• The Korean Journal of Nuclear Medicine
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• v.35 no.1
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• pp.33-42
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• 2001

Purpose: The purpose of this study was to evaluate the effect of scatter correction on the assessment of myocardial perfusion and left ventricular function by gated Tc-99m myocardial SPECT. Materials and Methods: Subjects were 11 normal volunteers, 20 patients with non-cardiac chest pain and 13 patients with coronary artery diseases. We classified above 3 groups into normal and diseased groups. Scatter correction was done using dual-energy-window scatter correction method (DEW-SC). We compared acquired counts, image contrast, corrected maximum relative counts, indices of left ventricular function, extent and severity of perfusion defects calculated by 'CEqual program' between scatter non-corrected and corrected images. Results: Scatter corrected studios was lower in counts by $18{\pm}3%$ than uncorrected studies, but image contrast were improved in all cases. Scatter correction using DEW-SC took 3 minutes to complete, and 512 kB memory to store. There were no significant differences among indices of left ventricular function between scatter non-corrected and corrected images. Although extents of perfusion defects were not significantly different, severity was severer in scatter corrected images. Conclusion: Scatter correction using DEW-SC is simple to do, and improves image contrast without changing other indices of myocardial perfusion and function.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.33-38
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• 2014

Purpose Auto exposure control (AEC) in SPECT/CT automatically controls the exposure dose (mA) according to patient's shape and size. The aim of this study was to evaluate the effect of AEC in SPECT/CT on exposure dose reduction and image quality. Materials and Methods The model of SPECT/CT used in this study was Discovery 670 (GE, USA), Smart mA for AEC; and $^{99m}Tc$ as a radioisotope. To compare SPECT and CT images by CT exposure dose variation, we used a standard technique set at 80, 100, 120, 140 kVp, 10, 30, 50, 100, 150, 200, 250 mA, and AEC at 80, 100, 120, 140 kVp, 10-250 mA. To evaluate resolution and contrast of SPECT images, triple line phantom and flangeless Esser PET phantom were used. For CT images, noise and uniformity were checked by anthropomrphic chest phantom. For dose evaluation to find DLP value, anthropomorphic chest phantom was used and the CT protocol of torso was applied by standard technique (120 kVp, 100 mA) and AEC (120 kVp, 10-250 mA). Results When standard and AEC were applied, the resolutions at SPECT images with attenuation correction (AC) were the same as FWHM by center 3.65 mm, left 3.48 mm, right 3.61 mm. Contrasts of standard and AEC showed no significant difference: standard 53.5, 29.8, 22.5, 15.8, 6.0, AEC 53.5, 29.6, 22.4, 15.7, 6.1 In CT images, noise values at standard and AEC were 15.4 and 18.5 respectively. The application of AEC increases noise but the value of coefficient variation were 33.8, 24.9 respectively, obtaining uniform noise image. The values of DLP at standard and AEC were 426.78 and 352.09 each, which shows that the application of AEC decreases exposure dose more than standard by approximately 18%. Conclusion The results of our study show that there was no difference of AC in SPECT images based on the CT exposure dose variation at SPECT/CT images. It was found that the increased CT exposure dose leads to the improvement of CT image quality but also increases the exposure dose. Thus, the use of AEC in SPECT/CT contributes to obtaining equal AC SPECT images, and uniform noise in CT images while reducing exposure dose.

• The Korean Journal of Nuclear Medicine
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• v.36 no.6
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• pp.317-324
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• 2002

Purpose: The use of statistical parametric mapping (SPM) program has increased for the analysis of brain PET and SPECT images. Montreal Neurological Institute (MNI) coordinate is used in SPM program as a standard anatomical framework. While the most researchers look up Talairach atlas to report the localization of the activations detected in SPM program, there is significant disparity between MNI templates and Talairach atlas. That disparity between Talairach and MNI coordinates makes the interpretation of SPM result time consuming, subjective and inaccurate. The purpose of this study was to develop a program to provide objective anatomical information of each x-y-z position in ICBM coordinate. Materials and Methods: Program was designed to provide the anatomical information for the given x-y-z position in MNI coordinate based on the Statistical Probabilistic Anatomical Map (SPAM) images of ICBM. When x-y-z position was given to the program, names of the anatomical structures with non-zero probability and the probabilities that the given position belongs to the structures were tabulated. The program was coded using IDL and JAVA language for 4he easy transplantation to any operating system or platform. Utility of this program was shown by comparing the results of this program to those of SPM program. Preliminary validation study was peformed by applying this program to the analysis of PET brain activation study of human memory in which the anatomical information on the activated areas are previously known. Results: Real time retrieval of probabilistic information with 1 mm spatial resolution was archived using the programs. Validation study showed the relevance of this program: probability that the activated area for memory belonged to hippocampal formation was more than 80%. Conclusion: These programs will be useful for the result interpretation of the image analysis peformed on MNI coordinate, as done in SPM program.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.317-325
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• 1994

The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.88-93
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• 2011

Purpose: As to analytical method of data, the AutoQUANT software in which it is used quantitative rating of the myocardial perfusion SPECT are reported that there is a difference. Therefore the measured value error of the mutual program is expected to be generated even if the quantitative analysis is made data of the same patient. The purpose of this study is to offer the comparative analysis of myocardial extract method in Quantitative Perfusion SPECT. Materials and methods: We analyzed the 51 patients who were examined by Tc-99m MIBI gated myocardial SPECT in nuclear medicine department of Pusan National University Hospital from June to December 2010(34 men, 17 women, mean age $66.5{\pm}9.9$). We acquired the extracted image in myocardial extract protocol. QPS program that uses the AutoQUANT software measured TID(Transient Ischemic Dilation), ESD(Extent of Stress Defect), SSS(Summed Stress Score). Then analyzed the results. Results: The correlation of appyling myocardial extract is TID(r=0.98), ESD(r=0.99), SSS(r=0.99). In the 95% confidence limit, there was no satistically significant difference(TID p=0.78, ESD p=0.31, SSS p=0.19). After blinding test with a physician for making a qualitative analysis, there was no difference. Conclusion: Quantitative indices in QPS program showed good correlation and the results showed no statistically signigicant difference. The variance between method was small. therefore, the functional parameters by each method can be used interchangeably. Also, we expect patient's satisfaction.

• The Korean Journal of Nuclear Medicine
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• v.30 no.4
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• pp.541-547
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• 1996

The previous monoclonal antibody labeling method for bone marrow immunoscintigrapy was complicated and laborious for clinical application. Also it showed a relatively low labeling efficiency. To improve this procedure, we compared several direct labeling methods of $^{99m}Tc$. 1) The labeling efficiency in the method using gluconate as a transchelator was low (40-70%), but immunoscintigraphy using this radiotracer produced a clear image. 2) To improve labeling efficiency, ${\beta}$-mercaptoethanol was removed after reduction. The labeling efficiency was improved up to 70-80%, but the radioactivity of the blood pool was high. 3) The higest labeling efficiency (>90%) and best quality images could be obtained by using MDP as a transchelating agent. It did not require additional procedures for separation of labeled antibodies. The immunoreactivity of this antibody was 60%. Residual MDP which can be taken up by the bone could be removed by PD-10 column. The reduced antibodies were stable with a high labeling efficiency (>90%) for up to 47 days by deep freezing. We concluded that the improved procedure for $^{99m}Tc$ labeling of anti-NCA-95 monoclonal antibody using MDP as a transchelating agent will be a simple and useful method for clinical application.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.394-401
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• 2023

Background: Pregnancy is associated with a number of physical, emotional, and biological changes that can exacerbate maternal psychological disturbances, such as body image concerns and depression. Sleep disturbances during pregnancy can also have adverse impacts. This study aimed to determine the prevalence of depression, sleep disturbances, and body image concerns among pregnant women. The study also examined the relationship between these factors and pregnancy-related variables, such as bad obstetric history and whether the pregnancies were unplanned. Methods: A cross-sectional study of 146 pregnant patients was conducted at a tertiary care center over 15 months. The patients were administered the Beck Depression Inventory, Pittsburgh Sleep Quality Index, and Body Image Concern Inventory questionnaires. Contingency tables, Fisher exact test, and Spearman correlation were used to identify underlying relationships. Results: The prevalence of depression was 22.6%. Although body image disturbance was noted in only 2.7% of patients, 46.6% had poor sleep quality. Poor sleep was associated with primigravida status. Bad obstetric history and unplanned pregnancy were associated with depression. Depression was found to be significantly correlated with body image disturbances and poor sleep quality. Conclusion: Psychiatric disorders were prevalent during pregnancy. This study highlights the importance of screening for depression in pregnant patients. Counselling and caregiver education can be useful for mitigating psychological disturbances. Management of pregnancies by multidisciplinary teams that include psychiatrists could be immensely useful in improving the pregnancy experiences of patients.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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• pp.183-190
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• 1987

In Raynaud's phenomenon, the authors measured finger blood flow after ice water exposure by analyzing the time activity curve of radionuclide angiography on both hands. The results were as follows: 1) The digital blood flow did not decrease after ice water exposure in normal subjects. 2) In the patients with Raynaud's phenomenon, there were two groups: the one had decreased digital blood flow after cold exposure, and the other had paradoxically increased digital blood flow after cold exposure. 3) There was no difference in the digital blood flow of hand in room temperature between the normal and the patients with reduced digital blood flow after cold exposure, but the digital blood flow of the hand in room temperature was markedly reduced in the patients with paradoxically increased flow after cold exposure. 4) In the static image the difference was not significant in comparision with the dynamic study, because it represents pooling of the blood in the vein rather than flow. 5) After the treatment with nifedipine, the digital blood flow increased. In conclusion, the radionuclide angiography was useful in measuring the digital blood flow in Raynaud's phenomenon, and further studies with various drugs is expected.

• Journal of Korean Neurosurgical Society
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• v.39 no.2
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• pp.136-140
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• 2006

The authors report three microcystic meningiomas with its characteristic immunohistochemical findings and chromosomal pattern. Three patients with surgically treated microcystic meningioma were studied for its radiological, histopathological findings, and chromosomal analysis was done in the one patient. Tumors were convexity meningioma in the frontal area. The tumors were enhanced homogenously in the two, and enhanced in homogenously with multiple small cysts in the other one on preoperative magenetic resonance image. Pathological examination showed marked nuclear pleomorphism, many small cysts, hyaline thickening in blood vessel wall, and mucinous background, compatable to microcystic type. EMA and vimentin were positive on the immunohistochemical stain. Chromosomal analysis showed tetrasomies of chromosome 5, 13, 17, and 20, and trisomies of chromosome 6, 7, 9, 11, 12, 16, 19, and 21, which are quite different from those of benign meningioma.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.374-381
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• 2003

Purpose: Determining an appropriate thresholding is crucial for PDG PET analysis since strong control of Type I error could fail to find pathological differences between eariy Alzheimer' disease (AD) patients and healthy normal controls. We compared the SPM results on FDG PET imaging of early AD using uncorrected p-value, random-field based corrected p-value and false discovery rate (FDR) control. Materials and Methods: Twenty-eight patients ($66{\pm}7$ years old) with early AD and 18 age-matched normal controls ($68{\pm}6$ years old) underwent FDG brain PET. To identify brain regions with hypo-metabolism in group or individual patient compared to normal controls, group images or each patient's image was compared with normal controls usingthe same fixed p-value of 0.001 on uncorrected thresholding, random-field based corrected thresholding and FDR control. Results: The number of hypo-metabolic voxels was smallest in corrected p-value method, largest in uncorrected p-value method and intermediate in FDG thresholding in group analysis. Three types of result pattern were found. The first was that corrected p-value did not yield any voxel positive but FDR gave a few significantly hypometabolic voxels (8/28, 29%). The second was that both corrected p-value and FDR did not yield any positive region but numerous positive voxels were found with the threshold of uncorrected p-values (6/28, 21%). The last was that FDR was detected as many positive voxels as uncorrected p-value method (14/28, 50%). Conclusions FDR control could identify hypo-metaboiic areas in group or individual patients with early AD. We recommend FDR control instead of uncorrected or random-field corrected thresholding method to find the areas showing hypometabolism especially in small group or individual analysis of FDG PET.