• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.273-281
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• 1999

Purpose: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. Materials and Methods: 118 patients (M: F=66: 52, $62.7{\pm}10.5$ years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-20l/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods ($14.6{\pm}5.6$ days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Results: Perioperative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease, Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. Conclusion : We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.

• Journal of Magnetics
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• v.17 no.3
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• pp.229-232
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• 2012

This study examined the correlation between MR cine and myocardium Single-photon emission computed tomography (SPECT) by comparing the measured cardiac ejection fractions. The usefulness of cardiac MRI was also evaluated. Ten patients (8 men, 2 women and average age of 58.6 years), who underwent a myocardium SPECT scan and cardiac cine MRI scan among patients who visited the hospital for the chief complaint of cardiac disorder from June 1, 2010 to February 10, 2011, were enrolled in this study. The cardiac ejection fraction was calculated from the images obtained in both scans. The data was used to examine the correlation. The regression equation the cardiac ejection fraction values of the 10 patients obtained in myocardium SPECT and MRI cine was Y = 1.12X-8.91 ($R^2$ = 0.78, significance of F = 0.001639, and confidence level of 95%). The results were significant when the cardiac ejection fraction obtained from MRI cine was compared with that obtained from myocardium SPECT. Overall, a cardiac examination using MRI enables an investigation of not only the ejection fraction but also the ED and ES volumes, stroke volume, wall thickness, and wall thickening in a higher spatial resolution despite the examination being conducted once. This examination is believed to be very useful for diagnosing patients with cardiac disease.

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.100-106
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• 2005

Non-invasive evaluation of cardiac function by nuclear medicine technologies are one of the major contribution of nuclear medicine. Gated cardiac blood pool scan was once a novel and robust technique which enabled evaluation of ventricular function. Concept of EKG gating was one of the major breakthrough in nuclear cardiology. According to the evolution of echocardiographic techniques, and as the evaluation of myocardial perfusion by perfusion SPECT became feasible, number of gated blood pool study dong in nuclear medicine laboratory is declining. And recently, evaluation of ventricular function with gated perfusion SPECT further decreased the use of gated blood pool scan. In this article, assessment of ventricular function using gated blood pool scan is discussed including some insight about the role of gated blood pool SPECT.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.25-32
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• 2010

Background: Patients with vascular diseases commonly have coronary artery disease and associated cardiac problems. Therefore, their underlying heart diseases may be induced or exacerbated after vascular surgery. The effectiveness of SPECT imaging, which is a relatively simple and non-invasive imaging modality, for assessing these underlying heart diseases is still controversial. This study was performed to evaluate the clinical effect of tests and treatment based on SPECT imaging prior to vascular surgery on the development of post-operation cardiac complications. Material and Method: Sixty three patients who were treated at Inje University Pusan Paik Hospital between April 2004 and September 2007 and who underwent adenosine infusion technetium-99m (Tc-99m) tetrofosmin SPECT imaging prior to vascular surgery were selected for this study and we retrospectively reviewed their records. Result: The sensitivity and specificity of detecting a perfusion defect on SPECT to predict the development of cardiac complications was relatively low at 41.2% and 52.2%, respectively. However when coronary angiographies were done on the patients with abnormal SPECT and this was followed by aggressive treatment such as coronary artery intervention and coronary artery bypass grafting based on the angiography results, there was a tendency for lower cardiac complication rates. Conclusion: SPECT imaging shows low effectiveness as a screening test for predicting cardiac complications after vascular surgery.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.100-107
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• 2003

Purpose : To assess the usefulness of cardiac MR imaging (MRI) in the diagnosis of acute myocardial infarction and in the assessment of myocardial viability in comparision with T1-201 SPECT. Materials and Methods : We retrospectively studied 17 patients who complained of chest pain and dyspnea with cardiac MRI . The patients were evaluated for the presence or absence of high signal intensity on T2-weighted image (T2wI), abnormal wall motion on 2D-FIESTA, perfusion defect on Gd-DTPA enhanced T1WI, and delayed myocardial enhancement on 15-minutes delay Gd-DTPA enhanced T1WI. The results were correlated with the images on T1-201 SPECT, taken at rest and stress, through which reversibility of perfusion defect was assessed. Results : Both cardiac MRI and T1-201 SPECT proved to be useful methods for diagnosing acute myocardial infarction. In order of decreasing correspondence, T2WI, T1-201 SPECT, delayed enhancement study, and wall motion images all showed significant statistical correlation with the clinical diagnosis of myocardial infarction. Perfusion MRI, on the other hand, showed no significant statistical difference was found between T1-201 SPECT and cardiac MRI. The results on T2WI showed high accordance with those on Tl-201 SPECT, while delayed myocardial enhancement and wall motion studies showed no agreement with Tl-201 SPECT. Conclusion : Cardiac MRI is useful method for diagnosis of acute myocardiac infarction. With respect to the assessment of myocardial viability, the results obtained on cardiac MRI showed high agreement with those on Tl-201 SPECT. However, further study is necessary at this point for standardization and establishment of the methods for assessing myocardial viability on cardiac MRI.

• The Korean Journal of Nuclear Medicine
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• v.39 no.2
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• pp.69-74
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• 2005

Ever since it was first introduced as a method of scintigraphically measuring regional myocardial perfusion, myocardial perfusion study has been widely used in patients diagnosed or suspected with coronary artery diseases, and continuously improved upon. In addition to the technological enhancement of nuclear medicine equipments, the innovation of radiopharmaceuticals used in the cardiac exams were important contributors to such improvement. Besides the cardiac perfusion studies, new radiopharmaceuticals that visualize fat metabolism or receptors of the sympathetic nervous system have successfully been applied to clinical practice. More information can be collected before diagnosing coronary vascular disease, evaluating the patient's condition, or assessing therapeutic effects. In this review article, the clinical efficacy and characteristics of radiopharmaceutical products tailored for cardiac SPECT that are commonly used in Korea currently, plus the ones not being used yet but have proven value are briefly described.

• Journal of Korea Multimedia Society
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• v.6 no.3
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• pp.444-454
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• 2003

An analysis of heart movement is to estimate a role which supplies blood in human body. We have constructed a left ventricle myocardium model and mathematically evaluated the motion of myocardium. The myocardial motility was visualized using some parameters about cardiac motion. We applied the myocardium model in the gated myocardium SPECT image that showed a cardiac biochemical reaction, and analyzed a motility between the gated myocardium SPECT image and the myocardium model. The myocardium model was created of the based on three dimensional super-ellipsoidal model that was using the sinusoidal function. To express a similar form and motion of the left ventricle myocardium, we calculated parameter functions that gave the changing of motion and form. The LSF algorithm was applied to the myocardium gated SPECT image data and the myocardium model, and finally created a fitting model. Then we analyzed a regional motility direction and size of the gated myocardium SPECT image that was constructed on a fitting model. Furthermore, we implemented the Bull's Eye map that had evaluated the heart function for presentation of regional motility. Using myocardium's motion the evaluation of cardiac function of SPECT was estimated by a contraction ability, perfusion etc. However, it is not any estimation about motility. So, We analyzed the myocardium SPECT's motility of utilizing the myocardium model. We expect that the proposed algorithm should be a useful guideline in the heart functional estimation.

• Proceedings of the KSMRM Conference
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• 2002.11a
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• pp.134-134
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• 2002

목적： 심근경색의 가역성 여부 판단시 cardiac MR imaging(CMRI)와 myocardial SPECT의 정확성을 비교하기 위하여 대상 및 방법： 흉통을 주소로 내원한 환자 중 CMRI와 SPECT를 시행한 17를 대상으로 역행적으로 조사하였다. CMRI는 double and triple inversion recovery image(IR)에서 심벽의 고신호강도, 2D-FIESTA에서 심기능 분석을 조사하였다. 이어 gadopentetate를 주입하여 확산스캔에서 확산결손을 조사하였다. 연속하여 gadopentetate를 더 주입 후 5분 후 지연심근강조영상을 얻어 지연조영증강 유무와 미세혈류 폐쇄를 조사하였다. SPECT는 아데노신으로 stress 스캔을 얻은 후 T1-201을 재주사 후 rest 스캔하여 확산결손과 재분배를 조사하여 가역성을 판단하였다.

• The Korean Journal of Nuclear Medicine
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• v.38 no.5
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• pp.331-337
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• 2004

Cardiac neurotransmission imaging allows in vivo assessment of presynaptic reuptake, neurotransmitter storage and postsynaptic receptors. Among the various neurotransmitter, I-123 MIBG is most available and relatively well-established. Metaiodobenzylguanidine (MIBG) is an analogue of the false neurotransmitter guanethidine. It is taken up to adrenergic neurons by uptake-1 mechanism as same as norepinephrine. As tagged with I-123, it can be used to image sympathetic function in various organs including heart with planar or SPECT techniques. I-123 MIBG imaging has a unique advantage to evaluate myocardial neuronal activity in which the heart has no significant structural abnormality or even no functional derangement measured with other conventional examination. In patients with cardiomyopathy and heart failure, this imaging has most sensitive technique to predict prognosis and treatment response of betablocker or ACE inhibitor. In diabetic patients, it allow very early detection of autonomic neuropathy. In patients with dangerous arrhythmia such as ventricular tachycardia or fibrillation, MIBG imaging may be only an abnormal result among various exams. In patients with ischemic heart disease, sympathetic derangement may be used as the method of risk stratification. In heart transplanted patients, sympathetic reinnervation is well evaluated. Adriamycin-induced cardiotoxicity is detected earlier than ventricular dysfunction with sympathetic dysfunction. Neurodegenerative disorder such as Parkinson's disease or dementia with Lewy bodies has also cardiac sympathetic dysfunction. Noninvasive assessment of cardiac sympathetic nerve activity with I-123 MIBG imaging nay be improve understanding of the pathophysiology of cardiac disease and make a contribution to predict survival and therapy efficacy.

• The Korean Journal of Nuclear Medicine
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• v.34 no.1
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• pp.39-54
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• 2000

Purpose: Dipyridamole stress myocardial perfusion SPECT could predict prognosis, however, long-term follow-up showed change of hazard ratio in patients with suspected coronary artery disease. We investigated how long normal SPECT could predict the benign prognosis on the long-term follow-up. Materials and Methods: We followed up 1169 patients and divided these patients into groups in whom coronary angiography were performed and were not. Total cardiac event rate and hard event rate were predicted using clinical, angiographic and SPECT findings. Predictive values of normal and abnormal SPECT were examined using survival analysis with Mantel-Haenszel method, multivariate Cox proportional hazard model analysis and newly developed statistical method to test time-invariance of hazard rate and changing point of this rate. Results: Reversible perfusion decrease on myocardial perfusion SPECT predicted higher total cardiac event rate independently and further to angiographic findings. However, myocardial SPECT showed independent but not incremental prognostic values for hard event rate. Hazard ratio of normal perfusion SPECT was changed significantly (p<0.001) and the changing point of hazard rate was 4.4 years of follows up. However, the ratio of abnormal SPECT was not. Conclusion: Dipyridamole stress myocardial perfusion SPECT provided independent prognostic information in patients with known and suspected coronary artery disease. Normal perfusion SPECT predicted least event rate for 4.4 years.