• Title/Summary/Keyword: Myocardial SPECT

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The Role of Rest Image in Patients Showing Normal Stress Image on Tc-99m Myocardial Perfusion Scan (심근 관류스캔 중 정상 부하영상 소견을 보인 환자에서 휴식기 영상의 필요성에 대한 평가)

  • Bom, Hee-Seung;Song, Ho-Chun;Min, Jung-Jun;Kim, Ji-Yeul
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.502-506
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    • 1996
  • Tc-99m myocardial perfusion agents such as Tc-99m sestamibi or Tc-99m tetrofosmin has advantages over T1-201 for myocardial perfusion scan fuck as low attenuation and easy availability. However, Tc-99m agents do not redistribute so they need to be given T times, namely after stress and at rest. To evaluate whether rest image is needed in patients showing normal stress image, 43 patients who underwent both myocardial perfusion scan and coronary angiography and showed normal stress images were evaluated. Findings of rest images of them were evaluated whether they change the diagnosis or treatment plans. Among 43 patients who showed normal stress myocardial perfusion imaging, 31 (72.1%) showed no additional informations. However, among 5 patients with vasospastic angina 4 (80%) showed abnormal rest images in spite of normal stress images. So, when vasospastic angina is suspected clinically, rest image could be helpful in identifying patients with coronary vasospasm. In conclusion, rest myocardial perfusion images were not helpful in 72.1 % of patients with angina when stress images were normal. In only exception was those with vasospastic angina.

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The Evaluation of Resolution Recovery Based Reconstruction Method, Astonish (Resolution Recovery 기반의 Astonish 영상 재구성 기법의 평가)

  • Seung, Jong-Min;Lee, Hyeong-Jin;Kim, Jin-Eui;Kim, Hyun-Joo;Kim, Joong-Hyun;Lee, Jae-Sung;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.58-64
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    • 2011
  • Objective: The 3-dimensional reconstruction method with resolution recovery modeling has advantages of high spatial resolution and contrast because of its precise modeling of spatial blurring according to the distance from detector plane. The aim of this study was to evaluate one of the resolution recovery reconstruction methods (Astonish, Philips Medical), compare it to other iterative reconstructions, and verify its clinical usefulness. Materials and Methods: NEMA IEC PET body phantom and Flanges Jaszczak ECT phantom (Data Spectrum Corp., USA) studies were performed using Skylight SPECT (Philips) system under four different conditions; short or long (2 times of short) radius, and half or full (40 kcts/frame) acquisition counts. Astonish reconstruction method was compared with two other iterative reconstructions; MLEM and 3D-OSEM which vendor supplied. For quantitative analysis, the contrast ratios obtained from IEC phantom test were compared. Reconstruction parameters were determined by optimization study using graph of contrast ratio versus background variability. The qualitative comparison was performed with Jaszczak ECT phantom and human myocardial data. Results: The overall contrast ratio was higher with Astonish than the others. For the largest hot sphere of 37 mm diameter, Astonish showed about 27.1% and 17.4% higher contrast ratio than MLEM and 3D-OSEM, in short radius study. For long radius, Astonish showed about 40.5% and 32.6% higher contrast ratio than MLEM and 3D-OSEM. The effect of acquired counts was insignificant. In the qualitative studies with Jaszczak phantom and human myocardial data, Astonish showed the best image quality. Conclusion: In this study, we have found out that Astonish can provide more reliable clinical results by better image quality compared to other iterative reconstruction methods. Although further clinical studies are required, Astonish would be used in clinics with confidence for enhancement of images.

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Viability Assessment with T1-201 Rest-24 hour Delay Redistribution SPECT before Coronary Artery Bypass Graft in Coronary Artery Diseases (관상동맥 질환에서 우회로 수술 전 T1-201 휴식-24시간 지연 심근 관류 SPECT를 이용한 심근생존능의 평가)

  • Yoon, Seok-Nam;Kim, Ki-Bong;Lee, Won-Woo;Chung, June-Key;Lee, Myung-Chul;Seo, Jung-Don;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.493-501
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    • 1996
  • To assess contribution of T1-201 rest-24 hour delay redistribution in detection of viable myocardium, we studied the predictive value of this redistribution in 17 patients who peformed rest-24 hour delay perfusion SPECT before bypass surgery. Regional wall motion was compared with gated SPECT in 10 patients and echocardiography in 7 patients before and after bypass surgery. Rest and 24 hour delayed uptakes were scored from 0 (normal perfusion) to 3 (defect). In rest SPECT, 56 segments showed perfusion decrease. Thirty four segments(61%) improved after surgery and were defined as viable Nineteen(34%) segments had more uptake of T1-201 at 24 hour delay, and the other 37 segments did not. In 81%(25/31) of segments with mildly decreased perfusion, wall motion after bypass surgery improved, 57% (8/14) of segments with severely decreased perfusion improved, and 9%(1/11) of segments with defects improved. In 14 among 19 segments which had more T1-201 uptakes at 24 hour delay, wall motion was improved(positive predictive value of redistribution: 74%). 20 among 37 segments which had persistent decreases in rest-24 hour redistribution improved and 17 did not(negative predictive value: 46%). Segments having severe perfusion decrease or defects showed improved wall motion after surgery in 64%(7/11), if it had redistribution at delay. Segments with either mildly decreased uptake in resting or rest-delayed redistribution showed improved wall motion in 76%(32/42). Among the 14 segments which showed improvement in wall motion, 10 had partial reversibility in stress-rest images and the other 4 had persistent perfusion defects in stress-rest images. These 4 segments were found viable only with rest-24 hour delayed perfusion SPECT. We concluded that rest T1-201 uptake or redistribution at 24 hour delay should be referred as an evidence to warrant postoperative improvement of abnormal wall motion and we could predict myocardial viability with preoperative rest-24 hour delay perfusion SPECT in the segments with rest perfusion decreases.

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Stress/Rest Tc-99m-MIBI SPECT in Comparison with Rest/Stress Rubidium-82 PET (휴식/부하 심근 Rubidium-82 양전자단층촬영과 부하/휴식 심근 Tc-99m-MIBI 단일광자단층촬영의 비교)

  • Lee, D.S.;Kang, K.W.;Lee, K.H.;Jeong, J.M.;Kwark, C.;Chung, J.K.;Lee, M.C.;Seo, J.D.;Koh, C.S.
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.31-40
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    • 1995
  • We compared stress/rest myocardial Tc-99m-MIBl tomographic image findings with rest/stress rubidium-82 tomographic images. In 23 patients with coronary artery disease (12 of them received bypass grafts before) and 6 normal subjects, rest rubidium PET study was performed : rubidium-82 and Tc-99m-MIBI were injected simultaneously to each patient after dipyridamole stress for rubidium PET and MIBI SPECT; and rest MIBI SPECT was performed 4 hours thereafter. We scored segmental decrease of rubidium or MIBI uptakes into 5 grades for 29 segments from 3 short-axis, vertical and horizontal slices. Scores were summed for each major arterial territory. When more score than two grade-2's or one grade-3 was considered as the cue for significant stenosis for major arterial territories, 67% of 46 stenosed arteries were found with MIBI studies and 78% of them by rubidium studies. Fourteen among 28 grafted arterial territories of 12 post-CABG patients were found normal with both rubidium and MIBI. Segmental scores were concordant between rubidium and MIBI in 72% of 709 stress segments and in 80% of 825 rest segments. Stress rubidium segmental scores were less than stress MIBI scores in 9%, so were rest rubidium scores. Stress rubidium scores were more than stress MIBI scores in 20% of segments, and rest rubidium segmental scores were more than rest MIBl scores in 11%. Rank correlations (Spearman's rho's more than 0.7(stress) and 0.5(rest), slopes (MIBI/rubidium) around 0.7(stress) and 0.9 (rest)) suggested deeper and wider defects in stress with rubidium. Slope over 1 (MIBI/rubidium) with LAD segemental scores at rest and 7 territories which had much larger score with MIBI revealed exaggeration of rest defects with rest MIBI in same-day stress/rest study. Difference scores (stress-rest for each territory) suggesting Ischemia were larger with rubidium (slope of MIBI/rubidium around 0.45). As has been implied by animal or separate-day-human studies, these segmental analyses with simultaneous examination in patients told that rubidium PET flow studies disclose ischemia more often than MIBI studies and that rest MIBI studies in same-day stress/rest-sequence gave a little larger rest defect than they would have shown.

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A Study on Optimal Myocardium Perfusion SPECT According to Possible Myocardial Infarct Sites (8) 예측성 경색 부위별 최적의 심근관류 단층촬영술 시행에 관한 연구)

  • Song Jae Beom;Lee Wan Kyu;Shu Myung Duk;Jang Sang Sup
    • Journal of The Korean Radiological Technologist Association
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    • v.25 no.1
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    • pp.234-252
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    • 1999
  • Purpose : Physical properties of radiophamaceuticals of technetium($^{99m}Tc$) and thallium($^{201}Tl$) have early been used for clinical diagnostics. The studies of those radiophamaceuticals have been contributed to the efficient to

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Semi-automatic segmentation and quantitative data visualization for evaluation of myocardial function (심근의 기능 평가를 위한 반자동 분할 및 정량적 데이터의 시각화)

  • 이유경;최수미;김명희
    • Proceedings of the Korean Information Science Society Conference
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    • 2001.04b
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    • pp.634-636
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    • 2001
  • 본 논문에서는 단일광자방출 전산화 단층촬영영사(SPECT)을 이용하여 심근의 기능을 보다 쉽고 정확하게 평가하기 위해 반자동 분할 및 정량적 데이터를 시각화하는 인터페이스를 구현하였다. 먼저 반자동 분할에서는 환자영상에서 보여지듯이 심근 기능이 저하되어 부분적으로 심근이 불연속적으로 나타나는 영상에서도 내.외벽의 외각을 연속성을 가지고 견고하게 분리할 수 있도록 사용자가 간단히 조작할 수 있는 반자동 분리 인터페이스를 구현하였다. 또한 내.외벽으로 분리된 외곽선들을 이용하여 측정한 지역적 모션 데이터를 사용자가 보다 이해하기 쉽도록 Bull's eye 그래프를 이용하여 가시화하였다. 본 논문에서 구현한 반자동 분할 및 정량적 데이터의 시각화 인터페이스는 환자의 심근에 대한 기능 영상처럼 분석이 어려운 영상에서도 보다 견고하고 정확한 평가를 할 수 있도록 해준다.

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Automated Functional Morphology Measurement Using Cardiac SPECT Images (SPECT 영상을 사용한 기능적 심근형태의 자동 계측법 개발)

  • Choi, Seok-Yoon;Ko, Seong-Jin;Kang, Se-Sik;Kim, Chang-Soo;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.133-139
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    • 2012
  • For the examination of nuclear medicine, myocardial scan is a good method to evaluate a hemodynamic importance of coronary heart disease. but, the automatized qualitative measurement is additionally necessary to improve the decoding efficiency. we suggests the creation of cardiac three-dimensional model and model of three-dimensional cardiac thickness as a new measurement. For the experiment, cardiac reduced cross section was obtained from SPECT. Next, the pre-process was performed and image segmentation was fulfilled by level set. for the modeling of left cardiac thickness, it was realized by applying difference equation of two-dimensional laplace equation. As the result of experiment, it was successful to measure internal wall and external wall and three-dimensional modeling was realized by coordinate. and, with laplace formula, it was successful to develop the thickness of cardiac wall. through the three-dimensional model, defects were observed easily and position of lesion was grasped rapidly by the revolution of model. The model which was developed as the support index of decoding will provide decoding information to doctor additionally and reduce the rate of false diagnosis as well as play a great role for diagnosing IHD early.