• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.381-387
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• 1999

Purpose: The International Labor Organization (ILO) has established an international standard for chest X-ray diagnosis of pneumoconiosis since 1980. However, there is a need for improved diagnosis and staging in occupational disease. We evaluated Ga-67 citrate scintigraphy quantitatively and correlated the scintigraphic findings with pulmonary function tests and chest X-ray results. Materials and Methods: Twenty-five patients underwent whole body scintigraphy with additional chest and abdomen images 48 hrs after intravenous injection of 185 MBq of Ga-67 citrate. Ten normal controls were also studied. Regions of interest (ROI) were drawn on the posterior image to measure counts from the liver and lungs (Lung/Liver Ratio). Results: L/L ratio according to the stages of chest X-ray classification were as follows; stage 0 (normal, n=10): $0.3948{\pm}0.0692$, stage 1 (n=10): $0.5763{\pm}0.1537$, stage 2 (n=11), $0.6849{\pm}0.1459$, stage 3 (n=4) $0.9913{\pm}0.0712$. There was a significant correlation between the scintigraphic L/L ratio and the X-ray stage (r=0.618, p<0.05). However, no significant correlation between L/L ratio and pulmonary function tests were observed (p>0.05). Conclusion: Quantitative Ga-67 scintigraphy can be a useful method for staging of silicosis. However, it is not a method to assess pulmonary functional impairment.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.10-18
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• 2009

Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

• Progress in Medical Physics
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• v.16 no.4
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• pp.183-191
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• 2005

The utilization of PET has been increased so fast since the usefulness of the PET has been proved in various clinical and research fields. Among the many applications, the PET Is especially useful in oncology and most of the clinical PET scans are peformed for the oncologic examination Including the different diagnosis of malignant and benign tumors and assessment of the treatment effects and recurrent tumors. As the PET-CT scanners are widely available, there is Increasing interest in the application of the PET Images to the radiation treatment planning. Although the CT images are conventionally used for the target volume determination in the radiation treatment planning, there are fundamental limitation In use of only the anatomical information. Therefore, the volume determination of the functionally active tumor region using the PET would be important for the treatment planning. However, the accurate determination of the tumor boundary is not simple in PET due to the relatively low spatial resolution of the currently available PET scanners. In this study, computer simulations were peformed to study the relationship between the lesion size, PET resolution, lesion to background ratio and the threshold of Image Intensity to determine the true tumor volume.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.83-87
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• 2011

Purpose: Recently in diagnostics area PET/CT is using a variety of areas including oncology, as well as in cardiology, neurology, etc. While increasing in the importance of PET/CT, there are various researches in the image quality related to reconstruction method. We compared and tested Iterative 2D Reconstruction Method with True X Reconstruction method by Siemens through phantom experiment, so we can see increasing of clinical usefulness of PET/CT. Materials and Methods: We measured contrast ratio and FWHM due to evaluating images on dose and experiment using Biograph 40 True Point PET/CT (Siemens, Germany). Getting a result of contrast ratio and FWHM, we used NEMA IEC PET body phantom (Data Spectrum Corp.) and capillary tube. We used the current TrueX and the previous Iterative 2D algorithm for all images which have 10 minutes long. Also, a clinical suitability of parameter for Iterative 2D and a recommended parameter by Siemens for True X are applied to the experiment. Results: We tested FWHM using capillary tube. As a result, TrueX was less than Iterative 2D. Also, the differences of FWHM get bigger in low dose. On the other hand, we tested contrasts ratio using NEMA IEC PET body phantom. As a result, TrueX was better aspect than Iterative 2D. However, there was no difference in dose. Conclusion: In this experiment, TrueX get higher results of contrast ratio and spatial resolution than Itertive 2D through experiment. Also, in the reconstruction result through TrueX, TrueX had better aspect of resolution than Iterative 2D in low dose. However, contrast ratio had no specific difference. In other words, TrueX reconstruction method in PET/CT had higher clinical value in use because TrueX can reduce exposure of patient and had a better quality of screen.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.42-45
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• 2016

Purpose Neuracep is used to other diagnostic evaluations of the brain to estimate beta-amyloid neuritic plaque density in adult patients with cognitive impairment and inspected cognitive impairment. $^{18}F-Florbetaben$ specially has moderate lipophilicity and property of the added ethanol. It is the subject of interest of the patient pain and residual activity after injecting. Our study is effective injection method of the radiopharmaceutical and patient care. So it is for the highest quality image. Materials and Methods Patients were targeted 70 subjects, it was injected mean $259{\pm}74MBq$ to the patients ($^{18}F-FDG$: 20 subjects, $^{18}F-FP-CIT$: 20 subjects, $^{18}F-Florbetaben$: 30 subjects). After injection (reflusing 2 times, reflusing 3 times) using a 3-way set, it measured the residual activity. When injecting $^{18}F-Florbetaben$, we evaluated the effective injection methods(3-way set method and heparin cap method). The average residual activity after the injection was compared using a statistical analysis of SPSS 12.0(ANOVA, t-test analysis). Also, elemental analysis was performed on $^{18}F-Florbetaben$ by GC (Gas Chromatography). Results When reflusing 2 times measured residual activity as follows ($^{18}F-FDG$: 1.48 MBq, $^{18}F-FP-CIT$: 7.4 MBq, $^{18}F-Florbetaben$: 32.6 MBq). And when reflusing 3 times measured residual activity as follows ($^{18}F-FDG$: 1.85 MBq, $^{18}F-FP-CIT$: 3.7 MBq, $^{18}F-Florbetaben$: 36.3 MBq). There was a significant difference when reflusing 2 times(P < 0.05) and reflusing 3 times (P < 0.05). But when reflusing 3 times, there was no significant difference relation FDG and FP-CIT (P > 0.05). $^{18}F-Florbetaben$ Residual activity according to the injection method was a significant difference (P < 0.05). GC analysis results were measured ethanol: 207665 ppm and acceton: 377.4 ppm. Conclusion $^{18}F-Florbetaben$ was high residual activity compared to FDG and FP-CIT. Heparin cap method was effective when $^{18}F-Florbetaben$ was injected. $^{18}F-Florbetaben's$ ethanol component analysis was highly measured. So it is recommended that inject to 6 sec/ml or more in order to reduce the pain.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.1
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• pp.46-50
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• 2018

Purpose Generally, a collimator that installed in front of detector set a direction of gamma ray and remove a scatter ray. By the way, a lateral or oblique scatter ray is detected into crystal through collimator. At this study, we will evaluate a mount of count and spectrums of lateral scatter ray. Materials and Methods We used the SKY LITE (philips, netherlands) as a gamma camera, and $^{99m}Tc$, 1.11 GBq point source as a phantom. we put this point source at backside 50 cm of detector. After acquiring this for 1 min, we turned a detector next 10 degrees. Likely this, we acquired images at every 10 degrees from $0^{\circ}$ to $360^{\circ}$, analyzed images and spectrums. In case of patient study, we choose a 3 phase bone scan patient who had a hand disease, because scatter rays from body would detect on crystal. After acquiring blood flow and blood pool images, we analyzed images and spectrums. Additional, we put a lead gown on patient's hand, body. And then we compared and evaluated 3 type blood pool images (non lead gown, lead gown on a hand and on body). Results In case of phantom study, scatter ray counts at backside ($270^{\circ}-90^{\circ}$) are same with a background count. By the way, counts of scatter ray of oblique side ($0^{\circ}-50^{\circ}$, $220^{\circ}-270^{\circ}$) are 100-600 cps, furthermore, counts at frontside are over 4 Mcps. In case of patient study, a counts of hand blood pool scan are 1510 cps. But counts of hand with lead gown on hands and on body are each 1554 cps, 1299 cps. Conclusion Therefore, even though there is a collimator in front of detector, lateral scatter rays detect on crystal and affect to images and spectrums. Especially, if there is a high activity source at outside of detector when we examine low activity organs like hands or foot, we have to shield and remove the source at outside for a good image.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.59-65
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• 2016

Purpose Dynamic kidney scan is a typical imaging technique that visualizes kidney function. Reproducibility of dynamic kidney scans has been evaluated by comparing low-dose kidney scans with low-dose radiopharmaceutical and standard dynamic kidney scan. With this comparative study, if reproducibility is superb, the dynamic kidney scan method with reduced radioactivity to patients is to be utilized and radiation exposure to patient is to be reduced. Materials and Methods For gamma camera, Orbiter, SymbiaE (Siemens, Germany) was used. Among patients who had used 370 Mbq (10 mCi) from January of 2013 to February 2014 and other patients who had used 185 Mbq (5 mCi) from March of 2014 to July of 2015 with identical condition, 21 subjects using DTPA and 20 subjects using $MAG_3$, 41 subjects in total, had been selected as subjects for data. From renogram of the result image, frame of the peak point was selected. Then, region of interest of kidney and background had been selected and Kidney to Background Ratio has been calculated for comparison. Results In tests using DTPA, kidney to background ratio when using 370 Mbq was $5.67{\pm}0.8$ at average while it was $5.62{\pm}0.87$ when using 185 Mbq, which didn't show much difference. Also in the tests using $MAG_3$, kidney to background ratio when using 370 Mbq was $14.95{\pm}2.58$ at average and $14.56{\pm}2.02$ in 185 Mbq, which neither showed much difference. In paired sample t-test, p-value was 0.566 in DTPA and 0.363 in $MAG_3$, which confirmed that there was no difference between the groups. Conclusion In identical patients, when dose was decreased from 370 Mbq to 185 Mbq, reproducibility of dynamic kidney scan was proven to be excellent. Low-dose Dynamic kidney scan can achieve results with fine reproducibility without improvement in performance of gamma camera and is expected to reduce radiation exposure to patient.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.67-70
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• 2013

Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.90-94
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• 2013

Purpose: In the PET/CT images, various artifacts cause degradation of the quantitative assessment. Most hotspot generated by radiopharmaceutical injection errors cause an artifact and degrade the quality of the images as well as the accuracy of the quantitative evaluation. The purpose of this study is to assess effectiveness of the elimination of the hotspot at the injection sites using shifting the center of DFOV (Display Field of View, DFOV) method and evaluate the quantitative evaluation of result. Materials and Methods: GE Discovery STE 16 (GE Healthcare, Milwaukee, USA) and 1994 NEMA phantom were used for imaging acquisition. Phantom was filled with 0.005 MBq/mL of $^{18}F-FDG$. A hotspot was artificially placed on the outside of the phantom. The ratio of hotspot area activity to background area activity was regulated as 200:1. After image acquisition with routine protocol, all of the images were reconstructed using the shifting the center of DFOV method that wasn't overlapped with hotspot. Those images obtained before and after applying the shifting reconstruction method were compared. ROIs (Region Of Interests) were set in the hotspot areas, meanSUVs and standard deviations were calculated. Percentage differences were calculated with those meanSUVs and standard deviations. The evaluation on the effects of the shifting reconstruction method was done by comparison of the meanSUVs and the standard deviations, which were calculated for background areas unaffected by hotspot. Results: In the areas of unaffected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.67{\pm}0.06g/mL$ and $0.65{\pm}0.06g/mL$, respectively. In the artifact areas affected by hotspot, meanSUVs before and after applying the shifting of center of DFOV method were $0.32{\pm}0.08g/mL$ and $0.56{\pm}0.12g/mL$, respectively. The percentage differences of the area adjacent to the hotspot and the area distant from the hotspot were 65.3% and 97.4%, respectively. Conclusion: In the PET/CT images, meanSUV was improved by 32.1% when the effect of artifact was removed with application of the shifting the center of DFOV methode. In other areas unaffected by artifacts, meanSUVs were not significantly different after applying DFOV center shift method. As shown in the result, adverse effects of hotspot made by swelling in the injection site can be reduced by applying DFOV center shift method. Therefore, DFOV center shift method can be applied for the more precise quantitative evaluation, and contribute to the increase of the diagnostic value of the images.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.78-83
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• 2013

Purpose: SPECT/CT, a combination of SPECT and CT, is capable of expressing the results of attenuation correction on images biased by automatic program. As a result, this research evaluates the usefulness of images with CT attenuation correction, using various phantoms and images of patients. Materials and Methods: From July of 2012 to September of 2012, this research was conducted on the contrast, spatial resolution, and images of patients. We studied the contrast with IEC body phantom and Jaszczak phantom, while the spatial resolution was evaluated with NEMA triple line phantom. Further, a comparative study was carried out on the quality of the images, on the difference between the images before and after the CT attenuation correction. Results: Compared the differences between the contrast before and after the CT attenuation correction in IEC body phantom. The contrast was improved by 33.6% at minimum, 89.8% at maximum. In case of Jaszczak Phantom, the contrast was enhanced by 9.9% at minimum, 27.8% at maximum. In NEMA Triple line phantom, the resolution was raised by 4.5% in average: 4.4% in horizontal, 4.5% in vertical. In Anthropomorphic Torso Phantom, the perfusion score of the interior wall with the most severe attenuation was measured to be 29.4%. In the experiment carried out on myocardial perfusion SPECT/CT patients, 9% improvement was discovered in the interior wall, where the most dramatic attenuation occurred, after the CT attenuation correction. Conclusion: SPECT/CT proved its clinical usefulness by enabling the acquisition of images with enhanced contrast and spatial resolution compare to the ones resulted from SPECT.