• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.39-43
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• 2008

Purpose: There are various methods to diagnose hemangioma, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) and nuclear medicine. However, by development of SPECT imaging, the blood-pool scan using $^{99m}Tc$-labeled red blood cell has been used, because it was non-invasive and the most economical method. Therefore, in this study, we proposed that the usefulness of $^{99m}Tc$-RBC scan and SPECT of the head and neck to diagnose unlocated hemangiomas. Materials and Methods: $^{99m}Tc$-RBC scan and SPECT was performed on 6 patients with doubtful hemangioma (4 person, head; 1 person, neck; 1 person, another). We labeled radiopharmaceutical using modified in vivo method and then, centrifuged it to remove plasma. After a bolus injection of tracer, dynamic perfusion flow images were acquired. Then, anterior, posterior, both lateral static blood-pool images were obtained as early and 4 hours delayed. SPECT was progressed 64 projections per 30 seconds. Each image was interpreted by physicians, Nuclear medicine specialist, and technologist blinded to patient's data. Results: In 5 patients of all the radioactivity of doubtful site didn't change in flow images, but, in blood-pool, delayed and SPECT images, it was increased. So, it was a typical hemangioma finding. The size of lesion was over 2 cm, and it could discriminate as comparing to the delayed and SPECT imaging. On the other hand, in 1 patient, the radioactivity was increased in blood-pool images, but, not in delayed and SPECT images, so, it was proved no hemangioma. Conclusion: Using $^{99m}Tc$-RBC Scan and SPECT, we could diagnose the hemangiomas in head and neck, as well as, liver, more non-invasive, economical, and easy. Therefore, it considered that $^{99m}Tc$-RBC scan and SPECT would offer more useful information for diagnosis of hemangioma, rather than otherimaging such as US, CT, MRI.

• The Korean Journal of Nuclear Medicine
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• v.32 no.4
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• pp.365-373
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• 1998

Purpose: The conventional gamma camera is not ideal for scintimammography because of its large detector size (${\sim}500mm$ in width) causing high cost and low image quality. We are developing a small gamma camera dedicated for breast imaging. Materials and Methods: The small gamma camera system consists of a NaI (T1) crystal ($60 mm{\times}60 mm{\times}6 mm$) coupled with a Hamamatsu R3941 Position Sensitive Photomultiplier Tube (PSPMT), a resister chain circuit, preamplifiers, nuclear instrument modules, an analog to digital converter and a personal computer for control and display. The PSPMT was read out using a standard resistive charge division which multiplexes the 34 cross wire anode channels into 4 signals ($X^+,\;X^-,\;Y^+,\;Y^-$). Those signals were individually amplified by four preamplifiers and then, shaped and amplified by amplifiers. The signals were discriminated ana digitized via triggering signal and used to localize the position of an event by applying the Anger logic. Results: The intrinsic sensitivity of the system was approximately 8,000 counts/sec/${\mu}Ci$. High quality flood and hole mask images were obtained. Breast phantom containing $2{\sim}7 mm$ diameter spheres was successfully imaged with a parallel hole collimator The image displayed accurate size and activity distribution over the imaging field of view Conclusion: We have succesfully developed a small gamma camera using NaI(T1)-PSPMT and nuclear Instrument modules. The small gamma camera developed in this study might improve the diagnostic accuracy of scintimammography by optimally imaging the breast.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.532-539
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• 2004

Purpose: There has been a renewal of interest in Macrophage migration inhibitory factor (MIF), especially correlation in pathogenesis of sepsis by many infectious diseases and in regulation of host inflammatory and immune response. We developed immunoradiometric assay (IRMA) to determine serum human MIF concentration. Materials and Methods: The IRMA system utilizes solid phase bound monoclonal anti-recombinant human MIF (rhMIF) antibody as a capture antibody, biotinylated polyclonal anti-rhMIF antibody as a detector antibody. We applied with rhMIF that concentration of standard solutions increased from 0 ng/ml to 100 ng/ml. We used $^{125}I$-streptavidin (SA) as radiotracer to determination of rhMIF concentration. Streptavidin was labeled with $^{125}I$ by Chloramine-T method and $^{125}I$-SA was purified by ultracentrifugation. $^{125}I$-SA stability was evaluated by ITLC analysis at $4^{\circ}C$ and room temperatures until 60days. To validate IRMA system for MIF, we experimented intra-assay and inter-assay coefficients of variation, recovery test and dilution test. Results: Radiolabeling yield of $^{125}I$-SA was 87% and purified $^{125}I$-SA retained above 99% radiochemical purity. $^{125}I$-SA showed above 93% stability in $4^{\circ}C$ until 60days that it is good for immunoradiometric assay as radiotracer. Plotted standard dose response curve showed that increased concentration of rhMIF linearly correlated (R2=0.99) with bound radioactivity of $^{125}I$-SA. The highest intra- and inter-assay coefficients of variation were 5.5% and 7.6%, respectively. The average of recovery of MIF in samples was 102%. In dilution test, linear response curves were obtained (R2=0.97). Conclusion: Radioimmunoassay using $^{125}I$-SA as radiotracer thought to be useful for the determination of serum MIF concentration, and further, its data will be used to evaluate the correlation between clinical significance and serum MIF concentration in patients with various inflammatory diseases.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.3-11
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• 2015

Purpose It is hard to obtain high quality images of knee and T.M joint because of a lot of soft tissues in the knee and T.M joint area. Most conventional system for high resolution scintigraphy was used by 4 mm aperture pinhole collimator. Performance comparison of high-resolution pinhole SPECT for Micro deluxe phantom using conventional system. the aim of this study is to evaluate performance of each aperture according to the diameter size and the usefulness of 24-hour delayed bone scintigraphy. Materials and Methods In this study 6 mm, 8 mm diameter pinhole collimators were mounted on Siemens E.CAM systems. In order to evaluate performance evaluation of each aperture and Micro Deluxe phantom was used for performance comparison of conventional SPECT system, Projection data were obtained with 9 degree increment per 30 second. Transverse images were reconstructed using dedicated OSEM algorithm with recovery of detector blurring. $^{99m}Tc-HDP$ source was used for 24-hour delayed bone scintigraphy. Results The knee joint images obtained with 24-hour delay were improved more than those obtained with 3-hour delay in our study. The 6 mm and 8 mm pinhole collimators FWHM have improved by 28% SNR and Uniformity have improved by 35%, Contrast has improved by 7% in 24-hour delayed knee joint image. While in 24-hour delayed T.M joint image of the 6 mm and 8 mm pinhole collimators FWHM have decreased by 60% SNR has decreased by 20% and Uniformity has decreased by 25%, Contrast has decreased significantly. Conclusion Pinhole collimators with 6 mm and 8 mm diameter could offer a superior performance for 24-hour delayed bone scintigraphy. The use of 24-hour delayed image provides additional benefits for pinhole scintigraphy of knee joint. Therefore, we expect that it is useful for precise diagnosis of knee joint and it is applicable to others joint imaging.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.70-75
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• 2017

Purpose Radioactive iodine thyroid uptake (RAIU) rate is an examination which determines and seeks about general functions of thyroid gland. The size of thyroid gland is normally different between each person, also patients having thyroid diseases have had a variety of size of thyroid gland compared with others. The purpose of this study will investigate about the counting rate which is effected by the geometric factors through the length and volume changes of the source in RAIU rate. Materials and Methods I-131 185 kBq ($5{\mu}Ci$) were placed in a cylindrical phantom of 0.5 cm, 1 cm, 1.5 cm, and 3 cm in diameter, respectively, and saline was added to gradually increase the length by 1 cm in the horizontal and vertical directions to give a change in volume. The source was measured 20 times for 20 seconds from a distance of 25 cm to $364.4keV{\pm}20%$ energy ROI with Captus 3000 thyroid uptake system (Capintec, NJ, USA). Results When the source was located in the transverse direction of the detector, the consequence of one-way ANOVA is that even though the length of source is increased each diameter, there is mostly no significant difference. When the source was located in the longitudinal direction and the counting rate of length 1 cm at all diameter is set to 100%, the average is 92.57% for length 2 cm, 86.1% for 3 cm, 80.69% for 4 cm, 74.82% for 5 cm, and 69.68% at 6 cm. Conclusion According to this study, it is expected that the gap of RAIU rate has been depended on the thickness of thyroid gland as well as the diameter of the beaker. We know that the change of the volume with the increase of the length of the source had less effect on the change of the counting rate. Thus, in order to reduce the error in the measurement of the counting rate with the thyroid uptake rate equipment, an accurate counting rate can be relatively measured if the counting rate which is measured is corrected by thickness or the distance between the thyroid and the thyroid uptake rate equipment is changed.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.17-24
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• 2019

Purpose: The present study aims to assess the level of coherency and the accuracy of Point dose of the Isocenter of VERO, a linear accelerator developed for the purpose of the Stereotactic Body Radiation Therapy(SBRT). Materials and Method: The study was conducted randomly with 10 treatment plans among SBRT patients in Kyungpook National University Chilgok Hospital, using VERO, a linear accelerator between June and December, 2018. In order to assess the equipment's power stability level, we measured the output constancy by using PTW-LinaCheck, an output detector. We also attempted to measure the level of accuracy of the equipment's Laser, kV(Kilo Voltage) imaging System, and MV(Mega Voltage) Beam by using Tofu Phantom(BrainLab, Germany) to assess the accuracy level of geometrical Isocenter. We conducted a comparative analysis to assess the accuracy level of the dose by using an acrylic Phantom($30{\times}30{\times}20cm$), a calibrated ion chamber CC-01(IBA Dosimetry), and an Electrometer(IBA, Dosimetry). Results: The output uniformity of VERO was calculated to be 0.66 %. As for geometrical Isocenter accuracy, we analyzed the error values of ball Isocenter of inner Phantom, and the results showed a maximum of 0.4 mm, a minimum of 0.0 mm, and an average of 0.28 mm on X-axis, and a maximum of -0.4 mm, a minimum of 0.0 mm, and an average of -0.24 mm on Y-axis. A comparison and evaluation of the treatment plan dose with the actual measured dose resulted in a maximum of 0.97 % and a minimum of 0.08 %. Conclusion: The equipment's average output dose was calculated to be 0.66 %, meeting the ${\pm}3%$ tolerance, which was considered as a much uniform fashion. As for the accuracy assessment of the geometric Isocenter, the results met the recommended criteria of ${\pm}1mm$ tolerance, affirming a high level of reproducibility of the patient's posture. The difference between the treatment plan dose and the actual measurement dose was calculated to be 0.52 % on average, significantly less than the 3 % tolerance, confirming that it obtained predicted does. The current study suggested that VERO equipment is suitable for SBRT, and would result in notable therapeutic effect.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.1
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• pp.27-32
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• 2022

Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.87-92
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• 2015

Purpose When the patients takes myocardial perfusion SPECT using $^{201}Tl$, the operator gives the patients an injection of $^{201}Tl$. But the uniformity correction map in SPECT uses $^{99m}Tc$ uniformity correction map. Thus, we want to compare the image quality when it uses $^{99m}Tc$ uniformity correction map and when it uses $^{201}Tl$ uniformity correction map. Materials and Methods Phantom study is performed. We take the data by Asan medical center daily QC condition with flood phantom including $^{201}Tl$ 21.3 kBq/mL. After postprocessing with this data, we analyze CFOV integral uniformity(I.U) and differential uniformity(D.U). And we take the data with Jaszczak ECT Phantom by American college of radiology accreditation program instruction including $^{201}Tl$ 33.4 kBq/mL. After post processing with this data, we analyze spatial Resolution, Integral Uniformity(I.U), coefficient of variation(C.V) and Contrast with Interactive data language program. Results In the flood phantom test, when it uses $^{99m}Tc$ uniformity correction map, Flood I.U is 3.6% and D.U is 3.0%. When it uses $^{201}Tl$ uniformity correction map, Flood I.U is 3.8% and D.U is 2.1%. The flood I.U is worsen about 5%, but the D.U is improved about 30% inversely. In the Jaszczak ECT phantom test, when it uses $^{99m}Tc$ uniformity correction map, SPECT I.U, C.V and contrast is 13.99%, 4.89% and 0.69. When it uses $^{201}Tl$ uniformity correction map, SPECT I.U, C.V and contrast is 11.37%, 4.79% and 0.78. All of data are improved about 18%, 2%, 13% The spatial resolution was no significant changes. Conclusion In the flood phantom test, Flood I.U is worsen but Flood D.U is improved. Therefore, it's uncertain that an image quality is improved with flood phantom test. On the other hand, SPECT I.U, C.V, Contrast are improved about 18%, 2%, 13% in the Jaszczak ECT phantom test. This study has limitations that we can't take all variables into account and study with two phantoms. We need think about things that it has a good effect when doctors decipher the nuclear medicine image and it's possible to improve the image quality using the uniformity correction map of other radionuclides other than $^{99m}Tc$, $^{201}Tl$ when we make other nuclear medicine examinations.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.102-109
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• 2009

Purpose: Flash 3D (pixon(R) method; 3D OSEM) was developed as a software program to shorten exam time and improve image quality through reconstruction, it is an image processing method that usefully be applied to nuclear medicine tomography. If perfoming brain diamox perfusion scan by reconstructing subtracted images by Flash 3D with shortened image acquisition time, there was a problem that SNR of subtracted image is lower than basal image. To increase SNR of subtracted image, we use LEAP collimators, and we emphasized on sensitivity of vessel dilatation than resolution of brain vessel. In this study, our purpose is to confirm possibility of application of LEAP collimators at brain diamox perfusion tomography, identify proper reconstruction factors by using Flash 3D. Materials and methods: (1) The evaluation of phantom: We used Hoffman 3D Brain Phantom with $^{99m}Tc$. We obtained images by LEAP and LEHR collimators (diamox image) and after 6 hours (the half life of $^{99m}Tc$: 6 hours), we use obtained second image (basal image) by same method. Also, we acquired SNR and ratio of white matters/gray matters of each basal image and subtracted image. (2) The evaluation of patient's image: We quantitatively analyzed patients who were examined by LEAP collimators then was classified as a normal group and who were examined by LEHR collimators then was classified as a normal group from 2008. 05 to 2009. 01. We evaluate the results from phantom by substituting factors. We used one-day protocol and injected $^{99m}Tc$-ECD 925 MBq at both basal image acquisition and diamox image acquisition. Results: (1) The evaluation of phantom: After measuring counts from each detector, at basal image 41~46 kcount, stress image 79~90 kcount, subtraction image 40~47 kcount were detected. LEAP was about 102~113 kcount at basal image, 188~210 kcount at stress image and 94~103 at subtraction image kcount were detected. The SNR of LEHR subtraction image was decreased than LEHR basal image about 37%, the SNR of LEAP subtraction image was decreased than LEAP basal image about 17%. The ratio of gray matter versus white matter is 2.2:1 at LEHR basal image and 1.9:1 at subtraction, and at LEAP basal image was 2.4:1 and subtraction image was 2:1. (2) The evaluation of patient's image: the counts acquired by LEHR collimators are about 40~60 kcounts at basal image, and 80~100 kcount at stress image. It was proper to set FWHM as 7 mm at basal and stress image and 11mm at subtraction image. LEAP was about 80~100 kcount at basal image and 180~200 kcount at stress image. LEAP images could reduce blurring by setting FWHM as 5 mm at basal and stress images and 7 mm at subtraction image. At basal and stress image, LEHR image was superior than LEAP image. But in case of subtraction image like a phantom experiment, it showed rough image because SNR of LEHR image was decreased. On the other hand, in case of subtraction LEAP image was better than LEHR image in SNR and sensitivity. In all LEHR and LEAP collimator images, proper subset and iteration frequency was 8 times. Conclusions: We could archive more clear and high SNR subtraction image by using proper filter with LEAP collimator. In case of applying one day protocol and reconstructing by Flash 3D, we could consider application of LEAP collimator to acquire better subtraction image.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.1
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• pp.1-10
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• 2012

Purpose: To evaluate dose distribution differences when the dose rates are randomly changed in intensity-modulated radiation therapy using a dynamic multileafcollimator. Materials and Methods: Two IMRT treatment plans including small-field and large-field plans were made using a commercial treatment planning system (Eclipse, Varian, Palo Alto, CA). Each plan had three sub-plans according to various dose rates of 100, 400, and 600 MU/min. A chamber array (2D-Array Seven729, PTW-Freiburg) was positioned between solid water phantom slabs to give measurement depth of 5 cm and backscattering depth of 5 cm. Beam deliveries were performed on the array detector using a 6 MV beam of a linear accelerator (Clinac 21EX, Varian, Palo Alto, CA) equipped with 120-leaf MLC (Millenium 120, Varian). At first, the beam was delivered with same dose rates as planned to obtain reference values. After the standard measurements, dose rates were then changed as follows: 1) for plans with 100 MU/min, dose rate was varied to 200, 300, 400, 500 and 600 MU/min, 2) for plans with 400 MU/min, dose rate was varied to 100, 200, 300, 500 and 600 MU/min, 3) for plans with 600 MU/min, dose rate was varied to 100, 200, 300, 400 and 500 MU/min. Finally, using an analysis software (Verisoft 3.1, PTW-Freiburg), the dose difference and distribution between the reference and dose-rate-varied measurements was evaluated. Results: For the small field plan, the local dose differences were -0.8, -1.1, -1.3, -1.5, and -1.6% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +0.9, +0.3, +0.1, -0.2, and -0.2% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.4, +0.8, +0.5, +0.3, and +0.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). On the other hand, for the large field plan, the pass-rate differences were -1.3, -1.6, -1.8, -2.0, and -2.4% for the dose rate of 200, 300, 400, 500, 600 MU/min, respectively (for 100 MU/min reference), +2.0, +1.8, +0.5, -1.2, and -1.6% for the dose rate of 100, 200, 300, 500, 600 MU/min, respectively (for 400 MU/min reference) and +1.5, +1.9, +1.7, +1.9, and +1.2% for the dose rate of 100, 200, 300, 400, 500 MU/min, respectively (for 600 MU/min reference). In short, the dose difference of dose-rate variation was measured to the -2.4~+2.0%. Conclusion: Using the Varian linear accelerator with 120 MLC, the IMRT dose distribution is differed a little <(${\pm}3%$) even though the dose-rate is changed.