• Journal of Chest Surgery
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• v.23 no.6
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• pp.1067-1073
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• 1990

To clarify the changes of left ventricular function under normothermia, the time interval between the onset of ischemia and the beginning of contracture of left ventricle[TIC] were recorded in newborn piglet. Myocardial performance was assessed using intraventricular balloon to determine compliance and systolic function after 5 to 10 minutes interval per-fusing normothermic substrate free Krebs solution as a perfusate. The time to onset TIC was 29.5\ulcorner1.7 minutes and peak ischemic contracture was 46.7\ulcorner4.0 minutes[p<0.01]. In myocardial performance, systolic function of left ventricle[defined as cardiac contractility] was kept until 25 minutes of perfusion, but was decreased abruptly after 30 minutes of perfusion[p<0.0018] and diastolic function of left ventricle[defined as diastolic compliance] was kept until 15 minutes of perfusion, but was decreased after 20 minutes of perfusion [p=0.00\ulcorner9]. This study demonstrated maximal time of the tolerance to normothermic global ischemia and functional changes of left ventricle using Krebs perfusate under the same condition.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.465-467
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• 2014

We present a patient who developed recurrent angina after coronary artery bypass grafting (CABG). Myocardial single-photon emission computed tomography (SPECT) demonstrated deterioration in the myocardial perfusion, and coronary angiography revealed an overgrown side branch of the grafted left internal thoracic artery (ITA); otherwise, there were no significant changes compared with previous imaging studies obtained after the CABG. After percutaneous embolization of the grafted left ITA side branch, the angina was resolved and myocardial SPECT showed improved perfusion.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.28-32
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• 2014

Purpose Patient motion during myocardial perfusion SPECT can produce images that show visual artifacts and perfusion defects. This artifacts and defects remain a significant source of unsatisfactory myocardial perfusion SPECT. Motion correction has been developed as a way to correct and detect the patient motion for reducing artifacts and defects, and each motion correction uses different algorithm. We corrected simulated motion patterns with several motion correction methods and compared those images. Materials and Methods Phantom study was performed. The anthropomorphic torso phantom was made with equal counts from patient's body and simulated defect was added in myocardium phantom for to observe the change in defect. Vertical motion was intentionally generated by moving phantom downward in a returning pattern and in a non-returning pattern throughout the acquisition. In addition, Lateral motion was generated by moving phantom upward in a returning pattern and in a non-returning pattern. The simulated motion patterns were detected and corrected similarly to no-motion pattern image and QPS score, after Motion Detection and Correction Method (MDC), stasis, Hopkins method were applied. Results In phantom study, Changes of perfusion defect were shown in the anterior wall by the simulated phantom motions, and inferior wall's defect was found in some situations. The changes derived from motion were corrected by motion correction methods, but Hopkins and Stasis method showed visual artifact, and this visual artifact did not affect to perfusion score. Conclusion It was confirmed that motion correction method is possible to reduce the motion artifact and artifactual perfusion defect, through the apply on the phantom tests. Motion Detection and Correction Method (MDC) performed better than other method with polar map image and perfusion score result.

• 대한핵의학회:학술대회논문집
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• 2000.05a
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• pp.79.2-79.2
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• 2000

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.77-78
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• 2008

A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of $^{99m}Tc$-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical & mid area of anterior & lateral wall and mid & basal inferior wall. Coronary CT angiograph was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion softwear package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.65-71
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• 2011

Purpose: The recently adopted multiple confocal SPECT SYSTEM (hereinafter called IQ SPECT$^{TM}$) has a high difference from the conventional myocardial perfusion SPECT in the collimator form, image capture method, and image reconstruction method. This study was conducted to compare this novice equipment with the conventional one to design a protocol meeting the IQ SPECT, and also determine the characteristics and usefulness of IQ SPECT. Materials and Methods: 1. For the objects of LEHR (Low energy high resolution) collimator and Multiple confocal collimator, $^{99m}Tc$ 37MBq was put in the acrylic dish then each sensitivity ($cpm/{\mu}Ci$) was measured at the distance of 5 cm, 10 cm, 20 cm, 30 cm, and 40 cm respectively. 2. Based on the sensitivity measure results, IQ SPECT Protocol was designed according to the conventional general myocardial SPECT, then respectively 278 kBq/mL, 7.4 kBq/mL, and 48 kBq/mL of $^{99m}Tc$ were injected into the myocardial and soft tissues and liver site by using the anthropomorphic torso phantom then the myocardial perfusion SPECT was run. 3. For the comparison of FWHMs (Full Width at Half Maximum) resulted from the image reconstruction of LEHR collimator, the FWHMs (mm) were measured with only algorithms changed, in the case of the FBP (Filtered Back projection) method- a reconstruction method of conventional myocardial perfusion SPECT, and the 3D OSEM (Ordered subsets expectation maximization) method of IQ SPECT, by using $^{99m}Tc$ Line source. Results: 1. The values of IQ SPECT collimator sensitivity ($cpm/{\mu}Ci$) were 302, 382, 655, 816, 1178, and those of LEHR collimator were measured as 204, 204, 202, 201, 198, both at the distance of 5 cm, 10 cm, 20 cm, 30 cm, and 40 cm respectively. It was found the difference of sensitivity increases up to 4 times at the distance of 30 cm in the cases of IQ SPECT and LEHR. 2. The myocardial perfusion SPECT Protocol was designed according to the geometric characteristics of IQ SPECT based on the sensitivity results, then the phantom test for the aforesaid protocol was conducted. As a result, it was found the examination time can be reduced 1/4 compared to the past. 3. In the comparison of FWHMs according to the reconstructed algorithm in the FBP method and 3D OSEM method followed after the SEPCT test using a LEHR collimator, the result was obtained that FWHM rose around twice in the 3D OSEM method. Conclusion : The IQ SPECT uses the Multiple confocal collimator for the myocardial perfusion SPECT to enhance the sensitivity and also reduces examination time and contributes to improvement of visual screen quality through the myocardial-specific geometric image capture method and image reconstruction method. Due to such benefits, it is expected patients will receive more comfortable and more accurate examinations and it is considered a further study is required using additional clinical materials.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.67-72
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• 2010

Purpose: In Asan Medical Center we perform myocardial perfusion SPECT to evaluate cardiac event risk level for non-cardiac surgery patients. In case of patients with cancer, we check tumor metastasis using whole body bone scan and whole body PET scan and then perform myocardial perfusion SPECT to reduce unnecessary exam. In case of short term in patients, we perform $^{201}Tl$ myocardial perfusion SPECT after whole body bone scan a minimum 16 hours in order to reduce hospitalization period but it is still the actual condition in which the evaluation about the affect of the crosstalk contamination due to the each other dissimilar isotope administration doesn't properly realize. So in our experiments, we try to evaluate crosstalk contamination influence on $^{201}Tl$ myocardial perfusion SPECT using anthropomorphic torso phantom and patient's data. Materials and Methods: From 2009 August to September, we analyzed 87 patients with $^{201}Tl$ myocardial perfusion SPECT. According to $^{201}Tl$ myocardial perfusion SPECT yesterday whole body bone scan possibility of carrying out, a patient was classified. The image data are obtained by using the dual energy window in $^{201}Tl$ myocardial perfusion SPECT. We analyzed $^{201}Tl$ and $^{99m}Tc$ counts ratio in each patients groups obtained image data. We utilized anthropomorphic torso phantom in our experiment and administrated $^{201}Tl$ 14.8 MBq (0.4 mCi) at myocardium and $^{99m}Tc$ 44.4 MBq (1.2 mCi) at extracardiac region. We obtained image by $^{201}Tl$ myocardial perfusion SPECT without gate method application and analyzed spatial resolution using Xeleris ver 2.0551. Results: In case of $^{201}Tl$ window and the counts rate comparison result yesterday whole body bone scan of being counted in $^{99m}Tc$ window, the difference in which a rate to 24 hours exponential-functionally notes in 1:0.114 with Ventri (GE Healthcare, Wisconsin, USA), 1:0.249 after the bone tracer injection in 12 hours in 1:0.411 with 1:0.79 with Infinia (GE healthcare, Wisconsin, USA) according to a reduction a time-out was shown (Ventri p=0.001, Infinia p=0.001). Moreover, the rate of the case in which it doesn't perform the whole body bone scan showed up as the average 1:$0.067{\pm}0.6$ of Ventri, and 1:$0.063{\pm}0.7$ of Infinia. According to the phantom after experiment spatial resolution measurement result, and an addition or no and time-out of $^{99m}Tc$ administrated, it doesn't note any change of FWHM (p=0.134). Conclusion: Through the experiments using anthropomorphic torso phantom and patients data, we found that $^{201}Tl$ myocardium perfusion SPECT image later carried out after the bone tracer injection with 16 hours this confirmed that it doesn't receive notable influence in spatial resolution by $^{99m}Tc$. But this investigation is only aimed to image quality, so it needs more investigation in patient's radiation dose and exam accuracy and precision. The exact guideline presentation about the exam interval should be made of the validation test which is exact and in which it is standardized about the affect of the crosstalk contamination according to the isotope use in which it is different later on.

• Journal of Chest Surgery
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• v.24 no.9
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• pp.881-889
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• 1991

The ideal goal of the coronary artery bypass surgery is complete revascularization. To estimate the numerical degree of completeness of revascularization, the following formula was used in 50 patients having aorta-coronary bypass grafting for the treatment of unstable angina. myocardial perfusion score of revascularized area Degree of Completeness = ----------------------------------------------------------------------------- x100[%] preoperative myocardial perfusion score Randomized patients who underwent revascularization procedures in 19Hb were compared with the patients who received similar elective operation each year from 1988 through 1991. To obtain these data, the patients aged 38 ~ 75[mean 54$\pm$9.1years], composed of 31 males and 19 females were randomly sampled. The number of grafts per patient increased from 2.30 in 1986, to 3.07 in 1988 - 89, to 3.21 in 1990, and to 3.50 in 1991. [0.05 The degree of completeness improved from 75.4% to 81.4%, 91.6% and 88.6% respectively. It improved significantly in the last two years, [P<0.05, Mann-Whitney U test] At a follow-up of three months, 90 percent[45/50] of patients remained angina, free, 6 percent[3/50] had residual angina, and 4 percent[2/50] died. The last two patients degree of completeness corresponded to 43% and 30% respectively As a conclusion, the degree of completeness seems to improve year by year, and to have close relationship with the clinical results.

• Korean Journal of Radiology
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• v.19 no.6
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• pp.1007-1020
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• 2018

Objective: To compare the diagnostic performance of cardiovascular magnetic resonance (CMR) myocardial perfusion at 1.5- and 3-tesla (T) for detecting significant coronary artery disease (CAD), with invasive coronary angiography (ICA) as the reference method. Materials and Methods: We prospectively enrolled 281 patients (age $62.4{\pm}8.3$ years, 193 men) with suspected or known CAD who had undergone 1.5T or 3T CMR and ICA. Two independent radiologists interpreted perfusion defects. With ICA as the reference standard, the diagnostic performance of 1.5T and 3T CMR for identifying significant CAD (${\geq}50%$ diameter reduction of the left main and ${\geq}70%$ diameter reduction of other epicardial arteries) was determined. Results: No differences were observed in baseline characteristics or prevalence of CAD and old myocardial infarction (MI) using 1.5T (n = 135) or 3T (n = 146) systems. Sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC) for detecting significant CAD were similar between the 1.5T (84%, 64%, 74%, 76%, and 0.75 per patient and 68%, 83%, 66%, 84%, and 0.76 per vessel) and 3T (80%, 71%, 71%, 80%, and 0.76 per patient and 75%, 86%, 64%, 91%, and 0.81 per vessel) systems. In patients with multi-vessel CAD without old MI, the sensitivity, specificity, and AUC with 3T were greater than those with 1.5T on a per-vessel basis (71% vs. 36%, 92% vs. 69%, and 0.82 vs. 0.53, respectively). Conclusion: 3T CMR has similar diagnostic performance to 1.5T CMR in detecting significant CAD, except for higher diagnostic performance in patients with multi-vessel CAD without old MI.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.8 no.2
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• pp.63-70
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• 2022

The development of myocardial perfusion imaging (MPI) agents has been motivated because coronary artery disease has been one of the leading causes of death worldwide since the 1960s. Several positron emission tomography (PET) MPI agents were developed, and ¹⁸F-labeled phosphonium cations were reported actively among them. In this study, we synthesized novel ¹⁸F-labeled phosphonium cations, (5-[¹⁸F]fluoropentyl)diphenyl(pyridin-2-yl)phosphonium and (2-(2-[¹⁸F]fluoroethoxy)ethyl)diphenyl(pyridin-2-yl)phosphonium, and evaluated potential as MPI agents. Two labeled compounds were synthesized via nucleophilic substitution reactions of ¹⁸F-fluoride with the appropriate tosylate precursor in the presence of Kryptofix 2.2.2 and K₂CO₃. MicroPET studies were performed in normal rats to evaluate in vivo distribution of radiolabeled phosphonium cations for 60 min. The radiolabeled compounds were synthesized with 5%-10% yield. The radiochemical purity of labeled compounds was > 98% by analytical HPLC, and the specific activity was > 11.8 GBq/µmol. The result of microPET studies of these labeled compounds in rats showed intense uptake in the myocardium at 30 and 60 min. The results suggest that these ¹⁸F-labeled novel phosphonium cations would have potential as promising candidates for myocardial perfusion imaging.