• The Korean Journal of Nuclear Medicine Technology
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• v.27 no.1
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• pp.47-54
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• 2023

Purpose PET-CT imaging require an appropriate quality assurance system to achieve high efficiency and reliability. Quality control is essential for improving the quality of care and patient safety. Currently, there are performance evaluation methods of UN2-1994 and UN2-2001 proposed by NEMA and IEC for PET-CT image evaluation. In this study, we compare phantom images with the same experiments before and after PET-CT 3D normalization and well counter correction and evaluate the usefulness of quality control. Materials and methods Discovery 690 (General Electric Healthcare, USA) PET-CT equiptment was used to perform 3D normalization and well counter correction as recommended by GE Healthcare. Based on the recovery coefficients for the six spheres of the NEMA IEC Body Phantom recommended by the EARL. 20kBq/㎖ of ¹⁸F was injected into the sphere of the phantom and 2kBq/㎖ of ¹⁸F was injected into the body of phantom. PET-CT scan was performed with a radioacitivity ratio of 10:1. Images were reconstructed by appliying TOF+PSF+TOF, OSEM+PSF, OSEM and Gaussian filter 4.0, 4.5, 5.0, 5.5, 6.0, 6,5 mm with matrix size 128×128, slice thickness 3.75 mm, iteration 2, subset 16 conditions. The PET image was attenuation corrected using the CT images and analyzed using software program AW 4.7 (General Electric Healthcare, USA). The ROI was set to fit 6 spheres in the CT image, RC (Recovery Coefficient) was measured after fusion of PET and CT. Statistical analysis was performed wilcoxon signed rank test using R. Results Overall, after the quality control items were performed, the recovery coefficient of the phantom image increased and measured. Recovery coefficient according to the image reconstruction increased in the order TOF+PSF, TOF, OSEM+PSF, before and after quality control, RCmax increased by OSEM 0.13, OSEM+PSF 0.16, TOF 0.16, TOF+PSF 0.15 and RCmean increased by OSEM 0.09, OSEM+PSF 0.09, TOF 0.106, TOF+PSF 0.10. Both groups showed a statistically significant difference in Wilcoxon signed rank test results (P value<0.001). Conclusion PET-CT system require quality assurance to achieve high efficiency and reliability. Standardized intervals and procedures should be followed for quality control. We hope that this study will be a good opportunity to think about the importance of quality control in PET-CT

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.233-241
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• 2022

Purpose: The purpose of this study was to assess the dimensional change of 3D-printed dentures after post-curing. Materials and Methods: The upper and lower dentures were designed in Exocad DentalCAD software and exported as STL files. The upper and lower dentures were printed from 10 STL files using a DLP-type dental 3D printer. The printed upper and lower dentures were cleaned, and a scan file was created using a model scanner before and after post-curing. The dimensional change was evaluated by superimposing the scanned denture files before and after post-curing and measuring the distance between measurement points on the denture. SPSS was used for statistics, and the level of significance was 5%. Results: The maxillary denture reduced in size during post-curing, with the most notable color change occurring in the posterior palatal region. The reduction in anteroposterior maxillary denture length (A-D, A-E, A-F), as well as the distance between the first molars on both sides (B-C), was statistically significant. After post-curing, the mandibular denture showed more noticeable color change in the posteriorly buccal and lingual region. The decrease of length on the posterior (A-M, A-D, A-E, A-L, A-H, A-I, H-I) and lingual (J-K, L-M) sides of the denture were statistically significant. Conclusion: There was significant dimensional change in both the length and width of the 3D-printed maxillary and mandibular dentures after post-curing in this experiment. Consequently, it is seemed necessary to develop post-curing techniques and materials that reduce such denture deformation.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.235-240
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• 2008

Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.94-97
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• 2014

Purpose: Standardized uptake value (SUV) is a simple semi-quantitative method that can measure the ratio of the tissue radioactivity between the tumor and normal. SUV is commonly used in PET/CT, however, SUV is affected by various factor. The purpose of this study was to evaluate the impact of the residual activity on SUV depending on the location of catheter insertion device post injection. Materials and Methods: NEMA IEC Body Phantom was imaged using a Discovery 600 PET scanner. In 22 mm diameter sphere, the different activity of $^{18}F-FDG$ (7.4, 14.8, 22.2, 29.6, 37, 55.5 MBq) was filled and background was filled with $^{18}F-FDG$ (5.7 kBq/mL). We scaned the phantom on the assumption that the radioactivity in sphere was residual activity in insertion device. Simulation of PET was divided into three groups based on the location of sphere in Scan FOV (SFOV); inclusion, 1/2 inclusion and exclusion group. Results: Among three groups, the group of excluded sphere showed the highest SUV regardless of the amount of $^{18}F-FDG$ activity. In case of 7.4 MBq, average SUV of inclusion group, 1/2 inclusion and exclusion group was 0.780, 0.840 and 0.896 respectively. However, average SUV of 55.5 MBq showed 0.372, 0.460 and 0.508 with same order. Depend on residual radioactivity in the sphere and position of sphere, the SUV was different minimum of 10.4%, maximum of 62.8%. Conclusion: This study showed that SUV is underestimated as the residual radio-activity is increased. In addition, SUV was a changed according to the position of residual radio-activity. And among the position, exclusion group showed the difference of SUV was lowest. If we measure the residual radio-activity of inserting devices and radio-activity from extra-vasation in the patients, it seems to be more useful in clinical field.

• Investigative Magnetic Resonance Imaging
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• v.3 no.2
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• pp.154-158
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• 1999

Purpose : The purpose of this study was to find the optimum TE value for enhancing $T_2^{*}$ weighting effect and minimizing the SNR degradation and to compare the BOLD effects according to the changes of TE in 1.5T and 3.0T MRI systems. Materials and Methods : Healthy normal volunteers (eight males and two females with 24-38 years old) participated in this study. Each volunteer was asked to perform a simple finger-tapping task (sequential opposition of thumb to each of the other four fingers) with right hand with a mean frequency of about 2Hz. The stimulus was initially off for 3 images and was then alternatively switched on and off for 2 cycles of 6 images. Images were acquired on the 1.5T and 3.0T MRI with the FLASH (fast low angle shot) pulse sequence (TR : 100ms, FA : $20^{\circ}$, FOV : 230mm) that was used with 26, 36, 46, 56, 66, 76ms of TE times in 1.5T and 16, 26, 36, 46, 56, 66ms of TE in 3.0T MRI system. After the completion of scan, MR images were transferred into a PC and processed with a home-made analysis program based on the correlation coefficient method with the threshold value of 0.45. To search for the optimum TE value in fMRI, the difference between the activation and the rest by the susceptibility change for each TE was used in 1.5T and 3.0T respectively. In addition, the functional $T_2^{*}$ map was calculated to quantify susceptibility change. Results : The calculated optimum TE for fMRI was $61.89{\pm}2.68$ at 1.5T and $47.64{\pm}13.34$ at 3.0T. The maximum percentage of signal intensity change due to the susceptibility effect inactivation region was 3.36% at TE 66ms in 1.5T 10.05% at TE 46ms in 3.0T, respectively. The signal intensity change of 3.0T was about 3 times bigger than of 1.5T. The calculated optimum TE value was consistent with TE values which were obtained from the maximum signal change for each TE. Conclusion : In this study, the 3.0T MRI was clearly more sensitive, about three times bigger than the 1.5T in detecting the susceptibility due to the deoxyhemoglobin level change in the functional MR imaging. So the 3.0T fMRI I ore useful than 1.5T.

• Korean Journal of Poultry Science
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• v.44 no.2
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• pp.83-92
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• 2017

The purpose of this study was to estimate the inbreeding level and effective population size of Korean indigenous chickens. In the study, two variables were considered to evaluate the pedigree completeness: (1) the proportion (%) of animals with complete pedigree, and (2) the proportion of animals with inbreeding coefficients greater than zero. In the proportion of animals having complete pedigree, all strains reached almost 100% completeness in 1~2 years. In the proportion of animals with inbreeding coefficients greater than zero, all strains reached almost 100% completeness in 5~6 years. We considered that the pedigree recoding system is well managed and that the inbreeding coefficient is a reliable measure. Over the past 20 years, the increase of inbreeding coefficients in Korean indigenous chicken strains has been 7.6~10.9%. The S strain showed the most rapid increase of inbreeding coefficient of 8.2% in 10 years. The reason for this rapid increase is considered to be associated with the fact that the numbers of sires and dams involved in reproduction was 115 and 91, respectively, which are lower than those of the other strains. According to average rates of increase in inbreeding coefficients (${\Delta}F$), all strains have ${\Delta}F$ values of 0.39~0.85%, which is lower than 1%, and the effective population size is above 50. The results showed that inbreeding levels were within the acceptable range and that Korean indigenous chicken population scan be regarded as safe from the threat of extinction.

• Radiation Oncology Journal
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• v.7 no.2
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• pp.213-225
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• 1989

An analysis has been made of two hundred seven patients who were treated at the department of Radiation Oncology of Korea University Hospital for lung cancer from January 1981 through December 1986. There were 137 patients of nonsmall cell carcinoma (137/207, 66%), 26 patients of small cell carcinoma (26/207, 12.5%) and 44 patients of unproven histology. By aims of treatment, there were 104 patients (104/207, 50%) treated for cure, 89 patients (89/207, 42.9%) for palliation and 14 patients treated postoperatively. In 22 out of 207 patients, chemotherapy was done with radiotherapy, 12 of which were patients with small cell carcinoma. Stage II patients were 49 (49/207, 23.6%), stage III patients were 157 (157/207, 75.8%) and one patient had an occult cancer The tumor was initial Iy measured by CAT scan and chest X-rays in the 165 (165/207, 79.7%) patients, among which 117 patients had tumor diameter more than 5cm and 48 patients less than 5cm. Radiation therapy was given with Cobalt 60 teletherapy unit and the treatment volume encompassed primary tumor and the mediastinum. For curative aim, daily tumor dose of 180 cGy was given up to the range of 5,400~6,120cGy/30~34F/6~7 week period and for palliative aim, daily tumor dose of 300 cGy was given up to the range of 3,600~4,500 cGy/12~15F/2~3 week period. Postoperatively, mediastinum was treated for total dose of 5,040 cGy/28F/5.5 week period. 123 patients (123/207, 59%) were followed up after completion of radiotherapy for 14 months to 7 years. Local tumor response to the irradiation was measured by chest X-ray taken at one month follow up and was evaluated for response rate, if they were regressed more than 50% or less than 50% of the initial tumor size. The treatment results were as follows; 1. The median survival time was 8.5 months and survival rates for 1 year, 2 year and 5 year was 25%, 3.5% and 1% of nonsmall cell lung ca of 74 evaluable patients. 2. More than 50% of local tumor response rate was obtained in about half of overall cases; 90.5% for small cell ca, 50% for squamous cell ca, 25% for adenoca and 57% for large cell ca. 3. Response rate more than 50% was seen in the 50% of the patient group with tumor diameter more than 5cm and in the 55% of those with tumor diameter less than 5cm. 4. By total raidation dose given, patient group which was given 5,400~6,120 cGy equivalent dose or higher showed tumor response rate more than 50% in 53% of the patients, whereas the group with dose less than 5,400cGy equivalent, in 25% of the patients. 5. Survival rate for 6 month, 1 year and 2 year was compared between the group of local tumor response rate more than 50% vs. group with response rate less than 50%; 74% vs. 43%, 33% vs, 23%, 10% vs. 1%, respectively. 6. Local failure was seen in 21%(44/207) of the patients, which occured mostly within 15 months after completion of radiation therapy. Distant metastases were seen in 49.7%(103/207) of the patients, of which 43 cases were found before initiation of radiotherapy. The most common metastatic sites were bone and brain. In this sutdy, 1 year,2 year and S year survival rates were somewhat poor compared to the other studies. It mainly seems to be due to the poor general status of the patients and the far-advanced stage of the disease. In nonsmall cell cancer patients who had limited local disease and had small primary tumor size, we observed better local response. In addition, dose higher than 6,000 cGy group showed better tumor control than lower dose group. Survival rate was better for the local control group. For imporvement of local control of the lung cancer and hence, the survival of the patients with lung cancer, proper radical radiotherapy with high dose for localized disease is needed. New modality of treatment such as high LET beam in radiation therapy or drugs for the advanced disease as well as early diagnosis is also needed.

• Childhood Kidney Diseases
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• v.13 no.1
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• pp.40-48
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• 2009

Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.29-34
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• 2012

Purpose : Presently, hardwares and softwares for reducing radiation exposure are continually developed for PET/CT examination. Purpose of this study is to evaluate effectiveness of reducing radiation exposure dose of CT and SUV changes of PET when applied each kernel to ACCT (Attenuation Correction Computed Tomography) according to adopted IRIS (Iterative Reconstruction in Image Space) software. Materials and Methods : Biograph mCT (Siemens, Germany) was used as a PET/CT scanner. Using AAPM CT performance phantom, from standard (120 kVp, 100 mAs), 7 scans were conducted by reducing 15 mAs each. After image reconstruction by FBP (Filtered Back Projection) and IRIS, noise and spatial resolution were evaluated. The same method was applied to anthropomorphic chest phantom and acquired images were compared. NEMA IEC body phantom was used for SUV evaluation. Injected dose rate for hot sphere (hot) and background cylinder (BKG) were 1:8. CT dose condition (120 kVp, 50 mAs) was the same for each scan and PET scan durations were 1, 2, 3 and 4min. After scanning, each kernel of IRIS was applied to ACCT. And PET images were reconstructed by ACCT adopted IRIS for comparing SUV changes. Results : AAPM phantom test for noise evaluation, SD for FBP 100 mAs, IRIS 55 mAs were 8.8 and 8.9. FBP 85 mAs, IRIS 40 mAs were 9.5 and 9.7. FBP 70 mAs, IRIS 25 mAs were 11.9 and 11.1. Above mAs condition for FBP and IRIS, SD showed similar values. And for spatial resolution test, there was no significant difference. For chest phantom test, when applied the same mAs and kernel to both of FBP and IRIS, every applied kernels showed reduced noise. Lower mAs and higher kernel value showed higher noise reduction. There was no considerable difference only except for I70 very sharp kernel for SUV comparison using NEMA IEC body phantom. Conclusion : In this study, low mAs (55 mAs) applied IRIS and standard mAs (100 mAs) applied FBP showed similar noise. And only except for I70 kernel, there was no significant SUV changes. It is possible to reduce needless radiation exposure and acquire better image quality than FBP's through applying appropriate kernel of IRIS to PET/CT.

• The Korean Journal of Nuclear Medicine
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• v.31 no.1
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• pp.90-101
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• 1997

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [$^{18}F$]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained. the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. ($TBR_{51}$), tumor-to-background ratio of areas under time-activity curves ($TBR_{area}$) and the ratio between the activities of tumor ROI at 51 min p. i. and at the time which background ROI reaches maximum activity on the time-activity curves ($T_{51}/T_{max}$). The pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, $TBR_{51},\;TBR_{area}$ and $T_{51}/T_{max}$ for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by $TBR_{51}$, 83.3%, 100%, 93.8% by $TBR_{area}$ and 66.7%, 70.0%, 68.8% by $T_{51}/T_{max}$. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual, analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy In conclusion, all pSUV, aSUV, $TBR_{51}$, and $TBR_{area}$ are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.