• Title/Summary/Keyword: 4P Model

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Modeling Brand Equity for Lifestyle Brand Extensions: A Strategic Approach into Generation Y vs. Baby Boomer (생활방식품패확장적품패자산건모(生活方式品牌扩张的品牌资产建模): 침대Y세대화영인조소비자적전략로경(针对Y世代和婴儿潮消费者的战略路径))

  • Kim, Eun-Young;Brandon, Lynn
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.35-48
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    • 2010
  • Today, the fashion market challenged by a maturing retail market needs a new paradigm in the "evolution of brand" to improve their comparative advantages. An important issue in fashion marketing is lifestyle brand extension with a specific aim to meet consumers' specific needs for their changing lifestyle. For fashion brand extensions into lifestyle product categories, Gen Y and Baby Boomer are emerging as "prospects"-Baby Boomers who are renovating their lifestyle, and generation Y experiencing changes in their life stage-with demands for buying new products. Therefore, it is imperative that apparel companies pay special attention to the consumer cohort for brand extension to create and manage their brand equity in a new product category. The purposes of this study are to (a) evaluate brand equity between parent and extension brands; (b) identify consumers' perceived marketing elements for brand extension; and (c) estimate a structural equation model for examining causative relationship between marketing elements and brand equity for brand extensions in lifestyle product category including home fashion items for the selected two groups (e.g., Gen Y, and Baby boomer). For theoretical frameworks, this study focused on the traditional marketing 4P's mix to identify what marketing element is more importantly related to brand extension equity for this study. It is assumed that comparable marketing capability can be critical to establish "brand extension equity", leads to successfully entering the new categories. Drawing from the relevant literature, this study developed research hypotheses incorporating brand equity factors and marketing elements by focusing on the selected consumers (e.g., Gen Y, Baby Boomer). In the context of brand extension in the lifestyle products, constructs of brand equity consist of brand awareness/association, brand perceptions (e.g., perceived quality, emotional value) and brand resonance adapted from CBBE factors (Keller, 2001). It is postulated that the marketing elements create brand extension equity in terms of brand awareness/association, brand perceptions by the brand extension into lifestyle products, which in turn influence brand resonance. For data collection, the sample was comprised of Korean female consumers in Gen Y and Baby Boomer consumer categories who have a high demand for lifestyle products due to changing their lifecycles. A total of 651 usable questionnaires were obtained from female consumers of Gen Y (n=326) and Baby Boomer (n=325) in South Korea. Structural and measurement models using a correlation matrix was estimated using LISREL 8.8. Findings indicated that perceived marketing elements for brand extension consisted of three factors: price/store image, product, and advertising. In the model of Gen Y consumers, price/store image had a positive effect on brand equity factors (e.g., brand awareness/association, perceived quality), while product had positive effect on emotional value in the brand extensions; and the brand awareness/association was likely to increase the perceived quality and emotional value, leading to brand resonance for brand extensions in the lifestyle products. In the model of Baby Boomer consumers, price/store image had a positive effect on perceived quality, which created brand resonance of brand extension; and product had a positive effect on perceived quality and emotional value, which leads to brand resonance for brand extension in the lifestyle products. However, advertising was negatively related to brand equity for both groups. This study provides an insight for fashion marketers in developing a successful brand extension strategy, leading to a sustainable competitive advantage. This study complements and extends prior works in the brand extension through critical factors of marketing efforts that affect brand extension success. Findings support a synergy effect on leveraging of fashion brand extensions (Aaker and Keller, 1990; Tauber, 1988; Shine et al., 2007; Pitta and Katsanis, 1995) in conjunction with marketing actions for entering into the new product category. Thus, it is recommended that marketers targeting both Gen Y and Baby Boomer can reduce marketing cost for entering the new product category (e.g., home furnishings) by standardized marketing efforts; fashion marketers can (a) offer extension lines with premium ranges of price; (b) place an emphasis on upscale features of store image positioning by a retail channel (e.g., specialty department store) in Korea, and (c) combine apparel with lifestyle product assortments including innovative style and designer’s limited editions. With respect to brand equity, a key to successful brand extension is consumers’ brand awareness or association that ensures brand identity with new product category. It is imperative for marketers to have knowledge of what contributes to more concrete associations in a market entry into new product categories. For fashion brands, a second key of brand extension can be a "luxury" lifestyle approach into new product categories, in that higher price or store image had impact on perceived quality that established brand resonance. More importantly, this study increases the theoretical understanding of brand extension and suggests directions for marketers as they establish marketing program at Gen Y and Baby Boomers.

A Cohort Study on Risk Factors for Chronic Liver Disease: Analytic Strategies Excluding Potentially Incident Subjects (만성간질환 위험요인에 대한 코호트연구: 잠재적 발병자 집단을 감안한 분석전략)

  • Kim, Dae-Sung;Kim, Dong-Hyun;Bae, Jong-Myun;Shin, Myung-Hee;Ahn, Yoon-Ok;Lee, Moo-Song
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.4
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    • pp.452-458
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    • 1999
  • Objectives: The authors conducted the study to evaluate bias when potentially diseased subjects were included in cohort members while analyzing risk factors of chronic liver diseases. Methods: Total of 14,529 subjects were followed up for the incidence of liver diseases from January 1993 to June 1997. We have used databases of insurance company with medical records, cancer registry, and death certificate data to identify 102 incident cases. The cohort members were classified into potentially diseased group(n=2,217) when they were HBsAg positive, serum GPT levels higher than 40 units, or had or has liver diseases in baseline surveys. Cox's model were used for potentially diseased group, other members, and total subjects, respectively. Results: The risk factors profiles were similar for total and potentially diseased subjects: HBsAg positivity, history of acute liver disease, and recent quittance of smoking or drinking increased the risk. while intake of pork and coffee decreased it. For the potentially diseased, obesity showed marginally significant protective effect. Analysis of subjects excluding the potentially diseased showed distinct profiles: obesity increased the risk, while quitting smoking or drinking had no association. For these intake of raw liver or processed fish or soybean paste stew increased risk; HBsAg positivity, higher levels of liver enzymes and history of acute liver diseases increased the risk. Conclusions: The results suggested the potential bias in risk ratio estimates when potentially diseased subjects were included in cohort study on chronic liver diseases, especially for lifestyles possibly modified after disease onset. The analytic strategy excluding potentially diseased subjects was considered appropriate for identifying risk factors for chronic liver diseases.

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Optimal Incentives for Customer Satisfaction in Multi-channel Setting (멀티채널에서의 고객만족제고 인센티브 연구)

  • Kim, Hyun-Sik
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.25-47
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    • 2010
  • CS is one of the major concerns of managers in the world because it is well known to be a key medium construct for firms' superior outcome. One of the major agents for CS management is retailers. Firms try to manage not only employees but also retailers to promote CS behaviors. And so diverse incentives are used to promote their CS behaviors under diverse channel setting such as multi-channel. However in spite of the rising needs there has been scarce studies on the optimal incentive structure for a manufacturer to offer competing retailers at the multi-channel. In this paper, we try to find better way for a manufacturer to promote the competing retailers' CS behaviors. We investigated how to promote the retailers' CS behavior via game-theoretic modeling. Especially, we focus on the possible incentive, CS bonus type reward introduced in the studies of Hauser, Simester, and Wernerfelt(1994) and Chu and Desai(1995). We build up a multi stage complete information game and derive a subgame perfect equilibrium using backward induction. Stages of the game are as following. (Stage 1) Manufacturer sets wholesale price(w) and CS bonus($\eta$). (Stage 2) Both retailers in competition set CS effort level($e_i$) and retail price($p_i$) simultaneously. (Stage 3) Consumers make purchasing decisions based on the manufacturer's initial reputation and retailers' CS efforts.

    Structure of the Model We investigated four issues about the topic as following: (1) How much total incentive is adequate for a firm of a specific level of reputation to promote retailers' CS behavior under multi-channel setting ?, (2) How much total incentive is adequate under diverse level of complimentary externalities between the retailers' CS efforts to promote retailers' CS behavior?, (3) How much total incentive is adequate under diverse level of cost to make CS efforts to promote retailers' CS behavior?, (4) How much total incentive is adequate under diverse level of competition between retailers to promote retailers' CS behavior? Our findings are as following. (1) The higher reputation has the manufacturer, the higher incentives for retailers at multi-channel are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the manufacturer's reputation level(a) under some parameter conditions(b=1/2;c=0;$\beta$=1/2). (2) The bigger complimentary externalities exists between the retailers' CS efforts, the higher incentives are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the complimentary externalities level($\beta$) under some parameter conditions(a=1;b=1/2;c=0). (3) The higher is the retailers' cost, the lower incentives are required in the equilibrium.
    shows the decreasing pattern of optimal incentive level along the cost level(c) under some parameter conditions(a=1;b=1/2;$\beta$=1/2). (4) The more competitive gets those two retailers, the higher incentives for retailers at multi-channel are required in the equilibrium.
    shows the increasing pattern of optimal incentive level along the competition level(b) under some parameter conditions(c=0;a=1;$\beta$=1/2). One of the major contribution points of this study is the fact that this study is the first to investigate the optimal CS incentive system under multi-channel setting.

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A Study on the Influence of the Selective Attributes of Home Meal Replacement on Perceived Utilitarian Value and Repurchase Intention: Focus on Consumers of Large Discount and Department Stores (HMR(Home Meal Replacement) 선택속성이 지각된 효용적 가치, 재구매 의도에 미치는 영향에 관한 연구: 대형 할인마트와 백화점 구매고객을 대상으로)

  • Seo, Kyung-Hwa;Choi, Won-Sik;Lee, Soo-Bum
    • Journal of the East Asian Society of Dietary Life
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    • v.21 no.6
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    • pp.934-947
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    • 2011
  • The purpose of this study is to analyze products for good taste and convenience, which become an engine to constantly create customers. In addition, this study is aimed at investigating the relationship between the selective attributes of Home Meal Replacement, the perceived utilitarian value, and the repurchase intention, and drawing new suggestions on the Home Meal Replacement market from a new marketing perspective. Based on a total of 215 samples, this study reviewed the reliability and fitness of the research model and verified a total of 5 hypothesized using the Amos program. The result of study modeling was GFI=0.905, AGFI=0.849, NFI=0.889, CFI=0.945, and RMR=0.0.092 at the level of $x^2$=230.22 (df=126, p<0.001). First, the food quality (${\beta}$=0.221), convenience (${\beta}$=0.334), packing (${\beta}$=0.278), and employee service (${\beta}$=0.204) of home meal replacement consideration attributes had a positive (+) influence on perceived utilitarian value. Second, perceived utilitarian value (${\beta}$=0.584) had a positive (+) influence on repurchase intention. The factors to differentiate one company from other competitors in terms of the utilitarian value are the quality of food, convenience, wrapping, and services by employees. This study has illustrated the need to focus on the development of a premium menu to compete with other companies and to continue to research and develop nutritious foods that are easy to cook. Moreover, the key factors to have a distinct and constant competitive edge over other companies are the alleviation of consumer anxiety over wrapping container materials, the development of more designs, and the accumulation of service know-how. Therefore, it is necessary for a company to strongly develop the key factors based on its resources as a core capability.

Estimation of SCS Runoff Curve Number and Hydrograph by Using Highly Detailed Soil Map(1:5,000) in a Small Watershed, Sosu-myeon, Goesan-gun (SCS-CN 산정을 위한 수치세부정밀토양도 활용과 괴산군 소수면 소유역의 물 유출량 평가)

  • Hong, Suk-Young;Jung, Kang-Ho;Choi, Chol-Uong;Jang, Min-Won;Kim, Yi-Hyun;Sonn, Yeon-Kyu;Ha, Sang-Keun
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.3
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    • pp.363-373
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    • 2010
  • "Curve number" (CN) indicates the runoff potential of an area. The US Soil Conservation Service (SCS)'s CN method is a simple, widely used, and efficient method for estimating the runoff from a rainfall event in a particular area, especially in ungauged basins. The use of soil maps requested from end-users was dominant up to about 80% of total use for estimating CN based rainfall-runoff. This study introduce the use of soil maps with respect to hydrologic and watershed management focused on hydrologic soil group and a case study resulted in assessing effective rainfall and runoff hydrograph based on SCS-CN method in a small watershed. The ratio of distribution areas for hydrologic soil group based on detailed soil map (1:25,000) of Korea were 42.2% (A), 29.4% (B), 18.5% (C), and 9.9% (D) for HSG 1995, and 35.1% (A), 15.7% (B), 5.5% (C), and 43.7% (D) for HSG 2006, respectively. The ratio of D group in HSG 2006 accounted for 43.7% of the total and 34.1% reclassified from A, B, and C groups of HSG 1995. Similarity between HSG 1995 and 2006 was about 55%. Our study area was located in Sosu-myeon, Goesan-gun including an approx. 44 $km^2$-catchment, Chungchungbuk-do. We used a digital elevation model (DEM) to delineate the catchments. The soils were classified into 4 hydrologic soil groups on the basis of measured infiltration rate and a model of the representative soils of the study area reported by Jung et al. 2006. Digital soil maps (1:5,000) were used for classifying hydrologic soil groups on the basis of soil series unit. Using high resolution satellite images, we delineated the boundary of each field or other parcel on computer screen, then surveyed the land use and cover in each. We calculated CN for each and used those data and a land use and cover map and a hydrologic soil map to estimate runoff. CN values, which are ranged from 0 (no runoff) to 100 (all precipitation runs off), of the catchment were 73 by HSG 1995 and 79 by HSG 2006, respectively. Each runoff response, peak runoff and time-to-peak, was examined using the SCS triangular synthetic unit hydrograph, and the results of HSG 2006 showed better agreement with the field observed data than those with use of HSG 1995.

Small Animal PET Imaging with [$^{124}I$]FIAU for Herpes Simplex Virus Type 1 Thymidine Kinase Gene Expression in a Hepatoma Model (간암 동물 모델에서 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabinofuranosyl-5-[$^{124}I$iodo-uracil ($[^{124}I]FIAU$) 소동물 PET 영상 연구)

  • Chae, Min-Jeong;Lee, Tae-Sup;Kim, June-Youp;Woo, Gwang-Sun;Jumg, Wee-Sup;Chun, Kwon-Soo;Kim, Jae-Hong;Lee, Ji-Sup;Ryu, Jin-Sook;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.235-245
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    • 2008
  • Purpose: The HSV1-tk gene has been extensively studied as a type of reporter gene. In hepatocellular carcinoma (HCC), only a small proportion of patients are eligible for surgical resection and there is limitation in palliative options. Therefore, there is a need for the development of new treatment modalities and gene therapy is a leading candidate. In the present study, we investigated the usefulness of substrate, 2'-fluoro-2'-deoxy-1-${\beta}$-D-arabino-furanosyi-5-[$^{124/125}I$]iodo- uracil ([$I^{124/125}I$]FIAU) as a non-invasive imaging agent for HSV1-tk gene therapy in hepatoma model using small animal PET. Material and Methods: With the Morris hepatoma MCA cell line and MCA-tk cell line which was transduced with the HSV1-tk gene, in vitro uptake and correlation study between [$^{125}I$]FIAU uptake according to increasing numeric count of percentage of MCA-tk cell were performed. The biodistribution data and small animal PET images with [$^{124}I$]FIAU were obtained with Balb/c-nude mice bearing both MCA and MCA-tk tumors. Results:, Specific accumulation of [[$^{125}I$]FIAU was observed in MCA-tk cells but uptake was low in MCA cells. Uptake in MCA-tk cells was 15 times higher than that of MCA cells at 480 min. [$^{125}I$]FIAU uptake was linearly correlated (R2 =0.964, p =0.01) with increasing percentage of MCA-tk numeric cell count. Biodistribution results showed that [$^{125}I$]FIAU was mainly excreted via the renal system in the early phase. Ratios of MCA-tk tumor to blood acting were 10, 41, and 641 at 1 h, 4 h, and 24 h post-injection, respectively. The maximum ratio of MCA-tk to MCA tumor was 192.7 at 24 h. Ratios of MCA-tk tumor to liver were 13.8, 66.8, and 588.3 at 1 h, 4 h, and 24 h, respectively. On small animal PET, [$^{124}I$]FIAU accumulated in substantial higher levels in MCA-tk tumor and liver than MCA tumor. Conclusion: FIAU shows selective accumulation to HSV1-tk expressing hepatoma cell tumors with minimal uptake in normal liver. Therefore, radiolabelled FIAU is expected to be a useful substrate for non-invasive imaging of HSV1-tk gene therapy and therapeutic response monitoring of HCC.

A Study on Titanium Miniscrew as Orthodontic Anchorage : An experimental investigation in dogs (성견에서 교정적 고정원으로서의 티타늄 미니스크류에 대한 연구)

  • Yoon, Byung-Soo;Choi, Byung-Ho;Lee, Won-You;Kim, Kyoung-Nam;Shim, Hyung-Bo;Park, Jin-Hyung
    • The korean journal of orthodontics
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    • v.31 no.5 s.88
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    • pp.517-523
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    • 2001
  • Titanium miniscrews we being used increasingly as an anchorage for tooth movement, because they ate easy to place and to remove, increase the number of sites available, give minimum strain to patients regarding surgical procedures, and offer uneventful healing alter removal. The use of titanium miniscrews as an orthodontic anchorage has been reported in clinical case reports, but clinicians have experienced screw loosening when using such screws.' To our knowledge, there are no published reports evaluating the stability of miniscrews. Information about the length of miniscrews used in relation to the location is of some importance, as stability will vary depending on bone duality The purpose of this study was to evaluate a variety of Lengths of miniscrews (dimeter: 2mm) which were inserted in maxilla or mandible and to demonstrate in a dog model which miniscrew provides fundamental stability in the jaws. 10 mm long miniscrews in the maxilla and 8mm long: miniscrews in the mandible showed no clinical mobility and retained their position throughout an 8 weeks force (200g) application. The mucosal condition around the screws was healthy in cases in which miniserews were inserted in the alveolar bone between the roots and the head of the screws emerged into the attached gingiva. When the force application was terminated, radiographic analysis revealed neither rent resorption not periodontal pathology around the miniscrews that remained stable during the entire treatment period. This study suggests that if titanium miniscrews with adequate length are properly used depending on the location, they provide sufficient stability for orthodontic anchorage.

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Clinical Outcomes of Ultrasound-Guided Subacromial Bursal Steroid Injection in Shoulder Impingement Syndrome (견관절 충돌 증후군에서 초음파하 견봉하 점액낭내 스테로이드 국소 주사의 임상적 결과)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Park, Bum-Suk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.68-73
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    • 2009
  • Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.

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Stressful Life Events, Health Symptoms, Social Support and Coping/in Early Adolescents (스트레스생활사건, 건강문제, 대응, 사회적 지지의 관계 -청소년을 대상으로-)

  • 오가실;한정석
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.414-429
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    • 1990
  • Numerous research reports have substantiated the role of stressful life events in relation to the onset of health changes. The relationship tends to hold across different age groups. Theoretically, adolescence has been considered a developmental crisis period of great stress, impoverished coping skills and high vulnerability to biological, social and psychological demands. The research problem addressed by this study was to examine the relationships between stressful life events and health symptom patterns, and the effect of two variables, coping and social, support, theoretically considered to mediate the relationship between stress and health symptoms in adolescents. The following five hypotheses were tested in this research : 1. Health symptoms are positively related to stressful life events in adolescents, 2. Health symptoms are negatively related to coping in adolescents, 3. Health symptoms are negatively related to social support in adolescents, 4. When coping is controlled, the relationship between health symptoms and stressful life events will decrease, and 5. When social support is controlled, the relationship between health symptoms and stressful life events will increase. The study subjects consisted of 1090 high school students of the metropolitan city of Seoul. The following sampling procedure was used : 1. Of the 169 high schools in nine school administrative districts in the city, a proportional sample of ten schools was selected. 2. One class from each of the freshman and sophomore was randomly selected and all the students who were in the sampled class were used as the study sample. The study was limited to freshman and sophomore adolescents, aged 15 to 18(mean=16.6). Of the 1090 subjects 688(63%) were boys and 402(37%) were girls. An Adolescent Inventory of Stressful Life Events, a Health Symptom Questionnaire and an Adolescent Coping Inventory were adapted for this study. The Norbeck Social Support questionnaire was utilized to collect the data on perceived social support. Five high school teachers in the areas of school health and counselling reviewed the items of each questionnaire for content validity. A pilot study was undertaken to ascertain reliability. Fifty three high school students responded to the questionnaires and gave their opinions on the items. For stressful life events, health symptoms, coping, and social support, the Cronbach's alpha's on the study were .70, .94, .77, and .76, respectively. Research assistants attended all the sampled classes with the school proctor to explain the purpose and procedures of the study to the students. The questionnaires along with a ballpoint pen were distributed to the students who were asked to complete each item. The research assistants left the ballpoint pen with the students as a gift for their cooperation. An average of 50 minutes was required to complete the questionnaires. Using an SPSS, the first, three hypotheses were tested using Gamma, a measure of association for ordinal variables. Partial gamma was used to test the fourth and fifth hypotheses. Patterns of elaboration described by Babbie were selected to interpret the relationship of the three variable analyses. The significance of gamma was determined by Chisquare at a .05 level of significance. There was a positive relationship between health symptoms and stressful life events(Gamma=.35, p=.000). Thus the first hypothesis was supported. Unexpectedly, coping was positively related with health symptoms(Gamma=.13, p=.000). That is, the higher the coping levels, the greater number of health problems. The third hypothesis, the higher the level of social support, the fewer the health symptoms, was not accepted in this adolescent study group. When coping was controlled, under the condition of low coping the association between health symptoms and stressful life events increased significantly to a partial gamma of .39, and under the condition of high coping it was .30. According to the elaboration model, when one partial relationship is the same or greater than the original and the other is smaller, the control variable should be considered to be specifying the conditions. When social support was controlled the relationship between stressful life events and health symptoms increased under the condition of low social support, but with high social support, the relationship decreased. Both partial gamma were statistically significant at .05 level(.43 and .26 relatively). It can be interpreted that stressful life events are strongly and positively related to health symptoms under the condition of low social support, however this relationship can not be expected with high social support. Thus, the last two hypotheses were conditionally sustained. In this study, the relationships between stressful life events and health symptoms, and the specified me diating roles of coping and social support were found to have statistical interaction. This finding supports the theoretical position of this study. It suggests that stressful life events would create high susceptability to biological social and psychological health symptoms and coping and social support buffering the relationship between stressful life events and health symptom. The findings of this study have implications for nursing practice. When adolescents are confronted with non-developmental life events that are perceived as stressful, nurses should recognize the evidence of the stress-buffering effect of coping and social support on health symptoms and utilize the diverse sources of social support that are readily available to adolescents.

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TI-201 Redistribution SPECT and N-13 Ammonia PET Images in Patients with Old Myocardial Infarction and Left Ventricular Dysfunction: Segmental Comparison and Discordance Analysis (좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 TI-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석)

  • Choi, Joon-Young;Lee, Kyung-Han;Kim, Young-Hwan;Lee, Eun-Jeong;Chung, Hyun-Woo;Lee, Su-Jin;Lee, Sang-Hoon;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.218-224
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    • 2004
  • We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients with old myocardial infarction and left ventricular dysfunction whose dipyridamole - 4hr redistribution TI-201 SPECT showed one or more severe fixed defects. Regional perfusion and metabolism were evaluated visually and quantitatively with 5-segment myocardial model. Results: There were high concordant rate in uptake pattern (80/90 segments, 88.9%) and high correlation coefficient on quantitative analysis (R=0.81, p<0.001) between redistribution TI-201 SPECT and N-13 ammonia PET images. Nine of 18 patients had SPECT-PET concordant pattern (Group I). Ten segments (9 in inferior wall, 1 in apex) from the remaining 9 patients showed SPECT-PET discordant pattern with abnormal TI-201 defect and near normal N-13 ammonia uptake (Group II). The diastolic and systolic left ventricular dimensions were significantly increased in Group II compared to those of Group I. When attenuation uncorrected N-13 ammonia PET images were reconstructed in Group II, it resulted in PET images with severe inferior wall defects nearly identical to those seen in redistribution TI-201 SPECT images. Conclusion: Redistribution TI-201 SPECT images showed high concordant rate and correlation with rest N-13 ammonia PET images. Most of discordant segments had fixed thallium defects in inferior wall with nearly normal N-13 ammonia uptake, which may result from severe left ventricular dilatation and attenuation by the left hemidiaphragm and cardiac blood pool.