• The Korean Journal of Nuclear Medicine
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• v.34 no.6
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• pp.456-464
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• 2000

Purpose: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. Materials and Methods: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM$^{(R)}$ for Windows$^{(R)}$. Results: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. Conclusion: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.100-109
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• 1999

Purpose: Preamplifier and amplifier are very important parts for developing a portable counting or imaging gamma probe. They can be used for analyzing pulses containing energy and position information for the emitted radiations. The commercial Nuclear Instrument Modules (NIMs) can be used for processing these pulses. However, it may be improper to use NIMs in developing a portable gamma probe, because of its size and high price. The purpose of this study was to develop both preamplifier and amplifier and measure their performance characteristics. Materials and Methods: The preamplifier and amplifier were designed as a charge sensitive device and a capacitor resistor-resistor capacitor (CR-RC) electronic circuit, respectively, and they were mounted on a print circuit board (PCB). We acquired and analyzed energy spectra for Tc-99m and Cs-137 using both PCB and NIMs. Multichannel analyzer (Accuspec/A, Canberra Industries Inc., Meriden Connecticut, U.S.A) and scintillation detectors (EP-047(Bicron Saint-Gobain/Norton Industrial EP-047 (Ceramics Co., Ohio, U.S.A) with $2"{\times}2"$ NaI(T1) crystal and R1535 (Hamamatsu Photonics K.K., Electron Tube Center, Shizuoka-ken, Japan) with $1"{\times}1"$ NaI(T1) crystal were used for acquiring the energy spectra. Results: Using PCB, energy resolutions of EP-047 detectors for Tc-99m and Cs-137 were 12.92% and 5.01%, respectively, whereas R1535 showed 13.75% and 5.19% of energy resolution. Using the NIM devices, energy resolutions of EP-047 detector for Tc-99m and Cs-137 were measured as 14.6% and 7.58%, respectively. However, reliable energy spectrum of R1535 detector could not be acquired, since its photomultiplier tube (PMT) requires a specific type of preamplifier. Conclusion: We developed a special preamplifier and amplifier suitable for a small sized gamma probe that showed good energy resolutions independent of PMT types. The results indicate that the PCB can be used in developing both counting and imaging gamma probe.

• The Korean Journal of Nuclear Medicine
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• v.32 no.3
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• pp.266-275
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• 1998

Purpose: We measured pulmonary epithelial permeability by $^{99m}Tc-DTPA$ radioaerosol clearance in patients with diabetes and correlated with the presence of microangiopathy to understand the pathophysiology of pulmonary microangiopathy and evaluate $^{99m}Tc-DTPA$ radioaerosol clearance as a diagnostic test to assess pulmonary microangiopathy. Materials and Methods: We performed $^{99m}Tc-DTPA$ radioaerosol scan in 10 normal subjects, 10 asymptomatic smokers, 20 diabetic patients without history of smoking (10 with microangiopathy, 10 without microangiopathy). $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) was calculated, then compared with the result of chest radiography and pulmonary function test. Results: Chest radiography and pulmonary function test were normal in all subjects. There were no significant difference of clinical or laboratory characteristics between these groups except age. The diabetic patients with microangiopathy were significantly older (p<0.05). The $T_{1/2}$ of normal subjects and asymptomatic smokers were significantly different ($65.2{\pm}23.7min$ vs $39.6{\pm}9.8min$, p<0.05). For diabetic patients with microangiopathy, the $T_{1/2}$ was $90.5{\pm}46.5min$ and significantly delayed when compared with those of normals and asymptomatic smokers (p<0.05). However, the $T_{1/2}$ of diabetic patients without microangiopathy, $70.0{\pm}12.7min$, was not significantly different from those of normals or asymptomatic smokers (p>0.05). No significant correlation was found between the $T_{1/2}$ and spirometric parameters including DLco, FVC, $FEV_1,\;FEV_1/FVC$ (%) and $FEF_{25-75%}$ in all subjects, and between the $T_{1/2}$ and duration of diabetes ;in diabetic patients. Conclusion: Eventhough the influence of age can't be excluded, delayed $^{99m}Tc-DTPA$ clearance half-time ($T_{1/2}$) in diabetic patients with microangiopathy indicates decreased pulmonary capillary permeability as one of the pathophysiologic results of pulmonary microangiopaththy. Further studies are needed in larger number of age matched control and diabetic patients to evaluate the diagnostic efficacy.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.220-226
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• 1994

This study was performed to evaluate the clinical applicability of the reverse transcription polymerase chain reaction (RT-PCR ) kit of HCV-RNA using biotinylated and radioiodinated primers. Study subjects were 118 patients with positive anti-HCV. HCV-RNA in patient's serum was extracted by guanidium thiocyanate method. After first amplification, the product was reamplified by primers labelled with biotin and I-125. The final amplification product was defected by counting the radioactivity after incubation in avidin coated tubes. In 51 samples, the test was repeated for evaluation of reproducibility. This new method was also compared with conventional RT-PCR methods in 34 samples from patients with chronic liver disease. The results were as follows ; 1) HCV-RNA was positive in 85(97%)of 88 patients with chronic liver disease, and in 23 (73%) of 30 patients with normal liver function. 2) In comparison with conventional method, HCV-RNA was detected in 32(94%) of 34 patients with new method, whereas in 27(79%) of the same group with conventional method. 3) Repeated test with new method in 52 samples demonstrated 82% of concordant result. In conclusion, new method with biotinylated and radioiodinated primers was more sensitive than conventional method. However, great care must be taken for quality control because there were considerable interassay variation and possiblity of false positivity and false negativity.

• The Korean Journal of Nuclear Medicine
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• v.38 no.1
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• pp.21-29
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• 2004

Purpose: Much evidence suggests long-term cigarette smoking alters coronary vascular endothelial response. On this study, we applied nonnegative matrix factorization (NMF), an unsupervised learning algorithm, to CO-less $H_2^{15}O-PET$ to investigate coronary endothelial dysfunction caused by smoking noninvasively. Materials and methods: This study enrolled eighteen young male volunteers consisting of 9 smokers $(23.8{\pm}1.1\;yr;\;6.5{\pm}2.5$ pack-years) and 9 nonsmokers $(23.8{\pm}2.9 yr)$. They do not have any cardiovascular risk factor or disease history. Myocardial $H_2^{15}O-PET$ was performed at rest, during cold ($5^{\circ}C$) pressor stimulation and during adenosine infusion. Left ventricular blood pool and myocardium were segmented on dynamic PET data by NMF method. Myocardial blood flow (MBF) was calculated from input and tissue functions by a single compartmental model with correction of partial volume and spillover effects. Results: There were no significant difference in resting MBF between the two groups (Smokers: 1.43 0.41 ml/g/min and non-smokers: $1.37{\pm}0.41$ ml/g/min p=NS). during cold pressor stimulation, MBF in smokers was significantly lower than 4hat in non-smokers ($1.25{\pm}0.34$ ml/g/min vs $1.59{\pm}0.29$ ml/gmin; p=0.019). The difference in the ratio of cold pressor MBF to resting MBF between the two groups was also significant (p=0.024; $90{\pm}24%$ in smokers and $122{\pm}28%$ in non-smokers.). During adenosine infusion, however, hyperemic MBF did not differ significantly between smokers and non-smokers ($5.81{\pm}1.99$ ml/g/min vs $5.11{\pm}1.31$ ml/g/min ; p=NS). Conclusion: in smokers, MBF during cold pressor stimulation was significantly lower compared wi4h nonsmokers, reflecting smoking-Induced endothelial dysfunction. However, there was no significant difference in MBF during adenosine-induced hyperemia between the two groups.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.186-191
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• 1994

Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.81-85
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• 2011

Purpose: With the introduction of PET since 1994, test methods have made rapid progress. Accordingly, the studies on the diagnosis and treatment of cancer as well as treatment response evaluation PET test are useful. However, it is difficult to divide stomach lesions and secretion. The purpose of this study is to reduce additional shooting by dividing lesions and secretion of stomach. Materials and Method: This study aiming at total 228 cancer patients was conducted from Aug 18 to Sep. 10, 2010. Among them, 115 patients had a test without water intake before shooting from Aug. 8 to 31 and 113 had a test after drinking 500 cc water right before shooting from Sep. 1 to 10 The Discovery ST PET/CT (GE Healthcare, USA) was used, and pearson's chi-square test was conducted to analyze significance through SPSS (Ver.18). Results: Among the total 228 cancer patients, there were 115 who had a test without water intake before shooting, 89 who had no double additional shooting, 13 who had stomach additional shooting and 13 who had other additional shooting. In addition, 109 had no additional shooting among 113 who had a test after taking 500 cc water, 1 had stomach additional shooting and 3 had other additional shooting. According to the findings above, the patients who had a test without water intake show reduced additional shooting, but for more exact significance, pearson's Chi-square test was carried out and the significance percentage was 0.001 that is smaller than 0.05, which means two groups have a significant relationship. As the minimum expectation frequency was 6.94 and there was no expectation frequency smaller than 5, so that it doesn't need to carry out pearson's exact verification. Conclusion: The above analysis has found that if one drinks 500cc water before the test, not only stomach additional shooting but also other additional shooting can be dramatically reduced, and test delay can be also reduced.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.34-38
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• 2011

Purpose: The SUV is a widely used semi-quantitative index in PET for the estimation of radio-tracer accumulation in VOI. In this study, SUVs from three different PET/CT scanners were assessed, and differences between SUVs were evaluated. Materials and Methods: The PET/CT scanners which were assessed in this study were GEMINI, GEMINI TF 64 (Philips) and Biograph True Point True V 40 (Siemens). The NEMA PET phantom (Data Spectrum Corp., USA) was used to evaluate SUVs. The NEMA PET phantom has6.8 kg weight and three hot inserts. Two different activity distributions for the background and inserts were tested. The activity ratio were 3.7:3.7:7.4:11.1 MBq (1:1:2:3) and 1.85:7.4:9.25:11.1MBq (1:4:5:6) for each of background, insert 1, insert 2 and insert 3. Acquisition time was 2 minutes per bed position and NEMA PET phantom could be covered by two bed positions for all PET/CT scanners. The SUVs from each PET/CT scanner were compared with calculated true value. Results: For both activity ratios, all scanners showed similar results. The differences between each scanner were insignificant. Each scanner showed 91.2%, 85.9% and 87.2% of true SUV for GEMINI, GEMINI TF 64, Biograph True Point TrueV, respectively. Conclusion: For all scanners, SUVs were slightly lower than true value. However, the difference between scanners was insignificant. The SUVs from these scanners would be clinically meaningful if their consistent underestimation is kept in mind.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.10-16
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• 2011

Purpose: The partial volume effect occurs because of limit of the spatial resolution. It makes partial loss of intensity and causes SUV to be lower than it should actually be. So the purpose of this study is to calculate recovery coefficient for correcting PVE from phantom study and to compare before and after SUV correction applying to PET/CT examination. Materials and Methods: The flangeless Esser PET phantom consisting of four hot cylinders was used for this study. All of the hot cylinders were filled with FDG solution of 20.72 MBq per 1000 ml, and the phantom background was filled with FDG solution of different concentrations (33.30, 22.20, 16.65 MBq per 6440 ml) to yield H/B ratios of around 4:1, 6:1 and 8:1. Using the Biograph Truepoint 40(SIEMENS, Germany), we applied recovery coefficient method to 30 patients who were diagnosed with lung cancer after PET/CT exam. And then we analyzed and compared SUV before and after correcting partial volume effect. Results: The smaller the diameter of hot cylinder becomes, the more recovery coefficient decreased. When we applied recovery coefficient to clinical patients and compared SUV before and after correcting PVE, before the correction all lesions gave an average max SUV of 7.83. And after the correction, the average max SUV increases to 10.31. The differences in the max SUV between before and after correction were analyzed by paired t test. As a result, there were statistically significant differences (t=7.21, p=0.000). Conclusion: The SUV for quantification should be measured precisely to give consistent information of tumor uptake. But PVE is one of factors that causes SUV to be lower and to be underestimated. We can correct this PVE and calculate corrected SUV using the recovery coefficient from phantom study. And if we apply this correction method to clinical patients, we can finally assess and provide quantitative analysis more accurately.