• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.24-27
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• 2010

Purpose: Early diagnosis of breast is of the utmost importance to improve prognosis. We have a limitation for mammography and sonography detecting small cancer. Clinical importance of Breast Specific Gamma Imaging (BSGI) has improved for that reason. So We studied performance evaluation test of count rate and resolution with high sensitivity to the low dose of BSGI. Materials and Methods: BSGI of Dilon 6800, point source of $^{99m}Tc$ from 1.85~148 MBq (0.05~4 mCi) at the intervals of 1.85~37 MBq (0.05~1 mCi) was used for the test. Performance evaluation method was performed for measuring deadtime for choosing at the 5 different point in the useful field of view (UFOV), acquired image for 60 seconds. Compared with reference of clinical uptake distribution of breast, activity increased according to the distance change 10, 20, 30, 40, 50 mm in the useful field of view. Results: Counting curve increased according to the activity from 1.85 MBq (0.05 mCi) to the 74 MBq (2 mCi), and it change flat shape over 74 MBq (2 mCi). The variation of the full width of half maximum (FWHM) to the distance is 4.05, 4.73, 5.77, 6.90, 8.00, 9.32 mm in 1.85 MBq (0.05 mCi), 4.30, 4.80, 5.90, 7.00, 8.10, 9.07 mm in 3.7 MBq (0.1 mCi), 4.90, 5.60, 6.20, 7.20, 8.20, 9.10 mm in 5.55 MBq (0.15 mCi), 5.30, 6.10, 6.60, 7.00, 7.90, 8.70 mm in 7.40 MBq (0.2 mCi). Conclusion: Distortions of image would be acquired because of the deadtime in BSGI. We found out the fact that specification of $^{99m}Tc$ reaction under 74 MBq (2 mCi) for BSGI. Second, FWHM distribution change from varied distance from the detector, clearly distinguished the location of the lesion.

• 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.

• The Korean Journal of Nuclear Medicine
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• v.22 no.2
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• pp.193-197
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• 1988

Measurement of gastric emptying rate has been performed by a variety of techniques. Nuclear medicine method is a major advance in the quantitative evaluation of gastric function and also of pharmacologic intervention. Normal gastric emptying rate was measured in 48 healthy volunteers using live chicken liver labeled with $^{99m}Tc-Tin$ Colloid as a solid phase marker. In vitro studies were performed to evaluate the labeling efficiency and stability in hydrochloric acid and in human gastric juice of intracellularly labeled chicken liver. Anterior image counts only were compared with the geometric mean of anterior and posterior counts in 12 healthy volunteers who were studied by both anterior count and posterior count. The results were as follows: 1) The labeling efficiency in gastric juice and hydrochloric acid were $95.5{\pm}1.23%,\;95.7{\pm}1.15%$, respectively. 2) Half gastric emptying time by anterior count only was $126{\pm}21$ minutes 3) Although standard deviation of geometric mean method was smaller than anterior count method, gastric emptying curves from both method were similar. In daily practice, anterior count method may be useful alternative to geometric mean method in evaluation of gastric emptying rate.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.66-70
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• 2008

Reports about FDG PET in biliary tumor are limited and there are almost no reports regarding its efficacy. Biliary tumor is divided to intrahepatic and extrahepatic bile duct cancer, and intrahepatic bile duct cancer can be further divided to peripheral type which occurs at lobular duct and hilar type which occurs at hepatic hilum. Surgical resection is the only curative method for bile duct tumor, and accurate staging plays an important role in deciding treatment modality. Among intrahepatic bile duct tumors, peripheral type and hilar type have the same histological characteristics, but different clinical manifestations and tumor growth pattern. On PET image, FDG uptake is also different between peripheral type and hilar type. Most of the former shows high FDG uptake at primary and metastasis site so it is very useful for determining stage and changing treatment plans. However, the later is diversified among low uptake and very high uptake. The FDG uptake pattern of hilar type is similar to that of extrahepatic bile duct cancer, and mucinous component is an important factor, which affects FOG uptake. When tumor cells are scattered in desmoplatsic stroma, then FDG uptake is low as well. In contrast, when FDG uptake is high, it is likely to be tubular type which has high tumor density. Tumor growth pattern also affects FDG uptake. Nodular type mostly takes higher FDG compared to infiltrative type. There are many cases where benign inflammatory diseases take high FDG that PET alone can not distinguish malignant lesion from benign lesion. In conclusion, studies about PET using FDG are still limited. Thus, it is hard to make accurate conclusion about the roles of PET or PET/CT in biliary cancers, but peripheral type intrahepatic bile duct cancers and mass forming hilar and extrahepatic bile duct cancers appear to be good indications performing FDG PET or PET/CT.

• Progress in Medical Physics
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• v.24 no.3
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• pp.176-182
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• 2013

Through this research, we measure the data for several SUVs such as SUVLBM, SUVBW, and SUVBSA using volume of interest in order to enhance the diagnostic level in whole-body image for healthy examinees via F-18 FDG PET/CT. Maximum value, mean value, standard deviation, and threshold value for each SUVs are shown. The measurement of SUVs are carried out with 31 examinees who have taken whole-body examination with F-18 FDG PET/CT from July, 2012 to August, 2012. To secure the preciseness of measurement, we selected 26 healthy examinees as a subject of measurement according to diagnostic view of a nuclear-medical doctor. We see from the measurement of SUVs of PET/CT that the value of SUVBW is hightest and followed by SUVLBM and SUVBSA in turn regardless of the use of contrast media. By comparing the SUVLBM-maximum data for the group used contrast media with those for the group used no contrast media, there found a trend that the measured values increase when the contrast media are used. Among them, liver, aorta, lumbar-5, and Cerebellum exhibit significant difference (p<0.05). We conclude that our data for SUVs would be basic references in overall image interpretation, and hope that the research using VOI would be active.

• The Korean Journal of Nuclear Medicine
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• v.33 no.3
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• pp.316-326
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• 1999

Purpose: We evaluated the feasibility of extracting pure left ventricular blood pool and myocardial time-activity curves (TACs) and of generating factor images from human dynamic N-13 ammonia PET using factor analysis. The myocardial blood flow (MBF) estimates obtained with factor analysis were compared with those obtained with the user drawn region-of-interest (ROI) method. Materials and Methods: Stress and rest N-13 ammonia cardiac PET imaging was acquired for 23 min in 5 patients with coronary artery disease using GE Advance tomograph. Factor analysis generated physiological TACs and factor images using the normalized TACs from each dixel. Four steps were involved in this algorithm: (a) data preprocessing; (b) principal component analysis; (c) oblique rotation with positivity constraints; (d) factor image computation. Area under curves and MBF estimated using the two compartment N-13 ammonia model were used to validate the accuracy of the factor analysis generated physiological TACs. The MBF estimated by factor analysis was compared to the values estimated by using the ROI method. Results: MBF values obtained by factor analysis were linearly correlated with MBF obtained by the ROI method (slope = 0.84, r = 0.91), Left ventricular blood pool TACs obtained by the two methods agreed well (Area under curve ratio: 1.02 ($0{\sim}1min$), 0.98 ($0{\sim}2min$), 0.86 ($1{\sim}2min$)). Conclusion: The results of this study demonstrates that MBF can be measured accurately and noninvasively with dynamic N-13 ammonia PET imaging and factor analysis. This method is simple and accurate, and can measure MBF without blood sampling, ROI definition or spillover correction.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.93-101
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• 2015

Purpose In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. Thus, a wide range of scatter correction(SC) methods have been studied and this study is to evaluate the accuracy of CT based SC(CTSC) used in SPECT/CT as the comparison with existing energy window based SC(EWSC). Materials and Methods SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. In both conditions, Astonish(iterative : 4 subset : 16) reconstruction method and CT attenuation correction were commonly applied and three types of SC methods such as non-scatter correction(NSC), EWSC, CTSC were used in images filled with image. For EWSC, 9 sub-energy windows were set additionally in addition to main(=peak) energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Results Based on the image filled with air, %SF of images filled with water to which each SC method was applied is NSC 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the most scattering counts were removed in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. Conclusion In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.13-19
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• 2016

Purpose In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (${\theta}$) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view. Materials and Methods From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (${\theta}$) between ventricular septum and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of ${\theta}$ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO ${\theta}$ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed. Results $Mean{\pm}SD$ of ${\theta}$ on total 253 patients was $37.0{\pm}8.5^{\circ}$. Among them, the patients whose difference between 45 and ${\theta}$ degrees were more than ${\pm}10$ degrees were 88 patients ($29.3{\pm}6.1^{\circ}$). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=62.0{\pm}6.6%$ vs. LVEF ${\theta}=64.0{\pm}5.6%$; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=66.7{\pm}7.2%$ vs. LVEF ${\theta}=69.0{\pm}6.4%$; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO ${\theta}$, there was no significant difference statistically. Conclusion We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO ${\theta}$ view.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.46-48
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• 2016

Purpose The liver one of the most common site for distant metastasis for a variety of tumor, especially of gastrointestinal origin. the purpose of this study was to analyze image quality between standard scan and additional liver scan. Materials and Methods From September 2015 to February 2016. 152 patients were examined undergo gastrointestinal cancer. 32 patients confirmed liver metastasis analyzed same liver ROI level and check the SNR, SUV and T/N ratio Results The $SNR_{mean}$ of standard was $17.7{\pm}10.3$; addition was $22.3{\pm}9.7$ (p<0.05). In $SUV_{max}$ of standard was $6.7{\pm}2.8$; addition was $7.6{\pm}3.2$ (P<0.05). and the T/N ratio of standard was $2.1{\pm}0.6$; addition was $2.5{\pm}0.8$ (P<0.05). Conclusion The $SNR_{mean}$, $SUV_{max}$ and T/N ratio were higher than those on the first scan (P<0.05). The SNRmean showed the highest change rate among the parameters. A additional liver scan is more favorable for the detection of gastrointestinal cancer patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.54-58
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• 2019

Purpose At now, there are many kind of dedicated heart SPECT machine in clinical nuclear medicine. Among those, the fixed focusing type SPECT can make a good quality, quantity image because a detectors of this SPECT arranged forward a special ROI and didn't rotate around of body. So, in this paper, we will evaluate a spatial uniformity about resolution and sensitivity at a same plane of a fixed focusing type SPECT. Materials and Methods We used D-SPECT as a fixed focusing type SPECT and Cario MD as a rotated parallel type SPECT to comparing each other. We injected $^{99m}Tc(14.8MBq/1cc)$ to 10 capillary tube (diameter=1mm), and we set those line sources a tfield of view of each SPECT. And then we acquired SPECT date, we applied are construction by recommended methods. By using two tomography images, we calculated a full width of half maximum as a resolution and total counts as a sensitivity, and we compared a CV (coefficientofvariation) values between two images as a spatial uniformity. Results In case of D-SPECT, a CV of resolution and sensitivity are 7.45%, 12.34%. In case of Cario MD, an CV of resolution and sensitivity are 12.49%, 21.84% Conclusion As a results, CV of resolution and sensitivity of a fixed focusing type SPECT is 67.75%, 77.00% higher than ones of a rotated parallel type SPECT. It means that a fixed focusing type SPECT is more uniformed, because this new SPECT can reduce a motion blur artifact by rotating detector around body, also all of detector that made by semiconductor arrange forward a special FOV like heart.