hospital's 60case. Group 2 is Bucheon St. Mary's hospital's 50case. Last case is lower the average daily number of patients than group 2. Measured time is 8:00, 10:00, 13:00, 15:00 and 17:00. Measured part is 4 point of toilet, basin and wastepaper basket, also measured accumulation dose of toilet during 3 month. Hospitals is installed PET/CT ware surveyed on presence of bathroom that used only by patient and worker has been using the bathroom. Results: The highest average surface contamination level of toilet is group1($8.38{\pm}4.56$), but the highest spatial dose rate is group3. Cumulative exposure dose measured by TLD during 3months is St.Vincent's hospital 0.78 mSv and Bucheon St.Mary's hospital 0.37 mSv. And result of survey is 16.12% worker using the bathroom. Conclusions: The more daily number of patient, the higher surface contamination level of bathroom. Especially, wastepaper basket's surface contamination level is exceed the reference value $4Bq/cm^2$. Based on This survey, Bathroom require special attention and proper decontamination.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.13-17
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• 2010

Purpose: Partial volume effect (PVE) is the phenomenon to lower the accuracy of image due to low estimate, which is to occur from PET/CT 3D image acquisition. The more resolution is declined and the lesion is small, the more it causes a big error. So that it can influence the test result. Studied the optimum image reconstruction method by using variation of parameter, which can influence the PVE. Materials and Methods: It acquires the image in each size spheres which is injected $^{18}F$-FDG to hot site and background in the ratio 4:1 for 10 minutes by using NEMA 2001 IEC phantom in GE Discovey STE 16. The iterative reconstruction is used and gives variety to iteration 2-50 times, subset number 1-56. The analysis's fixed region of interest in detail part of image and compute % difference and signal to noise ratio (SNR) using $SUV_{max}$. Results: It's measured that $SUV_{max}$ of 10 mm spheres, which is changed subset number to 2, 5, 8, 20, 56 in fixed iteration to times, SNR is indicated 0.19, 0.30, 0.40, 0.48, 0.45. As well as each sphere's of total SNR is measured 2.73, 3.38, 3.64, 3.63, 3.38. Conclusion: In iteration 6th to 20th, it indicates similar value in % difference and SNR ($3.47{\pm}0.09$). Over 20th, it increases the phenomenon, which is placed low value on $SUV_{max}$ through the influence of noise. In addition, the identical iteration, it indicates that SNR is high value in 8th to 20th in variation of subset number. Therefore, to reduce partial volume effect of small lesion, it can be declined the partial volume effect in iteration 6 times, subset number 8~20 times, considering reconstruction time.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.25-28
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• 2011

Purpose: The aim of study is to find accuracy of pocket dosimeter in measuring exposed dose in compared with survey meter and to compare exposed dose according as Nuclear medicine exams. Materials and Method: First, radiation dose to point source(185 MBq,370 MBq, ${\ldots}$, 1665 MBq, 1850 MBq) were measured in using a pocket dosimeter and a survey meter. Second, radiation dose to 12 patients injected $^{18}F$-FDG 370 MBq were measured in using a pocket dosimeter and a survey meter. Third, radiation dose to 10 patients injected $^{99m}Tc$-DPD 925 MBq were measured in using a pocket dosimeter and a surveymeter. Result: The average is $70.12{\pm}39.36{\mu}Sv/h$ in measurement of point source with Surveymeter and $5{\pm}3.06{\mu}Sv$ in measurement of point source with Pocket dosimeter. The average is $25.04{\pm}6.16{\mu}Sv/h$ in measurement of PET/CT patients with Surveymeter and $2.41{\pm}0.51{\mu}Sv$ in measurement of PET/CT with Pocket dosimeter. The average is $8.58{\pm}0.96{\mu}Sv/h$ in measurement of Bone Scan patients with Surveymeter and $1{\mu}Sv$ in measurement of Bone Scan patients with Pocket dosimeter. Significant difference found between Survey meter value and Pocket dosimeter value in all experimentation (p<0.001). Conclusion: Accoring to rusult Wearing Pocket dosimeter is usefulnee in manerage of exposed dose in nucler medicine exams.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.140-144
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• 2014

Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

• Journal of radiological science and technology
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• v.35 no.2
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• pp.141-149
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• 2012

The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like $^{99m}Tc$-HDP and $^{18}F$-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety management regulations, and take actions to maximally reduce locally exposed dose to hands monitoring with ring TLD.

• Progress in Medical Physics
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• v.22 no.3
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• pp.140-147
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• 2011

The purpose of this study was to estimate internal motion using molecular sieve for quantitative improvement of lung tumor and to localize lung tumor in the small animal PET image by evaluated data. Internal motion has been demonstrated in small animal lung region by molecular sieve contained radioactive substance. Molecular sieve for internal lung motion target was contained approximately 37 kBq Cu-64. The small animal PET images were obtained from Siemens Inveon scanner using external trigger system (BioVet). SD-Rat PET images were obtained at 60 min post injection of FDG 37 MBq/0.2 mL via tail vein for 20 min. Each line of response in the list-mode data was converted to sinogram gated frames (2~16 bin) by trigger signal obtained from BioVet. The sinogram data was reconstructed using OSEM 2D with 4 iterations. PET images were evaluated with count, SNR, FWHM from ROI drawn in the target region for quantitative tumor analysis. The size of molecular sieve motion target was $1.59{\times}2.50mm$. The reference motion target FWHM of vertical and horizontal was 2.91 mm and 1.43 mm, respectively. The vertical FWHM of static, 4 bin and 8 bin was 3.90 mm, 3.74 mm, and 3.16 mm, respectively. The horizontal FWHM of static, 4 bin and 8 bin was 2.21 mm, 2.06 mm, and 1.60 mm, respectively. Count of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.10, 4.83, 5.59, 5.38, and 5.31, respectively. The SNR of static, 4 bin, 8 bin, 12 bin and 16 bin was 4.18, 4.05, 4.22, 3.89, and 3.58, respectively. The FWHM were improved in accordance with gate number increase. The count and SNR were not proportionately improve with gate number, but shown the highest value in specific bin number. We measured the optimal gate number what minimize the SNR loss and gain improved count when imaging lung tumor in small animal. The internal motion estimation provide localized tumor image and will be a useful method for organ motion prediction modeling without external motion monitoring system.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.252-256
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• 2005

Purpose: Thyroglobulin (Tg) is a valuable and sensitive tool as a marker for diagnosis and follow-up for several thyroid disorders, especially, in the follow-up of patients with differentiated thyroid cancer (DTC). Often, clinical decisions rely entirely on the serum Tg concentration. But the Tg assay is one of the most challenging laboratory measurements to perform accurately owing to antithyroglobulin antibody (Anti-Tg). In this study, we have compared the degree of Anti-Tg effects on the measurement of Tg between availale Tg measuring kits. Materials and Methods: Measurement of Tg levels for standard Tg solution was performed with two different kits commercially available (A/B kits) using immunoradiometric assay technique either with absence or presence of three different concentrations of Anti-Tg. Measurement of Tg for patient's serum was also performed with the same kits. Patient's serum samples were prepared with mixtures of a serum containing high Tg levels and a serum containg high Anti-Tg concentrations. Results: In the measurements of standard Tg solution, presence of Anti-Tg resulted in falsely lower Tg level by both A and B kits. Degree of Tg underestimation by h kit was more prominent than B kit. The degree of underestimation by B kit was trivial therefore clinically insignificant, but statistically significant. Addition of Anti-Tg to patient serum resulted in falsely lower Tg levels with only A kit. Conclusion: Tg level could be underestimated in the presence of anti-Tg. Anti-Tg effect on Tg measurement was variable according to assay kit used. Therefore, accuracy test must be performed for individual Tg-assay kit.