• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.51-54
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• 2018

Purpose $^{18}F-THK5351$ is the newly developed PET probe for tau imaging in alzheimer's disease. The purpose of study was to establish the automated production of $^{18}F-THK5351$ on a commercial module. Materials and Methods Two different approaches were evaluated for the synthesis of $^{18}F-THK5351$. The first approach (method I) included the nucleophilic $^{18}F$-fluorination of the tosylate precursor, subsequently followed by pre-HPLC purification of crude reaction mixture with SPE cartridge. In the second approach (method II), the crude reaction mixture was directly introduced to a semi-preparative HPLC without SPE purification. The radiosynthesis of $^{18}F-THK5351$ was performed on a commercial GE $TRACERlab^{TM}$ $FX-_{FN}$ module. Quality control of $^{18}F-THK5351$ was carried out to meet the criteria guidelined in USP for PET radiopharmaceuticals. Results The overall radiochemical yield of method I was $23.8{\pm}1.9%$ (n=4) as the decay-corrected yield (end of synthesis, EOS) and the total synthesis time was $75{\pm}3min$. The radiochemical yield of method II was $31.9{\pm}6.7%$ (decay-corrected, n=10) and the total preparation time was $70{\pm}2min$. The radiochemical purity was>98%. Conclusion This study shows that method II provides higher radiochemical yield and shorter production time compared to the pre-SPE purification described in method I. The $^{18}F-THK5351$ synthesis by method II will be ideal for routine clinical application, considering short physical half-life of fluorine-18 ($t_{1/2}=110min$).

• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.131-141
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• 2001

Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

• Progress in Medical Physics
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• v.21 no.1
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• pp.16-21
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• 2010

To acquire good image quality and to minimize unnecessary radiation dose to patients, it is important to ensure that the radiopharmaceutical administered is accurately measured. Quality control of radionuclide calibrators should be performed to achieve these goals. The purpose of this study is to support the quality control of radionuclide calibrators in nuclear medicine centers and to investigate the level of measurement accuracy of the radionuclide calibrators. 58 radionuclide calibrators from 45 nuclear medicine centers, 74 radionuclide calibrators from 58 nuclear medicine centers, and 60 radionuclide calibrators from 45 nuclear medicine centers were tested with I-131, Tc-99m and I-123, respectively. The results showed that 81% of calibrators for I-131, 61% of calibrators for Tc-99m and 67% of calibrators for I-123 were within ${\pm}5%$. 17% of calibrators for I-131, 20% of calibrators for Tc-99m and 15% of calibrators for I-123 had a deviation in the range 5%< $|{\Delta}|{\leq}10%$. 2% of calibrators for I-131, 19% of calibrators for Tc-99m and 18% of calibrators for I-123 had a deviation of $|{\Delta}|$ >10%. Follow-up measurements were performed on the calibrators whose error exceeded the ${\pm}10%$ limit. As a result, some of the calibrator showed an improvement and their deviation decreased below the ${\pm}10%$ limit. The results have shown that such comparisons are necessary to improve the accuracy of the measurement and to identify malfunctioning radionuclide calibrators.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.44-47
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• 2013

Purpose: There are several methods of measuring SUV in PET/CT imaging including $SUV_{bw}$ which uses the body weight, $SUV_{bsa}$ which that uses body surface area and $SUV_{lbm}$ which uses lean body mass. Currently, Seoul National University Hospital uses $SUV_{bw}$ method which minimizes the variability. In this study, we compared and analyzed the correlation between $SUV_{bw}$ and $SUV_{bsa}$ according to patients' body mass index. Materials and Methods: Using Biograph mCT40 (Siemens, Germany), we conducted $^{18}F-FDG$ PET/CT imaging on 70 patients (41 males, 29 females; ages $58.04{\pm}12.44$). We classified the patients as underweight (BMI<20), normal weight (20$${\leq_-}$$BMI<25), overweight (25$${\leq_-}$$BMI<30), obese (30$${\leq_-}$$BMI<35) and severely obese (35$${\leq_-}$$BMI) according to the patient's sex, age and BIM. Then, bone, liver and lungs were set as ROI for calculation of maximum values of $SUV_{bw}$ and $SUV_{bsa}$, through Syngo.via VA11A analysis program. Results: Comparing the five groups divided according to the BMI by the standard differences between $SUV_{bw}$ to $SUV_{bsa}$, $SUV_{max}$ was measured to be $0.66{\pm}0.15$, $0.78{\pm}0.35$, $0.77{\pm}0.21$, $1.00{\pm}0.44$, $1.53{\pm}0.38$ for bones in underweight, normal weight, overweight, obese and severely obese groups, respectively. For liver, values of $SUV_{max}$ were $1.64{\pm}0.16$, $2.06{\pm}0.34$, $2.19{\pm}0.21$, $2.52{\pm}0.21$ and $2.74{\pm}0.40$ in the same order. And for lung, values of $SUV_{max}$ were $0.69{\pm}0.33$, $0.54{\pm}0.17$, $0.62{\pm}0.23$, $0.83{\pm0.29}$, $1.03{\pm}0.30$. Conclusion: By comparing and analyzing the differences between $SUV_{bw}$ and $SUV_{bsa}$ in this study, it was found that the differences between $SUV_{bw}$ and $SUV_{bsa}$ increased as patient's BMI increased. Thus, there is room for error in the values of SUV depending on the methods of calculations, and appropriate methods must be applied according to the circumstances in clinical settings.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.25-30
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• 2013

Purpose: To evaluate kidney function, renal relative uptake is very important and is affected by kidney and the setting of background region of interest (ROI). In particular, in the case of patients with hydronephrosis to the naked eyes, such as size, position and shape etc. can be difficult to identify. So according to ROI to be set by user, the results are many differences. This study assumes the ROI of a constant kidney. According to the change of background ROI by analyzing renal relative uptake affect how the results are intended to study. Materials and Methods: From January 2012 to February 2013, we analyzed 27 patients with hydronephrosis who were examined MAG3 test in nuclear medicine department of Samsung medical center. After patients were received intravenous injection of $^{99m}Tc-MAG3$ 185 MBq (5 mCi) data were obtained. While we reconstructed images of patients, we've changed background ROI in the process of setting up ROI. First, in the process of renal processing, automatic ROI which set automatically and background ROI which needed to set manually were compared. Second, we set the ROI position separated by above, lateral and bottom of kidney. Third, background setting time were compared with 1-2 min and 2-3 min. Results: The relative uptake occurred in 3.7%p of the errors on average in Automatic & Manual ROI study. And comparison of background ROI position study, located in the lower position was more accurate results. Above, lateral, bottom each of the values 74.6%, 67.6% and 62.0% showed respectively. The standard value was 59.9%. finally, split function range test doesn't show significant difference. Conclusion: The study shows that relative uptake of kidney is affected in the background ROI. Therefore, it should be set by considering various dependent factors.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.62-67
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• 2012

Purpose : At this time, the sentinel lymph node mapping using radioisotope and blue dye is preceded for breast cancer patient's sentinel lymph node biopsy. But all patients were applied the same protocol without consideration of physical specific character like the breast sizes and body mass indexes. The purpose of this study is search the optimized scan time in breast sentinel lymphangiography by observing how much the body mass index and breast size influence speed of lymphatic flow. Materials and Methods : The Object of this study was 100 breast cancer patients(Female, 100 persons, average age $50.34{\pm}10.26$ years old)at Severance hospital from October 2011 to December 2011. They were scanned breast sentinel lymphangiography before operation. This study was performed on Forte dual heads gamma camera (Philips Medical Systems, Nederland B.V.). All patients were intra-dermal injected $^{99m}Tc$-Phytate 18.5 MBq, 0.5 ml. For 80 patients, we have scanned without limitation of scan time until the lymphatic flow from the lymph node since injection. We measured how long the lymphatic flow time between departures from injects site and arrival to lymph node using stopwatch. After we calculated patient's Body mass Index and classified as 4 groups. And we measured patient's breast size and classified 3 groups. The modified breast lymphangiography that changing scan time according to comparison study's result was performed on 20 patients and was estimated. Results : The mean scan time as breast size was A group 2.48 minutes, B group 7.69 minutes, C group 10.43 minutes. The mean scan time as body mass index was under weight 1.35 minutes, normal weight 2.56 minutes, slightly over 5.62 minutes, over weighted 5.62 minutes. The success rate of modified breast lymphangiography was 85%. Conclusion : As the Body mass index became higher and breast size became bigger, the total scan time is increased. Based on the obtained information, we designed modified breast lymphangiography protocol. At the cases applying that protocol, most of sentinel lymph nodes were visualized as lymphatic pool. In conclusion, we found that the more success rate in modified protocol considering physical individuality than study carrying out in the same protocol.

• 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.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 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.70-74
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• 2011

Purpose: In the Nuclear Medicine department of Asan Medical Center, radioactive waste has been disposed of by using several disposal boxes designed for nuclear waste. However, some quantity of radioactivity has been detected occasionally due to some radiologists' carelessness not only from radioactive waste, but also from medical waste such as uncontrolled radioactive waste related to patients, poly gloves or saline solution bottles from radiopharmaceuticals laboratory. Thus, this study is going to suggest a solution to maintain the medical wastes made from controlled areas that can be below maximum permissible surface dose limits by finding the cause of radioactive contamination. Materials and methods: This study was taken place in 17 different places-2 medical wastebaskets in the waiting room, 2 medical wastebaskets in the PET room, 5 medical wastebaskets in the in vitro laboratory and 6 medical wastebaskets in the radiopharmaceuticals laboratory of the East building, 2 medical wastebaskets in the waiting room of the New building of Nuclear Medicine Department in Asan Medical Center from April to August 2010. Mean radioactivity and its standard deviation of each place have been found by measuring surface contamination of medical wastebaskets and backgrounds twice a week, totaling 30 times. An independent t-test of SPSS (Ver. 12.0) statistic program has been used for statistical analysis. Swabs, saline solution bottles and poly gloves collected from each place also measured 30 times, respectively. Results: This study analyzed medical waste and the backgrounds of each place by using survey meter detectors that significant differences of five places did not exist, but existed statistically in twelve places (p<0.05). Also, swabs, saline solution bottles and poly gloves collected from each radioactive waste partly exceed the legal dose limit as a result of measuring by a gamma counter. Conclusion: Backgrounds and the surface doses of radioactive disposal box in all 17 places measured by the survey meter did not exceed the legal dose limit; however, it obviously showed that there were prominent differences in 12 places. Assuming that the cause of the differences was swabs, saline solution bottles and gloves, we examined them by gamma counter, and the results showed remarkably high doses of radioactivity. Consequently, swabs and poly gloves which are normally disposed in the general medical waste box should be disposed in the radioactive waste box furnished by radiopharmaceuticals laboratory. Also, saline solution discharged from radioactive pharmaceutical places is considered as radioactive liquid waste so that it should be disposed of by the septic tank specifically designed for radioactive liquid.