• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.91-95
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• 2004

Several MRI studies have reported reductions in temporal lobe volumes in Alzheimer's disease (AD). Measures have been usually obtained with regions-of-interest (ROI) drawn manually on selected medial and lateral portions of the temporal lobes, with variable choices of anatomical borders across different studies. We used the automated voxel-based morphometry (VBM) approach to investigate gray matter abnormalities over the entire extension of the temporal lobe in 10AD patients (MM5E 22)and 22 healthy controls. Foci of significantly reduced gray matter volume in AD patients were detected in both medial and lateral temporal regions, most significantly in the right and left posterior parahippocarmpal gyri. At a more flexible statistical threshold (P<0.01, uncorrected for multiple comparisons), circumscribed foci of significant gray matter reduction were also detected in the right amygdala/enthorinal cortex, the anterior and posterior borders of the superior temporal gyrus bilaterally, and the anterior portion of the left middle temporal gyrus. These VBM results confirm previous findings of temporal lobe atrophic changes in AD, and suggest that these abnormalities may be confined to specific sites within that lobe, rather than showing a widespread distribution.

• Progress in Medical Physics
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• v.24 no.3
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• pp.176-182
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• 2013

Through this research, we measure the data for several SUVs such as SUVLBM, SUVBW, and SUVBSA using volume of interest in order to enhance the diagnostic level in whole-body image for healthy examinees via F-18 FDG PET/CT. Maximum value, mean value, standard deviation, and threshold value for each SUVs are shown. The measurement of SUVs are carried out with 31 examinees who have taken whole-body examination with F-18 FDG PET/CT from July, 2012 to August, 2012. To secure the preciseness of measurement, we selected 26 healthy examinees as a subject of measurement according to diagnostic view of a nuclear-medical doctor. We see from the measurement of SUVs of PET/CT that the value of SUVBW is hightest and followed by SUVLBM and SUVBSA in turn regardless of the use of contrast media. By comparing the SUVLBM-maximum data for the group used contrast media with those for the group used no contrast media, there found a trend that the measured values increase when the contrast media are used. Among them, liver, aorta, lumbar-5, and Cerebellum exhibit significant difference (p<0.05). We conclude that our data for SUVs would be basic references in overall image interpretation, and hope that the research using VOI would be active.

• Clinical and Experimental Pediatrics
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• v.51 no.12
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• pp.1342-1345
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• 2008

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare white matter disorder, first described in the early 1990s. The brain in patients with MLC appears swollen on MRI, with diffuse white matter abnormalities; in addition, there is an invariable presence of subcortical cysts, primarily in the anterior temporal region sparing the deep white matter, basal ganglia, thalami, and cerebellum. Patients with MLC present with macrocephaly and neurological abnormalities such as motor deterioration, ataxia, spasticity, and cognitive deficits. We report a twenty-month-old boy who presented with seizures and macrocephaly, delay in development, and abnormal brain MRI findings compatible with the diagnosis of MLC. The brain MRI revealed bilateral hypersignal intense subcortical white matter regions in the frontal, temporal, and parietal lobes on T2-weighted images, which were not yet associated with cystic changes. During follow-up, the frequency of seizures decreased after anticonvulsant medication was started, but the head circumference remained above the 97th percentile, and the patient continued to have developmental delay.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.1-8
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• 1997

뇌성마비는 뇌 발달시기중 초기의 장애로 인하여 운동기능과 자세의 이상 등을 초래하는 질환으로 임상적으로 여러 유형으로 나누어진다. 뇌성마비 환자중에서 MRI 상 롤란도야의 이상소견을 보이는 경우 특이한 임상적 특징을 나타낸다고 보고되어있다. 본 논문에서는 이들을 대상으로 하여 뇌 단일광자컴퓨터촬영에서 나타나는 뇌혈류 이상 소견과 MRI 소견, 그리고 임상양상들을 비교해보고자 하였다. 임상적으로 뇌성마비로 진단된 80여명의 환자중 MRI상 롤란도야에 저산소성 뇌질환의 소견을 보인 7명을 대상으로 하였다. 이들에게 5-10mCi의 Tc-99m-ECD를 정맥주사후 뇌 단일광자컴퓨터촬영을 하였다. 뇌 단일광자컴퓨터촬영상에서는 특히 뇌피질, 선조체, 시상, 뇌간 및 소뇌의 혈류이상 소견을 분석하였고, 이를 MRI 소견 및 임상증상과 비교하였다. 모든 환자들은 만삭 또는 만삭에 가깝게 태어났고, 주산기 아사가 여섯명의 환자에서 있었다. 임상적으로는 긴장성 사지마비로 나타났다. Tc-99m ECD를 이용한 뇌 단일광자 컴퓨터촬영상 롤란도야의 혈류감소는 모두에서 확연하게 나타났다 MRI상에서 롤란도야의 이상소견은 5명에서는 확실하게 나타났고, 2명에서는 의심되었다. MRI상에서 이상소견을 보인 것보다 더 광범위한 부분에서 뇌단일광자컴퓨터촬영상 이상소견이 보였다. 결론적으로, 롤란도야에서 이상소견을 보인 환자는 임상적, 구조적, 그리고 기능적으로 특이한 소견을 보였다. Tc-99m-ECD를 이용한 뇌 단일광자컴퓨터촬영은 매우 민감하게 반영하였고, MRI보다 뇌의 더 광범위한 부위에서 이상소견을 보였다.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.1
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• pp.33-37
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• 2022

Purpose ¹⁸F-Florbetaben (FBB) Readings are made by visually comparing the signal strengths of gray matter and white matter. We intend to evaluate the usefulness of image analysis by comparing quantified image analysis with readout. Materials and Methods Based on the reading results, 100 patients were divided into a negative scan and a positive scan, and 300 MBq of FBB was injected, and images were taken 90 minutes later for 20 minutes. The equipment was a Discovery 600 (GE Healthcare, MI, USA). Four regions of interest (lateral temporal lobes, frontal lobes, posterior cingulate & precuneus, and parietal lobes) were established based on the amyloid reading standard provided by the manufacturer. For image analysis, SUVratio (SUVr) was calculated by dividing each SUVmean by the cerebellum, and the average SUVr in the entire area was performed. Statistical analysis analyzed the cutoff derivation through ROC Curve, the difference between groups in Independent sample t-test, and the degree of agreement with the reading result through Kappa test. Results The average SUVr cutoff in the entire area was 1.23. Concordance with the read results using cutoff was 95/100 (95%) for negative and 92/100 (92%) for positive. As a result of the t-test, there was a statistically significant difference between the groups (P < 0.05), and the Kappa statistical result showed a high degree of agreement with 0.867 (P < 0.05). Conclusion The results of image analysis were statistically significant and showed a high degree of agreement with the reading results. In addition, FBB image analysis can be viewed by 3D mapping the area where amyloid is accumulated, location estimation is possible, and quantitative analysis results can be viewed in detail. If quantified FBB image analysis is used as an auxiliary indicator, it is thought to be helpful in reading.

• The Korean Journal of Nuclear Medicine
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• v.36 no.2
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• pp.91-101
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• 2002

Purpose : The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Materials and Methods : Tc-99m HMPAO brain SPECT was peformed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5 - 24) and the mean MMSE score of the follow-up was 8.1 (range: 0 - 17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was peformed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Results : Significant correlation was found between the blood-flow decrease in left inferior prefrontal region (BA 47) and left middle temporal legion (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed the similar trends. Conclusions : A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's disease(AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.421-429
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• 2005

Purpose: It has been postulated that dopamine release in the striatum underlies the reinforcing properties of nicotine. Substantial evidence in the animal studies demonstrates that nicotine interacts with dopaminergic neuron and regulates the activation of the dopaminergic system. The aim of this study was to visualize the dopamine release by smoking in human brain using PET scan with $[^{11}C]raclopride$. Materials and Methods: Five male non-smokers or ex-smokers with an abstinence period longer than 1 year (mean age of $24.4{\pm}1.7$ years) were enrolled in this study $[^{11}C]raclopride$, a dopamine D2 receptor radioligand, was administrated with bolus-plus-constant infusion. Dynamic PET was performed during 120 minutes ($3{\times}20s,\;2{\times}60s,\;2{\times}120s,\;1{\times}180s\;and\;22{\times}300s$). following the 50 minute-scanning, subjects smoked a cigarette containing 1 mg of nicotine while in the scanner. Blood samples for the measurement of plasma nicotine level were collected at 0, 5, 10, 15, 20, 25, 30, 45, 60, and 90 minute after smoking. Regions for striatal structures were drawn on the coronal summed PET images guided with co-registered MRI. Binding potential, calculated as (striatal-cerebellar)/cerebellar activity, was measured under equilibrium condition at baseline and smoking session. Results: The mean decrease in binding potential of $[^{11}C]raclopride$ between the baseline and smoking in caudate head, anterior putamen and ventral striatum was 4.7%, 4.0% and 7.8%, respectively. This indicated the striatal dopamine release by smoking. Of these, the reduction in binding potential in the ventral striatum was significantly correlated with the cumulated plasma level of the nicotine (Spearman's rho=0.9, p=0.04). Conclusion: These data demonstrate that in vivo imaging with $[^{11}C]raclopride$ PET could measure nicotine-induced dopamine release in the human brain, which has a significant positive correlation with the amount or nicotine administered bt smoking.

• Clinical and Experimental Pediatrics
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• v.45 no.11
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• pp.1373-1380
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• 2002

Purpose : Acute measles encephalitis(ME) is characterized by an abrupt onset of fever and obtundation, frequently accompanied by seizures and multifocal neurological signs. The aim of this study was to clarify the clinical manifestation, progression and the brain SPECT patterns in patients with acute ME. Methods : This study included 11 children with acute ME admitted to Chonbuk National University Hospital. Ten patients received a first dose of measles vaccine, one patient did not receive a first dose, and no patients received a second dose. ME was diagnosed based on characteristic clinical pictures, measles antibodies by ELISA and abnormal CSF findings. Brain MRI and brain SPECT were performed in 11 patients with acute ME. Results : There were four males and seven females whose ages at onset ranged between 18 months and 14 years(mean : 10.5 years). The main clinical neurologic pictures were loss of consciousness( 10) and seizure(five). The titer of IgG and IgM antimeasles antibodies in serum were positive in 10 patients. In CSF, nine patients had IgG antibodies and one patient had IgM antibodies. The concentration of protein(mean : $124{\pm}60mg/dL$) and WBC counts(mean : $158{\pm}157/{\mu}L$) in CSF were elevated in all patients. In electroencephalographic examination, nine patients showed increased slow waves. Seven of 11 patients(63.6%) revealed high signal intensity on the brain MRI. In contrast, all patients showed hypoperfusion in brain SPECT examination. According to brain SPECT, the perfusion deficits were frequently observed in the frontal lobe(nine), temporal (nine), parietal(eight) and thalamus(eight). Conclusion : Brain SPECT is more sensitive than MRI for the evaluation of brain damage in early stages of acute ME.

• The Korean Journal of Nuclear Medicine
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• v.38 no.1
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• pp.30-40
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• 2004

Purpose: The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron omission tomography (FDG PET). Materials and Methods: MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was peformed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Results: Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Conclusions: Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.293-300
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• 1994

It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD), we included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status ex amination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.